[Distinctive tabard: A solution to avoid work interruptions in the blood transfusion?] / Gilet distinctif : une solution pour éviter les interruptions de tâche dans le domaine transfusionnel ?

AIM: In the blood transfusion, the interruption of work (IW) can lead to serious incidents and/or adverse effects. The aim of our work is to evaluate the wearing of a distinctive tabard in the IW. METHODS: Several voluntary departments from 5 establishments of health in the Center-Val de Loire region have participated in this work from October to December 2017. The survey was given to nurses (identified by the first three letters of the first name) before and after wearing the tabard (for 2 months) for all transfusions realized in their respective department. We matched the survey by nurse and by department. The Student t test was conducted to evaluate the contribution of the tabard during IW. RESULTS: One hundred and one survey (31 in surgery, 70 in medicine) were collected before wearing and 91 (27 in surgery, 64 in medicine) after wearing the tabard. Before wearing the tabard, the number of nurse having or not IW was the same. After wearing the tabard, 42% had an IW and 58% didn't had IW (P=0.43; χ2). Sixty-four surveys were matched (27 exclusions : different IDEs) according to IW before and after wearing the tabard. The wearing of the tabard allows a statistically significant decrease IW (z=2.61, P=0.009, student test). CONCLUSION: Wearing the tabard during blood transfusions is statistically significant means of reducing IW. It's probably a first solution to increase the security of the act, to which must be added other means (poster, phone management, poster and information campaign). It's easier to eliminate IW than to manage.

Tracheoesophageal fistula caused by mycobacterial tuberculosis adenopathy.

Tracheoesophageal fistulas resulting from a Mycobacterium tuberculosis infection are uncommon. We describe a patient with such a lesion that had the radiologic and clinic appearance of a malignant tracheoesophageal fistula. Use of an anterior cervical approach with one-stage esophageal repair along with tracheal resection and anastomosis allowed definitive diagnosis and treatment of this life-threatening complication.

Experience with immunoglobulins in thyroid autoimmunity.

The physiopathology of Graves' ophthalmopathy is poorly understood. Therefore, the best treatment of Graves' ophthalmopathy is still a matter of debate. Steroids, X-ray therapy, surgery and more recently cyclosporine, plasma exchange and somatostatine analogs have been tried. There is no doubt that we are dealing with an autoimmune process. The use of immunoglobulins has been shown to be safe and efficient.

[Pseudotumoral xanthogranulomatous pyelonephritis. A propos of 2 cases]. / Pyélonéphrite xanthogranulomateuse pseudotumorale. A propos de deux cas.

We report two cases of xanthogranulomatous pyelonephritis observed in elderly women. Diagnosis before surgery is difficult. CT is the best single examination.

[Emphysematous pyelonephritis. A case medically treated]. / Pyélonéphrite emphysémateuse. Un cas traité médicalement.

Authors report on a case of emphysematous pyelonephritis in a woman affected with diabetes and renal failure. In order to avoid chronic dialysis, no nephrectomy was performed and the patient was treated only with drugs. Full recovery was obtained, without worsening of the renal function.