[Mortality-morbidity conferences: evaluation of an intervention to expand their practice in a university hospital].

Background: Mortality-morbidity conferences (M&MC) are a recognized technique for evaluating and improving medical practices as well as improving patient safety.

Objectives: To describe the current practices for identification and management of care-related adverse events and to evaluate the effectiveness of an intervention to promote M&MC in a university hospital.

Methods: The study was designed as a before-and-after survey.

[Improving patient safety: decreasing adverse events associated with medical care].

Awareness of the importance of what were previously called iatrogenic accidents is not new, but recent publications have demonstrated the frequency and severity of the accidents and incidents associated with care, which are now known simply as "adverse events". Research has helped us to understand the principal mechanisms underlying them and the circumstances that promote them. It shows that root causes, often linked to the organization of care, should be sought beneath the initial appearance of mistakes.

Esophageal involvement as an initial manifestation of Churg-Strauss syndrome.

Introduction: Churg-Strauss syndrome (CSS) is a systemic disease characterized by asthma, blood and tissue eosinophilia, and necrotizing vasculitis with extravascular eosinophilic granulomas.

Cases: We describe two cases of patients with CSS: a 56-year-old man, whose presentation was highly unusual because its initial predominant manifestation was odynophagia, and a 35-year-old man whose disease was diagnosed after a work-up because of nausea, vomiting and abdominal pain. In both cases, thoracic computerized tomography scans showed congestive esophagitis with a markedly thickened esophageal wall at diagnosis and at relapse.

Response to antiviral treatment in hepatitis C virus-associated marginal zone lymphomas.

A link between chronic hepatitis C virus (HCV) infection and low-grade B-cell lymphomas has been suggested by epidemiological studies. Marginal zone lymphomas (MZLs) including splenic lymphomas with villous lymphocytes are among the most frequently reported subgroups in the setting of chronic HCV infection. In this study, we examined the effect of antiviral treatment in eight patients with HCV-associated MZL.

Reactive hemophagocytic syndrome in adult systemic disease: report of twenty-six cases and literature review.

Objective: To analyze specific clinical findings, underlying disorders, treatments, outcomes, and prognostic factors for reactive hemophagocytic syndrome (RHS) in systemic disease.

Methods: Data were collected using standardized forms as part of a French national survey. Adult cases without an underlying malignancy, diagnosed on bone marrow or lymph node biopsy, were included.

[Value of MRI for the diagnosis of cardiac involvement in sarcoidosis].

Purpose: The aim of the study was to assess the place of cardiac Magnetic Resonance Imaging (MRI) in patients with sarcoidosis with or without cardiac involvement.

Materials And Methods: Fifty patients with histologically-proven sarcoidosis underwent initial cardiac evaluation including MRI, ECG, holter ECG, echocardiography. Seven of them had cardiac involvement (cardiac insufficiency, auriculo-ventricular block, bundle-branch block).

Cutaneous and mediastinal lymphadenitis due to Mycobacterium kansasii.

Mycobacterium kansasii most commonly causes a slowly progressive pulmonary disease. Skin and disseminated infections are seen less frequently and only in immunocompromised hosts. To our knowledge, no case of Mycobacterium kansasii infection or skin infection associated with additional organ involvement in an immunocompetent patient has been reported.

[Risks incurred by the first intravenous drug injection].

Aims: The objectives of the study were to describe the circumstances surrounding the initiation of intravenous drug use, the role of the introducer and to evaluate intravenous drug users risk behaviors at the first injection of drug.

Design: In 1997, we conducted a cross-sectional survey using a structured questionnaire concerning the initiation process into intravenous drug abuse. IDUs were interviewed in four treatment drug abuse and psychosocial centers in Paris and in one prison.

Venous thromboembolism in medical inpatients: prophylaxis with low-weight heparin in a university hospital and prevalence of thromboembolic events.

The aim of this study was to determine the prevalence of venous thromboembolism (VT) in current prophylactic practice with low-molecular-weight heparin (LMWH) among medical inpatients and to analyze associated risk factors for VT. A cross-sectional survey on five given days was conducted in the medical departments of a university hospital. The prevalence of prophylaxis and confirmed VT was measured.

Full spectrum of clinical, serological, and epidemiological features of complicated forms of Lyme borreliosis in the Paris, France, area.

The aim of this study was to report the clinical, serological and epidemiological features of a homogeneous cohort of patients with various forms of Lyme borreliosis, based on recent European case-definition guidelines. Complete clinical and epidemiological reports were requested from the patients' physicians for case definition. Enzyme immunoassay IgG and IgM screening tests were performed.

[Risks incurred by first-injection intravenous drug users] [In Process Citation].

Aims. - The objectives of the study were to describe the circumstances surrounding the intiation of intravenous drug use, the role of the introducer and to evaluate intravenous drug users risk behaviors at the first injection of drug. Design.

HCV status knowledge and risk behaviours amongst intravenous drug users.

The aim of this study was to identify relationships between injecting and sexual risk behaviours and hepatitis C virus (HCV) status knowledge in intravenous drug users (IDUs). It was a cross-sectional survey (March 1994-June 1995) in 10 drug abuse treatment or psychosocial centres in Paris, France. We used a structured questionnaire about sexual, injecting, HIV and HCV antibody testing practices and results during the previous 6 months.

Polymorphonuclear leukocyte-elastase in Crohn's disease: correlation with 99mtechnetium hexamethyl propylene amine oxime leukocyte scintigraphy.

In Crohn's disease (CD), labeled leukocyte scintigraphy results are highly correlated with radioendoscopic findings and the degree of histologic inflammation. We evaluated the correlation between leukocyte activity measured by two complementary methods. polymorphonuclear leukocyte (PMN)-elastase concentration and leukocyte scintigraphy.

[Lung neoplasms revealing a rare cutaneous tumor: eccrine porocarcinoma].

Introduction: Eccrine sweat gland carcinoma, which belongs to the eccrine sweat gland carcinoma family, is a rare malignancy of the skin with a potential aggressive growth and metastatic spread.

Exegesis: We report here a case of malignant eccrine poroma arising on the upper leg, with widespread pulmonary metastases.

Conclusion: A brief synopsis of the pathological and clinical aspects of eccrine sweat gland carcinoma is presented with the currently available therapies.

[Mediastinoscopy in the case of recurrent uveitis].

Introduction: The authors report the case of a patient who presented for 4 years recurrent anterior uveitis accompanied by asymptomatic tuberculous mediastinal lymphadenitis.

Exegesis: CT scan of the chest showed the existence of mediastinal lymphadenopathy (< 1 cm). Mediastinoscopy with biopsy of the right laterotracheal lymph node was performed.

Effects of testosterone on gonadotropins, testes, and plasma 17alpha,20beta-dihydroxy-4-pregnene-3-one levels in postbreeding mature Atlantic salmon, Salmo salar, male parr.

Atlantic salmon, Salmo salar, mature male parr were implanted with testosterone (T) in small (T3) or large (T10) Silastic capsules in the breeding season or at its end in November or December, in order to find out whether the postbreeding decline in 17alpha, 20beta-dihydroxy-4-pregnene-3-one (17,20beta-P) and milt production is a consequence of declining T levels. In the first of three experiments, fish were sampled the following January and March, whereas in the second and in the third they were sampled in April. Pituitary and plasma concentrations of gonadotropic hormone (GTHs) I and II and plasma levels of T, 11-ketotestosterone (11-KT) and 17, 20beta-P were measured by radioimmunoassays, and the testes were examined histologically.

[Recurrent bilateral pleurisy in an 80-year-old man].

An 80-year-old man was admitted with recurrent asphyxiating pleurisy, first attributed to heart failure. During the recurrent episodes, the patient presented fever, signs of inflammation, no signs of heart failure, and subnormal cardiac function, prompting further investigations which disclosed that the patient was a homozygous carrier of the severe type of periodic disease mutation. The patient's age at symptom onset and the clinical features of this case of periodic disease are exceptional.