Optimizing Emergency Medical Service Structures Using a Rule-Based Discrete Event Simulation-A Practitioner's Point of View.

Many studies in research deal with optimizing emergency medical services (EMS) on both the operational and the strategic level. It is the purpose of this method-oriented article to explain the major features of "rule-based discrete event simulation" (rule-based DES), which we developed independently in Germany and Switzerland. Our rule-based DES addresses questions concerning the location and relocation of ambulances, dispatching and routing policies, and EMS interplay with other players in prehospital care.

[Clinico-immunological study of 16 cases of benzoate intolerance in children].

The authors report a sery of 16 cases of intolerance to the benzoates in children. Sixteen children (9 boys and 7 girls) were directed to the Hospital of Tarbes from June 1995 to July 1995, for recurring urticaria (7/16) combined with asthma (1/16), atopic eczema (2/16), dermorespiratory syndrome (2/16) and asthma (1/16). All were subject to an immunological examination comprising alimentation inquiry, prick test, IgE determination, RAST, oral provocation test to benzoates, which establishes the diagnosis, whose confirmation is certified by the benefit of the food eviction.

[Asthma and intolerance to benzoates].

Background: Some foods and drug additives may induce allergic reactions.

Case Report: A girl with a family history of asthma in both parents developed asthma in her early life. She was successfully given continuous bronchodilator therapy until the age of 7 years.

[Turner's syndrome and isoforms of LH and FSH. Value of polyclonal enzymatic techniques].

Background: The glycoproteic hormones, LH and FSH, circulate under heterogenous molecular forms, the isoforms. The more acidic isoforms of FSH are found in hypogonadic patients and a displacement towards the basic forms is observed during substitutive treatment.

Case Report: A 13 year-old girl with Turner syndrome was examined for pubertal delay.

[Association of Moebius syndrome and hypopituitarism due to a midline anomaly. A case report].

A 14 year old patient had both Moebius anomalad with arthrogryposis and growth hormone deficiency due to a midline defect. This combination suggests an abnormality in the organization of the neural crest and homologous neural tube segment.

[Iatrogenic Cushing syndrome in infants. Report of a case with dwarfism].

We report a case of iatrogenic Cushing syndrome with dwarfism (-6 SD) in an eight-month-old infant. The respective role of exposure to corticosteroids in utero (the mother took 30 mg prednisolone per day throughout pregnancy) and postnatally (oral prednisolone, prednisolone in breast milk, and betamethasone cream) is discussed. Two other features are pointed out, i.

[Rescue from sudden death syndrome and allergy to milk proteins (apropos of a case)].

Allergy to milk proteins may be responsible for the syndrome of unexplained, sudden death of infants, but well-documented cases are rare. The authors report an observation where clinical history and complementary investigations support the incrimination of this factor.

[Intrarectal clonazepam in children. Plasma and CSF levels].

Eleven children with seizures were treated with clonazepam by rectal route. Thirty minutes after the administration, the plasma (8 to 28 ng/ml) and CSF (0.9 to 2.

[Rod myopathy. A fatal neonatal case].

A new lethal case of nemaline myopathy is reported. Muscle biopsy at 20 days of age permitted the diagnosis but this boy died at the 35th day of life. In a review of the literature (15 similar cases) the authors analyse the diagnostic, histopathogenic, genetic and evolutive aspects of this heterogeneous disorder, apparently less "benign" than previously thought.