[Origins of French telemedicine legislation].

After the creation of the european institute of telemedicine on 10 July 1989 at Paul Sabatier university in Toulouse, it became clear that legislation was needed to provide a solid framework for this new medical practice. The French government's decision in 1993 to create an experimental telemedicine network in the Midi-Pyrenees region, bringing together all public and private healthcare establishments, led us to manage telemedicine in much the same way as a hospital department. This resulted in the creation of institutional systems suited to multicenter networking and requiring particular regulations to govern healthcare professionals' responsibilities, financing, data security, and the use of new communication and information technologies.

International concerted action on collaboration in telemedicine: recommendations of the G-8 Global Healthcare Applications Subproject-4.

The main objectives of the G-8 Global Healthcare Applications Subproject-4 (G-8 GHAP-SP-4) were to establish an international concerted action on collaboration in telemedicine, telehealth, and health telematics (hereafter referred in this paper as telemedicine). In order to promote and facilitate the implementation of telemedicine or health telematics networks around the world, it was considered necessary to address certain key issues. Five thematic solution-seeking forums were held between May 1998 and December 1999.

[Child victims of house fires in France. Mortality, morbidity, prevention].

Children injuries by house fires in France are the cause of a severe mortality (sixty deaths in average each year) and of a morbidity for the survival due to smoke toxicity (oxygen deprivation and inhalation of toxic gases--CO and HCN) and to thermal burns. Epidemiological studies show that young children (0 to 4) are specially concerned by this threat and that the deaths occurred more often in some part of France (Nord-Pas-de-Calais Region). A special strategy for this prevention should be applied in France, the same available in USA, Sweden and UK, including information on the behavior one should have with children: never leave them alone and escape with them as soon as possible out of the smoke.

[Axillary block of the brachial plexus and flunitrazepam premedication in surgery of the upper limb (study of 1,500 cases)].

The authors report their experience of regional block using anaesthesia of the brachial plexus by the axillary approach. 1 500 axillary blocks have been done since 1976. They perfect their technology and report their results.

Early cerebral prognosis of anoxic encephalopathy using brain energy metabolism.

Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (OGI) was greater than 85%.

[Mediastinitis caused by odontogenic anaerobic bacteria].

Anaerobic odontogenic mediastinitis appeared to be on the increase. The case described had a favourable outcome. The aetiology and pathology of this disease, the dreadful prognosis of which was a mortality rate of 50%, were discussed.

[Phosgene poisoning].

Phosgene, a combat gaz of the first world war is now very used in industry. Authors report a few observations about acute intoxications in the manufacture of this gaz in Toulouse. They insist about the risks of slow coming out lung oedema when safety instructions are not correctly followed.

[Plasma fibronectin. Role in severe infections and intensive care].

Plasma fibronectin (pFN) levels were measured in 52 patients throughout their stay in an intensive care unit. At the same time a close watch was kept for signs of sepsis. Low pFN levels regularly accompanied--but did not precede--infectious episodes and were also found in patients without septic complications.

[Peridural analgesia during labor: comparative study of a fentanyl-marcaine combination and marcaine alone].

A randomised trial was carried out to evaluate the use of a mixture of fentanyl with marcaine in epidural analgesia. Two series of 30 patients each were studied: in the first only marcaine was given for the epidural and in the second marcaine and fentanyl mixed. Stronger and longer analgesia was obtained in the series where fentanyl was added showing that local anaesthetics can be potentiated by opiates.

[Comparative analgesic kinetics of fentanyl and droperidol-fentanyl association (author's transl)].

Unlabelled: To specify pharmacological interferences between droperidol and fentanyl an experimental study was carried out on mice. The analgesic kinetic was studied after the administration of the two drugs in a concentration ratio between 25/1 and 150/1.

Results: Fentanyl is a potent analgesic with a short time effect.

[Massive blood transfusion in 50 seriously injured patients. Occurrence of pulmonary oedema (author's transl)].

This retrospective study shows correlations between the occurrence of pulmonary and massive blood transfusion in 50 seriously injured patients. They received massive transfusions on an average of 13 titers (minimum 51, maximum 30 l) including from 0 to 7,51 of macromolecular solutions (average 2,43 1). These seriously injured patients were divided into 4 groups: --20 thoracic injured patients with associated abdominal lesions, --15 thoracic injured patients without any abdominal lesions, --4 peripheral traumatism with abdominal lesions, --11 polytraumatic patients (considering only lesions of the limbs).

[Treatment of severe acute pancreatitis (30 cases). Respective role of surgery, intensive care and artificial nutrition (author's transl)].

The authors report on a retrospective study of 30 severe acute pancreatitis. The severity of the illness is documented by operative statement and evolution of the disease = 50 p. cent of mortality.

Pharmacokinetics of fazadinium in patients with renal failure.

The serum concentrations of fazadinium and its metabolites were measured in 14 surgical patients with end-stage renal failure and in 11 patients free from kidney disease undergoing abdominal surgery. A two-compartment open model was used in the pharmacokinetic analysis of the data. The elimination half-life (T 1/2 beta) was prolonged by 60% in patients with renal failure (from 85 to 140 min) and corresponded to a 30% decrease of the plasma clearance.