Does the unexpected death of the manikin in a simulation maintain the participants' perceived self-efficacy? An observational prospective study with medical students.

Background: The death of a simulated patient is controversial. Some educators feel that having a manikin die is prejudicial to learning; others feel it is a way of better preparing students for these situations. Perceived self-efficacy (PSE) reflects a person's perception of their ability to carry out a task.

[VENTILOP survey. Survey in peroperative mechanical ventilation].

Introduction: Mechanical ventilation can initiate ventilator-associated lung injury and postoperative pulmonary complications. The aim of this study was to evaluate (1) how mechanical ventilation was comprehended by anaesthetists (physician and nurses) and (2) the need for educational programs.

Methods: A computing questionnary was sent by electronic-mail to the entire anaesthetist from Alsace region in France (297 physicians), and to a pool of 99 nurse anaesthetists.

[Specialized Studies Diploma (S.S.D): assessment of Urology and Andrology by degree candidates at Faculté des Sciences de la Santé (FSS) at Cotonou].

Purpose: Inventory views of urologists in training on teaching of Urology and Andrology received at Cotonou.

Methods: An anonymous electronic questionnaire was sent by email to 26 doctors in training of specialized studies diploma of Urology and Andrology current month of May and June 2013. The questionnaire asked their knowledge of educational objectives, their appreciation of theoretical courses and practical training Receipts.

[Learning ultrasonography: where do the anesthesiology residents of the French north-eastern sector currently stand?].

Objective: Ultrasonography is in continuing expansion in anesthesiology and critical care medicine (ACCM). It is an operator-dependent tool whose contribution is partly related to the quality of the user's initial and subsequent training. Within the framework of the ACCM residency, the French north-east anesthesiology residents have an initiation to ultrasonography by 24 hours of formal lectures.

[National exam for the validation of the second medicine cycle in France: What does this examination evaluates?].

Introduction: Since 2004, the national exam for the validation of the second medicine cycle in France has been changed in its organization, its form and contents. The objective of this study is to analyze the records and the contents of this exam.

Material And Method: We analyzed according to a predetermined grid, each record in the annals of the national exam for the validation of the second medicine cycle in France since 2004.

[Severe facial trauma: control of the upper airway?].

This is the case report of a 16-year-old male who suffered major facial trauma in a road traffic accident (unhelmeted scooter rider against signpost). During prehospital care, he was stable and awake. He was admitted to the emergency room of our university hospital and rapidly transferred, in a sitting position and breathing spontaneously, to the operating room for emergent surgical tracheostomy under local anaesthesia and sedation.

[Efficiency and safety of recombinant activated factor VII in a case of severe postpartum hemorrhage].

We report the case of a severe postpartum hemorrhage (PPH) that was successfully treated with two administrations of recombinant activated factor VII (rFVIIa). Two major thromboembolic events (TEE) occurred shortly afterwards: the first was an acute lower limb ischemia at H3, the second was a cardiac arrest complicating a massive pulmonary embolism on day 5. Fortunately, both events had a favorable outcome.

Gender stereotypes: an explanation to the underrepresentation of women in emergency medicine.

Objectives: Women are underrepresented in emergency medicine (EM) residency programs in comparison with many other specialties. The reasons for this are unclear. One hypothesis is that negative gender stereotypes about EM careers might exist among female medical students.

Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients.

Purpose: To develop and validate the IPREA (Inconforts des Patients de REAnimation) questionnaire for the assessment of discomfort perceived by patients related to their intensive care unit (ICU) stay.

Methods: This was a two step-study comprising a phase of item generation conducted in one ICU and a phase of psychometric evaluation during a multicenter prospective cohort study in 14 ICUs. Patients were unselected consecutive adult surviving ICU patients.

[Eclampsia].

Eclampsia, the major neurological complication of preeclampsia, is defined as a convulsive episode, or any other sign of an altered consciousness, arising in a setting of preeclampsia, and which cannot be attributed to any other preexisting neurological condition. Convulsive episodes have been described up to 15 days post-partum. Visual disturbances (cortical blindness) are common and must be considered as the equivalent of a convulsive crisis.

Emotional electrodermal response in coma and other low-responsive patients.

Emotional processing in coma remains an open question. Skin conductance responses to emotional and neutral auditory stimuli were recorded in 13 low-responsive patients (12 of whom were in coma). A differential response between emotional and neutral stimuli was found, which significantly correlated with the Glasgow Coma Scale and the Cook and Palma score.

Continuous at-home postoperative analgesia using a catheter in the case of hand surgery: preliminary study about 40 cases.

In hand surgery, ever since continuous at-home postoperative analgesia (CPA) was implemented, procedures which cause pain for more than 24h can now be performed in ambulatory surgery. The aim of our work was to study the feasibility of CPA. Our series comprised 40 patients with a mean age of 50 years.

[Assessment of quality in day-case hand surgery].

Objective: To determine the level of satisfaction in terms of pain relief and comfort among patients receiving different postoperative analgesia protocols after hand surgery under regional anaesthesia in a day care unit.

Methods: Cohort study among patients after hand surgery under regional anaesthesia during two consecutive three months time periods, with patient stratification according to the expected pain level with different balanced analgesia protocols (group A: carpal tunnel, group B: other surgery without bone involvement, group C: bone surgery). A telephone survey, scoring analgesia and comfort, each with a numerical (0-10) scale was conducted on days 1 and 7.

Cortical information processing in coma.

Objectives: To evaluate cortical information processing (particularly, semantic processing) in acute nontraumatic coma by means of event-related brain potentials (ERPs).

Methods: The tests included measures of obligatory auditory processing (N100), automatic (Mismatch Negativity) and controlled (P300) detection of stimulus deviance, and semantic processing (ERP effects in word pairs and sentences). The tests were presented to 20 healthy participants and 42 coma patients with Glasgow Coma Scale <9.

Influence of drotrecogin alpha (activated) infusion on the variation of Bax/Bcl-2 and Bax/Bcl-xl ratios in circulating mononuclear cells: a cohort study in septic shock patients.

Objective: Drotrecogin alpha (activated) (DAA), or recombinant human activated protein C, is a new treatment in sepsis-induced multiple organ failure, leading to significant reduction in the mortality rate, thanks to its anticoagulant properties. It has been suggested that DAA has anti-inflammatory and antiapoptotic effects in sepsis animal models. This study investigates the potential actions of DAA on circulating mononuclear cells apoptosis in human septic shock.

Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France.

We present a consensus report from the SFAR/SLRF (Société Française d'Anesthésie et de Réanimation/Société de Réanimation de Langue Française) Consensus Conference, held on 13 October 2005 in Paris, France. The consensus report made recommendations on five topics relevant to the treatment of circulatory failure in sepsis and its underlying rationale. These topics are as follows: therapeutic goals of haemodynamic support in sepsis; goals of fluid resuscitation (including transfusion); role of inotropes and vasoactive drugs; role of other treatments; and treatment strategy.

[Assessment of patient satisfaction after regional anaesthesia in two institutions].

Objectives: This study was designed to assess patient satisfaction after regional anaesthesia for limb surgery.

Methods: An anaesthesia satisfaction questionnaire was developed, validated (Kappa coefficient) and submitted to 314 patients operated in two institutions (one university hospital with anaesthesiology residents and one specialised in orthopaedics with experienced anaesthesiologists). Items explored were information modalities, pain and anxiety during procedure and global satisfaction rated with four levels (very satisfied [VS], satisfied [S], partially satisfied [PS], non-satisfied [NS]).

[Role of MRI in the diagnostic of Gayet Wernicke's encephalopathy (GWE) after gastrectomy and parenteral nutrition].

GWE is rarely described after gastric surgery following parenteral nutrition. The case of a 33 years old female with no previous alcohol addiction, who presented severe neurological disorders after reoperation for postoperative peritonitis and total parenteral nutrition is reported. She was operated 8 days before for gastric leiomyoma and underwent partial gastrectomy.