[Simulation of difficult airway management for residents: prospective comparative study].

Background And Objectives: Procedural simulation training for difficult airway management offers acquisition opportunities. The hypothesis was that 3 hours of procedural simulation training for difficult airway management improves: acquisition, behavior, and patient outcomes as reported 6 months later.

Methods: This prospective comparative study took place in two medical universities.

Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study.

Background: High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (residual anxiety [RA]). Secondary goals were to evaluate the instructors' ability to estimate students' RA and to identify potential risk factors for high RA.

Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF): in collaboration with the French Society of Anesthesiology and Intensive Care (SFAR).

Postpartum haemorrhage (PPH) is defined as blood loss ≥500mL after delivery and severe PPH as blood loss ≥1000mL, regardless of the route of delivery (professional consensus). The preventive administration of uterotonic agents just after delivery is effective in reducing the incidence of PPH and its systematic use is recommended, regardless of the route of delivery (Grade A). Oxytocin is the first-line prophylactic drug, regardless of the route of delivery (Grade A); a slowly dose of 5 or 10 IU can be administered (Grade A) either IV or IM (professional consensus).

[Metastatic cervical fasciitis revealing invasive lobular breast carcinoma].

Background: We describe the case of a 71-year-old woman presenting cervical metastatic fasciitis with invasive lobular carcinoma (ILC) of the breast.

Patients And Methods: The patient consulted for a deep and painless skin infiltration of the neck associated with dysphagia and restricted cervical mobility. Skin and muscle biopsies were normal.

[Anesthetic management of severe or worsening postpartum hemorrhage].

Introduction: Risk factors of maternal morbidity and mortality during postpartum hemorrhage (PPH) include non-optimal anesthetic management. As the anesthetic management of the initial phase is addressed elsewhere, the current chapter is dedicated to the management of severe PPH.

Methods: A literature search was performed using PubMed and Medline databases, and the Cochrane Library, for articles published from 2003 up to and including 2013.

Stroke volume optimization after anaesthetic induction: An open randomized controlled trial comparing 0.9% NaCl versus 6% hydroxyethyl starch 130/0.4.

Objective: Postinduction hypotension during general anaesthesia could be corrected by a rapid cardiac preload optimization by fluid infusion. The type of fluid to be used in this context remains debated. The aim of our study was to compare the amount of fluid challenges required to optimize stroke volume after induction of anaesthesia with colloid (HES) or crystalloid (0.

[Practical aspects of vaccination in elderly subjects].

The elderly subjects are at high risk of infection due to decreased immune responses and institutionalization. Studies show the effectiveness of influenza vaccination every year in subjects over 65 years, and pneumococcal vaccination every 5 years in patients with risk factors. Vaccinations against diphtheria low dose, tetanus, and polio should be renewed every 10 years.

An increase in aortic blood flow after an infusion of 100 ml colloid over 1 minute can predict fluid responsiveness: the mini-fluid challenge study.

Background: Predicting fluid responsiveness remains a difficult question in hemodynamically unstable patients. The author's objective was to test whether noninvasive assessment by transthoracic echocardiography of subaortic velocity time index (VTI) variation after a low volume of fluid infusion (100 ml hydroxyethyl starch) can predict fluid responsiveness.

Methods: Thirty-nine critically ill ventilated and sedated patients with acute circulatory failure were prospectively studied.

[Recommendations of the Infectious Disease Committee of the French Association of Urology. Diagnosis, treatment and monitoring candiduria].

The candiduria are frequently encountered in urology. We present the recommendations of the Infectious Diseases Committee of the French Association of Urology for diagnosis, treatment and monitoring of urinary tract infections. C.

[Is haemostasis assessment mandatory in case of pregnancy loss?].

Pregnancy losses must be categorised into biochemical loss, early embryonic loss, late foetal loss and stillbirth cases. No haemostasis-related investigations are necessary for biochemical losses. Antiphospholipid antibodies must be checked for three early losses or one late loss.

[Necrotic arachnidism in the south of France: two clinical cases of loxoscelism].

Background: loxosceles spiders are found throughout the world and are responsible for numerous cases of envenomation in America and Southern Europe. We describe, to our knowledge for the first time in France, two clinical cases of cutaneous loxoscelism.

Case Report: two cases of skin necrosis arising after supposed spider bites were grouped together because of their similar clinical presentation: an initial painless bite and rapid development of an inflammatory and painful cutaneous lesion with a central hemorrhagic bulla surrounded by a perimeter of blanched skin (the "red, white, and blue" sign).

Ileal reservoir with ileo-anal anastomosis: long-term complications.

Coloproctectomy with ileo-anal anastomosis (CP-IAA) has been in use for 30 years. This intervention is the standard technique when surgery is indicated for familial adenomatous polyposis (FAP) and for ulcerative colitis (UC). Although the surgery is safe with mortality of less than 1%, it is associated with a morbidity of 18-70%.

Reduction of the severe sepsis or septic shock associated mortality by reinforcement of the recommendations bundle: a multicenter study.

Introduction: We determined whether the implementation of a bundle of 10 recommendations leads to the reduction of mortality in ICU patients with severe sepsis or septic shock.

Methods: All patients with severe sepsis or septic shock during two consecutive phases: a 6-month quality control period (observational) and secondly a 6-month intervention period based on the implementation of a bundle of 10 recommendations adapted from the Surviving Sepsis Campaign guidelines (initial bacteriological samples and initiating antibiotics, measurement of arterial lactate, volume expansion > or =20 ml/kg, targeted mean arterial pressure > or =65 mmHg and the assessments of central venous pressure and Scv(O2); glucose control, low doses of corticosteroids, a tidal volume < or =8 ml/kg in mechanically ventilated patients with ALI; adequate use of recombinant human activated protein C) were evaluated in 15 ICUs. The primary endpoint was the 28-day mortality rate and the secondary endpoint was the compliance with the recommendations of the care bundle.

How the relationships between general practitioners and intensivists can be improved: the general practitioners' point of view.

Introduction: The present study assessed the opinion of general practitioners (GPs) concerning their relationships with intensivists.

Methods: An anonymous questionnaire was mailed to 7,239 GPs. GPs were asked about their professional activities, postgraduate intensive care unit (ICU) training, the rate of patient admittance to ICUs, and their relationships with intensivists.

[Colpocleisis without mid-urethral sling: A valid concept in the elderly with vault vaginal prolapse and stress urinary incontinence?].

Objectives: Estimate the urinary impact of vaginal occlusion without mid-urethral sling in the elderly with vault vaginal prolapse and stress urinary incontinence.

Patients And Methods: Retrospective case series of 22 women who underwent a vaginal closure between May 2005 and April 2009. Postoperating evaluation of the impact on the urinary tract of this surgery and of the satisfaction of the patients to a phone investigation.

[Cryoglobulinemic peripheral neuropathy in hepatitis C virus infection: clinical and anatomical correlations of 22 cases].

Introduction: Cryoglobulinemic neuropathies caused by hepatitis C virus are frequent and may have severe clinical outcomes. The aim of this study was to clarify the clinical and anatomical correlations of these neuropathies.

Methods: Between 1992 and 2007, 22 consecutive patients with cryoglobulinemic neuropathies caused by hepatitis C virus were retrospectively included.

[Clinical examination in dyschesia].

Dyschesia, also called obstructed defecation syndrome (ODS), is a difficulty to exonerate with straining. A rectocele or an intussusception are the main causes. Defecation is facilitated by digital maneuvers into vagina in case of rectocele or on the perineum in intussusception.