Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2004
Review[A new role for neutrophils during sepsis: target and source of interleukin-12].
The immune response against a bacterial aggression involves the monocytes-macrophages and polymorphonuclear neutrophils (PMN) in the first line of defense. This natural or innate immunity controls the proliferation of micro-organisms while waiting for the development of aspecific immunity related to lymphocytes. ⋯ IL-12 would thus support the local recruitment of PMN via an autocrine loop of amplification. In a second in vivo study in septic patients, we noted a defect in the pulmonary and systemic production of IL-12, suggesting a dysregulation of innate immunity during the course of sepsis.
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We report a case of a spontaneous rupture of a normal stomach after therapeutic oxygen administration. In this case, early treatment precluded the need for a laparotomy. This rare complication highlights the importance of the right positioning of a nasal catheter and leads us to question its role compared to other means of oxygen delivery (nasal cannulae, Hudson mask, Venturi mask).
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Ann Fr Anesth Reanim · Mar 2004
[Assessment of teaching methods of anaesthesiology and intensive care medicine in France: opinions of teacher and residents].
The objective of this study was to provide informations about French practice of anaesthesiology and intensive care graduation. ⋯ Despite the fact that "Carnet de stage" and written examinations are frequently used, pedagogic dimension of evaluation need to be improved.
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Ann Fr Anesth Reanim · Mar 2004
[Antimicrobial prophylaxis in surgical procedures: assessment of the guidelines application and validation of antibiotic prophylaxis kits].
Surgical wounds infections represent a major cause of morbidity and are at the origin of an increase in the postoperative mortality rate. Those infections represent in France one-fourth of the nosocomial infections. Combine with the elementary hygiene rules and the surgical "good practices", antimicrobial prophylaxis with antibiotics is an essential tool for the reduction of the surgical wound infections rate. In the French hospitals, antimicrobial prophylaxis represents one-third of the antibiotic prescriptions. The rules for the application of surgical prophylaxis are based on current guidelines for antibiotic prophylaxis, however, guidelines are not totally respected. ⋯ In this study, guidelines diffusion seems to be an essential but also an insufficient point for the improvement of the quality prescriptions in surgical antimicrobial prophylaxis. The "day by day" nominative antibiotic prophylaxis deliverance in the shape of a << ready to use >> antibiotic kit went with an increase in the respect of the recommendations, by correcting in a significant way the persistent weak points identified during the first part of our study. The antibiotic prescriptions control is an imperative goal in individual health (the patient himself), but also in public health (the community). This radical change in habits is listed in a policy of antimicrobial agent prescription improvement (best efficacy with less cost).