B Acad Nat Med Paris
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B Acad Nat Med Paris · Nov 1994
[Anesthetic safety: recommendations of the French Society of Anesthesia-Resuscitation].
As in other developed countries, the French Society of Anaesthesia and Intensive Care has established since 1989 nine recommendations concerning the safety of anaesthetic practice, for all types of anaesthesia, and whatever the place where anaesthesia is to be given. They include recommendations for the preanaesthetic period (especially the preanaesthetic visit), for monitoring an anaesthetized patient, and for recovery. ⋯ For each recommendation, minimum standards for facilities, organisation, personal and equipment have been defined. These standards safety requirements could be used as indicators in assessing anaesthetic safety in a hospital accreditation process.
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Accidents caused by anesthesia constitute 4% of peri-operative mortality and are mostly preventable. The methods for reducing these accidents in pre-, intra- and post-operative situations are explained. Pre-operative tests are ineffective when used without clinical guidance which requires a pre-anesthetic consultation. ⋯ This situation requires a rapid improvement. The rational utilization of the described methods for improving anesthetic safely means avoiding the dispersion of anesthetic units. Professional demographics contradicts the idea that an increase in the number of anesthesiologists could solve problems caused by deficient organizations or systems.
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B Acad Nat Med Paris · Apr 1994
Review[Parasitic specificity and development of stray parasites of animal origin in man].
As on introduction to the selected topic, the author, after conjuring up the problem of parasite specificity, describes the various biological behaviour of parasites of animal origin having got into man. So doing, he quotes two main types of parasitic zoonoses (1) holozoonoses, in which the parasites are able to pass from animals to man and back; (2) hemi-zoonoses, in which parasites cannot go back from man to animals. The latter are due: (a) either to the inability for the parasite to reach, in man, the stage which would enable it to follow on its life cycle; this is a biological phenomenon: man is a dead-lock for the parasite; (b) or to the necessity for a parasite having reached a suitable stage in man, to go back-to animal through predation of man by the animal; this is an ethological phenomenon: man is a cul-de-sac for the parasite.
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B Acad Nat Med Paris · May 1992
Review[Congenital indifference and congenital insensitivity to pain].
Congenital indifference to pain is often mistaken for congenital insensitivity. It is characterized by the occurrence since childhood of lesions, mainly cutaneous and osteoarticular secondary to strictly painless traumas. However, despite the lack of pain, the patient is able to discriminate a painful stimulus. ⋯ Congenital analgesia is associated with anhidrosis in Swanson's syndrome (in which Lissauer the tractus is absent in the spinal cord) and with dysautonomia in Riley-Days's disease (in which there is a lack of amyelicinic fibres). On account of these data, some authors refuse the autonomy of congenital indifference and classify it in the group of the various autonomic and sensory neuropathies. However it seems justified to acknowledge the congenital analgesia with two varieties: congenital indifference in which there is no sensation of pain but normal sensory pathway and tonic function of endomorphinic system, congenital insensitivity in which the painful stimulus is not transmitted to the central nervous system.
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The negative effects of noise on sleep and behaviour have been related to three mechanisms: a physiological arousal (above a certain threshold of noise), an aversive reaction and an interference with non auditive neurophysiological and mental processes. The perturbation of verbal communication and the effects of sleep are the directly observable consequences. The negative effects of noise above a certain threshold on sleep have been demonstrated both in experimental conditions and in real life. ⋯ Objective expressions of discomfort: use of aural protections, closing the windows, staying indoor, changing residence, increase linearly with the intensity of noise. Noise influences the incidence of stress-related disorders: hypertension, related cardio-vascular diseases, psychosomatic and psychological disorders. It has been shown by the use of different techniques (epidemiological studies based on the frequency of medical contacts, on the diagnoses made by general practitioners, on the use of specific drugs, and on the examination of the whole population) that the prevalence increases in relation with the level of noise in the vicinity of airports.(ABSTRACT TRUNCATED AT 250 WORDS)