Presse Med
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A hospital-wide evaluation of the process and results of pain management was set up at the Bordeaux University Hospital, France, as part of a pain management quality improvement program. The methods and the main results of a cross-sectional survey are reported. ⋯ A complete evaluation kit was developed for this first hospital-wide study in France on pain management. The individual and global results, sent to each ward, were designed to help all healthcare workers to become more aware of the urgent need to improve pain management and to serve as a basis for future evaluations.
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Soft tissue sarcoma accounts for a approximately 1% of all cancers. Excluding Kaposi sarcoma, the incidence of soft tissue sarcoma has remained stable in Europe (3-4/100,000). ENDOGENOUS FACTORS: Endogenous factors are related to rare genetic syndromes (Li-Fraumeni syndrome, neurofibromatosis, Werner syndrome, bilateral retinoblastom). ⋯ Many studies suggest that environmental or occupational exposure to chlorophenol, phenoxy-herbicides or dioxin increase the risk of soft tissue sarcoma. FURTHER RESEARCH: Little is known about the epidemiology of soft tissue sarcoma. Case-control studies are needed.
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PREVENTION OF FISTULA FORMATION: Pancreatic fistulae occur in about 10-20% of patients undergoing pancreaticoduodenectomy and are a leading cause of morbidity. We reviewed trials devoted to prevention. Surgical procedures for reduction of pancreatic secretion and modification of the remnant pancreas could be useful as preventive measures.
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POTENTIAL PROTECTIVE EFFECT OF H. PYLORI: Epidemiological studies have not demonstrated an association between H. pylori infection and symptoms of gastroesophageal reflux, reflux esophagitis, or Barrett's esophagus with or without dysplasia or esophageal adenocarcinoma. On the contrary, an apparently favorable negative association has been identified suggested a potential protective effect of H. pylori. ⋯ In addition, eradication of H. pylori could favor he development of gastroesophageal reflux or reflux esophagitis. The degree of risk is unknown. Pangastritis with significant lesions of the gastric body leading to a reversible decrease in the secretion of acid after H. pylori eradication might lower the risk of gastroesophageal reflux.
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Case Reports
[Idiopathic segmental infarct of the omentum. Differential diagnosis in an obese patient].
Infarction of the greater omentum is a rare etiology of acute abdominal pain. The differential diagnosis, especially with appendicitis, is difficult to establish. ⋯ The correct diagnosis of omental infarction is important to establish preoperatively in acute abdominal pain, as in uneventful courses surgery can be avoided.