interest of automated parameters of the platelet count in the diagnosis of essential thrombocythemia

Essential thrombocythemia is an increase of the initial platelet, which frequency tends to increase with the generalization of platelet counts on automat, allowing a positive diagnosis. The objective of this study is to compare platelet parameters of the ADVIA 120@ [Bayer Diagnostic, Tarrytown USA] between two populations of essential thrombocythemia [ET] and Secondary Thrombocythemia [ST] and to establish threshold values for these analyzed platelet parameters. This study include 210 patients, hospitalized at service of internal medicine, and whose selection criteria were an platelet count > 400G/L and/or diagnosis of Essential thrombocythemia. Then, the formula composed with threshold values of platelet parameters that we have found was applied on other groups of patients with a hyper-platelet count >400G/L and whose diagnosis was undetermined. Six platelet parameters out of nine present a significant difference between Et and ST [Mean platelet volume [VPM], variation Coefficient of the platelet of the platelet volume [CV Plat], Mean Platelet, Concentration [CPM], Standard deviation of the platelet concentration [ETCP], big platelet and Aggregate count], and the combination of at least four parameters, gives a sensitive [65 percent] and specific [95 percent] diagnosis Key for ET. These preliminary results show a major interest for ETCP parameters and big platelet parameters. Their association with other platelet parameters and the platelet count higher than 600 G/L should allow to better direct the diagnosis of ET

Infections bacteriennes communautaires aux urgences

The most frequent community infections caused by bacteria that are found at medical emergencies are urinary infections and meningiti. This study's aim is to determine the type and frequency of the bacteria isolated at the emergencies, and to test their sensitivity against different antibiotics. Material and methods: We have studied in a prospective way 220 bacteriological samples of 200 patients at the medical emergencies during 7 months from the begining of June 2001 till Janury 2002. Each patient was tested according to the signs he presented and to the available technical means. We did: 100 spinal punctures [US], 82 cytological bacteriological urinary examination [ECBU], 21 blood-culture, 8 pus, 6 effusion liquids, 3 plate culture of faeces. Klebsillea and Echerichia coli are responsible for most of the urinary infections. The bacteria found showed a very high level of resistance [almost 100%] against ampicillin and [60%] against amoxicillin / calvolanic acid. However they were sensitive to fluoroquinolons and to 3 rd generation cephalosporins. Pneumococus is the most frequent germ for purulent meningitis. Isolated bacteria were all sensitive to penicillin G. The progression of resistance to antibiotics of the principal community bacteria implies to rationalize the use of antibiotics, and to monitor regularly the resistance of these bacteria, and also to make new therapeutical recommendations based on the local epidemiological data