[Child victims of house fires in France. Mortality, morbidity, prevention]. / Enfants, victimes d'incendies d'habitations en France. Mortalité, morbidité, prévention.

Children injuries by house fires in France are the cause of a severe mortality (sixty deaths in average each year) and of a morbidity for the survival due to smoke toxicity (oxygen deprivation and inhalation of toxic gases--CO and HCN) and to thermal burns. Epidemiological studies show that young children (0 to 4) are specially concerned by this threat and that the deaths occurred more often in some part of France (Nord-Pas-de-Calais Region). A special strategy for this prevention should be applied in France, the same available in USA, Sweden and UK, including information on the behavior one should have with children: never leave them alone and escape with them as soon as possible out of the smoke. The usefulness of smoke detectors should be confirmed by French administration and recommended to the public, since they have had effective results in other countries.

[Axillary block of the brachial plexus and flunitrazepam premedication in surgery of the upper limb (study of 1,500 cases)]. / Le bloc axillaire du plexus brachial et la prémédication par le flunitrazépam pour la chirurgie du membre supérieur (étude de 1 500 cas).

The authors report their experience of regional block using anaesthesia of the brachial plexus by the axillary approach. 1 500 axillary blocks have been done since 1976. They perfect their technology and report their results. Because of the innocuity of regional block and its simplicity, they use it in seventy per cent of superior limb acute or regular surgery.

Early cerebral prognosis of anoxic encephalopathy using brain energy metabolism.

Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (OGI) was greater than 85%. Our results suggest that cerebral recovery is linked with increased oxidation associated with the beginning of nonglycolytic metabolism.

[Mediastinitis caused by odontogenic anaerobic bacteria]. / Les médiastinites à anaérobies odontogéniques.

Anaerobic odontogenic mediastinitis appeared to be on the increase. The case described had a favourable outcome. The aetiology and pathology of this disease, the dreadful prognosis of which was a mortality rate of 50%, were discussed. The aggravating factors appeared to be general, these patients presenting a particular predisposition, due to steroids and malnutrition, and anatomical, as the cellulitis spread along cervical fascial planes. The treatment always required was mediastinal surgical drainage by a transcervical approach or by thoracotomy, the association of three antibiotics (a penicillin with an imidazole, an aminoglycoside or a macrolide) and a high energy and nitrogen intake.

[Toxic pneumopathy following voluntary ingestion of 1 1/2 liters of gas-oil]. / Pneumopathie toxique après ingestion volontaire d'un litre et demi de gas-oil.

Authors recall an original observation about a twenty years old young girl who ingested one and half litre of gas-oil for suicide. A severe toxic lung disease appeared in the following days. Several weeks will be necessary for complete resorption, but no heavy breathing assistance will be needed. This observation confirmates the very rare cases described in publication.

[Phosgene poisoning]. / Intoxications par le phosgène.

Phosgene, a combat gaz of the first world war is now very used in industry. Authors report a few observations about acute intoxications in the manufacture of this gaz in Toulouse. They insist about the risks of slow coming out lung oedema when safety instructions are not correctly followed. However better knowledge and observance of these instructions permitted a reduction of these intoxications in number and gravity.

[Plasma fibronectin. Role in severe infections and intensive care]. / Fibronectine plasmatique. Rôle dans l'infection sévère en réanimation.

Plasma fibronectin (pFN) levels were measured in 52 patients throughout their stay in an intensive care unit. At the same time a close watch was kept for signs of sepsis. Low pFN levels regularly accompanied--but did not precede--infectious episodes and were also found in patients without septic complications. These findings indicate that a fall in pFN does not constitute a factor of increased susceptibility to infection.

[Peridural analgesia during labor: comparative study of a fentanyl-marcaine combination and marcaine alone]. / Analgésie péridurale au cours du travail: étude comparative de l'association fentanyl-marcaïne et de la marcaïne seule.

A randomised trial was carried out to evaluate the use of a mixture of fentanyl with marcaine in epidural analgesia. Two series of 30 patients each were studied: in the first only marcaine was given for the epidural and in the second marcaine and fentanyl mixed. Stronger and longer analgesia was obtained in the series where fentanyl was added showing that local anaesthetics can be potentiated by opiates. There was no significant difference in the two series as far as the cardiovascular, respiratory and blood gas measurements were concerned, either in the mother or in the fetus.

[Comparative analgesic kinetics of fentanyl and droperidol-fentanyl association (author's transl)]. / Cinétique analgésique comparée du fentanyl et de l'association dropéridol + fentanyl. Etude expérimentale.

UNLABELLED: To specify pharmacological interferences between droperidol and fentanyl an experimental study was carried out on mice. The analgesic kinetic was studied after the administration of the two drugs in a concentration ratio between 25/1 and 150/1. RESULTS: Fentanyl is a potent analgesic with a short time effect. It has very good correlations between dose effect and time effect. Droperidol does not have a analgesic effect. The behaviour of the two drugs depends on the way they are administered, either simultaneously or consecutively: simultaneous administration of the two drugs increases the level and duration of analgesia: nalaxone reverses analgesia, a fentanyl injection given 5 minutes before a droperidol injection produces the same analgesia as fentanyl alone, a droperidol injection given 5 minutes before a fentanyl injection induces a level of analgesia lower than fentanyl alone. Droperidol appears to reverse the fentanyl analgesia.