[The accreditation procedure: An external recognition of quality in public and private health centres in France. ]. / La rocedure d' accreditation: Une reconnaissance externe de la qualite dans les etablissements de sante publics et prives en france.

Since early 1990, the structures and financing of various health systems have been reformed. For the first time, some western Europe countries have admitted that quality insurance within the health system can become a governmental responsibility and, as in the past, simply the responsibility of the professionals and/or the health service administrators. During the last decade of the XXth century, pressure has gradually been increased for governments to become more involved in health system quality. This focus on quality was linked to human safety. In this historical perspective, the emergence of AIDS and the difficulty to control this epidemic, and the consequences of contamination by injection needles have probably played a part in this collective awareness. In this context, quality has become a major concern in Europe.

[Lung abscess due to Mycoplasma pneumoniae in an adolescent]. / Abcès du poumon à Mycoplasma pneumoniae chez un adolescent.

UNLABELLED: Pulmonary abscess is an uncommon complication of pneumonia in children. Pyogenes, in particular Staphylococcus aureus or Streptococcus pneumoniae are the principal responsible bacteria. Mycoplasma pneumoniae is rarely the cause. CASE REPORT: A 14-year-old child was hospitalized with right thoracic pain. The patient was non-febrile and had a recent history of moderate infection. He was receiving antibiotic (macrolide) and non-steroidal anti-inflammatory therapy. CT scan confirmed a mid-lobe abscess in the right lung. Interruption of therapy resulted in fever and increase in C-reactive level with hyperleucocytosis, suggesting that the abscess was caused by a bacterial infection. The child's general condition and the radiographic picture improved with combined antibiotic therapy with amoxycillin and clavulanic acid, aminoglycosides and macrolides. The suspected diagnostic of M. pneumoniae was confirmed by increased IgM antibodies for M. pneumoniae. Recovery was complete two months later without sequelae. COMMENT: Pulmonary abscess is a rare complication of M. pneumoniae infection in children. This complication should be considered when the general condition does not improve despite appropriate early treatment of a pneumonia, as in the case of our patient.

[Intermittent ureteropelvic junction obstruction and aberrant vessel to the lower pole of the kidney in children]. / Obstruction intermittente de la jonction pyélo-urétérale et vaisseaux polaires inférieurs chez l'enfant.

Intermittent ureteropelvic junction obstruction in children is a distinct clinical syndrome, it is often associated with an anteriorly crossing aberrant vessel to the lower pole of the kidney. The presence of these vessels increases the risk of complication and requires surgical management. CT scan is already the best exam to find these vessels in adults before treatment. It seems to be also efficient in children. This case report illustrates this indication.