[Colchicine poisoning: a case report]. / A propos d'une intoxication létale à la colchicine.

Colchicine is a drug commonly used for treatment of acute and chronic gout. Poisoning is a rare but always serious event. The purpose of this report is to describe the case of a 16-year-old girl who ingested an unknown amount of colchicine in a suicide attempt. At the time of admission she presented with gastrointestinal manifestations and reduced consciousness. After ten days in the intensive care unit she died due to multiple organ failure. This case provides the opportunity not only to review the clinical course and prognostic factors associated with colchicine poisoning but also to underline the difficulty of its management due to the absence of a specific antidote and of emergency pharmacologic doses.

[Femoral-venous catheterization: a delayed perforation]. / Cathétérisme veineux fémoral: cas d'une perforation secondaire.

Later vascular injury after central venous catheterization is not common. In literature, there are only cases reporting jugular or subclavian vein catheterization territories with a higher significative risk if the catheter is larger and in left position. We report a case of inferior vena cave perforation, nine days following femoral vein catherization for parenteral nutrition in a 72-year-old patient. This vascular perforation induced an infusion in the peritoneal and the retroperitoneal cavity with abdominal and pelvic pain. This case report may ask the question of recommendations about femoral catherization.

[Interest of new molecular typing method in the study of hospital transmitted Staphylococcus aureus population]. / Etude des populations staphylococciques hospitalières: apport des techniques récentes de biologie moléculaire.

OBJECTIVES: To determinate the origin of acquired S. aureus among hospitalised patients and to evaluate the transmission of strains between health care workers and hopistalised patients. METHODS: The method chosen is a prospective study in risky clinical yards. Nasal swabing of patients and health care workers has been done to isolate bacterial samples. Caracterisation and comparaison of bacterial strains have been made using their antibiotic resistance profil and a recent molecular genotyping technic named MLVA (Multi Locus Variable Number of Tandem Repeat). It has never been used in such context. RESULTS: One hundred and fifty-seven strains have been isolated. They have been compared while realizing 1900 PCR and agar gel electrophoresis in 10 days. 15 clones were identified. One of them is mainly represented among patient's nasal carriage and acquired strains. As far as antibiotype and agr type are concerned, it is similar to hospital-acquired clone described in Europe with other technics (MRSA, Gentamicine-S agr 1). This clone appears to be also transmitted between health care workers and patients. CONCLUSION: Although it exists, we can't appreciate the intensity of this transmission. These results don't allow us to proceed to a systematic screening for nasal carriage among our health care workers. This study shows that MLVA could be a reliable molecular typing method, which could be used in every day practice. In our experience, it is as performing as PFGE, more didactic, faster and easier.

[Medical treatment by bilateral endobronchial intubation of iatrogenic tracheal lesion in intensive care]. / Traitement médical par intubation endobronchique bilatérale d'une rupture trachéale iatrogène en réanimation.

We report one case of tracheal lesion following a change of cannula of tracheotomy in intensive care. The clinical features were respiratory failure, bilateral pneumothorax and subcutaneous emphysema. The bronchoscopy made diagnosis of tracheal lesion. The location of the lesion and the features of the patient made us choose a conservative treatment by bilateral endobronchial intubation. The different treatments of the tracheal lesions and the practical achievement of conservative treatment are discussed.

[Severe complications after a translaryngeal tracheotomy]. / Complication sévère après une trachéotomie translaryngée.

We report the case of a 71-year-old man receiving anticoagulant treatment because of a mechanical aortic valve. Because of an unsuccessful weaning after abdominal surgery, a translaryngeal tracheostomy was realised without incident. The patient died few days later after a hypoxic cardiac arrest due to a severe haemorrhage after the first recannulation. This case illustrates a severe complication because of the recannulation after a translaryngeal tracheostomy and how cautions one should be before realizing a percutaneous tracheostomy in a patient under anticoagulant treatment.

[Anesthesia-resuscitation in war situations. Apropos of 43 cases]. / Anesthésie-réanimation en situation de guerre. A propos de 43 cas.

The work of a french field surgical hospital deployed in Bosnia-Herzegovina is described (Sarajevo, July 1993-November 1993). Forty three patients with acute war injuries were admitted. The patterns of wounding and the methods of casualties management are discussed with special considerations for fluid resucitation and autotransfusion.