Peripheral blood vs bone marrow as a source for allogeneic hematopoietic stem cell transplantation.

In this randomized prospective study, we included 30 patients with different hematological diseases (acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, myelodysplastic syndrome or severe aplastic anemia) to compare peripheral blood stem cells (PBSC) (15 patients; mean age 23) and bone marrow (BM) (15 patients; mean age 21.8) as a source for allogeneic transplantation regarding the tempo of hematopoietic recovery and the incidence of acute graft-versus-host disease (GVHD). In the BM group, the median nucleated cell count harvested was 1.3 x 10(10), while in the PBSC group, the aphereses contained a median of 4.4 x 10(6) CD34+/kg recipient weight. PBSC transplantation (PBSCT) was associated with faster hematopoietic reconstitution measured as absolute neutrophil count (ANC) >0.5 x 10(9)/l (log-rank P value <0.0018) and platelet count >25 x 10(9)/l (log-rank P value <0.0098). Seven patients (46.7%) in the BM group vs only one patient (6.7%) in the PBSC group developed acute GVHD (P = 0.013). Therefore, we conclude that PBSCT is associated with faster hematopoietic recovery and the incidence of acute GVHD does not exceed that seen with BMT.

[Analysis of the variation of length of stay in a homogeneous group of diabetic patients]. / Analyse de la variabilité des durées de séjour au sein d'un groupe homogène de malades diabétiques.

The French hospital reform requires the development of different activities indicators which may be utilized by hospitals in order to negotiate reorganizations and redistributions. The French-DRG's classification is a useful tool in this type of negotiation as it allows the description of an activity and the evaluation of its budget. Nevertheless, it is insufficient in taking into account high-cost patients. The clinical characterization of high-cost subgroups completes the DRG description. We studied the length of stays of 801 discharge reports of the 418 French DRG "diabetes, age > 36 years" of the Amiens University Hospital for 1996. It showed that this DRG is made up of 3 subgroups, of which the most costly gathers 14% of all patients. Criteria which were significantly linked with this third subgroup were: the number of comorbidities by RSS and the number of diabetes complications by RSS.

[Epidemiologic aspects of acute respiratory infections in children less than 6 months of age through a retrospective study in Algiers--Algeria]. / Aspects épidémiologiques des infections respiratoires aiguës chez des enfants de moins de 6 ans à travers une étude rétrospective à Alger--Algerie.

Personal medical files of 874 children from 0 to 4 years old monitored in a Maternal and Child Health Center were reviewed. Acute respiratory infections (ARI) represent about 37% of the total of these outpatients. Annual frequent occurrence of ARI has been estimated at 2.13 per child/per annum among babies less than 1 year old, and diminishes regularly with age to reach 0.74 per child/per annum in the age group 3-4 years. ARI were a motive for medical advice more frequent among boys than girls (p less than 0.01). Distribution of ARI according to their level shows that ARI above glottis represent 46% of total ARI, this percentage increasing with age. Approximately 63% of these ARI were treated by antibiotics.