[Care pathway for high urinary tract infection: an update in an emergency department of a French military hospital]. / Parcours de prise en charge des infections urinaires hautes: état des lieux aux urgencies d'un établissement militaire français.

Objectives Assessing the impact of professional practices on a patient's course is an interesting way to optimize health care pathway. The aim of our study is to update and evaluate the compliance to the recommendations of the Societe de Pathologie Infectieuse de Langue Francaise with regards to professional practices and the route of patients admitted to the emergency department of a French military hospital for high urinary tract infection. Patients and methods A retrospective study was carried out on patients admitted to the emergency department and treated for high urinary tract infection from January 1st, 2015 to April 30th, 2015. Clinical and administrative data, medical exams, and antibiotic prescriptions were extracted from computerized patient medical files and from emergency medical files. Results Out of 91 medical cares, 57% were compliant with the recommendations. For 60% of the patients, blood cultures were not argued and in 70% of cases, imaging wasn't justified. Antibiotic prescriptions were not compliant in 31% of cases, mostly due to long prescription durations. Two third of patients received outpatient care. All hospitalizations were argued. Conclusions Drawing up a caring protocol, regularly raising awareness to the good use of antibiotics, as well as reinforcing a cross disciplinary approach will allow optimizing health care pathways for patients coming to the emergency department with high urinary tract infection.

[Imported malaria at Desgenettes Military Hospital in Lyon, France: a retrospective study of 115 cases from 2006 to 2008]. / Le paludisme d'importation à l'hôpital d'instruction des armées Desgenettes de Lyon en 2006-2008 : étude rétrospective de 115 cas.

PURPOSE: The purpose of this report is to describe the clinical, epidemiologic, and parasitological features and therapeutic modalities associated with cases of imported malaria managed at the Desgenettes Military Hospital in Lyon, France. MATERIAL AND METHODS: Review of the files of all patients treated for imported malaria in the emergency and travel medicine departments of the Desgenettes Military Hospital from January 1, 2006, through December 31, 2008. RESULTS: The study included 115 patients (13 of them French armed forces personnel). Most cases (75.6%) were due to falciparum malaria. Only 28.7% of patients had taken proper malaria prophylaxis. Severe symptoms were seen in none of the ambulatory care patients versus 22.7% of the hospitalized patients. Quinine treatment was used for 67% of ambulatory care patients and 89.4% of those hospitalized. CONCLUSIONS: The epidemiologic features observed in the patients described here are similar to those reported by the French national reference center for imported and autochthonous malaria. The frequent use of quinine for ambulatory treatment was not consistent with current guidelines recommending first-line treatment with atovaquone-proguanil or artemether-lumefantrine.

Fluorescent in-situ hybridization and sequence-tagged sites for delineation of an X:Y translocation in a patient with secondary amenorrhoea.

We describe a phenotypically normal female with secondary amenorrhoea due to a translocation of genetic material involving the long arm of chromosome X (Xq28) and the long arm of chromosome Y (Yq11). We used fluorescent in situ hybridization to localize the breakpoint on the Xq. The Y chromosome breakpoint was identified using polymerase chain reaction (PCR) detection of sequence-tagged sites (STS) specific for interval 5 at Yq11.21. The relationship between this X:Y translocation and premature ovarian failure is discussed.

[Surgical treatment of 48 primary peripheral, non-small cell lung cancers equal to or greater than 8 cm. Prognostic factors and 5 years' survival]. / A propos du traitement chirurgical de quarante-huit cancers bronchiques périphériques primitifs, non à petites cellules, de taille égale ou supérieure à 8 cm. Etude des facteurs pronostiques et survie à cinq ans.

In a series of 885 resections for lung carcinoma performed between 1976 and 1986, 48 (5.5%) were for large size tumors of 8 cm and over. Pneumonectomy was performed in 28 patients (58.3%), lobectomy in 17 (35.5%) and bilobectomy in 3 (6.2). Histological type of tumor was squamous cell in 27, adenocarcinoma in 9, large cell carcinoma in 10, and adenosquamous carcinoma in 2. The stage of the disease was stage I in 16 cases, stage II in 3 cases, and stage III in 29 cases. Total survival rate including perioperative mortality (3 deaths) was 30.5% at 3 years and 16.3% at 5 years. The best prognostic factors are: age under 60 (23% survival at 5 years, and no survival over 60, (p = 0.01), absence of weight loss (24% survival at 3 years, and 14% at 3 years in case of weight loss (p = 0.02), absence of symptoms (44% at 3 years) but no survival in case of symptoms (p = 0.02), no invasion of mediastinal lymph nodes (N0 and N1), and stage I and II of the disease (50% of survival at 3 years against 20% for stage III (p = 0.04). There was no relation to survival rate between T2 and T3, squamous and adenocarcinoma, and between lobectomy and pneumonectomy. Most of our patients died of post-operative metastasis (52%), related to the large size of the tumor.