A satellite infrastructure for health early warning in post-disaster health management.

The risk of epidemics and emerging or re-emerging diseases such as avian flu, tuberculosis, malaria and other vector-borne diseases, is rising. These risks can be contained with prevention, early warning, and prompt management. Despite progress in information technology, communication is still a bottleneck for health early warning and response systems in post-disaster situations. This paper presents Satellites for Epidemiology (SAFE), a component-based interoperable architecture for health early warning that employs satellite, radio, and wireless networks, geographic information systems, integration technology, and data mining to promptly identify and respond to a disease outbreak. In a post-disaster situation, a mobile health emergency coordination center is established and integrated to public health services for health monitoring. The added-value of SAFE for post-disaster health management will be demonstrated as part of an earthquake readiness exercise regarding a typhoid fever epidemic, in the island of Crete. Advanced communication and data mining techniques in SAFE offer new tools to the "Epidemic Intelligence" and contribute to advanced preparedness and prompt response by lifting communication barriers, promoting collaboration, and reducing the isolation of affected areas.

Patient preparation and monitoring for carotid stenting: the operating room nurse's perspective.

Endovascular procedures should be performed by a trained surgical staff in a surgical suite equipped with a high-resolution fluoroscopic unit. The operating room nurse must be skilled in the handling and preparation of specialized instruments and equipment necessary for carotid angioplasty procedures. Patient preparation and postprocedural wound care techniques are particular to the cervical approach for carotid angioplasty; the operating room nurse should be well trained in these areas in order to provide optimum assistance during the procedure.

[Cutaneous neuroendocrine carcinoma of the external ear canal]. / Carcinome neuro-endocrine cutane localise dans le conduit auditif externe.

Authors report a case of a neuroendocrine carcinoma (Merkel cell tumor) located in the external meatus. These tumors have a fearsome prognostic. Immunohistochemical study has become indispensable to make the diagnosis. A literature review is presented, and therapeutic choices discussed. Wide and precocious surgical resection is advised.

[Tuberculosis of the submandibular gland. Apropos of a case and review of the literature]. / Tuberculose de la glande sous-maxillaire. A propos d'une observation et revue de la littérature.

Tuberculosis of the submaxillary gland is uncommon. Surgery is often necessary. Histologic analysis and the bacteriology made the diagnosis.

[Cervical leiomyosarcoma. Apropos of a case and review of the literature]. / Léiomyosarcome cervical. A propos d'une observation et revue de la littérature.

A case of leiomyosarcoma of the head and neck is presented together with a review of the literature. The histopathological diagnosis is difficult in spite of immunocytochemistry. Surgery is the therapy of choice.

[Prevention of infectious complications of major upper respiratory and digestive tract surgery by the combination of pefloxacin-amoxicillin-clavulanic acid]. / Prévention des complications infectieuses de la chirurgie majeure des cancers des voies aéro-digestives supérieures par l'association: pefloxacine-amoxicilline acide clavulanique.

The authors report the results of a therapeutic trial aimed at assessing the efficacy and costs of a twin-antibiotic therapy associating Pefloxacin and Amoxicillin-clavulanic acid for the prevention of infectious complications in major surgery for cancer of the upper respiratory and digestive tracts. The results obtained show 10% of complications, including 6.5% of local complications, with 4.5 to 9.5 day treatments. In our opinion, the poor results noted in the literature in studies on a simple intraoperative antibiotic prophylaxis confirm the need to use a real, so-called "curative" antibiotic therapy over a sufficient period for this type of surgery. This antibiotic therapy must be well tolerated, active for the contaminating organisms, produce no selection of resistant bacteria, and raise hopes to reduce postoperative infectious morbidity, therefore the costs of treatment.

[The diagnosis of Gougerot-Sjorgen syndrome in rheumatology. I. Evaul ation of the principal complementary examinations]. / Diagnostic du syndrome de Gougerot-Sjögren en rhumatologie. I. Evaluation des principaux examens complémentaires.

The examination of a patient with Sjögren's syndrome includes evaluation of the eye, the buccal cavity, and a search for certain factors in the blood. Schirmer's blotting-paper test is a good test but is not specific. In addition, a decreased amount of tearing is difficult to interpret after the age of 45. Slit-lamp examination (rose bengal and fluorescein) yields lesions which confirm keratoconjunctivitis due to decreased tearing. The buccal component is difficult to evaluate. A biopsy of the buccal mucosa gives the best results with minimum risk and expense. Nucleotide scanning is sensitive, but less specific. Salivary flow decreases with age. After 60 years of age this decrease can not be interpreted. The chemical composition of tears or of saliva is promising, but it is not yet a part of the usual diagnostic work-up. Of the available laboratory tests, anti-SS-A antibodies and/ or anti-SS-B antibodies are of value, but they are not found consistently.

[Physiological exploration of the eustachian tube using labeled compounds. Applications in the control of treatment (author's transl)]. / Exploration physiologique de la trompe par les molécules marquées. Application à la surveillance thérapeutique.

Sequential scintigraphy enables the qualitative and quantitative study of the drainage function of the Eustachian tube. Use is made of serum albumin labeled with technetium 99 m. After reviewing the various methods employed in an exploration of the functions of the Eustachian tube, and in particular the drainage function, the writers explain the method in detail (indicator, detection system, examination procedure, normal scintigraphic aspects) while stressing the control factors (onset of passage, speed and intensity of passage, length of time for the appearance of a trace on the pharynx, eventual aspects of blocking) and giving the basic characteristics; persistant spotting of the drum, transient image of the tube, partial stoppage at the ostium, and traces along the pharynx. The role of swallowing and the position of the head appear to be essential. Results obtained in various disorders of the middle ear, accessory cavities, the tube and the cavum are given in the form of tables. The writers then indicate the principal merits of the method: demonstration of the pathological role of the Eustachian tube in a work-up of transmission deafness, with its impact on treatment, the role of a deficient drainage function in surgical failures, and control of the efficacy of treatment, in particular crenotherapy. A study of the drainage function of the Eustachian tube, as a complement to the function of equalizing pressure, in an essential factor in formulating indications and in establishing the prognosis for tympanoplasties.