[Pediatric telephone advice in the emergency department]. / Les conseils téléphoniques aux urgences pédiatriques: expérience du centre hospitalier du Havre.

OBJECTIVES: To describe the activity of telephone advice in a pediatric emergency department and assess the influencing factors to improve quality of care. METHODS: Descriptive study about all the anonymous telephone calls received on the direct line of the pediatric emergency room of Le Havre hospital, from 25 January to 25 July 2002, and all the advices given by a doctor or a nurse. RESULTS: The mean daily call frequency was 2.15 (0-12) with 586 calls during the 6 months period and the mean call duration was 3 min (1-20). Parents took telephone advices for: fever (27%), digestive troubles (22%), and trauma (14%). We found no difference concerning symptoms according to season. The rush hours were, on a bimodal graph, 0-1 am and 8-9 pm, paralleling the rush activity of consultation in pediatric emergency room. The heavy days for phone advices during the week were Tuesday and Wednesday. We found no correlation between heavy days of week and phone call duration. Thirty percent of cases did not need any advice because the asks were only an orientation advice. Advice to go to our emergency department was done in 11% of orientation advice. The call duration was significantly longer for: (1) calls including several symptoms or griefs, (2) calls given by a nurse; (3) calls taking place during hours of lowest activity in the emergency room (between 6 and 12 am), (4) calls including advice about medication or diet; (5) calls for counselling an orientation other than medical establishment. CONCLUSION: Our assessment of telephone call advices represented the first step to improve the quality of answer to families. Next step will be written protocols to answer more adequately to main griefs and symptoms that lead families to search for phone counselling.

[Vesicoprostatic sarcomas]. / Sarcomes vésico-prostatiques.

The authors report three cases of prostatic sarcoma. One patient had been treated with chlorambucil, and another with cyclophosphamide, which may explain certain etiopathogenic theories. In fact, it has been demonstrated that ultrastructural studies are an essential factor in the classification of these sarcoma for which the prognosis is very poor.

[Infertility caused by uterus bipartitus. Value of the Bret-Palmer operation]. / Infertilité par cloisonnement corporéal de l'utérus. Intérêt de l'opération de Bret-Palmer.

Among the uterine malformations responsible for infertility, uterus bipartitus is one of the most amenable to surgery. The operation devised by Bret and Palmer is intended for those cases where the malformation is due to non-resorption of the medial septum and not for those where it is due to lack of fusion of the Mullerian ducts. The results are excellent, since 70% or 80% of previously infertile women subsequently became pregnant.