B Acad Nat Med Paris
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B Acad Nat Med Paris · Feb 2011
[Pediatric heart surgery in developing countries. Twenty years experience of La Chaine de L'espoir (Chain of Hope)].
Because of their high incidence, cardiac disorders in children are now a public health issue. These children require multidisciplinary management, but surgery is sometimes unavoidable. The two most frequent types of cardiac disorder in children are congenital defects and rheumatic valve disease. ⋯ Surgery is rarely attempted in terminally ill patients. Costs must be kept to a minimum, and this is why we have optedfor local manufacture of mitral rings, led by Daniel Roux. After 20 years of practice we have found that regional hospitals are the smallest structures that can offer acceptable results in terms of patient care and professional training
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The creation of University Hospital Centers (CHU) in 1958 paved the way for the modern era of medical research in France. A large number of initiatives have subsequently been implemented, one on top of the other, without proper integration within the existing infrastructure. This has resulted in an excessively complex organization of work undertaken in hospitals, universities and research agencies. ⋯ Nevertheless, IHUs will not integrate the different partners' specific missions of each parteners. In the Netherlands, University Medical Centers have been created within a single organization. Ten years later this set-up has proved to be highly successful and could serve as a model for future restructuring of French University Hospital Centers.
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B Acad Nat Med Paris · Dec 2010
Review[Universal implementation of pathogen inactivation in labile blood products is a major step towards transfusion safety].
Transfusion of labile blood products (red cell concentrates, platelet concentrates and plasma) is vital in the absence of alternatives. Patients and doctors have always feared infections transmitted by blood, blood components and blood-derived drugs. It is potentially dangerous to delay implementation of pathogen inactivation in labile blood products pending a perfect process. Universal implementation of pathogen inactivation in labile blood products is a major step towards transfusion safety.
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Etiologic investigations of infectious diarrhea were long limited to bacteria and protozoa. The advent of electron microscopy and molecular biology showed that diarrhea could also be caused by viruses, both in humans and in other animals. In 1969, electron microcopy was used to show, for the first time, the responsibility of a virus in a case of calf diarrhea. ⋯ Some of viruses found in animals, and particularly rotaviruses, can also infect humans. Rotaviruses have been identified in numerous animal species and are generally host-specific, but zoonotic transmission has been suggested by cross-infection (especially in experimental models), by genetic studies showing a close relationship between certain human and animal rotaviruses, and by the discovery of new animal genotypes during epidemiological surveillance of human rotaviroses. Some animal strains of norovirus, sapovirus, picobirnavirus and astrovirus are genetically related to human strains, but their human transmission has not been demonstrated.
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Sudden death of sportspersons is frequently in the news but is relatively uncommon when the total number of sudden deaths is taken into account (1500 vs 40 000 per year in France for example). Sport-related sudden death is often due to an unrecognized or underestimated cardiovascular disorder. The immediate causes of this dramatic event are age-dependent. ⋯ Prevention begins with screening, which remains imperfect. Patients with cardiovascular disorders at risk of sudden death must adapt their sports activities accordingly. Knowledge of life-saving first-aid procedures by those supervising sports activities can improve the prognosis.