Réanimation Urgences最新文献

{"title":"Quelle politique de prise en charge des urgences psychiatriques?","authors":"M. De Clercq","doi":"10.1016/S1164-6756(00)80007-9","DOIUrl":"10.1016/S1164-6756(00)80007-9","url":null,"abstract":"<div><p>The emergency services in general hospitals have had to deal with an increasing number of psychiatric emergencies, indicative of the stress imposed by modern urban life and the increasing size of the cities. The current means of treating these emergencies have been examined: mobile teams, crisis centers, emergency ward without psychiatrists, or with an ‘on-call’ psychiatric team, and psychiatric emergency services. The problems raised by the current means of treating psychiatric emergencies and the main aims of the steps taken to deal with these problems have been discussed. Finally, the means of establishing a coherent psychiatric emergency care policy have been outlined: a permanent psychiatric team, real integration of the psychiatric team within the emergency department, beds for short-term hospitalization, an isolation room, and offices where interviews can be carried out with a certain degree of privacy.</p></div><div><p>Les services des urgences des hôpitaux généraux sont amenés à faire face à une augmentation considérable du nombre des urgences psychiatriques, liées à la situation et au développement des grandes villes modernes. Les pratiques actuelles pour les affronter seront passées en revue: équipes mobiles, centres d’accueil et de crise, service des urgences sans psychiatre, service des urgences avec garde psychiatrique «appelable» et grands services des urgences psychiatriques. Les problèmes pos«s par les politiques actuelles de prise en charge des urgences psychiatriques et les objectifs majeurs des interventions pour y faire face seront développés. Enfin, les moyens d’une politique cohérente de prise en charge des urgences psychiatriques seront mis en évidence: équipe psychiatrique permanente, réelle intégration de l’équipe psychiatrique au sein du service des urgences, lits d’hospitalisation provisoire, chambre d’isolement et bureaux pour réaliser des entretiens.</p></div>","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80007-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90553976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations d’antibiotiques ou monothérapie en réanimation chirurgicale et en chirurgie","authors":"C. Auboyer (coordonateur),&nbsp;G. Beaucaire,&nbsp;H. Drugeon,&nbsp;F. Gouin,&nbsp;J.C. Granry,&nbsp;V. Jarlier,&nbsp;A.M. Korinek,&nbsp;C. Martin,&nbsp;P. Montravers,&nbsp;T. Pottecher,&nbsp;J.L. Pourriat,&nbsp;B. Schlemmer,&nbsp;J.P. Stahl,&nbsp;M. Wolff","doi":"10.1016/S1164-6756(00)80011-0","DOIUrl":"10.1016/S1164-6756(00)80011-0","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80011-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76062223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’urgence psychiatrique en crise","authors":"M. Patris","doi":"10.1016/S1164-6756(00)80002-X","DOIUrl":"10.1016/S1164-6756(00)80002-X","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80002-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84671210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noix de muscade: le parfum du poison","authors":"F. Lapostolle,&nbsp;B. Mirat,&nbsp;J.M. Agostinucci,&nbsp;C. Prudhomme,&nbsp;F. Adnet","doi":"10.1016/S1164-6756(00)80013-4","DOIUrl":"10.1016/S1164-6756(00)80013-4","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80013-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87534742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programme de médicalisation du système d’information et réanimation: embellie dans une relation conflictuelle?","authors":"B. Guidet","doi":"10.1016/S1164-6756(00)80001-8","DOIUrl":"10.1016/S1164-6756(00)80001-8","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80001-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87569992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diarrhées acquises chez les patients de réanimation","authors":"G. Bleichner,&nbsp;J.P. Sollet","doi":"10.1016/S1164-6756(00)80006-7","DOIUrl":"10.1016/S1164-6756(00)80006-7","url":null,"abstract":"<div><p></p><ul><li><span>—</span><span><p>Nosocomial infectious diarrhea</p></span></li></ul><ul><li><span>•</span><span><p><em>Clostridium difficile</em> diarrhea</p></span></li></ul><ul><li><span>•</span><span><p><em>Klebsiella oxytoca</em> diarrhea</p></span></li></ul><ul><li><span>•</span><span><p>Other infectious diarrheas</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhea due to drugs</p></span></li></ul><ul><li><span>•</span><span><p>Non-absorbable osmotic agents</p></span></li></ul><ul><li><span>•</span><span><p>Antibiotics</p></span></li></ul><ul><li><span>•</span><span><p>Anti-acids</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhea due to enteral feeding</p></span></li></ul><ul><li><span>•</span><span><p>Administration rate</p></span></li></ul><ul><li><span>•</span><span><p>Osmolarity</p></span></li></ul><ul><li><span>•</span><span><p>Composition of the diet</p></span></li></ul><ul><li><span>•</span><span><p>Microbial contamination of foods</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhea due to underlying diseases</p></span></li></ul><ul><li><span>•</span><span><p>Abdominal causes</p></span></li></ul><ul><li><span>•</span><span><p>Hypoalbuminemia</p></span></li></ul><ul><li><span>•</span><span><p>Malnutrition</p></span></li></ul><ul><li><span>•</span><span><p>Injuries, infections, burns</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diagnostic procedures</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Prevention</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Conservative treatment</p></span></li></ul></div><div><p></p><ul><li><span>—</span><span><p>Diarrhées infectieuses nosocomiales</p></span></li></ul><ul><li><span>•</span><span><p>Diarrhée à <em>Clostridium difficile</em></p></span></li></ul><ul><li><span>•</span><span><p>Diarrhée à <em>Klebsiella oxytoca</em></p></span></li></ul><ul><li><span>•</span><span><p>Autres diarrhées infectieuses</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhées médicamenteuses en dehors des diarrhées infectieuses</p></span></li></ul><ul><li><span>•</span><span><p>Substances osmolaires non-absorbables</p></span></li></ul><ul><li><span>•</span><span><p>Antibiotiques</p></span></li></ul><ul><li><span>•</span><span><p>Antiacides</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhées liées à la nutrition entérale</p></span></li></ul><ul><li><span>•</span><span><p>Vitesse d’administration</p></span></li></ul><ul><li><span>•</span><span><p>Osmolarité</p></span></li></ul><ul><li><span>•</span><span><p>Composition des mélanges</p></span></li></ul><ul><li><span>•</span><span><p>Contamination bactérienne des solutions nutritives</p></span></li></ul><p></p><ul><li><span>—</span><span><p>Diarrhées liées aux affections sous-jacentes</p></span></li></ul><ul><li><span>•</span><span><p>Causes locales</p></span></li></ul><ul><li><span>•</span><span><p>Hypoalbuminémie</p></span></li></ul><ul><li><span>•</span><","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)80006-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73164524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infections néonatales à Enterococcus fæcalis : analyse de 29 observations","authors":"M.S Lahbabi ,&nbsp;M Wafi ,&nbsp;M Benbachir ,&nbsp;S Benomar ,&nbsp;C Nejjari","doi":"10.1016/S1164-6756(00)90002-1","DOIUrl":"10.1016/S1164-6756(00)90002-1","url":null,"abstract":"<div><p><strong>Objective:</strong> Resistance of <em>Enterococcus fæcalis</em> to antibiotics has considerably increased and led to therapeutic difficulties. The purpose of our study is to specify the factors of risk of the <em>Enterococcus fæcalis</em> infection in a neonatal intensive care unit and to determine the sensitivity of isolate strains.</p><p><strong>Methods:</strong> We retrospectively analyzed 29 cases, collected during 1996 and 1997. Two groups were compared according to <em>χ</em>² test: group 1 (acquisition of <em>Enterococcus fæcalis</em> infection), group 2 (asymptomatic bacteremia). The determination of isolate strains was based on the method of disks.</p><p><strong>Results:</strong> The dominant clinical picture was severe in 38% (<span><math><mtext>11</mtext><mtext>29</mtext></math></span>) of the cases. In 31% (<span><math><mtext>9</mtext><mtext>29</mtext></math></span>) of cases, neurologic symptomes were predominant, and in 28% (<span><math><mtext>8</mtext><mtext>29</mtext></math></span>) a respiratory distress was observed. The risk factors for acquiring an <em>Enterococcus fæcalis</em> infection were the administration of large spectrum antibiotics in <span><math><mtext>14</mtext><mtext>15</mtext></math></span> (93%) for group 1 vs <span><math><mtext>6</mtext><mtext>14</mtext></math></span> (43%) for group 2, and the frequent use of buccopharyngeal aspirations: <span><math><mtext>6</mtext><mtext>15</mtext></math></span> (40%) for group 1 vs <span><math><mtext>1</mtext><mtext>14</mtext></math></span> (7%) for group 2. <em>Enterococcus fæcalis</em> were resistant to penicillin G in 50%, to amoxicillin in 34%, and exhibited a high level of resistance to gentamicin in 87%; no case of resistance to vancomycin was observed. Mortality rate was 20% (<span><math><mtext>3</mtext><mtext>15</mtext></math></span>) in group 1 and 7% (<span><math><mtext>1</mtext><mtext>14</mtext></math></span>) in group 2.</p><p><strong>Conclusion:</strong> <em>Enterococcus fæcalis</em> is a frequent cause of septicemia in critically ill newborns. The prevention of nosocomial infection by using the hygiene measures and a rational prescription of the antibiotics is underlined.</p></div>","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)90002-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87311221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndrome de Miller-Fischer, anticorps anti-GQ 1b et Campylobacter jejuni: à l'occasion d'une observation","authors":"G Laplatte ,&nbsp;C Bouterra ,&nbsp;A Itani ,&nbsp;K Kuteifan ,&nbsp;A.M Gutbub","doi":"10.1016/S1164-6756(00)90010-0","DOIUrl":"10.1016/S1164-6756(00)90010-0","url":null,"abstract":"<div><p>A case of Miller-Fischer syndrome is reported with serum antibody to ganglioside GQ 1b. Though no abdominal signs or diarrhoea have been elicited, elevated antibody titles to <em>Campylobacter jejuni</em> were found. Rapid improvement is obtained with intraveinous immunoglobulins. Previous publications report elevated titles of IgG antibody to ganglioside GQ 1b in patients with the Miller-Fischer syndrome whereas they are not found in other neurologic conditions and normal controls. This high specificity might he helpful in atypical cases. Prominent distribution of GQ 1b in oculomotor nodes and cerebellum could account for ataxia and ophtalmoplegia, main features of the Miller-Fischer syndrome. Moreover, anti-GQ 1b antibody recognize surface epitopes on <em>C. jejuni</em>, suggesting molecular mimicry. Thus, initiation of immunologic disorder might follow <em>Campylobacter</em> infection. However, other factors were found to explain onset of the disease whatever their correlation with host or bacteria.</p></div>","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)90010-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77894044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Législation des prélèvements d'organes en France","authors":"R.F. Gobeaux","doi":"10.1016/S1164-6756(00)90007-0","DOIUrl":"10.1016/S1164-6756(00)90007-0","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)90007-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75702612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Réponse des auteurs à la lettre de Lapostolle et Adnet","authors":"M. Ould-Ahmed","doi":"10.1016/S1164-6756(00)90013-6","DOIUrl":"10.1016/S1164-6756(00)90013-6","url":null,"abstract":"","PeriodicalId":101063,"journal":{"name":"Réanimation Urgences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1164-6756(00)90013-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81150589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}