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Abstract: The purpose of this retrospective observational multicenter study was to assess appropriateness of red blood cell (RBC) transfusion, according to the French national guidelines (Agence française de sécurité sanitaire des produits de santé) published in 2002. Six hundred and thirty-nine RBC transfusions from nine institutions have been randomly selected and analysed. The data collected are issued from different specialities. Patients’ characteristics, occurrences of transfusion, admission, pre-transfusion, post-transfusion and discharge haemoglobin concentrations have been collected. Two physicians (who are in charge) must evaluate the appropriateness of pre-transfusion, discharged haemoglobin concentrations, quantity and quality of transfused RBC. The mean pre-transfusion haemoglobin concentration was 7.89±1.24, the median number of transfused RBC was two (extremes: 1–16), the mean discharge haemoglobin concentration was 10.14±1.30 (−5 days after the end of transfusion). The pre-transfusion and discharge haemoglobin concentrations were higher if the patient presented a co-morbidity factor. Ninety-three percent of pre-transfusion and 79% of discharge haemoglobin concentrations are in accordance with the guidelines. According to the physicians, the RBC transfusions are too “precocious” when pre-transfusion haemoglobin concentration is above nine and the anaemia is asymptomatic. 50% of RBC transfusion with discharge haemoglobin concentration above 10 is not excessive. In case of acute anaemia, the pre-transfusion and discharge haemoglobin concentrations are higher and RBC transfusion excessive. In this study, the trigger haemoglobin concentration is “restrictive”, but the target haemoglobin concentration is “liberal” with a high-discharge haemoglobin concentration. Inappropriate RBC transfusions are mainly due to over-transfusion. [ABSTRACT FROM AUTHOR]

Abstract: Faecal occult blood tests (FOBT) have been established as the most relevant procedure for colorectal cancer screening in the general average risk population. Immunochemical FOBT consists in monoclonal antibodies reacting with the globin of the haemoglobin. These tests provide higher performances than traditional guaiac tests. They do not need any diet restriction and their analytic sensitivity is higher. An increasing number of papers suggest that their acceptance and clinical performances in the general population are more satisfactory than the guaiac test. The use of automated reading allowed to cut the process price making it similar to the guaiac test. The providing of quantitative measure of haemoglobin allows to choose the positivity threshold associated with the best balance between sensitivity, specificity and positivity rate. Comparative studies conducted in France suggest the use of a positivity threshold allowing an increase in both sensitivity and specificity compared to the guaiac tests. [Copyright &y& Elsevier]

Sickle cell disease is the number one genetic disease in France in terms of the number of children diagnosed each year in the neonatal period. Throughout their lives, people with sickle cell disease are likely to develop acute complications that require urgent treatment. Chronic complications are more common amongst adults than in children., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Introduction: Parmi les initiatives multiples que suscite aujourd’hui le diabète, les réseaux de santé proposent des services dont la place demande à être précisée. Patients et méthodes: La région de Mulhouse (Haut-Rhin) est marquée par un excès de prévalence et de morbidité du diabète mais aussi par une densité médicale plus faible. Le Réseau Santé de Haute Alsace dispose d’un site : [–] Multidisciplinaire (médecins, infirmières, diététiciennes, podologue, psychologue, comportementaliste) ; [–] Multiservices : dépistage, prévention, aide au diagnostic et au traitement, éducation thérapeutique… Le suivi est individualisé et s’inscrit dans la durée. Résultats: Recrutement : 17 % des patients qui ont adhéré au Réseau en 2006 avait une hémoglobine A1c inférieure à 6,5 % contre 25,4 % en moyenne régionale (ENTRED Alsace) et 33 % en moyenne nationale (ECODIA 2) témoignant d’une population à risque majoré. Évolution de l’hémoglobine A1c, : Une amélioration du taux d’hémoglobine A1c est obtenue dans 51,3 % des cas, résultats qui perdurent au long du suivi. Dépistage : 80 % des patients ont bénéficié d’un dosage de LDL et d’un dépistage de rétinopathie néphropathie et neuropathie dans l’année contre 26 % dans l’étude ECODIA 2. Le réseau veille selon les résultats au suivi ophtalmologique, podologique, médicamenteux (hypolipémiants, bloqueurs du système rénine angiotensine). Conclusion: En se fondant sur une articulation durable et concertée entre diagnostic et prévention, éducation et accompagnement, optimisation thérapeutique « on time » …, les résultats intermédiaires de prise en charge laissent espérer se rapprocher des objectifs de la déclaration de St-Vincent. [Copyright &y& Elsevier]