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Abstract: Objectives: The aim of this study is to evaluate the quality of disinfection of endoscopes at Brest hospital over a period from 2007 to 2009. Patients and methods: Retrospective study of microbiological investigations of endoscopes done at Brest hospital from 2007 to 2009. The interpretation of the microbiological investigations is based on the recommendations of the Comité technique national des infections nosocomiales et infections liées aux soins (CTINILS) of 2007. Results: Most of the controls realized over the period deal with gastroenterological endoscopes (63.4 %) and bronchial endoscopes (21.8 %). Most of the controls (66.8 %) are conformed to the target level. Only 26.7 % of the controls get the level of action. Globally, the rate of level of action significantly increases (p =0.004) from 2007 (21.2 %) to 2009 (35.6 %). This increase is relatively important in gastroenterology endoscopy (46.8 % in 2009 versus 24.1 % in 2007) whereas the rate decreases in bronchial endoscopy (14.8 % in 2009 versus 25.9 % in 2007). In gastroenterological endoscopy, rates vary with the type of endoscopes and the context of controls, but there is no significant difference between manual disinfection and automated disinfection. The most frequent germ found in gastroenterological and bronchial endoscopies is Pseudomonas aeruginosa. Conclusion: Our results show that it is very difficult to insure a perfect disinfection of endoscopes. Difficulties met are certainly related with the complexity of the endoscopes and of the techniques of disinfection. Infections of patients are very infrequent in endoscopy, which takes the question of the pertinence of the threshold used for microbiological investigations. [Copyright &y& Elsevier]

Introduction: We report a case in which ascites revealed chronic constrictive pericarditis (CCP) of tuberculous origin., Observation: A 65 year-old man had developed ascites the past over few weeks and oedema of the lower limbs. Treatment was surgical and consisted in pericardiectomy., Discussion: Chronic constrictive pericarditis has become rare in industrialised countries with the reduction in the incidence of tuberculosis. Currently, its principle aetiologies identified are previous cardiac surgery and radiotherapy. Treatment is usually surgical and gives excellent results. This clinical case clearly illustrates the interest of systematic biological analysis of ascites, since it may reveal a curable disease.

The purpose of the study was to investigate leukocyte beta adrenoceptors and platelet alpha 2 adrenoceptors in pheochromocytoma. The study concerned nine hypertensive patients, five men and four women (aged 42 +/- 8 years) with a pheochromocytoma demonstrated by high levels of urinary catecholamines and radiological data. Catecholamine plasma levels, assayed by HPLC were wide-ranging: 10.7 to 172.8 nM for noradrenaline and 0.7 to 3.9 nM for adrenaline. In each case the number of leukocyte beta adrenoceptors sites (measured with 125 I-cyanopindolol) significantly decreased: Bmax was 20.6 +/- 2.8 versus 48.5 +/- 1.5 fmol/mg protein in controls (p less than 0.05). In contrast, the number of platelet alpha 2 adrenoceptors sites (measured with 3H-yohimbine) was not modified: 206 +/- 22.6 versus 186.0 +/- 12.1 fmole/mg protein in controls. There was no change in affinity constant (Kd), neither for beta nor alpha2 adrenoceptors. After tumor removal, there was a significant increase in beta adrenoceptor number. We conclude that down regulation occurs in vivo for beta adrenoceptors but not for alpha2 adrenoceptors and that the decrease in leukocyte beta adrenoceptor number is an interesting and suitable index in the management of pheochromocytoma.