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Blood transfusion is an aspect of medical care on the battlefield. French assets include: red blood cell units (RBCu), lyophilized plasma (PLYO), fresh whole blood (FWB) but neither fresh-frozen plasma (FFP) nor platelets. French transfusion strategy in military operations follows the evolution of knowledge and resources. We describe the characteristics of the transfusion at the military hospital in Kabul.Retrospective study of records of patients transfused between October 2010 to December 2011 conducted in Kabul from transfusion register. Variables studied were: patient characteristics, biology at admission, type and amount of transfusion products, evolution.One hundred and twenty-six patients were transfused: 49 military (39%) which 22 French soldier (17%), most of time afghan (n=97; 77%), mean age at 24 years old (3-66). Two hundred and seventy-three RBCu from France were transfused and 350 unused were destroyed. Conditions leading to a transfusion were: 76 war wounds (60%), 21 trauma (17%) and 29 other (23%). In the first 24 hours, patients received in mean: two RBCu (0-12), one unit of FWB (0-18) and two PLYO (0-14). PLYO/RBCu ratio was 1/1.6. A massive transfusion (more than 10 RBCu) concerned 9% of patients. Twenty-seven percent of patients received FWB. We note 17 dead people (13.5%).The use of the FWB and PLYO in substitution of FFP and platelets can provide cares of high quality in a logistically constrained context while controlling costs.

Nicardipine is a commonly used anti-hypertensive drug for acute situations. We report the case of a 55-year-old man with hypoxemic pneumonia, who presented a worsening of his hypoxia secondary to the injection of this calcium channel inhibitor (CCI). This side effect was probably caused by inhibition of hypoxic pulmonary vasoconstriction. Effects of CCI on pulmonary vessels are well-known. They don't induce clinically relevant hypoxemia in patients without acute pulmonary pathology. This case report shows that nicardipine can severely worsen haematosis of patients with acute hypoxia. CCI should probably not be used in such patients.

Collagen enjoys a privileged position as a biomaterial in its cosmetic applications. It exists under different forms and is more particularly able to reticulate. The process which is used allows a modulated reticulation. This means that a collagenous matrix having a varying degree of solubility can be obtained, which can lend itself to different applications. The prilling technique consists in producing microspheres consisting of a more or less reticulated collagenous matrix being able or not to imprison an insoluble or lipophilic active substance having previously been incorporated in the original solution. In this way, it is possible to obtain either strongly reticulated and mechanically resistant microspheres of particles which dissolve when crushed. The cosmetic significance of these new products is connected with the biocompatibility characteristics of the collagenous material and with the characteristics relating to the modulated reticulation of the obtained product.

Systematic screening for congenital hypothyroidism was started in Lyon in September 1976. This screening was coupled with PKU screening, using the same dried blood samples in filter paper obtained on the 5 th day of life. TSH levels were determined by radioimmunoassay adapted for dried blood samples (Kit Abbott). In 24 months, 56 176 samples were analyzed. The critical level calling for control was successively raised from 20 to 30 now 40 muUl/ml of serum. A high level of TSH was found in 307 children (0.55 p. 100). Pathological deliveries were found in most of these infants (neonatal injury, cesarean section, forceps or ocytocic perfusion, neonatal icterus) and a second or a third measurement showed normal TSH level. Congenital hypothyroidism, was detected in 18 infants: 12 ectopic gland, 5 athyreosis and 1 dyshormonogenesis. Treatment was begun at a mean age of 38 days (29 to 50 days). Despite a short follow-up the psychomotor development of the infants seems to be normal in all cases but one (one athyreosis with a neonatal injury and a malformative syndrome).

Cytotoxicity of an antiseptic is usually evaluated by microscopic examination of a cell culture, after a set time of contact with the antiseptic. As this evaluation is largely subjective, a photometric method is proposed. The procedure consists in staining the cells by methylene blue after contact with the ATS and measuring the dye in a photometer after elution. Different dilutions of ATS are added to a 24 h-monolayer of Vero cells in a 96-well microtissue culture plate (8 wells for each dilution, 8 wells for cell control, and 8 wells for control of dye fixation by the plastic plate). The plate is incubated for three days at 37 degrees C in an atmosphere of 5% CO2 and 95% air. The plate is washed with PBS to remove dead cells and adherent cells are fixed. The plate is then washed with borate buffer and allowed to dry. The dye is eluted by adding 200 microliter of HCl 0.1 N to each well. The plate is then read automatically at 650 nm on a Titertek Multiskan, a vertical light path photometer. Cytotoxicity is expressed as the percentage of damaged cells as compared to control wells. Cytotoxic assay of glutaraldehyde shows that this technique is more reliable and more sensitive than microscopic examination. Moreover, result of cytotoxic assay and of a method consisting in measurement of protein in residual cells after exposure to ATS are significantly correlated.

By stimulating or depressing the macrophage system with Corynebacterium parvum or anti-macrophage serum, we were able to establish that macrophages play a role in Poly-I:C-induced interferon production. On the other hand macrophages do not seem to be the cells which produce endotoxin- or NDV-induced interferon, although a slight participation of these cells in the production of NDV-induced interferon cannot be excluded.

Systematic screening for congenital hypothyroidism was started in Lyon in september 1976. This screening was coupled with PKU, using the same dried blood samples on filter paper obtained on the 5th day of life. TSH levels were determined by radioimmunoassay adapted for dried blood samples (Kit Abbott). In 24 months, 56 176 samples were analyzed. The critical level calling for control was successively raised from from 20 to 30, now 40 microUI/ml of serum. A high level of TSH was found in 307 children (0,55%). Pathological deliveries were found in most of these infants (neonatal injury, cesarean, section forceps or ocytocic perfusion, neonatal icterus) and a second or a third measurement showed normal TSH level. Congenital hypothyroidism, was found detected in 18 infants: 12 ectopic gland, 5 athyreosis and 1 dyshormonogenesis. Treatment was begun at a mean age of 38 days (29 to 50 days).

Clostridium difficile has been searched in 153 stool samples from 138 children aged 0 to 12 months. We divided the population in two groups depending on the antibiotic treatment. We have found C difficile in 39 samples (25%). The colonization rate increases with age ranging from 5% before 1 month, to 36% between 1 and 6 months and 54% between 6 and 13 months. An environmental sampling yielded once C difficile. Contamination may be related to the environment. 29% of the isolates produced a cytopathic toxin. Toxin titers in infants' stools range from 1/160 to 1/10240. One only of these children had diarrhea. C difficile and its toxin does not seem to infer any signs of enteric illness with infants. The results obtained with the group of non treated infants are not significantly different from the ones of the other group: the colonization rates are 21% in the non treated group and 29% in the other group. The rate of strains yielding a cytophatic toxin is similar in the 2 groups. It seems reasonable to agree that antibiotics do not influence the settlement of C difficile in infants' intestine.

Neonatal screening of Duchenne Muscular Dystrophy using serum CK level measurement has been performed for 10 years in a part of the Rhône-Alpes area (40,000 newborns per year). This test avoids consecutive cases in an affected family by mean of an early genetic counselling. So, 10 potential DMD boys have been avoided (i.e. one out of five of the D.M.D., as a whole which would be born during this same ten year study). Details on familial structures and efficiency of genetic counselling are given, and this efficiency will be increased by the DNA study of the concerned families.

We report a biochemical and enzymatic study of two neonatal cases of non ketotic hyperglycinemia. We report the comparative evolution of glycine level in plasma and CSF during a restrictive diet excluding glycine and serine. The high levels of glycine found in CSF and brain are likely to reflect the brain damage. After autopsy, the glycine synthase activity determination shows a significative partial deficiency in the liver and a total deficiency in the brain. Glycine synthase affinity for glycine is similar for controls and patients and this lead use to think that the deficiency is due to a diminished biosynthesis of the enzyme molecule.

The systematic seek of an increased activity of the SCK among all newborns has permitted the detection of the Duchenne-type muscular dystrophy in the "Rhone-alpes" area. By the survey of 40,000 births during 5 years and the detection of 16 Duchenne-type muscular dystrophies the authors estimate the incidence of DMD at 1/6500 living new born boys. The number of false positives (1,5 p. 1000) is little and, up to now, no false negative has been recorded. A few boys and girls keep and increased activity of the SCK, and 3 boys hae a Becker-type muscular dystrophy.

The influence of dilution of povidone-iodine solutions on virucidal activity against poliovirus type 1 was investigated. After exposure to different concentrations of povidone-iodine, the reduction in virus titer was determined after separating the antiseptic by gel filtration. Diluted preparations (0.5 and 0.25%) achieved a greater reduction in virus titer (10(5) in one hour) than the 5% stock solution (10(3)). Moreover, dilute solutions exhibited a faster virucidal activity.

Thiopental is an anaesthetic drug which is currently used for cerebral resuscitation. In this last indication the drug is administrated at high doses over a period of several days. Under clinical trials thiopental and two metabolites namely 5 ethyl-5 (1' methyl-3' hydroxy-butyl) 2 thiobarbituric acid and 5 ethyl-5 (1' methyl-3' carboxy-propyl) 2 thiobarbituric acid have been determined by high performance liquid chromatography and mass spectrometry. In human plasma high concentrations of thiopental and 5 ethyl-5 (1' methyl-3' hydroxy-butyl) 2 thiobarbituric acid and a lower concentration of 5 ethyl-5 (1' methyl-3' carboxy-propyl) 2 thiobarbituric acid have been found. In urine samples these metabolites are excreted in large and approximately equal quantities, whereas small amounts of thiopental were recovered.