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Blastocystis sp. is the most common single-celled eukaryote colonizing the human gastrointestinal tract worldwide. Because of the proven zoonotic potential of this protozoan, sustained research is therefore focused on identifying various reservoirs of transmission to humans, and in particular animal sources. Numerous groups of animals are considered to be such reservoirs due to their handling or consumption. However, some of them, including mollusks, remain underexplored. Therefore, a molecular epidemiological survey conducted in wild mussels was carried out in Northern France (Hauts-de-France region) to evaluate the frequency and subtypes (STs) distribution of Blastocystis sp. in these bivalve mollusks. For this purpose, 100 mussels (Mytilus edulis) were randomly collected in two sampling sites (Wimereux and Dannes) located in the vicinity of Boulogne-sur-Mer. The gills and gastrointestinal tract of each mussel were screened for the presence of Blastocystis sp. by real-time polymerase chain reaction (qPCR) assay followed by direct sequencing of positive PCR products and subtyping through phylogenetic analysis. In parallel, sequences of potential representative Blastocystis sp. isolates that were previously obtained from temporal surveys of seawater samples at marine stations offshore of Wimereux were integrated in the present analysis. By taking into account the qPCR results from all mussels, the overall prevalence of the parasite was shown to reach 62.0%. In total, more than 55% of the positive samples presented mixed infections. In the remaining mussel samples with a single sequence, various STs including ST3, ST7, ST14, ST23, ST26 and ST44 were reported with varying frequencies. Such distribution of STs coupled with the absence of a predominant ST specific to these bivalves strongly suggested that mussels might not be natural hosts of Blastocystis sp. and might rather be carriers of parasite isolates from both human and animal (bovid and birds) waste. These data from mussels together with the molecular identification of isolates from marine stations were subsequently discussed along with the local geographical context in order to clarify the circulation of this protozoan in this area. The identification of human and animal STs of Blastocystis sp. in mussels emphasized the active circulation of this protozoan in mollusks and suggested a significant environmental contamination of fecal origin. This study has provided new insights into the host/carrier range and transmission of Blastocystis sp. and emphasized its potential as an effective sentinel species for water quality and environmental contamination. [ABSTRACT FROM AUTHOR]

Introduction of invasive alien species (IAS) is one of the main threats to biodiversity. The Northern raccoon (Procyon lotor), here after named "raccoon," recently introduced and rapidly expanding in three main populations in France, is one of the 47 IAS of concern in the European Union. At this date, there is no study on the ecology of the raccoon in France, yet the acquisition of knowledge of the species in its new environment is an essential step for a better evaluation of its impacts and improving its management. We studied space use and habitat selection by French raccoons in a rural population in the Marne department and in a suburban population in Gironde department, respectively, by tracking 14 individuals with GPS collars between May 2019 and August 2021. We estimated the home ranges' size using minimum convex polygon (MCP), adaptative local convex hull (a-LoCoH), and dynamic Brownian bridge motion model (dBBMM). Habitat selection was studied at the second and third order using Ivlev's electivity index and integrated step selection analysis (iSSA) models, respectively. Our results show that raccoons of the rural population have home ranges twice larger than those of the suburban population. Habitats are selected differently according to the population, highlighting the great plasticity of the raccoon. Woodlands are the most used habitats for both populations; however, anthropized areas also appear to be very attractive for the rural population. Surprisingly, this is not the case for the suburban population, which tends to avoid these habitats in favor of the wetland. [ABSTRACT FROM AUTHOR]

The Jacotines landslide is representative of the large mass movements that affect the Champagne vineyards. Understanding the subsurface structure of these slopes and the mechanisms leading to sliding events is of a great interest, particularly for winegrowers who produce Champagne. This knowledge is generally used to elaborate accurate hazard assessment maps, which is an important feature in land use planning. The approach presented is based on the integration of geophysical imaging (seismic wave velocity and electrical resistivity), lithostratigraphic analysis (drilling core) and geomorphological investigations (surface landforms) to reconstruct the relations between the landslide structure, surface water flow, groundwater regime and the overall slope stability. A first phase of instability resulting in a large rotational slip probably occurred during the Late Glacial Period in morphoclimatic conditions characterized by an excess of water. A second one, still active, leading to superficial reactivations and relates to present hydrogeological conditions determined by the internal structure of the landslide. [ABSTRACT FROM AUTHOR]

Investigations of hydric and hydrogeological mechanisms that contribute to the current reactivation of mass-movements feed predictive models that can be useful for risk management. Our model is based on an approach combining (1) a large-scale analysis of the landforms, using LiDAR imagery and field observations, (2) a characterization of the groundwater (piezometry, conductivity and temperature), both in the landslide and in the stable slope, and (3) electrical resistivity profiles. These combined data allow the reconstruction of the structure of the landslide to determine its influence on groundwater flow. The Saint Maur landslide bars the main aquifer of the Upper Ypresian sands whose slow flow results in lower piezometric level fluctuations and stronger mineralization than found in the unconfined aquifer on either side of the slip. The confined aquifer emptying occurs through the sliding plane so that the landslide aquifer is fed essentially by capillary rise from the shear plane and to a lesser extent by surface infiltration. Therefore, the amount of water in the landslide and the resulting probability of mass movement are weakly correlated with rainfall events. In addition, the wide dispersion of the conductivity values of the landslide aquifer reflects a weak mixing of the water. Groundwater circulation modelling allows us to correct in situ (i.e. underground) the flows causing reactivations, and confirms that stabilization by hydrogeological action is more efficient than a surface drainage. Thematic collection: This article is part of the Role of water in destabilizing slopes collection available at: https://www.lyellcollection.org/cc/role-of-water-in-destabilizing-slopes [ABSTRACT FROM AUTHOR]

Background: To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France. Methods: A multi-centric, cross-sectional analysis was conducted in 2018–19 in the QuAliV study—ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio. Results: 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] − 0.383, − 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI − 0.343, 0.012] in multivariable analysis (p = 0.068). Conclusions: Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation. Trial registration number: NCT03296202. [ABSTRACT FROM AUTHOR]

Since the Nobel Prize award more than twenty years ago for discovering the core apoptotic pathway in C. elegans, apoptosis and various other forms of regulated cell death have been thoroughly characterized by researchers around the world. Although many aspects of regulated cell death still remain to be elucidated in specific cell subtypes and disease conditions, many predicted that research into cell death was inexorably reaching a plateau. However, this was not the case since the last decade saw a multitude of cell death modalities being described, while harnessing their therapeutic potential reached clinical use in certain cases. In line with keeping research into cell death alive, francophone researchers from several institutions in France and Belgium established the French Cell Death Research Network (FCDRN). The research conducted by FCDRN is at the leading edge of emerging topics such as non-apoptotic functions of apoptotic effectors, paracrine effects of cell death, novel canonical and non-canonical mechanisms to induce apoptosis in cell death-resistant cancer cells or regulated forms of necrosis and the associated immunogenic response. Collectively, these various lines of research all emerged from the study of apoptosis and in the next few years will increase the mechanistic knowledge into regulated cell death and how to harness it for therapy. [ABSTRACT FROM AUTHOR]

Goat's milk production is an important activity in France. Gastrointestinal nematodes (GIN) remain a main threat for grazing goats, usually controlled using anthelmintic drugs (AH). However, 1) eprinomectin (EPN) is the sole molecule yet available without withdrawal time for milk in France; 2) nematodes AH resistances increase dramatically. First, a survey was performed on 13 farms in the Auvergne-Rhône-Alpes (AURA) region to evaluate the efficacy of 2 AH authorized for dairy goats: a benzimidazole (BZ) and a macrocyclic lactone (EPN pour-on). Fecal Egg Count Reduction Tests (FECRT) were carried out using 3 groups of 10 goats per farm: a control group, one treated with BZ (oxfendazole) and one treated with EPN. The results indicate a resistance to BZ in 11 out of 13 farms (84.6%) and a lack of efficacy for EPN pour-on in at least 10 farms (76.9%). Secondly, EPN was given orally or subcutaneously in 4 farms of the previous trial showing a lack of efficacy to EPN pour-on. A resistance to EPN was confirmed in 3 out of 4 farms. Although based on a few farms, these results confirm the high prevalence of resistance of GIN to BZ in dairy goat farms. They also highlight a high level of resistance to EPN and the lack of efficacy of EPN when used pour-on. Given the level of resistance to marketed drugs, there is an urgent need to explore alternative options to AH to prepare integrated, sustainable control of GIN. • This is the first survey on resistance of GINs to benzimidazoles and eprinomectin in dairy goats' farms in France. • A lack of efficacy for BZ and EPN was found in > 75% farms. • The occurrence of resistance to both BZ and EPN has been identified in several farms. • This last statement questioned the future of control of GIN in dairy small ruminants based on synthetic anthelmintics. [ABSTRACT FROM AUTHOR]

Spatial disparity of run-off conditions during low-water period in homogeneous watersheds depends on the degree of incision of valleys, but may also be influenced by a structural partitioning or some lateral variations in the aquifer lithology. For small basins (area <300 km2), often hydrometrically unsupervised, campaigns of serial flow measurements, gauging, conductivity and temperature are achieved. The Ardre basin, localised in the Tertiary formations of the Paris Basin is used as a workshop basin. Results validated by hydrological and physico-chemical profiles show increased hydrological yields in the basin which correspond to the increase in the thickness of aquifers and their porosity. These lateral variations of facies and of aquifer thicknesses are related to Eocene sedimentary conditions (Lutetian) for homogeneous basins, which explain the spatial disparity of water resources. [ABSTRACT FROM AUTHOR]

Purpose: We assessed factors associated with mortality and complicated course in the case of Clostridium difficile infection (CDI) acquired in the intensive care unit (ICU). Method: Retrospective cohort study conducted from 1 January 2002 through 1 January 2012. All patients who acquired CDI in our ICU were included. Results: Thirty-one patients were included. Twenty patients (65 %) had mild colitis, 8 (25 %) moderate colitis, and 3 (10 %) severe colitis. Initial antibiotherapy was metronidazole ( n = 30, 97 %) and vancomycin ( n = 1, 3 %). Seventeen patients (55 %) experienced at least one complication: failure of initial treatment ( n = 16, 52 %), shock ( n = 11, 34 %), need for surgery ( n = 1, 3 %) or renal replacement ( n = 4, 13 %), or death ( n = 8, 26 %). Risk factors of ICU mortality were history of corticosteroids prescription, prolonged ICU stay, low serum albumin level, and high Sequential Organ Failure Assessment (SOFA) score at the time of CDI diagnosis. Factors associated with a complicated course were high Simplified Acute Physiology Score (SAPS II), high SOFA score, and low serum albumin level at the time of CDI onset. Conclusion: Risk factors of poor outcome in patients with CDI acquired in the ICU are different from those in the general population suffering from CDI. The implementation of treatment algorithms taking into account these factors may reduce complication rates in this specific population. [ABSTRACT FROM AUTHOR]

This contribution proposes to analyze a single archaeological object crossed by different conservation processes, to isolate and understand the role of geomorphological parameters in the formation and the conservation of anthropogenic geomorphic features. For these purposes, this study characterizes the remnant morphologies of the WW1 railroad in the Montagne de Reims on the western front (France, Rheims sector) through LiDAR-derived digital terrain models combined with archival documents (maps and historical photographs), spatial analysis and field surveys. This study shows that the Heavy Railway Artillery (Artillerie Lourde sur Voie Ferrée - ALVF) is a significant morphogenic feature, preserved at more than 70%. However, this morphology is subject to a strong variability. Ruggedness analysis shows a much more pronounced morphology on the slopes than on the plateaus, demonstrating a difference in formation and preservation processes. For formation processes, the study's findings reveal that geotechnical constraints related to lithology and geomorphology can be overridden for military purposes. For conservation processes, they are largely dependent on land use practices. This research demonstrates that (i) the role of landscape and topographical parameters in the interpretability of features is predominant; (ii) military engineering has been able to adapt to a much diversified topography. • Study of WW1 railway artillery in Montagne de Reims (Marne, France). • Variability analysis of war morphologies according to their geomorphological context. • Integrated methods combining textual and cartographic archives, GIS, Lidar. • The formation and preservation of the rail footprint is driven by geomorphology. • War overrides natural processes for military purposes. [ABSTRACT FROM AUTHOR]

Abstract: The Lutetian limestones were used to build numerous historical monuments in the north-east part of France. In Rheims, Laon and Soissons areas more than 400 underground quarries have been inventoried, by research in the regional archives, on old maps and by several months of ground prospecting. Actually, most of these underground quarries are abandoned. Only 3 are now open, in the Soissons area. In the Rheims region, the last active quarry, located at Courville village, was closed in 2005, because of the safety conditions. The aim of the study was to demonstrate the importance of geomorphological context on the fracturing network and on the quarry spatial organisation. Underground topography, fracturing network measurement, aerial mapping and analysis of the geomorphological features show the high connection between natural constraints and extraction choices and may explain the progressive disappearance of building stone quarries in a part of the studied area. In the east of the studied area, where the usable limestone has a weak thickness and important mechanical distension stress, the galleries direction depends on fracturing network. In contrast, in the west (Soissons area), limestone shows thick homogeneous facies that allow a rational extraction using room and pillars mining system. [Copyright &y& Elsevier]

Objectives: Procalcitonin (PCT) kinetics is a good prognosis marker in infectious diseases, but few studies of community-acquired pneumonia (CAP) have been performed in intensive care units (ICU). We analyzed the relationship between PCT kinetics and outcome in ICU patients with severe CAP.Design and Setting: Prospective observational study in a 16-bed university hospital ICU.Patients: 100 critically ill patients with community-acquired pneumonia.Measurements and Results: Median PCT was 5.2 ng/ml on day 1 and 2.9 ng/ml on day 3. It increased from day 1 to day 3 in nonsurvivors but decreased in survivors. In multivariate analysis four variables were associated with death: invasive ventilation (odds ratio 10-), multilobar involvement (5.6-), LOD score (6.9-), and PCT increase from day 1 to day 3 (4.5-). In intubated patients with a PCT level below 0.95 ng/ml on day 3 the survival rate was 95%.Conclusion: Increased PCT from day 1 to day 3 in severe CAP is a poor prognosis factor. A PCT level less than 0.95 ng/ml on day 3 in intubated patients is associated with a favorable outcome. [ABSTRACT FROM AUTHOR]

The article assesses the 2008-2012 French Alzheimer Plan, including its objectives and the initiatives it has launched. Topics discussed include funds allocated for each of the program's objectives, organizations and government agencies that offered financing and other types of assistance to help meet the program's objectives and focus of the studies that were conducted in relation to the program. Also discussed are the effects of the plan on scientific research about Alzheimer's disease.

Purpose Autosomal dominant retinitis pigmentosa (adRP) affects approximately 1 in 12,000 individuals. To date, 21 adRP genes have been identified accounting theoretically for 44.7% of adRP families; therefore, genetic defects in many patients are yet to be identified. This study was intended to provide information on prevalence of known adRP genes in France and to localize new genes and loci. Methods Microsatellite markers for the 21 adRP genes were used to genotype large families. Non excluded genes were then sequenced. For some families, we performed a whole‐genome SNP analysis using Affymetrix 250K or 6.0 chips. For small families, the 8 most frequently mutated adRP genes were sequenced (in full for RHO, in hot spots only for PRPF31, RDS, RP1, PRPF8, IMPDH1, NRL and PRPF3). Results Hitherto 18 adRP families were studied by indirect genotype analysis. Of these, 15 have shown mutations in known genes and 2 are still in progress. For the last family, one new locus was identified by whole‐genome SNP analysis and confirmed by microsatellite genotyping defining a 43‐Mb locus on chromosome 2. The direct sequencing approach was performed on 143 proband DNAs (completely for the first 50 patients and only RHO for the 93 other patients). A causative mutation was found for 20 families (14%), among which 9 out of 11 were novel. Conclusion The preliminary results, on this limited cohort, showed that the prevalence of known genes is probably underestimated in the literature because the causative mutation was found for 15 families out of 18 (83%). However one new locus has been identified and is under active investigation. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a frequent complaint of patients with Parkinson's disease, and it negatively affects quality of life. Drugs that improve both sleep and parkinsonism would be of major benefit to patients with Parkinson's disease-related insomnia. We aimed to test the safety and efficacy of subcutaneous night-time only apomorphine infusion in patients with Parkinson's disease and insomnia.Methods: We did a randomised, multicentre, double-blind, placebo-controlled, crossover trial in 11 expert centres in Parkinson's disease and sleep centres in France. Participants aged 35-90 years with fluctuating Parkinson's disease and moderate to severe insomnia (Insomnia Severity Index score ≥15) were randomly assigned to either first receive night-time subcutaneous apomorphine (up to 5 mg/h) or matching placebo. Randomisation was done using a computer-generated plan in blocks of four, stratified by centre. This first intervention was followed by a 14-night washout period, then crossover to the other intervention. The treatment periods consisted of a 10-night titration phase followed by a 7-night fixed-dose phase. The dose was adjusted during the titration phase on the basis of a daily telephone call assessing sleep quality and treatment tolerability. The primary efficacy endpoint was the difference in Parkinson's disease sleep scale (PDSS) scores from the beginning to the end of each treatment period. Analysis was done on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, NCT02940912.Findings: Between Jan 31, 2017, and Jan 29, 2021, 46 participants were enrolled. 25 (54%) patients were randomly assigned to receive apomorphine first and 21 (46%) patients to receive placebo first. Mean change in PDSS score was significantly greater with night-time apomorphine infusion (15·18 [SD 24·34]) compared with placebo (5·23 [21·52]; treatment effect 9·95 [95% CI 0·88-19·03]; p=0·041). Adverse events were reported in 25 (54%) participants during the apomorphine period and in 17 (37%) participants during the placebo period (p=0·16). Apomorphine was associated with more frequent dizziness than was placebo (seven [15%] vs 0; p=0·041).Interpretation: Subcutaneous night-time only apomorphine infusion improved sleep disturbances according to difference on PDSS score, with an overall safety profile consistent with previous studies in Parkinson's disease. This treatment might be useful to manage sleep disturbances in patients with advanced Parkinson's disease and moderate to severe insomnia.Funding: Orkyn and Aguettant Pharma.Translation: For the French translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Background: Riluzole has been reported to be beneficial in patients with cerebellar ataxia; however, effectiveness in individual subtypes of disease is unclear due to heterogeneity in participants' causes and stages of disease. Our aim was to test riluzole in a single genetic disease, spinocerebellar ataxia type 2.Methods: We did a randomised, double-blind, placebo-controlled, multicentre trial (the ATRIL study) at eight national reference centres for rare diseases in France that were part of the Neurogene National Reference Centre for Rare Diseases. Participants were patients with spinocerebellar ataxia type 2 with an age at disease onset of up to 50 years and a scale for the assessment and rating of ataxia (SARA) score of at least 5 and up to 26. Patients were randomly assigned centrally (1:1) to receive either riluzole 50 mg orally or placebo twice per day for 12 months. Two visits, at baseline and at 12 months, included clinical measures and 3T brain MRI. The primary endpoint was the proportion of patients whose SARA score improved by at least 1 point. Analyses were done in the intention-to-treat population (all participants who were randomly assigned) and were done with only the observed data (complete case analysis). This trial is registered at ClinicalTrials.gov (NCT03347344) and has been completed.Findings: Between Jan 18, 2018, and June 14, 2019, we enrolled 45 patients. 22 patients were randomly assigned to receive riluzole and 23 to receive placebo. Median age was 42 years (IQR 36-57) in the riluzole group and 49 years (40-56) in the placebo group and 23 (51%) participants were women. All participants presented with moderate-stage disease, characterised by a median SARA score of 13·5 (IQR 9·5-16·5). The primary endpoint, SARA score improvement of at least 1 point after 12 months, was observed in seven patients (32%) in the treated group versus nine patients (39%) in the placebo group, with a mean difference of -10·3% (95% CI -37·4% to 19·2%; p=0·75). SARA score showed a median increase (ie, worsening) of 0·5 points (IQR -1·5 to 1·5) in the riluzole group versus 0·3 points (-1·0 to 2·5) in the placebo group (p=0·70). No serious adverse event was reported in the riluzole-treated group whereas four patients in placebo group had a serious adverse event (hepatic enzyme increase, fracture of external malleolus, rectorrhagia, and depression). The number of patients with adverse events was similar in both groups (riluzole 16 [73%] patients vs placebo 19 [83%] patients; p=0·49).Interpretation: We were able to recruit 45 patients moderately affected by spinocerebellar ataxia type 2 for this trial. Riluzole did not improve clinical or radiological outcomes in these patients. However, our findings provide data on progression of spinocerebellar ataxia type 2 that might prove to be valuable for the design of other clinical trials.Funding: French Ministry of Health. [ABSTRACT FROM AUTHOR]

PURPOSE: To assess the prevalence of PRPH2 in autosomal dominant retinitis pigmentosa (adRP), to report 6 novel mutations, to characterize the biochemical features of a recurrent novel mutation, and to study the clinical features of adRP patients. DESIGN: Retrospective clinical and molecular genetic study. METHODS: Clinical investigations included visual field testing, fundus examination, high-resolution spectral-domain optical coherence tomography (OCT), fundus autofluorescence imaging, and electroretinogram (ERG) recording. PRPH2 was screened by Sanger sequencing in a cohort of 310 French families with adRP. Peripherin-2 protein was produced in yeast and analyzed by Western blot. RESULTS: We identified 15 mutations, including 6 novel and 9 previously reported changes in 32 families, accounting for a prevalence of 10.3% in this adRP population. We showed that a new recurrent p.Leu254Gln mutation leads to protein aggregation, suggesting abnormal folding. The clinical severity of the disease in examined patients was moderate with 78% of the eyes having 1-0.5 of visual acuity and 52% of the eyes retaining more than 50% of the visual field. Some patients characteristically showed vitelliform deposits or macular involvement. In some families, pericentral RP or macular dystrophy were found in family members while widespread RP was present in other members of the same families. CONCLUSIONS: The mutations in PRPH2 account for 10.3% of adRP in the French population, which is higher than previously reported (0%-8%) This makes PRPH2 the second most frequent adRP gene after RHO in our series. PRPH2 mutations cause highly variable phenotypes and moderate forms of adRP, including mild cases, which could be underdiagnosed. [ABSTRACT FROM AUTHOR]

A novel fast and automatic methodology for the hierarchical classification and similarity matching of mid-infrared spectra of paint samples based on the principles of Soft Independent Modelling of Class Analogy (SIMCA) and on the definition and properties of the Mahalanobis distance is here proposed. This approach was tested in a so-called market study (i. e., targeting products largely accessible to the general public and conceived for a considerably wide range of usages) conducted across the surroundings of the city of Lille, in France, and has permitted not only to successfully achieve the chemical characterisation of most of the analysed samples but also to discover specific commonality patterns among specimens sharing the same chemical features. [Display omitted] • A hierarchical approach for paint sample classification and matching. • A market study conducted across the city of Lille, in France, and its surrounding. • Automatic identification of the chemical composition of spray paint samples. • Objective discovery of similarity patterns shared by paints of equal composition. • Analysis speed compatible with on-field applications. [ABSTRACT FROM AUTHOR]

This retrospective study assessed the conformity of prescriptions of labile blood products as well as the respect of legal requirements and recommendations concerning red blood cells specifications. This study was carried out in two phases one year apart, so as to be able to compare between them. It consisted in an analysis of the administrative and medical information present on the prescription forms and of the discrepancies between the prescribed product and that which was dispensed. Quality of prescriptions was overall better, but some points needed further improvement. The data moreover showed that some prescriptions of phenotyped and cross-matched red blood cells were incomplete. This did not improve over time. Out of 1000 prescriptions for red blood cells, 216 were altered by the transfusion service dispensing unit. A closer look at these changes showed that 49% were justified by statutory requirements or by local protocols. The discrepancies observed between the prescribed product and that which was dispensed were partly due to a poor understanding by the prescribers of statutory requirements. However they are mostly related to particular circumstances, such as emergencies. Furthermore, the prescribers expected the transfusion center to adapt the product in terms of the clinical context.