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Quelle politique de prise en charge des urgences psychiatriques? 精神科急诊的管理政策是什么?
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80007-9
M. De Clercq

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.

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.

综合医院的急诊服务不得不处理越来越多的精神紧急情况,这表明现代城市生活和城市规模不断扩大所带来的压力。对目前治疗这些紧急情况的手段进行了审查:流动小组、危机中心、没有精神科医生的急诊病房或有“随叫随到”的精神科小组,以及精神科急诊服务。讨论了目前治疗精神紧急情况的手段所引起的问题以及为处理这些问题所采取步骤的主要目的。最后,概述了建立连贯的精神科紧急护理政策的手段:一个常设的精神科小组,精神科小组在急诊科内的真正整合,短期住院的床位,隔离室,以及可以在一定程度上保密的情况下进行面谈的办公室。紧急情况的服务(hôpitaux)和紧急情况的服务(hôpitaux)和紧急情况的服务(()和紧急情况的服务()和紧急情况的服务()和紧急情况的服务()和紧急情况的服务(/ /)的扩展。“实际行动计划”是指:“行动计划”、“危机处理中心”、“无精神病紧急服务”、“可申诉的精神病紧急服务”和“精神紧急服务”。“问题的解决”是“政治的解决”,“现实的解决”是“紧急的解决”,“精神病学的解决”是“目标的解决”,“重大的干预措施的解决”是“公平的解决”。15 .在紧急情况下,将精神病学方面的主管与政治方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来,将精神病学方面的主管与紧急情况方面的主管结合起来。
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引用次数: 5
Associations d’antibiotiques ou monothérapie en réanimation chirurgicale et en chirurgie 手术复苏和外科手术中抗生素或单一疗法的组合
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80011-0
C. Auboyer (coordonateur), G. Beaucaire, H. Drugeon, F. Gouin, J.C. Granry, V. Jarlier, A.M. Korinek, C. Martin, P. Montravers, T. Pottecher, J.L. Pourriat, B. Schlemmer, J.P. Stahl, M. Wolff
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引用次数: 4
L’urgence psychiatrique en crise 危机中的精神急诊
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80002-X
M. Patris
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引用次数: 0
Noix de muscade: le parfum du poison 肉豆蔻:毒药的味道
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80013-4
F. Lapostolle, B. Mirat, J.M. Agostinucci, C. Prudhomme, F. Adnet
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引用次数: 0
Programme de médicalisation du système d’information et réanimation: embellie dans une relation conflictuelle? 信息系统和复苏的医疗化方案:冲突关系中的美化?
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80001-8
B. Guidet
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引用次数: 0
Diarrhées acquises chez les patients de réanimation 复苏患者获得性腹泻
Pub Date : 2000-07-01 DOI: 10.1016/S1164-6756(00)80006-7
G. Bleichner, J.P. Sollet

  • Nosocomial infectious diarrhea

  • Clostridium difficile diarrhea

  • Klebsiella oxytoca diarrhea

  • Other infectious diarrheas

  • Diarrhea due to drugs

  • Non-absorbable osmotic agents

  • Antibiotics

  • Anti-acids

  • Diarrhea due to enteral feeding

  • Administration rate

  • Osmolarity

  • Composition of the diet

  • Microbial contamination of foods

  • Diarrhea due to underlying diseases

  • Abdominal causes

  • Hypoalbuminemia

  • Malnutrition

  • Injuries, infections, burns

  • Diagnostic procedures

  • Prevention

  • Conservative treatment

  • Diarrhées infectieuses nosocomiales

  • Diarrhée à Clostridium difficile

  • Diarrhée à Klebsiella oxytoca

  • Autres diarrhées infectieuses

  • Diarrhées médicamenteuses en dehors des diarrhées infectieuses

  • Substances osmolaires non-absorbables

  • Antibiotiques

  • Antiacides

  • Diarrhées liées à la nutrition entérale

  • Vitesse d’administration

  • Osmolarité

  • Composition des mélanges

  • Contamination bactérienne des solutions nutritives

  • Diarrhées liées aux affections sous-jacentes

  • Causes locales

  • Hypoalbuminémie

  • <
—Nosocomial, diarrhea•艰难梭菌diarrhea•Klebsiella oxytoca diarrhea•Other, diarrheas—to people diarrhea由于•Non-absorbable osmotic•剂抗生素•Anti-acids—to enteral diarrhea由于脾供膳药••Osmolarity•组成of the diet•微生物污染of foods—to动心diseases diarrhea由于腹部••起因Hypoalbuminemia••伤害、感染、营养不良burns)—诊断程序—预防—治疗—保守派”艰难梭菌院内感染性腹泻腹泻••腹泻到Klebsiella oxytoca•其他感染性腹泻—感染性腹泻腹泻以外的药物物质•osmolaires non-absorbables••抗生素抗酸—entérale腹泻相关营养药速度••渗透压••混合物成分的营养细菌污染的解决方案—腹泻等疾病有关潜在原因•局部原因•低白蛋白血症•攻击、感染、烧伤•营养不良和功能性消化休息-诊断方法-预防-对症治疗
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引用次数: 4
Infections néonatales à Enterococcus fæcalis : analyse de 29 observations 新生儿fæcalis肠球菌感染:29项观察结果的分析
Pub Date : 2000-05-01 DOI: 10.1016/S1164-6756(00)90002-1
M.S Lahbabi , M Wafi , M Benbachir , S Benomar , C Nejjari

Objective: Resistance of Enterococcus fæcalis to antibiotics has considerably increased and led to therapeutic difficulties. The purpose of our study is to specify the factors of risk of the Enterococcus fæcalis infection in a neonatal intensive care unit and to determine the sensitivity of isolate strains.

Methods: We retrospectively analyzed 29 cases, collected during 1996 and 1997. Two groups were compared according to χ2 test: group 1 (acquisition of Enterococcus fæcalis infection), group 2 (asymptomatic bacteremia). The determination of isolate strains was based on the method of disks.

Results: The dominant clinical picture was severe in 38% (1129) of the cases. In 31% (929) of cases, neurologic symptomes were predominant, and in 28% (829) a respiratory distress was observed. The risk factors for acquiring an Enterococcus fæcalis infection were the administration of large spectrum antibiotics in 1415 (93%) for group 1 vs 614 (43%) for group 2, and the frequent use of buccopharyngeal aspirations: 615 (40%) for group 1 vs 114 (7%) for group 2. Enterococcus fæcalis 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% (315) in group 1 and 7% (114) in group 2.

Conclusion: Enterococcus fæcalis 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.

目的:粪肠球菌对抗生素的耐药性明显增加,导致治疗困难。本研究的目的是明确新生儿重症监护病房中f型肠球菌感染的危险因素,并确定分离菌株的敏感性。方法对1996 ~ 1997年收治的29例病例进行回顾性分析。两组比较采用χ2检验:1组(获得f型肠球菌感染),2组(无症状菌血症)。分离菌株的测定采用纸片法。结果:1129例患者中有38%的临床表现以重症为主。31%(929)的病例以神经系统症状为主,28%(829)的病例出现呼吸窘迫。获得f型肠球菌感染的危险因素是1组1415例(93%)对2组614例(43%)使用大谱抗生素,以及1组615例(40%)对2组114例(7%)频繁使用咽咽吸痰。对青霉素G耐药的占50%,对阿莫西林耐药的占34%,对庆大霉素高耐药的占87%;未见万古霉素耐药病例。1组死亡率为20%(315),2组死亡率为7%(114)。结论:粪肠球菌是危重新生儿败血症的常见病因。强调应采取卫生措施,合理使用抗菌药物,预防院内感染。
{"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><sup>2</sup> 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":"9 3","pages":"Pages 169-175"},"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}
引用次数: 2
Syndrome de Miller-Fischer, anticorps anti-GQ 1b et Campylobacter jejuni: à l'occasion d'une observation Miller-Fischer综合征,抗gq1b和空肠弯曲杆菌:1 .观察场合
Pub Date : 2000-05-01 DOI: 10.1016/S1164-6756(00)90010-0
G Laplatte , C Bouterra , A Itani , K Kuteifan , A.M Gutbub

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 Campylobacter jejuni 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 C. jejuni, suggesting molecular mimicry. Thus, initiation of immunologic disorder might follow Campylobacter infection. However, other factors were found to explain onset of the disease whatever their correlation with host or bacteria.

报告1例米勒-费舍尔综合征伴神经节苷脂GQ 1b血清抗体。虽然没有引起腹部症状或腹泻,但发现空肠弯曲杆菌抗体升高。静脉注射免疫球蛋白可迅速改善病情。先前的出版物报道了Miller-Fischer综合征患者神经节苷脂GQ 1b的IgG抗体升高,而在其他神经系统疾病和正常对照中未发现。这种高特异性可能对非典型病例有帮助。gq1b在动眼肌淋巴结和小脑的显著分布可能是米勒-费舍尔综合征的主要特征共济失调和眼麻痹的原因。此外,抗gq 1b抗体识别空肠梭菌表面表位,提示分子模仿。因此,弯曲杆菌感染可能引发免疫紊乱。然而,其他因素被发现可以解释疾病的发病,无论它们与宿主或细菌的关系如何。
{"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":"9 3","pages":"Pages 224-226"},"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}
引用次数: 2
Législation des prélèvements d'organes en France 法国关于器官采集的立法
Pub Date : 2000-05-01 DOI: 10.1016/S1164-6756(00)90007-0
R.F. Gobeaux
{"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":"9 3","pages":"Page 210"},"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}
引用次数: 1
Réponse des auteurs à la lettre de Lapostolle et Adnet 作者对Lapostolle和Adnet信的回复
Pub Date : 2000-05-01 DOI: 10.1016/S1164-6756(00)90013-6
M. Ould-Ahmed
{"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":"9 3","pages":"Pages 230-231"},"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}
引用次数: 0
期刊
Réanimation Urgences
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