Convergence des référentiels de qualité et implications pour la fonction technique biomédicale

Risk management in the hospital, which is one of the referentiels of the ANAES accreditation manual, may be considered on two levels. Firstly, risk management may be approached globally, in the same way as it is tackled in the accreditation process. Secondly, risk management may be more definite. A specific risk chosen in accordance with the priorities of a particular plan may be dealt with individually. In this respect, the tranfusion process allows the risk management method to be tested and developed.

Immune responses to protozoan parasites and its relevance to diagnosis in immunocompromised patients

The parasitology includes different parasites, of which some are very severe, which have a development in the blood, inside the cells and visible after coloration (Plasmodium, Babesia, Leishmania, Toxoplasma) or mobiles, outside the cells (Trypanosoma, microfilariae). The diagnosis of these parasites is the first aim of the biological technics. Direct diagnosis, under the microscope, allows to identifie the parasite, its stage of development, and the parasitaemia, which is essential to the prognosis and the therapeutic outcome.The technics include the direct examination to identify the extra cellular parasites, which are mobile among the blood red cells, or thin and thick smear, after coloration. It is often useful to use other technics, such as filtration, culture or animal inoculation. Recently, the molecular biology increased the sensitivity and the specificity of classical methods. Such progress, available by some laboratories, must be adapted to the methods of emergency and low cost diagnosis. In some cases of pauciparasitism or retrospective diagnosis, serological methods are useful to detect the trail of parasites by circulating antigens or antibodies.

The isoepoxydon dehydrogenase gene of patulin biosynthesis in cultures and secondary metabolites as candidate PCR inhibitors

This study evaluates the specificity of PCR isoepoxydon dehydrogenase (idh) primers on fungi associated with patulin production. The DNAs of 93 strains were extracted and analysed by PCR using primers of the idh gene of patulin biosynthesis. A single band at 620 bp was obtained on 17% of the analysed strains. Different molecular weight amplicons were observed in other strains. These were employed as binary characters for numerical analysis to obtain a dendrogram. Clusters were observed, which corresponded to morphological identifications in some cases. Amplicons at 400 and/or 500 bp were related to patulin non-detection for strains, whereas a 450 bp amplicon was associated with some Aspergillus and both of the Byssochlamys nivea strains tested. Hence, the idh primers are not specific for the gene and provide other amplicon products in other species. These results were useful providing (a) profiles of DNA to identify and classify fungi and (b) insights into patulin production. The DNA profiles in this study may be useful for determining patulin producing fungi. Obtaining multiple bands in culture-independent PCR of environmental samples by using the primers could indicate that more than one species is present.