The evaluation of needs and means concerning the care of patients in palliative treatment is among the problems seen as priority by the High Committee for Public Health. We have thus tried to characterise, in a specific health sector, the patients receiving palliative care in short-stay establishments in order to evaluate their care needs. We carried out an exhaustive descriptive survey among all public and private short-stay establishments in the Côte d'Or region. Of the 2116 patients in the hospital on the day of the survey, roughly 30% were considered as eligible for palliative care (patients suffering from serious, chronic and progressive illnesses). The average age of these patients is 63.9 years (standard deviation 19.7). They mainly suffer from tumours (50%), circulatory pathologies (15%), mental illness (7%), or neurological illnesses (6%). Among the patients that may need palliative care, 38% say they feel pain despite treatment with pain-killers among 25.3% of them. The personnel providing care is insufficiently trained in palliative care or in pain, as only a maximum of 18% of nurses and 5% of doctors in short-stay establishments have been trained in these areas.

Fever is a major symptom to characterize individual health status. Measurement of temperature is systematically made in everyday medical practice. In France, this measurement is generally assumed with a rectal glass mercury thermometer. In order to protect people and the environment, the "Conseil Supérieur d'Hygiène Publique de France" has approved recommendations to withdrawn medical use of mercury, specifically for thermometer. Rectal measurement is also debated since infectious risks are described. Thus, substitution of rectal glass mercury thermometer is on the agenda. New sites and techniques for measurement of temperature have been studied through a literature review, interview of experts and companies, and clinical research protocols. Cutaneous and axillary measurements are inaccurate and unsatisfactory. Two methods seems to be worth: oral measurement and tympanic measurement. Oral measurement is widespread in the world. This technique has some limits. Tympanic measurement is a new method in progress without these limits. Whatever the choice of the technique is, the substitution of rectal glass mercury thermometer requires training and awareness of staff and patients.

Fever is a major symptom to characterize individual health status. Measurement of temperature is systematically made in everyday medical practice. In France, this measurement is generally assumed with a rectal glass mercury thermometer. In order to protect people and the environment, the << Conseil Superieur d'Hygiene Publique de France >> has approved recommendations to withdrawn medical use of mercury specifically for thermometer. Rectal measurement is also debated since infectious risks are described. Thus, substitution of rectal glass mercury thermometer is on the agenda, New sites and techniques for measurement of temperature have been studied through a literature review interview of experts and companies, and clinical research protocols. Cutaneous and axillary measurements are inaccurate and unsatisfactory Two methods seems to be worth : oral measurement and tympanic measurement. Oral measurement is widespread in the world. This technique has some limits. Tympanic measurement is a new methods in progress without these limits. Whatever the choice of the technique is, the substitution of rectal glass mercury thermometer requires training and awareness of staff and patients.

A case of bone marrow necrosis associated with a serologically documented recent Parvovirus B 19 infection which preceded the development of PH1+ acute lymphoblastic leukemia is reported. No conclusions can be drawn on the basis of a single case but the question of the role of human Parvovirus B19 in the pathogenesis of bone marrow necrosis is discussed. It is suggested that the virus may act as a co-factor for the induction of bone marrow necrosis, in some cases.

Usual coagulation tests--Platelet count, Prothrombin Time (PT), Activated Partial Thromboplastine Time (APTT)--detect most of coagulation abnormalities in preoperative situation. Emergency surgery remains possible without bleeding in most cases. Patient history of haemostatic responses is absolutely necessary to know in addition to coagulation tests. Platelets transfusion may often be avoid in thrombocytopenic patients with platelet count higher than 50,000 mm3. The PT and/or APTT perturbations need further laboratory investigations to estimate the bleeding risk which is not constant. The correction of an antithrombotic treatment is usually easy except for drugs which inhibit platelet aggregation.

A registry of haematopoietic malignancies was established on January 1, 1980 in order to accurately determine the incidence and epidemiological features of these diseases in the department of Côte d'Or (population 478,000). Over five years (1980-1984), 704 new cases were recorded. The crude incidence rates were 32.7 per 100,000 for males and 24.9 per 100,000 for females. The corresponding age standardized rates were 26.4 and 16.7. The sex ratio was 1.6:1. In males, chronic lymphocytic leukaemias were the most common haematopoietic malignancies, followed by non Hodgkin's lymphomas, acute leukaemias and multiple myelomas. In females, multiple myelomas and acute leukaemias preceded non Hodgkin's lymphomas and chronic lymphocytic leukaemias. For men and women, the risk of haematopoietic malignancies was higher in urban areas than in rural areas. Compared to population based registries in other countries, incidence rates are among the highest reported and are particularly high for chronic lymphocytic leukaemia.