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Out of hopital

Yannis K Valtis, Maggie F Cochran, Louine Martineau, Bregenet Lamour, Jeffrey B Mendel, Aaron L Berkowitz
BACKGROUND: Neuroimaging is often unavailable in low-income countries, creating challenges for precise diagnosis of neurologic disease in individual patients, and impeding acquisition of precise neuroepidemiologic data for program and policy development. METHODS: We analyzed reports from 3614 head CTs performed between July 2013 and January 2016 at Hôpital Universitaire de Mirebalais, a public academic hospital in rural Haiti, extracting patients' age, study indication, and radiologic findings...
August 15, 2017: Journal of the Neurological Sciences
Rakesh Bhadade, Minal Harde, Rosemarie deSouza, Ashwini More, Ramesh Bharmal
BACKGROUND: Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. MATERIALS AND METHODS: It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months...
July 2017: Annals of African Medicine
Somda Namwin Siourimè, Bonkoungou Ouindgueta Juste Isidore, Traoré Oumar, Bassolé Ismael Henri Nestor, Traoré Yves, Barro Nicolas, Savadogo Aly
BACKGROUND: In Burkina Faso dirty water in particular those of the stoppings and the gutter ones are used for vegetables irrigation in the gardens. The aim of this study was to determine the prevalence and antibiotic susceptibility of Salmonella serotypes from humans and lettuce samples inBurkina Faso. Materials and Methods:Salmonella strains isolated from patients in 2009 to 2015 and lettuce samples in 2014 in Burkina Faso were serotyped using specific antisera. All strains were subjected to a set of 14 antibiotics to study their antibiogram by using Baeur-Kirby disk diffusion method...
2017: African Journal of Infectious Diseases
G Coulibaly, K P Yao, M Koffi, B A Ahouty, L K Louhourignon, M N'Cho, E K N'Goran
A prospective study was carried out from 2010 to 2012 at the Hôpital Général d'Abobo (HGA) in Abidjan, in order to determine the impact of infectious and parasitic diseases on child cognitive development. Blood samples were examined by means of thick drop and blood smear; as for stool by direct examination and concentration by formalin-ether method. We evaluated the prevalence, the parasite load of malaria and gastrointestinal parasites; then we investigated the risk factors for these disorders. Overall, 331 pregnant women in the last trimester of their pregnancy were enrolled...
May 2017: Bulletin de la Société de Pathologie Exotique
Alicia A Annamalay, Imane Jroundi, Joelene Bizzintino, Siew-Kim Khoo, Guicheng Zhang, Deborah Lehmann, Ingrid A Laing, James Gern, Jack Goldblatt, Chafiq Mahraoui, Rachid Benmessaoud, Cinta Moraleda, Quique Bassat, Peter Le Souëf
Human rhinovirus (RV) is commonly associated with severe acute lower respiratory infections (ALRI) in children. We aimed to describe the distribution of RV species and associations between RV species and clinical features in children hospitalized with clinically severe pneumonia (CSP) in Morocco. Nasopharyngeal aspirates (NPAs) were collected from 700 children, 2-59 months of age, admitted with CSP to the Hôpital d'Enfants de Rabat in Morocco. At least one respiratory virus was identified in 92% of children, of which RV was the most common (53%)...
April 2017: Journal of Medical Virology
Marie-Laure Raffin-Sanson, Gwenaelle Abiven, Katrin Ritzel, Pauline de Corbière, Laure Cazabat, Ramona Zaharia, Lionel Groussin, Rossella Libe, Jérôme Bertherat, Martin Fassnacht, Xavier Bertagna
Adrenocortical carcinoma is a rare cancer with a poor but heterogeneous prognosis. These tumours are more frequently encountered in women, sometimes very young and may be diagnosed in women in their child bearing years or already pregnant. Several clinical data have indicated that the secretion and or proliferation of adrenocortical tumors may be affected by the hormonal context of pregnancy. In this review, we will examine the link between ACC and pregnancy in two main aspects. We will first consider the situation of a pregnant woman with a clinical suspicion of adrenocortical carcinoma: which diagnostic procedures will be useful and safe for the foetus? What are the therapeutic options? What is the prognosis if the diagnosis is confirmed? In a second part, we will examine the possible risk of mothering a child in a patient previously treated for an ACC...
June 2016: Annales D'endocrinologie
S F Murphy, L Lenihan, F Orefuwa, G Colohan, I Hynes, C G Collins
BACKGROUND: The discharge letter is a key component of the communication pathway between the hospital and primary care. Accuracy and timeliness of delivery are crucial to ensure continuity of patient care. Electronic discharge summaries (EDS) and prescriptions have been shown to improve quality of discharge information for general practitioners (GPs). The aim of this study was to evaluate the effect of a new EDS on GP satisfaction levels and accuracy of discharge diagnosis. METHODS: A GP survey was carried out whereby semi-structured interviews were conducted with 13 GPs from three primary care centres who receive a high volume of discharge letters from the hospital...
May 2017: Irish Journal of Medical Science
Kathleen M O'Neill, Morgan Mandigo, Jordan Pyda, Yolande Nazaire, Sarah L M Greenberg, Rowan Gillies, Ruth Damuse
BACKGROUND: Women with breast cancer in low-income and middle-income countries (LMICs) account for 51% of cases globally and often present with advanced disease. Fear of costs contributes to delay in seeking care, as health expenditures are financially catastrophic for families worldwide. Despite efforts to improve affordability of health care in LMICs, the financial burden of indirect costs (eg, transportation and lost wages) is often overlooked. We aimed to identify and quantify the expenditures of patients seeking breast cancer care in a LMIC...
April 27, 2015: Lancet
Alexi Matousek, Ken Paik, Eric Winkler, Jennifer Denike, Stephen R Addington, Chauvet Exe, Rodolphe R E Jean Louis, Robert Riviello
BACKGROUND: Absence of outcome data is a barrier to quality improvement in resource poor settings. To address this challenge, we set out to determine whether follow up for surgical site infections (SSIs) using community health workers (CHWs) and smartphones is feasible in rural Haiti. METHODS: In this pilot study, all patients from a specific mountain region who received an operation between March 10, and July 1, 2014, at Hôpital Albert Schweitzer in rural Haiti were eligible for inclusion...
April 27, 2015: Lancet
Kathleen M O'Neill, Morgan Mandigo, Jordan Pyda, Yolande Nazaire, Sarah L M Greenberg, Rowan Gillies, Ruth Damuse
BACKGROUND: Women in low- and middle-income countries account for 51% of breast cancer cases globally. These patients often delay seeking care and, therefore, present with advanced disease, partly because of fear of catastrophic health care expenses. Although there have been efforts to make health care affordable in low- and middle-income countries, the financial burden of out-of-pocket (OOP) expenses for nonmedical costs, such as transportation and lost wages, often is overlooked. METHODS: An institutional review board exemption was granted from Boston Children's Hospital and Partners in Health/Zanmi Lasante for this cross-sectional study...
September 2015: Surgery
M Clark, M Julmisse, N Marcelin, L Merry, J Tuck, A J Gagnon
AIM: The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. BACKGROUND: Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings...
March 2015: International Nursing Review
Andrée Daigneault, Catherine Duclos, Sybille Saury, Jean Paquet, Daniel Dumont, Serge Beaulieu
BACKGROUND: Studies suggest that misdiagnosis of bipolar disorders (BD) is frequent in primary care. This study aimed to evaluate agreement between referral for BD by general practitioners (GP) and BD diagnosis by secondary care psychiatrists, and to evaluate the impact of age, gender, and BD type on agreement. METHODS: The study was conducted at Hôpital du Sacré-Coeur de Montréal׳s "Module Evaluation/Liaison" (MEL), which establishes/clarifies psychiatric diagnoses requested mainly from GPs and directs patients to appropriate treatment and care...
March 15, 2015: Journal of Affective Disorders
Faiez Zannad, Philippe Maugendre, Antoine Audry, Carole Avril, Lucile Blaise, Olivier Blin, Philippe Burnel, Béatrice Falise-Mirat, Danièle Girault, Isabelle Giri, Jean-Marie Goehrs, Catherine Lassale, Roland Le Meur, Pierre Leurent, Christelle Ratignier-Carbonneil, Patrick Rossignol, Evelyne Satonnet, Pierre Simon, Laurent Treluyer
The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation...
July 2014: Thérapie
Sura Alwan, Magdalena Dybalski, Irene M Yee, Talitha M Greenwood, Elaine Roger, Nancy Nadeau, Pierre Duquette, A Dessa Sadovnick
OBJECTIVE: To determine whether different health care systems may affect reproductive decision-making among patients with Multiple Sclerosis (MS), we describe the reproductive practices and attitudes of Canadian MS patients ascertained from the multidisciplinary MS Clinic at Hôpital Notre-Dame in Montreal, Quebec (NDMSC), in comparison to those of matched American self-registrants from the database of the North American Research Committee on Multiple Sclerosis (NARCOMS). METHODS: A total of 665 self-administered questionnaires on reproductive practices were sent out to eligible attendees attending the NDMSC...
July 2013: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Denys Pellerin
In his opening remarks to Academy of Medicine meeting devoted to Chronic Intestinal Failure and Transplantation on 7 February 2012, Bernard Launois recalled that the first successful intestinal transplantation worldwide was performed in 1987, in France, at Hôpital Necker-Enfants-Malades in Paris. Having had the pleasure of leading this great adventure, and being modestly (and almost by accident) its initiator, Denys Pellerin recalls the circumstances, the difficulties and the vicissitudes of the successive phases...
March 2012: Bulletin de L'Académie Nationale de Médecine
S Bellaiche, R Di Blasio, J Luauté, S Jacquin-Courtois, D Boisson, K Charvier, L Tell, G Rode
A diagnosis of esophageal perforation at some time after cervical spine surgery is difficult to establish since there exists no clinical picture specific to tetraplegic patients. We carried out a detailed retrospective study of revelatory clinical manifestations and conventional radiographic data in a series of 16 patients hospitalized at Hôpital Henry-Gabrielle (Lyon, France) for rehabilitation purposes between 1983 and 2010 and who presented this complication. The most frequent clinical picture associates cervical pain, fever and dysphagia...
February 2013: Annals of Physical and Rehabilitation Medicine
Yehudit Kerner, Ygal Plakht, Arthur Shiyovich, Pnina Schlaeffer
Proper management of pain reduces morbidity, assists in recovery, and increases patient satisfaction. The role of a nurse in an accurate pain evaluation is pivotal. It seems that pain evaluation guidelines are not fully adhered to by nurses. The aim of this study was to assess the performance of pain evaluation and management by nurses in patients admitted in internal medicine wards and to identify groups of patients in which pain evaluation was insufficient. In this cross-sectional study medical records of 59 randomly chosen patients were reviewed: age 64...
December 2013: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
M Al-Khtib, T Blachère, J F Guérin, A Lefèvre
STUDY QUESTION: What is the methylation status of the Nanog and Oct4 promoters in human gametes and ICSI embryos and is abnormal reprogramming of their methylation associated with developmental failure of ICSI embryos? SUMMARY ANSWER: Developmental failure of human ICSI embryos is associated with high methylation of the Oct4 promoter. WHAT IS KNOWN ALREADY: Nanog and Oct4 genes play critical roles in the establishment and maintenance of pluripotency during normal early embryonic development, and both are negatively regulated through the methylation of their promoters...
October 2012: Human Reproduction
B T Dembélé, A Traoré, I Diakité, L Kanté, A Togo, A Maiga, M B Diarra, Y Coulibaly, M Kéita, D M Diango, G Diallo
UNLABELLED: The objectives were to determine the frequency, to describe the clinical, therapeutic aspects and to evaluate the cost of the assumption of responsibility of occlusions by supports and or adherences. It was about a retrospective study carried out in the department of surgery general of the CHU Hôpital Gabriel TOURE from January 1st, 2002 to December 2008. Were included in this study all the patients operated for occlusion of hail on Brides and Adherence confirmed in per operational...
2011: Le Mali Médical
Deepti Suri, Surjit Singh, Amit Rawat, Anju Gupta, Chikako Kamae, Kenichi Honma, Noriko Nakagawa, Kohsuke Imai, Shigeaki Nonoyama, Koichi Oshima, Noriko Mitsuiki, Osamu Ohara, Chrystéle Bilhou-Nabera, Alexis Proust, Jasmina Ahluwalia, Sunil Dogra, Biman Saikia, Ranjana Walker Minz, Shobha Sehgal
BACKGROUND: The Wiskott-Aldrich syndrome (WAS) is a rare X-linked immunodeficiency disorder characterized by thrombocytopenia with small sized platelets, eczema, and recurrent infections. There is paucity of information on WAS from the Indian subcontinent. We describe the clinical and molecular profile of 8 patients with WAS as seen in the Pediatric Immunodeficiency Clinic at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. METHODS: A detailed analysis of the clinical profiles, investigations and outcome of the 8 children diagnosed with WAS during the period 2006- 2010 was performed...
March 2012: Asian Pacific Journal of Allergy and Immunology
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