Instruments for the identification of patients in need of palliative care: protocol for a systematic review of measurement properties.

The objective of this review is to provide a comprehensive overview of the psychometric properties of available clinician-reported instruments developed to identify patients in need of general and specialized palliative care in acute care settings. Identification of patients in need of palliative care has been recognized as an area where many health care professionals need guidance. Differentiating between patients who require general palliative care and patients with more complex conditions who need specialized palliative care is particularly challenging. To our knowledge, no dedicated instruments are available to date to assist health care professionals to make this identification. Included studies will report on i) instruments aiming to identify patients in need of palliative care, ii) adult patients in need of palliative care in acute-care settings, iii) clinician-reported outcome measures, or iv) the development process or one or more of its measurement properties. Studies conducted in intensive care units, emergency departments, or nursing homes will be excluded. We will search for studies published in English and French in a variety of sources, including Embase, Medline Ovid SP, PubMed, CINAHL EBSCO, Google Scholar, government websites, and hospice websites. All citations will be screened and selected by two independent reviewers. Data extraction, quality assessment, and syntheses of included studies will be performed according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria. PROSPERO CRD42020150074

Right ventricular outflow tract tachycardia worsened during pregnancy

We report the case of a 35 years old woman without underlying heart disease who was diagnosed with a right ventricular outflow tract tachycardia worsened during pregnancy. The diagnosis of ventricular tachycardia was made early in her pregnancy course but the patient had symptoms three months earlier. Her disease course was marked by rhythmic storms during the second trimester of pregnancy that led to three hospitalizations accounting for about two weeks in total. The combination of nadolol 80 mg and flecainide tablets 150 mg improved her rhythmic storms. Radiofrequency allowed a radical cure of this ventricular tachycardia. The patient is now asymptomatic 27 months after radiofrequency treatment

Traditional Adaptation Strategies to Hydrosystem Degradation for Sustainable Management of the Aheme Lake in Benin (West Africa)

The water system like the lake Aheme are abundant in halieutic species (fish, crabs, shrimps…) exploited by resident populations. Over exploitation and high degradation of ecosystems of the lake Aheme induce inexorably fish productivity reduction. Halieutic production reduction generates a subsequent fall of incomes of the households depending primarily on the fishery activities. The fall of halieutic production involves today significant migratory movements of the fishermen and socioeconomic problem. Thus, adaptation strategies are developed for sustainable management of the lake Aheme. These strategies consist in holding as sacred a part of the lake with the divinity Avlekete, fishing holes creation and mangrove restoration. Sacred lake park called ‘’Avlekete-tin’’ is the most important traditional strategy. These endogenous methods of ecological conservation constitute actually effective strategies of productivity and fishing development on the Aheme lake

Epidemiology of at-risk alcohol use and associated comorbidities of interest among community-dwelling older adults: a protocol for a systematic review.

There is little epidemiological evidence and knowledge about at-risk alcohol use among community-dwelling older adults and their chronic and acute alcohol-related comorbidities of interest. This systematic review will summarise and examine relevant studies about the epidemiology of at-risk alcohol use and associated comorbidities of interest in this population. We will search the following databases, without language or date restrictions, from inception to 31 August 2019: Embase.com, Medline Ovid SP, Pubmed (NOT medline[sb]), CINAHL EBSCO, PsycINFO Ovid SP, Central-Cochrane Library Wiley and Web of Science (Core Collection). Search strategies will be developed in collaboration with a librarian. We will use predefined search terms for alcoholism, epidemiology, the elderly, living place and comorbidities of interest, as well as terms related to the identification of "measurements", "tools" or "instruments" for measuring harm from alcohol use. At-risk status will be determined by the amount of alcohol consumed and any comorbidities of interest associated with at-risk alcohol use, with the latter being documented separately or using an assessment tool for at-risk drinking. We will also examine the bibliographies of all the relevant articles found and search for unpublished studies. We will consider publications in all languages. No ethical approval is necessary. Results will be presented in national and international conferences on addiction and published in a peer-reviewed journal. CRD42018099965

Le syndrome des ovaires micropolykystiques chez les femmes infertiles à Cotonou :Résultats de la prise en charge de 74 cas

Le but de l’étude est de déterminer les éléments du diagnostic du syndrome des ovaires micropolykystiques chez les femmes infertiles à Cotonou, analyser les modalités du traitement et établir le pronostic. C’est une étude prospective, longitudinale à but descriptif et analytique sur une période de 12 mois, du 1er janvier 2010 au 31 décembre 2010. Elle a porté sur des femmes suivies pour infertilité et répondant aux critères PCOS (polycystic ovary syndrome). Les principaux signes cliniques étaient la spanioménorrhée 61 sur 74, l’hirsutisme et l’acné dans les mêmes proportions 35 sur 74. Les critères échographiques ont été retrouvés chez toutes les patientes. Le taux de testostérone était élevé chez 55 sur 60. Les mesures hygiéno-diététiques n’ont pas été observées par toutes les patientes. La metformine a été utilisée chez 50 sur 74. Aucune patiente n’a bénéficié du « drilling » ovarien. Le cycle menstruel a été régularisé dans 34 cas, 15 grossesse ont été enregistrées

Risk factors for mood disorders among offspring of parents with bipolar disorder: Findings from a discordant-sibling study.

The purpose of this naturalistic, prospective study was to identify risk factors for mood disorders in offspring of parents with bipolar disorder (BPD) using the discordant-sibling design by comparing premorbid psychopathology or symptoms, temperament, personality traits and coping style as well as the perception of family-related characteristics among affected and unaffected siblings within the same family. This approach controls for confounding by unmeasured genetic and environmental factors shared within families. Our sample comprised 24 families of a parent with BPD with at least one child that developed BPD or major depressive disorder (n = 31), and at least one child who did not. Offspring were followed for a mean duration of 16.2 (s.d: 4.6) years. Information was collected from the offspring themselves. Generalized linear mixed models only revealed differences in three dimensions of the Dimension of Temperament Survey-Revised (DOTS-R) version: Offspring with mood disorders scored higher on "Approach-withdrawal", "Rhythmicity for daily habits", and "Task orientation" than their unaffected siblings. The higher scores, and not lower scores as expected, on these temperament dimensions observed in offspring that subsequently developed mood disorders may reflect increased vulnerability, but they could also mirror premorbid mood swings or strategies to cope with them

Growth factor concentrations and their placental mRNA expression are modulated in gestational diabetes mellitus: possible interactions with macrosomia

<p>Abstract</p> <p>Background</p> <p>Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the <it>in-utero </it>regulation of foetal growth.</p> <p>Methods</p> <p>30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, <it>i.e</it>., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, <it>i.e</it>., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR.</p> <p>Results</p> <p>The serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, <it>i.e</it>., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women.</p> <p>Conclusions</p> <p>Our results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.</p

Lutte contre l'érosion pluviale : Cas de la commune urbaine d'Abomey-Calavi.

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Extrêmes, normes et variabilité hydroclimatique dans le bassin versant de l’Ouémé à l’exutoire de Bonou au Bénin.

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