Temps et satisfaction aux urgences

Peu d études traitent spécifiquement du temps d attente aux urgences. L objectif principal de l'étude a consisté en l'évaluation de la satisfaction du délai de prise en charge médicale.Patients et Méthodes293 patients des Urgences du CHU d Angers ont été inclus du 18 au 24 novembre 2013 après avoir répondu à un premier questionnaire avant de voir un médecin. Un deuxième questionnaire était complété par téléphone à J+7 de la sortie des urgences par le même Interne. 181 patients ont répondu au deuxième questionnaire. Le critère de jugement principal a été évalué sur la notation (de 0 à 10) de la satisfaction concernant le délai de prise en charge médicale.Résultats Les satisfactions moyennes concernant le délai de prise en charge médicale et la durée de prise en charge sont respectivement de 6,77 et 6,08/10. Les délais de prise en charge moyens envisagé, acceptable, réel et ressenti étaient respectivement de 63, 62, 74 et 86 minutes. 67 % des patients auraient mieux vécu leur attente si on leur avait annoncé le délai prévisionnel de prise en charge médicale dès l arrivée aux Urgences. Seulement 10 % des patients interrogés ont correctement estimé leurs délais de prise en charge médicale. Les examens biologiques, la réalisation de scanner ou la demande d'avis spécialisés allongent la durée de prise en charge de manière significative. Conclusion L obtention de l information concernant le délai de prise en charge médicale prévisionnel après évaluation par l infirmière d'accueil pourrait être un moyen d'améliorer la satisfaction des patients consultant aux urgences.Only few studies deal specifically with waiting time in emergencies departments. The main objective of the study consisted in evaluating the physician waiting time satisfaction. Patients and Methods We conducted this study from November 18th to 24th at Angers university hospital center. 293 Emergency department patients were included. They answered a first questionnaire from an Intern before seeing a doctor. The second questionnaire was completed by the same Intern on the phone seven days after the patient went out from the Emergency department. 181 patients answered the second questionnaire. The main assessment criterion was the rating (from 0 to 10) of the physician waiting time satisfaction Results The average satisfactions concerning the physician waiting time and total waiting time are respectively 6,77 and 6,08/10. The average physician waiting time imagined, acceptable, real and felt were respectively 63, 62, 74 and 86 minutes. Were they announced the projected waiting time at the moment of admission, 67 % of the patients would have had a better experience of their hospitalization. Only 10 % of the patients estimated correctly their physician waiting time. The biological examinations, the realization of scanner or the specialized requests lengthen significantly the duration of Emergency total waiting time. ConclusionThe obtaining of the information concerning the physician waiting time after evaluation by the nurse could be a way to improve patient satisfaction.ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Facteurs de risque de la gonarthrose (étude prospective de la qualité de vie et de ses moyens d'évaluation dans une population normale (étude Arthros))

CAEN-BU Médecine pharmacie (141182102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Effects of Polychlorinated Biphenyls on Liver Ultrastructure, Hepatic Monooxygenases, and Reproductive Success in the Barbel

Polychlorinated biphenyls (PCBs) are organochlorinated micropollutants ubiquitously distributed in the environment. They are known to be strong inducers of hepatic monooxygenases in fish. This can adversely affect reproduction by increasing steroid metabolism. In this work, adult barbels were contaminated with food containing Aroclor 1260, a commercial PCB mixture from Monsanto, at environmentally relevant concentrations. A significant increase in cytochrome P450 was observed, and two particularly sensitive enzymes, ethoxyresorufin o-deethylase (EROD) and ethoxycoumarin o-deethylase (ECOD), were strongly induced. Electron microscopy revealed alterations in liver ultrastructure in contaminated fish, principally an increase in the number of cisternae of the rough endoplasmic reticulum, drastic glycogen depletion, dissolution of mitochondrial contents, and appearance of myelin figures. Contamination was also studied in relation to reproductive success in a hatchery. Contaminated males displayed no alteration in milt quality, but PCBs did alter female reproductive parameters. Total mortality of eggs and larvae increased significantly with the level of PCBs in the eggs. The most highly contaminated fish did not even spawn. All the adverse effects recorded here tended to be reversible when the intoxication ended, sometimes after only a 1-year detoxication period

PCBs contamination of aquatic ecosystems related to reproductive success in a sensitive fish species, Barbus barbs

peer reviewedDuring two seasons, the effect of a food contamination by organochlorine micropollutants (PCBs) was related to the fertility and reproductive success in aquarium-reared common barbel. In male fish, no alteration of milt quality was observed: number and mobility of spermatozoa remained. On the other hand, PCBs induced modifications of female reproductive parameters : total mortality of eggs and larvae increased significantly with PCB level in the eggs. Moreover, the most contaminated fish did not even spawn. Such phenomena are likely to result from perturbation of steroid metabolism pathways due to the induction of liver mixed-function oxidase

Contamination of European otters (Lutra lutra) by PCB congeners and organochlorinated pesticides in the wetlands of western France

During the forty years, otter (Lutra lutra) populations have severely declined over much of Europe. One of the main regression factors appears to be pollution by organochlorine xenobiotics, especially PCBs. The present study took place in France, in the wetlands of the Atlantic border, where otter populations are considered to the stable. Muscle, pericaudal fat, and liver of 33 otters were analysed for 22 PCB congeners and organochlorine pesticides. The mean concentrations of organochlorinated pesticides in samples are relatively low (from 0 to 5.71 mg/kg lipid weight). The PCB concentrations are higher (mean in muscular tissue: 26.19 mg/kg lipid weight), but still remain low compared to similar samples from other countries. The relation between PCB concentration and physiological variables is discussed. Congener specific analysis shows an important contamination due to highly chlorinated congeners and a poor contaminatin due to low chlorinated congeners. Potential hazards due to organochlorinated compounds are also discussed

PCBs contaminatie van de noordzee : concentraties en fluxes

Les biphényles polychlorés ou PCBs ont eu de très nombreuses applications industrielles en raison de leur stabilité et de leurs excellentes propriétés diélectriques. Vu leurs impacts sur l'écosystème, leur utilisation a été fortement restreinte en 1986. cette étude avait pour but de déterminer quelques années après leur quasi interdiction leur transfert d'un compartiment à l'autre de l'écosystème, et, in fine, les flux de PCBs vers la mer du nord

Summary of the instances of thermal striping observed on Phenix and lessons learned from this

Translated from French; Paper at LIMET Conf., Oct 1988SIGLEAvailable from British Library Document Supply Centre- DSC:9091.9F(Risley-Trans--5736)T / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Effects on Pcbs on Liver Ultrastructure and Monooxygenase Activities in Japanese Quail

HH/12/046 Health Hazards Impulse Programm

Otter and eel contamination by PCBs and organochlorinated pesticies in western France

Organochlorinated pesticides and PCBs were identified in 32 otter carcasses (road casualties) found in the wetlands of western France. The contamination levels are relatively low compared to those found in other otter European populations. As eel is the main prey of otters in that area, samples of that fish from the Marais poitevin were analysed too. They also show a low level of contamination by these compounds, their PCB congener pattern being different

Contamination par les PCBs et les pesticides organochlorés des poissons du Grand-Duché de Luxembourg : incidence possible sur les populations de loutre (

Les niveaux de contamination en pesticides organochlorés mesurés dans les poissons des rivières luxembourgeoises sont peu élevés, à l'exception des concentrations en lindane, pp'DDE et pp'DDT dans la basse-Sûre et ses affluents. Toutefois, ces concentrations ne sont pas particulièrement inquiétantes pour la santé humaine ou pour la survie des loutres. Les concentrations de PCBs mesurées dans les poissons des rivières sont comprises entre 50 et 3500 ng/g P.F., et sont extrêmement variables selon les cours d'eau et les espèces considérés. Dans le lac d'Esch-sur-Sûre, les concentrations sont plus faibles (10 à 200 ng/g P.F.), probablement parce qu'il s'agit d'individus qui ont fait l'objet de rempoissonnements. Dans les populations de poissons des rivières luxembourgeoises, les PCBs sont donc non seulement présents à des concentrations considérées comme problématiques ou dangereuses pour la survie des loutres, mais les standards de consommation pour la santé humaine sont aussi régulièrement dépassés dans les anguilles et chevesnes