RED BLOOD CELL TRANSFUSION IN VERY LOW BIRTH WEIGHT INFANTS AND/OR INFANTS LESS THAN 32 WEEKS OF GESTATIONAL AGE – 4 YEARS EXPERIENCE IN A NEONATAL INTENSIVE CARE UNIT

Introduction: Anemia is a common problem in preterm infants; red blood cell (RBC) transfusion is the most quick and efficient treatment. The aim of this study was the evaluation of the 2004 National Neonatal Guidelines application in the neonatal intensive care unit and the evaluation of morbidity of transfused or non-transfused preterm. Materials and Methods:Retrospective chart review of preterm infants with birth weight (BW) ≤1500 g and/or gestational age (GA) ≤32 weeks admitted in NICU between January 2010 and December 2013. Patients were divided into two groups according to RBC transfusions (transfusion group and non-transfusion group). BW, GA, gender and Apgar score <7 at 1st and 5th minutes were analyzed. Morbidity indicators included bron chopulmonary dysplasia (BPD), sépsis, persistence of ductus arteriosus (PDA), necrotizing enterocolitis, peri-intraventricular hemorrhage (PIVH), periventricular leukomalacia (PVL) and reti nopathy of prematurity. Results: 160 infants were enrolled in the study: 88 in the transfusion group and 72 in the non-transfusion group. In the transfusion group, GA and BW were lower and length of stay in hospital was higher. RBC transfusions were prescribed for higher haemoglobin levels in neonates in invasive ventilation and with less days of life. BPD, sépsis, PDA, PVL and PIVH were more common in the transfusion group. Discussion and Conclusion: RBC transfusions were more frequently used in preterm infants with lower GA and BW. Transfusion criteria applied were consistent with National Neonatal Guidelines in 2004. The transfused preterm infants had higher morbidity

Ventilação Não Invasiva: Três Anos de Experiência de Uma Unidade de Cuidados Intermédios Pediátricos

Introdução: A ventilação não invasiva (VNI) tem sido utilizada de forma crescente em crianças com insuficiência respiratória aguda (IRA), evitando as complicações associadas à ventilação invasiva (VI). Existem poucos dados acerca da sua utilização fora das unidades de cuidados intensivos pediátricos (UCIP). Pretendemos descrever a nossa experiência na utilização da VNI numa Unidade de Cuidados Intermédios (UCINT) e avaliar a sua eficácia em evitar a transferência das crianças para uma UCIP.Métodos: Estudo longitudinal retrospetivo de todas as crianças admitidas na UCINT e submetidas a VNI (2012-2015). Foram analisados dados demográficos e os parâmetros frequência respiratória (FR), frequência cardíaca (FC), parâmetros gasimétricos (pH e PaCO2) e relação SpO2/FiO2 antes e duas, quatro, seis, 12 e 24 horas após inicio da VNI. Os doentes foram divididos em dois grupos: sucesso vs insucesso da VNI, de acordo com a necessidade de transferência para uma UCIP.Resultados: Incluídas 35 crianças, com mediana de idade 42 dias. O diagnóstico principal foi bronquiolite em 28 doentes e a indicação para iniciar a VNI foi IRA hipoxémica e/ou hipercápnica em 32. Vinte e nove (82,9%) foram eficazmente ventilados e seis necessitaram de ser transferidos para uma UCIP. Verificou-se uma melhoria da FR, FC, pH e PaCO2 a partir das duas horas de VNI no grupo de sucesso (p&lt;0,05). A descida da PaCO2 foi o primeiro parâmetro a apresentar diferença significativa entre os dois grupos.Discussão: Confirmamos a eficácia da VNI em evitar o agravamento clínico das crianças com IRA, prevenindo a necessidade de VI e/ou transferência para uma UCIP

SOphrology Intervention to Improve WELL-Being in Hospital Staff (SO-WELL): Protocol for a Randomized Controlled Trial Study

Introduction: Stress at work and psychosocial risks are a major public health problem. Sophrology and neurolinguistic programming (NLP) have demonstrated benefits in terms of mental, physical and social health, both in the general population and in patients, and both in and out of hospital settings. However, these approaches have never been provided at the hospital for the benefit of health professionals at risk of suffering at work. In general, we aim to demonstrate the effectiveness of a hospital sophrology/NLP intervention for health care professionals at risk of stress-related disorders. The secondary objectives are to study (i) within-group, and (ii) between-group): (1) effects on mental, physical, and social health; (2) persistence of effect; (3) relationships between job perception and mental, physical, and social health; (4) intervention success factors (personality and job perception, attendance and practice, other); (5) effects on other stress biomarkers (other measures of autonomic nervous system activity, DHEAS, cortisol, etc.). Methods: Our study will be a randomized controlled prospective study (research involving the human person of type 2). The study will be proposed to any health-care workers (HCW) or any non-HCW (NHCW) from a healthcare institution (such as CHU of Clermont-Ferrand, other hospitals, clinics, retirement homes). Participants will benefit from NLP and sophrology interventions at the hospital. For both groups: (i) heart rate variability, skin conductance and saliva biomarkers will be assessed once a week during the intervention period (6 to 8 sophrology sessions) and once by month for the rest of the time; (ii) the short questionnaire will be collected once a week during the whole protocol (1–2 min); (iii) the long questionnaire will be assessed only 5 times: at baseline (M0), month 1 (M1), month 3 (M3), month 5 (M5) and end of the protocol (M7). Ethics and dissemination: The protocol, information and consent form had received the favorable opinion from the Ethics Committee. Notification of the approval of the Ethics Committee was sent to the study sponsor and the competent authority (ANSM). The study is registered in ClinicalTrials.gov under the identification number NCT05425511 after the French Ethics Committee’s approval. The results will be reported according to the CONSORT guidelines. Strengths and limitations of this study: The psychological questionnaires in this study are self-assessed. It is also possible that responses suffer from variation. For the study, participants need to attend 6 to 8 sophrology sessions and one visit per month for 7 months, which might seem demanding. Therefore, to make sure that participants will complete the protocol, two persons will be fully in charge of the participants’ follow-up

Time and Covid-19 stress in the lockdown situation: Time free,«Dying» of boredom and sadness.

International audienc

COVID‐19 lockdown consequences on body mass index and perceived fragility related to physical activity: A worldwide cohort study

International audienceBackground: This paper is a follow-up study continuing the COVISTRESS network previous research regarding health-related determinants.Objective: The aim was to identify the main consequences of COVID-19 lockdown on Body Mass Index and Perceived Fragility, related to Physical Activity (PA), for different categories of populations, worldwide.Design: The study design included an online survey, during the first wave of COVID-19 lockdown, across different world regions.Setting and participants: The research was carried out on 10 121 participants from 67 countries. The recruitment of participants was achieved using snowball sampling techniques via social networks, with no exclusion criteria other than social media access.Main outcome measures: Body Mass Index, Physical Activity, Perceived Fragility and risk of getting infected items were analysed. SPSS software, v20, was used. Significance was set at P < .05.Results: Body Mass Index significantly increased during lockdown. For youth and young adults (18-35 years), PA decreased by 31.25%, for adults (36-65 years) by 26.05% and for the elderly (over 65 years) by 30.27%. There was a high level of Perceived Fragility and risk of getting infected for female participants and the elderly. Correlations between BMI, Perceived Fragility and PA were identified.Discussion and conclusions: The research results extend and confirm evidence that the elderly are more likely to be at risk, by experiencing weight gain, physical inactivity and enhanced Perceived Fragility. As a consequence, populations need to counteract the constraints imposed by the lockdown by being physically active

Changes in Cannabis Consumption During the Global COVID-19 Lockdown: The International COVISTRESS Study

Introduction: COVID-19 lockdown measures have been sources of both potential stress and possible psychological and addiction complications. A lack of activity and isolation during lockdown are among the factors thought to be behind the growth in the use of psychoactive substances and worsening addictive behaviors. Previous studies on the pandemic have attested to an increase in alcohol consumption during lockdowns. Likewise, data suggest there has also been a rise in the use of cannabis, although it is unclear how this is affected by external factors. Our study used quantitative data collected from an international population to evaluate changes in cannabis consumption during the lockdown period between March and October, 2020. We also compared users and non-users of the drug in relation to: (1) socio-demographic differences, (2) emotional experiences, and (3) the information available and the degree of approval of lockdown measures. Methods: An online self-report questionnaire concerning the lockdown was widely disseminated around the globe. Data was collected on sociodemographics and how the rules imposed had influenced the use of cannabis and concerns about health, the economic impact of the measures and the approach taken by government(s). Results: One hundred eighty two respondents consumed cannabis before the lockdown vs. 199 thereafter. The mean cannabis consumption fell from 13 joints per week pre-lockdown to 9.75 after it (p < 0.001). Forty-nine respondents stopped using cannabis at all and 66 admitted to starting to do so. The cannabis users were: less satisfied with government measures; less worried about their health; more concerned about the impact of COVID-19 on the economy and their career; and more frightened of becoming infected in public areas. The risk factors for cannabis use were: age (OR = 0.96); concern for physical health (OR = 0.98); tobacco (OR = 1.1) and alcohol consumption during lockdown (OR = 1.1); the pre-lockdown anger level (OR = 1.01); and feelings of boredom during the restrictions (OR = 1.1). Conclusion: In a specific sub-population, the COVID-19 lockdown brought about either an end to the consumption of cannabis or new use of the drug. The main risk factors for cannabis use were: a lower age, co-addictions and high levels of emotions.publishedVersio