Etat des lieux de la prise en charge de l'adolescente enceinte dans les hôpitaux suisses

Introduction :¦Une grossesse chez l'adolescente est définie selon l'Office Fédéral de la Statistique (OFS) comme une grossesse survenant avant l'âge de 20 ans. Dans notre étude, nous avons choisi d'étudier plus particulièrement les grossesses d'adolescentes de moins de 18 ans, l'âge de la majorité civile étant fixé à 18 ans selon le Code pénal suisse. En Suisse, en 2009, ont eu lieu 647 naissances d'enfants de mères de moins de 20 ans (OFS). Plus rares sont les naissances de mères de moins de 18 ans ; entre 2005 et 2009, elles étaient 461 à donner naissance(OFS). Dans la littérature, la controverse est grande au sujet d'un éventuel risque augmenté de complications obstétricales et néonatales lors de grossesses à l'adolescence. Des programmes adaptés à la¦Prise en charge de l'adolescente enceinte ont été mis en place dans de nombreux pays et ont démontré des bénéfices par l'amélioration des perspectives sociales, éducationnelles et médicales de ces jeunes filles.¦But de l'étude :¦Cette recherche se divise en trois parties dont les objectifs sont bien distincts :¦I. Analyse Statistique des données suisses du point de vue médical et psychosocial concernant les grossesses et les accouchements chez les adolescentes.¦II. Identifier La présence en Suisse De spécialistes et/ou de programmes spécifiques pour la prise en charge de l'adolescente enceinte.¦III. Explorer En parallèle le vécu individuel par rapport au suivi de grossesse d'une jeune fille concernée.¦Méthode:¦I. Analyse Statistique des données de l'Association des Cliniques De Gynécologie-ˇ‐Obstétrique Suisse (AGOS).¦II. Envoi De questionnaires via programme LimeSurvey A 85 professionnels en Suisse, Répartis selon quatre corps de métiers: médecins cadre en gynécologie-ˇ‐obstétrique sans formation spécifique relative à l'adolescente, médecin gynécologue-ˇ‐obstétricien ayant une formation spécifique en gynécologie de l'adolescente, sages-°©‐femmes, assistantes sociales (taux de réponses: 63%, n=54).¦III. Entretien Structuré avec une jeune femme ayant accouché avant l'âge de 18 ans.¦Résultats:¦I.Selon Les données de l'Association des Cliniques De Gynécologie-ˇ‐Obstétrique Suisse, Il n'y a pas d'augmentation significative des complications obstétricales et néonatales lors de grossesses chez les adolescentes. Toutefois, Les différences se situent plutôt sur le plan des dépendances aux substances et des issues psychosociales des grossesses.¦II. Une part importante des adolescentes enceintes est prise en charge par des professionnels non spécifiquement formés en médecine de l'adolescence. Malgré cela, nous constatons une volonté générale de porter une attention particulière à ces grossesses avec la mise en place d'une prise en charge individualisée. De plus, le suivi est le plus souvent multidisciplinaire. La Plupart des professionnels non spécifiquement formés prenant en charge ces patientes pensent que les structures non spécialisées actuelles suffisent. En Suisse, Les principaux obstacles au développement de structures spécifiques sont le petit nombre de patientes potentielles et les faibles moyens financiers à disposition pour de tels projets.¦III. Organiser Les rencontres avec les adolescentes s'est avéré difficile, plusieurs adolescentes ne s'étant pas présentées aux rendez‐vous convenus malgré un consentement initial spontané. L'unique Adolescente qui a finalement pu être interviewée a bénéficié d'une prise en charge multidisciplinaire, principalement au CHUV. Questionnée Sur le regard qu'elle portait sur le suivi, elle s'est dite satisfaite tout en souhaitant que plus d'attention soit accordée à ses désirs. Cependant, La nécessité de protéger l'enfant est souvent un facteur limitant l'accès aux demandes des adolescentes

Structural Transition During Fibrillogenesis of Amyloid β Peptide

Alzheimer’s Disease (AD) is a neurodegenerative disease marked by progressive neuronal cell death, leading to dementia. AD is the most common disease that results in dementia and largely affects the elderly, with five million people in the United States diagnosed with the disease as of 2015 and approximately 35 million people worldwide. Diseases resulting in dementia cost the US healthcare system an estimated $172 billion in 2010 and that cost is expected to increase as the population ages and as diagnostic techniques improve so that more people are treated (Holtzman, 2011). The disease was first reported by psychiatrist Alois Alzheimer at the onset of the 20th century, when one of his patients “suffered memory loss, disorientation, hallucinations and delusions and died at the age of 55,” then was found to have severe brain atrophy post-mortem (Cipriani, Dolciotti, Picchi, & Bonuccelli, 2011). There are palliative treatments available that marginally slow disease progression but there is currently no cure for the disease (Awasthi, Singh, Pandey, & Dwivedi, 2016). More research is needed to develop effective therapeutic strategies to combat the disease. Currently, AD cytotoxicity is believed to be caused by increased amyloid β (Aβ) peptide plaque deposition in the brain, as described by the amyloid cascade hypothesis (Barage & Sonawane, 2015). The current understanding is that oligomers of Aβ peptide lead to neuronal death through multiple mechanisms, most notably hyper-phosphorylation of the tau protein. Having a better understanding of the structural changes in the fibrillization process of Aβ will provide a broader insight into mechanisms of cell death and open new possibilities for pharmacological treatments, which is what this research intends to provide

Revisión sistemática en procedimientos de uniones soldadas

RESUMEN Siempre que se va a realizar una unión soldada se hace necesario un procedimiento, es por ello que en este estudio nos enfocaremos en lo que refiere a la realización de un procedimiento de uniones soldadas con el objetivo de poder responder a los diversos vacíos que se tiene sobre este tema. A este respecto, Hernández dice que. El soldeo es el proceso de unión por el que se establece la continuidad entre las partes a unir con o sin calentamiento, con os in aplicación de presión y con o sin material de aporte. Los documentos que se eligieron fueron los que se refieren a los diferentes procesos de soldadura, composición de materiales, simbología y calificación de soldadores, por ser el principal conocimiento que se debe tener para poder realizar un procedimiento de soldadura, el periodo de antigüedad de documentos es como máximo tres años. En el afán de encontrar respuesta al vacío de conocimiento que se tiene respecto a cómo poder realizar de la mejor manera un procedimiento en cual fuere la unión a ser soldada, se realiza esta investigación sobre este tema de gran importancia para las personas que tienen a cargo dicho proceso. PALABRAS CLAVE: procedimiento, uniones soldadas, material base, temperatura

A metastable wet steam turbine stage model

Abstract A model for the prediction of the efficiency of axial flow steam turbine stage is described, where the flow through turbine cascade is considered non-homogeneous and metastable. At the exit an oblique shock brings it to equilibrium. The losses in the cascade are expressed according to Dunham and Came (Trans. ASME (1970)) and Kacker and Okapuu (J. Eng. Power (1982)) which is imprivemente of Ainley and Mathieson (1951) method. Two phase flow frictional multiplier is used as a correction factor for pressure coefficient. The model is compared with data of performance evaluation of large steam turbines of PWR power plants and results shows a good agreement

Mejora en los procesos de producción de cuy en criaderos y su impacto en la productividad, valle de Condebamba, 2021

La presente investigación tuvo por objetivo principal determinar el impacto de la mejora de la producción de cuy en criadero, en la productividad Valle de Condebamba, así mismo se planteó la hipótesis general el diseño de la mejora de la producción de cuyes en criadero, impacta positivamente en la productividad, Valle Condebamba, con una población de 120 cuyes promedio mensuales bajo un muestreo probabilístico con un error del 3· se eligió 108 cuyes, bajo una metodología cuasi experimental donde se lleva un grupo control y un grupo de experimento se procedió a plantear protocolos y diagramas de flujo que probaron la hipótesis, así mismo se realizó un análisis descriptivo para la variable independiente y una análisis inferencial para la variable dependiente obteniéndose como resultado un impacto positivo de la producción en la productividad, en el criadero Valle Condebamba, así manifiestan la contrastación de hipótesis bajo la metodología cuasi experimental estipulada en el presente estudio

Fibroblast activation protein inhibitor (FAPI)-based theranostics-where we are at and where we are heading: a systematic review

Cancer is the leading cause of death around the globe, followed by heart disease and stroke, with the highest mortality to this day. We have reached great levels of understanding of how these various types of cancer operate at a cellular level and this has brought us to what we call "precision medicine" where every diagnostic examination and the therapeutic procedure is tailored to the patient. FAPI is among the new tracers that can be used to assess and treat many types of cancer. The aim of this review was to gather all the known literature on FAPI theranostics. A MEDLINE search was conducted on four web libraries, PUBMED, Cochrane, Scopus, and Web of Sciences. All of the available articles that included both diagnoses and therapy with FAPI tracers were collected and put through the CASP (Critical Appraisal Skills Programme) questionnaire for systematic reviewing. A total of 8 records were deemed suitable for CASP review, ranging from 2018 to November 2022. These studies were put through the CASP diagnostic checklist, in order to assess the goal of the study, diagnostic and reference tests, results, descriptions of the patient sample, and future applications. Sample sizes were heterogeneous, both for size as well as for tumor type. Only one author studied a single type of cancer with FAPI tracers. Progression of disease was the most common outcome, and no relevant collateral effects were noted. Although FAPI theranostics is still in its infancy and lacks solid grounds to be brought into clinical practice, it does not show any collateral effects that prohibit administration to patients, thus far, and has good tolerability profiles

PET imaging of neuro-inflammation with tracers targeting the translocator protein (TSPO), a systematic review: from bench to bedside

Parkinson’s disease is the second most common neurodegenerative disorder, affecting 2–3% of the population of patients >65 years. Although the standard diagnosis of PD is clinical, neuroimaging plays a key role in the evaluation of patients who present symptoms related to neurodegenerative disorders. MRI, DAT-SPECT, and PET with [18F]-FDG are routinely used in the diagnosis and focus on the investigation of morphological changes, nigrostriatal degeneration or shifts in glucose metabolism in patients with parkinsonian syndromes. The aim of this study is to review the current PET radiotracers targeting TSPO, a transmembrane protein that is overexpressed by microglia in another pathophysiological process associated with neurodegenerative disorders known as neuroinflammation. To the best of our knowledge, neuroinflammation is present not only in PD but in many other neurodegenerative disorders, including AD, DLB, and MSA, as well as atypical parkinsonian syndromes. Therefore, in this study, specific patterns of microglial activation in PD and the differences in distribution volumes of these radiotracers in patients with PD as compared to other neurodegenerative disorders are reviewed

Radiolabeled dendrimer coated nanoparticles for radionuclide imaging and therapy: a systematic review

Background: Dendrimers are nanoscale-size polymers with a globular structure. They are composed of an internal core and branching dendrons with surface active groups which can be functionalized for medical applications. Different complexes have been developed for imaging and therapeutic purposes. This systematic review aims to summarize the development of newer dendrimers for oncological applications in nuclear medicine. Methods: An online literature search was conducted on Pubmed, Scopus, Medline, Cochrane Library, and Web Of Science databases selecting published studies from January 1999 to December 2022. The accepted studies considered the synthesis of dendrimer complexes for oncological nuclear medicine imaging and therapy. Results: 111 articles were identified; 69 articles were excluded because they did not satisfy the selection criteria. Thus, nine duplicate records were removed. The remaining 33 articles were included and selected for quality assessment. Conclusion: Nanomedicine has led researchers to create novel nanocarriers with high affinity for the target. Dendrimers represent feasible imaging probes and therapeutic agents since, through the functionalization of external chemical groups and thanks to the possibility to carry pharmaceuticals, it can be possible to exploit different therapeutic strategies and develop a useful weapon for oncological treatments