Intégration sociétale du peau-à-peau chez l'enfant prématuré et de petit poids pour réduire la mortalité et la morbidité

Le soin peau-à-peau permet une réduction de la mortalité néonatale dans les pays à faible revenu, alors que dans les pays à haut revenu il est justifié par la réduction de la morbidité et les bénéfices physiques et neurodéveloppementaux. Les bénéfices sociétaux, basés sur l'attachement, origine du lien familial, ont été préconisés depuis sa création, mais restent peu étudiés. La réalisation et les enjeux de notre programme Kangourou camerounais nous permettent de discuter ces liens sociétaux à la lumière de publications des pays à haut revenu

Pronostic des infarctus du tronc cerebral. [Prognosis in brain stem infarction]

A retrospective study of patients who suffered cerebrovascular accidents (CVA particularly brainstem damage) was conducted to look for risk factors which, present on admission, indicated the chance of survival. The evolution of 100 patients, hospitalized in the Neurology Department, University Hospital Lausanne, after having had their first CVA was studied. The risk factors chosen were age, sex, hypertension, smoker, late onset diabetes, hypercholesterolemia as well as the conscious state, the location of the lesion and whether it was bi- or unilateral. Analysis of the data was performed by means of a stepwise multiple logistic regression program. The results demonstrated that diabetes or bilateral lesions, regardless of their position in the brainstem, or the combination of these two factors, indicated an unfavorable outcome, associated with a short term mortality rate greater than 30%. In their absence and despite the presence of the other risk factors, it was less than 2%. At one month the mortality rate was shown to be very high. At two month it was non insignificant and thereafter it became similar to that of the Swiss population. Brainstem lesions extending to the vital centres or respiratory complications related to the state of dependence were the most common causes of short term deaths. At long term the aetiology of death was the same as for the population as a whole. Conclusion: The results obtained show the importance of the prevention and treatment of patients at risk of CVA, particularly diabetes. To avoid the fatal complications, that arise from severe handicap in bedridden patients, the management must be rapid and efficient (physiotherapy and drugs)

Morbidité et mortalité néonatale dans un hôpital de district urbain à ressources limités à Douala, Cameroun

In countries with limited health-care resources, achieving the fourth Millennium Development Goal recommended by the WHO requires the reduction of neonatal mortality. Interventions at different levels of the community and the health-care system are needed, including in district hospitals