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Introduction. Currently, there is a steadily increasing trend in losses due to flooding. Nevertheless, global warming, followed by an inevitable overuse of river valleys might further contribute to an increase in the frequency and destructive power of floods. It is quite important to trace the cause and effect chain of the economic, social and ecological impacts during the flood hazard. Material and methods. A bibliographic research was carried out by using historical and descriptive methods based on the keywords, underlining the medical, social and economic significance of the present issue. Results. There are 57 natural lakes and about 3 400 artificial water reservoirs found on the territory of the Republic of Moldova, including 90 amounting to over 1 million m3 per each. The accumulation basins help in preventing and combating overflows and flooding during spring and summer periods. Most of the dams do not comply with the technical norms, as they do not have channels of respite and drainage, thus, a dam failure on top dike might generate the collapse of the others at the lower watercourse, resulting in disastrous consequences. Therefore, individual health protection measures and appropriate population behavior are vitally important in catastrophic floods. Conclusions. Over the last decades, the floods occurring in the Republic of Moldova have conditioned the need to increase interventions for the prevention and reduction of both economic and human losses both at national and international levels.

Introduction: The occurrence of multimorbidity concerns more and more people living with HIV (PLWHIV) and its frequency increases with age. General practitioners should occupy a central place in the out-of-hospital follow-up of elderly PLWHIV with multimorbidities. Our study aims to understand the actual position of general practitioners and the barriers they encounter in the management of elderly PLWHIV with multimorbidities., Methods: This sub-study of the ANRS EP66-SEPTAVIH sancillary tudy, which assesses frailty in PLWHIV aged 70 years and over, is based on in-depth interviews with general practitioners and PLWHIV aged 70 years and over. The data were processed manually. Themes and sub-themes were identified and tabulated before being subjected to a cross-sectional thematic analysis., Results: Based on 30 interviews conducted between April 2020 and June 2021 with 10 general practitioners and 20 PLWHIV aged 70 years and over and with multiple diseases, this study identifies the difficulties that general practitioners encounter in fully participating in the care. The follow-up of these patients is characterized by symbolic partitions between groups of professionals: organizational fragmentation between general practitioners and specialists, fear of encroaching on the role of the other health professionals, and frequent absence of formalization of roles in the coordination of care., Conclusions: In order to promote optimal follow-up and improve the experience of elderly PLWHIV, it is important that the role of each stakeholder be better defined for better shared follow-up.

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Résumé: La pubalgie est une pathologie fréquente chez le sportif mais sa prise en charge reste pourtant un challenge. Sur le plan international, les terminologies s’harmonisent peu à peu et une volonté de créer des examens cliniques sensibles, spécifiques et reproductibles ainsi que des moyens de suivi thérapeutique validés émerge et devrait permettre la publication de travaux de plus haut niveau de preuve dans un proche avenir. Cette région anatomique est complexe et la physiopathologie reste discutée. Le diagnostic de pubalgie est un diagnostic d’élimination qui est posé suite à une démarche diagnostique rigoureuse. Quatre grandes entités anatomiques sont regroupées sous le terme de pubalgie. Cette dernière, dans de nombreux cas, présente une forme associée et le clinicien s’attache à proposer une cartographie précise des sites lésionnels. Il guide ainsi la prise en charge de rééducation qui est le plus souvent le traitement de première intention. Enfin par un suivi régulier, il évalue l’évolution des symptômes et opte si nécessaire pour un traitement chirurgical en cas d’échec ou de lésions ne répondant que partiellement au traitement conservateur. Une prise en charge multidisciplinaire centrée sur l’athlète permet un retour aux activités physiques sans douleur après plusieurs mois. [ABSTRACT FROM AUTHOR]

Abstract: Two types of scoliosis have been described in adults: adult idiopathic scoliosis (AIS), as an outcome for child scoliosis, and degenerative scoliosis (DS), of late onset. These two entities are difficult to distinguish after 50 years. Menopause is a critical period for DS. In both types functional outcome is severe as a consequence of pain related to rotatory subluxation, of lateral and sagittal unbalance, of cosmetic damages, and mainly with respect to protracted disease. Radiological survey needs a 3D approach because of complex spine deformity. Treatment is aiming at the restoration of spinal balance, to slow or stop outcome and to reduce pain. Medical management includes rehabilitation, guided joint injections, and brace. Non-surgical management is important and should be considered with surgical procedures, risky in elderly patients. Early diagnostic and management are essential in scoliosis. [Copyright &y& Elsevier]

soon as pregnancy has been confirmed, the members of the health care team must question the patient about alcohol consumption (similarly for lifestyle, smoking, medication and use of illicit substances). In France, alcohol, tobacco and cannabis are the three substances which are most frequently used. If the patient is found to be taking one of them, then inquiries should be made about the others. Alcohol is teratogenic and is the most dangerous of the addictive agents for the foetus. Ante-partum exposure to alcohol has damaging effects ranging from foetal alcohol syndrome (FAS) to related problems resulting from the effects of alcohol on the foetus. FAS is the main nongenetic cause of avoidable mental retardation. The prevention of the range of disorders caused by foetal exposure to alcohol (FASD-foetal alcohol spectrum disorder) depends on abstinence from all alcoholic drinks during pregnancy. This information should be imparted by all health professionals. Methods which are likely to change alcohol intake include short interventions and motivational interviews. Questionnaires such as AUDIT (Alcohol Use Disorders Identification Test) and T-ACE (Tolerance, Annoyed, Cut-down, Eye-opener) are recommended for screening for alcohol consumption in pregnancy, while laboratory markers are complementary to the clinical history. The management of alcohol abuse in pregnancy (at-risk pregnancy) is multidisciplinary involving established systems of perinatal care and those for treatment of addiction. The mother-child bond must be taken into account and psychosocial support should be offered. [ABSTRACT FROM AUTHOR]

Abstract: The current French hospital reform is based on the disease-related group (DRG) approach and the constitution of bigger units pooling several departments of different specialties. This reform needed an efficient assessment of various medical activities. We report our experience of a medical table of our hospital activities used for 27 months. This medical table was made with a basic software integrating 24 parameters. The original concept was the translation of the specific final diagnosis for DRG defined by the site of infection. To create this medical table, we first simplified the conclusions of the patient''s chart using a consensual and systematic plan. The number of patients per DRG and their evolution were therefore specifically determined. The medical table helped us in the daily management of our department, to identify the area of recruitment, the potential for heterogeneous care, allowing the implementation of protocols and their applications. Moreover, the table quantified morbidity and mortality, indicating our need for cooperation with other departments. All this data used medical-lexical terms, allowing other than economic analyses, even if this table identifies hospitalization-related costs, namely duration of hospital-stay, nosocomial infections and iatrogenic events. Finally, our table supports medical research and evaluation of practice. Our future goals are to introduce this table in several infectious-diseases units, and create specific tables for the main RDG, including economic parameters. [Copyright &y& Elsevier]

Introduction: Interstitial pregnancy accounts for 3 to 11% of ectopic pregnancy; these pregnancies are the more frequently non-tubal ectopic pregnancy. Medical treatment can be used in case of unruptured interstitial pregnancy and is used more and more frequently to avoid hemorrhagic risk and risk of conversion to radical surgery when a surgical management is decided. However, a larger use of methotrexate in interstitial pregnancy and conditions of use are not clearly defined. The aim of this study is to report a series of unruptured interstitial pregnancy managed by in situ injection of methotrexate., Women and Methods: This retrospective observational study included women treated for an interstitial pregnancy between 2010 and 2013 in a teaching hospital. Medical management used was an in situ injection of methotrexate (1mg/kg) guided by vaginal sonography plus an intramuscular injection of methotrexate (1mg/kg) in the 48hours following in situ injection and 600mg of mifepristone when progesterone blood rate was more than 9ng/mL. A great decrease of serum hCG without surgery was considered a success., Results: Fourteen women had an interstitial pregnancy during the study period. Six were managed surgically in 5 cases for suspicion of uterine rupture and one for pregnancy of unknown location. Eight women had a medical management and the success rate was 100%. Mean time for decrease of serum hCG until 2 UI/L was 54.4 days [34.0-74.8]. No uterine rupture or immediate complication was reported. Five women out of 8 had a spontaneous pregnancy after management of interstitial pregnancy., Conclusion: Medical management by in situ injection of methotrexate under sonographic guidance with an intramuscular injection within the 48hours following the in situ injection and mifepristone when ectopic pregnancy was active can be proposed in first-line therapy in case of unruptured interstitial pregnancy. This treatment has a great efficiency and low rate of complications., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)