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Objective: To assess the profile of metabolic syndrome (MS) in a hypertensive population in Mali. Patients and methods: Prospective study from June 1, 2022 to June 31, 2022, in the cardiology department of the Mother-Child University Hospital in Bamako, Luxembourg. Our study sample consisted of adult hypertensive patients, aged 18 years and older, received as an outpatient. Patients were included in our study after informed consent. The SM was established based on International Diabetes Federation (IDF) definitions. Results: Out of 520 patients, 238 were included in our study. The prevalence of SM was 30.2% according to IDF criteria. There was a female predominance (66%). The mean age was 57 ± 5 years. Grade II hypertension was in the majority with 39%. Seventy-five percent of patients with metabolic syndrome had 3 risk factors. Ischemic stroke was the most common complication with a rate of 12%. Dual therapy was indicated in 59.23% of patients. Calcium channel blockers were the most prescribed with a rate of 74.5%. SM is a reality in Mali. Adequate preventive measures are necessary to limit its progression. [ABSTRACT FROM AUTHOR]

The finality of medical research is to improve disease management by identifying the risk factors (epidemiology) and treating the disease or the underlying causes (clinical research). The assessment of the relationship between exposure to a risk factor or a treatment and the disease is a crucial step. As statistical tests provide information only on whether the -association is statistically significant, it is necessary to quantify the strength of the effect using measurements called "effect sizes" in statistics. Several effect sizes (risk difference, relative risk, odds ratio) are commonly used depending on the study design. This statistical note describes how to use and interpret effect sizes when both exposure and disease are dichotomous variables, i.e. the most common situation in practice. [ABSTRACT FROM AUTHOR]

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Coccidiosis is one of the most pathogenic intestinal diseases caused by different species of Eimeria spp. (Phylum:Apicomplexa), that cause important economic losses to the livestock industry. Given the importance of camel breeding and its products in the regional economy, in this study the risk factors of prevalence of camels Coccidiosis in the Turkestan region of Republic of Kazakhstan was investigated by oocyte excretion monitoring in the herd. The results revealed that the prevalence of Eimeria sp, was136 (42.5%); and three types of Eimeria spp. were identified: Eimeriabactriani, Eimeriacameli, Eimeria dromedarii. The statistical analysisdemonstratedthat the prevalence and intensity of infection in camel ≤1-year-old were 65.5% and 149.2 respectively, and they were more likely to be infected with Eimeria spp. compared with adult camels (22.5%, 5.7), (pvalue≤0.05). Another probable risk factor is seasons of the year as it seems the high and low prevalence andinfection intensityare observed in summer (60%, 102.1) and winter (20.6%, 21.25), respectively. Multivariate analysis of our data revealed that age and season were significant risk factors (p< 0.005) and adoption of hygienic measures and husbandry practice are needed among the high risk groups(in young camel and summer season) to minimize, control and prevent spreadof the infection.

Fetal death is defined as the spontaneous cessation of cardiac activity after fourteen weeks of amenorrhea. In France, the prevalence of fetal death after 22 weeks is between 3.2 and 4.4/1000 births. Regarding the prevention of fetal death in the general population, it is not recommended to counsel for rest and not to prescribe vitamin A, vitamin D nor micronutrient supplementation for the sole purpose of reducing the risk of fetal death (Weak recommendations; Low quality of evidence). It is not recommended to prescribe aspirin (Weak recommendation; Very low quality of evidence). It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2 (Strong recommendations; Low quality of evidence). It is not recommended to systematically look for nuchal cord encirclements during prenatal screening ultrasounds (Strong Recommendation; Low Quality of Evidence) and not to perform systematic antepartum monitoring by cardiotocography (Weak Recommendation; Very Low Quality of Evidence). It is not recommended to ask women to perform an active fetal movement count to reduce the risk of fetal death (Strong Recommendation; High Quality of Evidence). Regarding evaluation in the event of fetal death, it is suggested that an external fetal examination be systematically offered (Expert opinion). It is recommended that a fetopathological and anatomopathological examination of the placenta be carried out to participate in cause identification (Strong Recommendation. Moderate quality of evidence). It is recommended that chromosomal analysis by microarray testing be performed rather than conventional karyotype, in order to be able to identify a potentially causal anomaly more frequently (Strong Recommendation, moderate quality of evidence); to this end, it is suggested that postnatal sampling of the placental fetal surface for genetic purposes be preferred (Expert Opinion). It is suggested to test for antiphospholipid antibodies and systematically perform a Kleihauer test and a test for irregular agglutinins (Expert opinion). It is suggested to offer a summary consultation, with the aim of assessing the physical and psychological status of the parents, reporting the results, discussing the cause and providing information on monitoring for a subsequent pregnancy (Expert opinion). Regarding announcement and support, it is suggested to announce fetal death without ambiguity, using simple words and adapting to each situation, and then to support couples with empathy in the various stages of their care (Expert opinion). Regarding management, it is suggested that, in the absence of a situation at risk of disseminated intravascular coagulation or maternal vitality, the patient's wishes should be taken into account when determining the time between the diagnosis of fetal death and induction of birth. Returning home is possible if it's the patient wish (Expert opinion). In all situations excluding maternal life-threatening emergencies, the preferred mode of delivery is vaginal delivery, regardless the history of cesarean section(s) history (Expert opinion). In the event of fetal death, it is recommended that mifepristone 200mg be prescribed at least 24hours before induction, to reduce the delay between induction and delivery (Low recommendation. Low quality of evidence). There are insufficient data in the literature to make a recommendation regarding the route of administration (vaginal or oral) of misoprostol, neither the type of prostaglandin to reduce induction-delivery time or maternal morbidity. It is suggested that perimedullary analgesia be introduced at the start of induction if the patient asks, regardless of gestational age. It is suggested to prescribe cabergoline immediately in the postpartum period in order to avoid lactation, whatever the gestational age, after discussing the side effects of the treatment with the patient (Expert opinion). The risk of recurrence of fetal death after unexplained fetal death does not appear to be increased in subsequent pregnancies, and data from the literature are insufficient to make a recommendation on the prescription of aspirin. In the event of a history of fetal death due to vascular issues, low-dose aspirin is recommended to reduce perinatal morbidity, and should not be combined with heparin therapy (Low recommendation, very low quality of evidence). It is suggested not to recommend an optimal delay before initiating another pregnancy just because of the history of fetal death. It is suggested that the woman and co-parent be informed of the possibility of psychological support. Fetal heart rate monitoring is not indicated solely because of a history of fetal death. It is suggested that delivery not be systematically induced. However, induction can be considered depending on the context and parental request. The gestational age will be discussed, taking into account the benefits and risks, especially before 39 weeks. If a cause of fetal death is identified, management will be adapted on a case-by-case basis (expert opinion). In the event of fetal death occurring in a twin pregnancy, it is suggested that the surviving twin be evaluated as soon as the diagnosis of fetal death is made. In the case of dichorionic pregnancy, it is suggested to offer ultrasound monitoring on a monthly basis. It is suggested not to deliver prematurely following fetal death of a twin. If fetal death occurs in a monochorionic twin pregnancy, it is suggested to contact the referral competence center, in order to urgently look for signs of acute fetal anemia on ultrasound in the surviving twin, and to carry out weekly ultrasound monitoring for the first month. It is suggested not to induce birth immediately., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Introduction: In heart failure with preserved left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) has a diagnostic and prognostic value. This study aimed to identify the factors associated with the alteration of strain in heart failure with preserved left ventricular ejection fraction., Methods: This study was carried out in patients with heart failure and preserved LVEF seen in the echocardiography laboratory of the DAX hospital center from 1 st January to 31 st October 2022. Patients with altered GLS < -16% (cases) were compared to controls (GLS ≥ -16 %) matched by age group and sex., Result: During this period, 31 cases and 31 controls were recruited. The average age of the cases was 81.3 ± 11.8 years with a female predominance (51.6%). Alteration of left ventricular GLS was associated with history of coronary artery disease (OR 5.93, CI 95% [1.16-30.25], p = 0.04), very high cardiovascular risk (OR 19.6, CI 95% [1.90-201.63], p = 0,03), an interventricular septum thickness greater than 12 mm (OR 7, CI 95% [1.59-30.80], p = 0,00) and the presence of hypertrophic cardiomyopathy (p = 0.00)., Conclusion: GLS alteration was associated with history of coronary artery disease, very high cardiovascular risk, an interventricular septum thickness greater than 12 mm and hypertrophic cardiomyopathy. The knowledge of these factors could be interesting to improve the risk stratification and the management of heart failure with preserved LVEF., Competing Interests: Déclaration liens d'intérêts Les auteurs déclarent n'avoir aucun conflit d'intérêts., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Several risk factors are associated with neglectful behaviors. Yet their cumulative effect, which refers to the accumulation of risk regardless of the presence or absence of specific factors, remains unknown. This study aims to determine whether risk accumulation predicts caregivers' responses to children's emotional and cognitive needs in the general population and to examine the presence of clinical thresholds. A total of 1102 maternal figures of children aged 5 to 9 years old living in Quebec were questioned through a telephone survey. The response to children's emotional and cognitive needs was measured using a validated version of the Parent-Report Multidimensional Neglectful Behavior Scale. Ten individual, family and socioeconomic risk factors were combined to compute a cumulative risk index. Results indicate that the cumulative index predicts the response to children's emotional and cognitive needs in the general population. This effect is observed for families exposed to at least two risk factors and it increases considerably when risk exposure reaches 5 factors. This study supports the cumulative risk hypothesis, which until now had mainly been examined in vulnerable or clinical samples. It fosters a better statistical understanding of contexts compromising an optimal response to school age children's emotional and cognitive needs in the general population. This breakthrough is particularity important considering the challenges of identifying children at risk of having their needs neglected. [ABSTRACT FROM AUTHOR]

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Perinatal asphyxia (PA) is a major health problem, responsible for high mortality and a wide range of morbidity. Several factors play a part in the occurrence of perinatal mortality during asphyxia. The aim of this work was to identify factors predictive of perinatal mortality following PA, using an unmatched case-control study. Thus, 31 cases and 126 controls were identified with a total of 157 newborns suffering from PA. It was carried out during April 1 to June 30, 2022, at the Mohammed VI University Hospital in Marrakech. The socio-demographic, clinical, and biological data of the newborns were collected using an evaluation grid. In this series, the sex ratio was 0.96 and the case-fatality rate 20%. The results showed that the factors showing a statistically significant association in the genesis of mortality in PA cases were : intrauterine growth retardation [(ORA= 4711,799), 95%, IC : ( 48,964, 453416,766)] ; maternal history [ (ORA =31,876, 95%,CI : (1,346;755,149)] ; Apgar index after 5 min less than or equal to 3: [(ORA=139,75), 95%, CI : (16,523 ; 1182,01)]; and congenital malformations : [(ORA=241,435), 95%, CI : ( 6,044 ; 9644,748)]. Consequently, addressing these factors is crucial to identify high-risk newborns at an early stage and to implement appropriate measures. The goal is to eliminate avoidable morbidity and disability.

Objective: Breast cancer is the leading cancer in women in terms of incidence and mortality. The literature currently identifies several risk factors, some modifiable and others not. Because of its multifactorial nature, the combination of factors either increases or reduces the risk of cancer. Since 2004, the first commission's rapport of the French National Environmental Health Plan has recognized the significant impact of occupational exposure on the development of breast cancer. However, neither primary nor secondary preventive measures have yet been implemented in work environment., Method: Based on available literature, we reviewed current knowledge of breast cancer risk factors associated with occupational exposure., Results: The risk factors identified were ionizing radiation, magnetic fields, certain endocrine disruptors, ethylene oxide and night shift work., Conclusion: Recognition of breast cancer as an occupational disease is complicated. In some cases, however, it may be possible, particularly in cases of multifactorial exposure. This work should help to raise awareness among employers and reinforce preventive measures in the workplace., (Copyright © 2024. Published by Elsevier Masson SAS.)

Preventing falls in older adults requires a comprehensive approach that distinguishes between accidental falls and falls related to underlying medical problems, such as syncope. For unintentional falls, prevention follows a three-stage model. The primary level focuses on encouraging regular physical activity, assessing, and reducing footwear and environmental risks, managing comorbidities, and promoting healthy lifestyles. The secondary level aims to identify and manage all risk factors, including in-depth medical assessment and education of older people and their careers. Finally, the tertiary level aims to minimise the consequences of falls through post-fall care, regular medical monitoring and the introduction of mobility aids or monitoring technologies. Educating older people about the risks, adopting safe behaviours, promoting physical activity, and creating safe environments go beyond these levels. This holistic approach anticipates, identifies, and mitigates risks, promotes safe and active ageing, and aims to achieve overall well-being, reduce adverse outcomes, and promote optimal quality of life throughout the ageing process.

It's easy to imagine using medicines to treat or even cure an illness. For most people, however, the idea of taking one or more medicines to prevent or delay the onset of an illness or its complications seems less obvious. However, there is indeed a place for using medicines in the field of prevention. Knowing the definition of a medicine means you can immediately understand the role it can play in the field of prevention. What's more, the use of medicines should be based not only on evidence-based medicine, but also on an approach that integrates a collegial discussion with the patient, which will make it possible to discuss the expected benefits of such an approach, as well as explaining any possible side-effects. Only in this way can we expect better compliance of a person still without a disease. This article briefly summarizes the role that medicines can play in a prevention strategy.

Résumé: Les troubles cognitifs sont fréquemment retrouvés au cours la dépression du sujet âgé (DSA). Ils touchent de nombreuses fonctions cognitives, ce qui peut être sous-tendu par des dysfonctionnements au niveau des circuits cérébraux fronto-striataux et des hippocampes, en partie via des anomalies liées aux maladies cérébro-vasculaires. Il paraît important de distinguer la dépression tardive (DT) de la dépression précoce (DP) dont la présentation cognitive et l'étiopathogénie seraient différentes sur certains points. Il est à ce jour encore difficile de déterminer précisément quel type de marqueur représentent les troubles cognitifs au cours de la DSA : trait, état, facteur de risque ou de pronostique. Par ailleurs, l'intérêt de préciser la nature et la sévérité de ces troubles est multiple car ils peuvent avoir des conséquences péjoratives telles que la modification des informations à contenu émotionnel, favoriser un passage à l'acte suicidaire, limiter l'efficacité d'une psychothérapie, être un facteur de risque de mauvaise réponse aux antidépresseurs, ou encore constituer un potentiel facteur de risque d'évolution vers un trouble neurocognitif mineur (TNm) voire majeur (TNM), en particulier une maladie d'Alzheimer (MA). Cognitive disorders are frequently found during late-life depression. Many cognitive functions may be concerned and can be explained by fronto-striatal brain circuits and hippocampus dysfunctions partly through abnormalities related to cerebrovascular diseases. It seems important to distinguish between early and late onset depression whose cognitive characterisation and etiopathogenia differ in some aspects. Cognitive impairment may represent markers of depression but it is still unclear whether one should consider potential biomarkers of disease state or trait or risk factor. These disorders may precede depression and persist despite symptomatic remission. Moreover, the interest of specifying these disorders is multiple because they can have pejorative consequences such as the modification of emotional content, promote suicidal act, limit the effectiveness of psychotherapy, be a risk factor for poor response to antidepressants. or be a potential risk factor for progression to a minor or major neurocognitive disorder, especially Alzheimer's disease. [ABSTRACT FROM AUTHOR]

INTRODUCTION: High parity is a major public health concern in developing countries and it is a risk factor for postpartum hemorrhage (PPH). The aim of this study was to analyze the optimal parity cut-off values for predicting PPH in vaginal deliveries and cesarean sections in a rural Zambian setting. METHODS: all women who delivered at Zimba Mission Hospital in 2017 were reviewed in this retrospective survey. Those whose records were missing data on parity and those with risk factors for developing PPH (e.g. birth weight 4,000 g, multiple pregnancy, assisted vaginal delivery and placenta previa) were excluded. We analyzed the association between parity and PPH using multiple logistic regression and ROC curve analyses. RESULTS: among the 1,555 women included in the study, 72 (4.6%) women experienced PPH. The optimal cut-off values for parity in vaginal deliveries and cesarean sections were para 7 and 3, respectively. Using these cut-off values, the adjusted odds ratios (95% confidence intervals) were 3.26 (1.15, 9.21) and 8.28 (2.25, 30.5), respectively. CONCLUSION: proper preparation is required for vaginal deliveries in women with a history of =7 births and cesarean sections in women with a history of 3 births.

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Fibroadenomas are the most common breast disease that occurs usually in young. The coexistence of an invasive ductal carcinoma and a fibroadenoma in the ipsilateral breast is extremely rare. We present the case of a 52 years woman, presented to us for an upper-outer breast lump. Breast imaging concluded to tow contiguous lesions, one of them was suspicious. She had a conservative surgery. Histology concluded to a fibroadenoma and an invasive ductal carcinoma.

This article considers the spread of the SARS-CoV-2 virus, known as the COVID-19 pandemic, to have far-reaching consequences in terms of employment, production of goods and services worldwide. The article aims to research the dynamics of changes in attitudes towards the disease resulting in reshaping labor market strategies worldwide which include forming stay-at-home economy, digitization of business operations and emerging start-ups to facilitate delivering and consuming goods and services. A few research designs are used in this article with quantitative and case studies being major methods. The main results of this research allow one to associate coronavirus disease with a new business reality facilitator in the global economy rather than a mere risk factor. The topicality and urgency of this article are based on the novelty of the pandemic itself having started less than 2 years ago. This research may be helpful for upcoming fundamental studies in the field of 21st-century global emergencies.

INTRODUCTION: caesarean section rates have become a global public health. This study investigated obstetric and socio-demographic factors associated with caesarean section in northern Ghana. METHODS: this was a case-control study comparing 150 women who had caesarean section (cases) and 300 women who had vaginal delivery (controls). Data were collected retrospectively from delivery registers, postpartum and postnatal registers in the Bolgatanga Regional Hospital. Univariate and multivariate analysis of data were done using SPSS 22. RESULTS: the study revealed that women who had higher odds of having a caesarean section were women who; attended Antenatal care (ANC 4 times (Adjusted OR = 2.99, 95% CI1.762-5.065), were referred from other health facilities (Adjusted OR = 1.19, 95% CI 1.108-1.337) and had a foetal weight of 4000 grams (Adjusted OR = 1.21, 95% CI 1.064-1.657). There was a slight increase in odds of having a caesarean section among women who had a gestational age 40 weeks (Adjusted OR = 1.09, 95% CI 1.029-1.281). Women who had secondary/higher education (Adjusted OR = 0.55, 95% CI 0.320-0.941), gestational age 37 weeks (Adjusted OR = 0.20, 95% CI: 0.100-0.412) and women who had a foetal weight of 1500 grams to 2499 grams (Adjusted OR = 0.17, 95% CI 0.086-0.339) were associated with a lower odds of having a caesarean section. CONCLUSION: there was an increase in odds of having a caesarean section among pregnant women who had a foetal weight of 4000 grams and women who attended ANC 4 times. Pregnant women who were referred also had increase odds of having a caesarean section.

Résumé Introduction Les nouveau-nés sont parmi les plus vulnérables aux infections nosocomiales vues l’immaturité du système immunitaire, ce risque est accentué par la prématurité, et l’agressivité de certains soins invasifs. Ce problème crucial, justifie des recherches approfondies pour adopter des mesures de prévention appropriées orientées vers la maîtrise des facteurs de risques. C’est dans cette perspective que s’intègre notre travail ayant pour objectif la détermination des facteurs des risques des infections nosocomiales néonatales. Matériel et méthodes une étude analytique rétrospective type cas-témoin réalisée dans l’unité de néonatologie du CHU IBN El-Jazzar de Kairouan sur une période de 3 ans. Nous avons colligé 184 cas d’infection nosocomiale. Chaque cas est apparié à un témoin selon le genre et la période, soit 184 témoins. Résultats Parmi les 184 cas, La septicémie était la localisation la plus fréquente (72 cas soit 39,1 %), suivi par le sepsis clinique sans confirmation bactériologique (69 cas soit 37,5 %) et par la pneumopathie (36 cas soit 19,6 %). En analyse multivariée, les principaux facteurs de risque indépendants étaient : la ventilation mécanique (OR ajusté = 4,26 ; IC à 95 % = [1,74–10,40]) ; Le KTVO (OR ajusté = 3,82 ; IC à 95 % = [1,51–9,67]) ; l’anti-H2 (OR ajusté = 2,19 ; IC à 95 % = [1,11–4,29]) et Le gavage gastrique (OR ajusté = 2,50 ; IC à 95 % = [1,19–5,24]). Conclusion La prévention des infections nosocomiales représente un réel défi en néonatologie, certes elle se base sur des mesures générales d’hygiène mais elle doit englober des mesures spécifiques ciblant les facteurs de risques spécifiques au nouveau né. Summary Introduction New borns are among the most vulnerable people to nosocomial infections because of their immature immun-system. This risk is accentuated by the prematuruty and the agressivity of certain invasive techniques. This crucial problem justify deep researches in order to adopt appropriate preventive measures focusing on the control of risk factors from this perspective, our study aims to determinate risk factors of neonatal nosocomial infections. Methods Restrospective case-control analytic study conducted in the neonatal unity of CHU Ibn El Jazzar of Kairouan during a period of 3 years. We collected 184 cases o nosocomial infection. Each case was matched to a control according to the gender and the period. There were 184 contols. Results Among the 184 cases, septicemia was the most frequent localisation (72 cases, 39.1%), followed by clinic sepsis without bacteriologic confirmation (36 cases, 19.61 %) In multivariable analysis, the principal independant risk factors were mecanic ventilation (adjusted OR = 4.26, 95% CI); KTVO (adjusted OR = 3.32; 95% CI 1.51–9.67). Anti-H2 (adjusted OR = 2.19; 95% CI 1.11–4.29) and gastric gavage (adjusted OR = 2.5; 95% CI 1.19–5.24). Conclusion The prevention of nosocomial infection represente a real challenge in neonatology, certainly it's based on general measures of hygiene but it must Encompass specific measures targeting specific risk factors of new born. [ABSTRACT FROM AUTHOR]

In our days, tuberculosis, whet ever its localization, became a curable disease. The cornerstone is a 6 month course of isoniazid, rifampicine and pyrazinamide. All of the three first line antituberculosis drugs may induce hepatic damage which may have negative consequences for treatment outcome. Several risk factors were associated with the development of antituberculosis- drug-induced hepatotoxicity (ATDH). A retrospective study was conducted from July 2014 to March 2015 regarding all therapeutic drug-monitoring requests sent to the Laboratory of Poison Control and Pharmacovigilance Centre of Morocco. 142 patients diagnosed with active tuberculosis were included in study. Plasma peak levels of isoniazid, rifampicin and pyrazinamide were analyzed in plasma samples after 2 to 3 hours of administration of anti-tuberculosis treatment. Logistic regression was used to identify the ATDH risk factors. The incidence of ATDH was found 24.6% (35 patients out of 142). Intergroup differences in the plasma levels were statistically significant for isoniazid (p=0.036). ATDH was found to be associated with combined form of anti-TB drugs (p=0.002, COR=13.1, AOR= 13.5) and plasma concentration of INH superior to 2mg/l (p=0.045, COR=1.3, AOR= 1.4).age, gender, alcohol intake and smoking status were not significantly associated with ATDH. The finding of 24.6% incidence of hepatotoxicity is extremely high. Many factors can be associated with the development of ATDH such as genetic factors, combined forms of treatment and plasma peak levels.

Résumé Le terme « capital social » est un concept à la fois géographique, politique, économique et sociologique, basé sur le principe d’un réseau de relations interpersonnelles. L’association entre capital social et santé mentale est étudiée en tant que facteur modulateur/explicatif de différence et de variation des états de santé des personnes d’un groupe, ainsi que pour son impact sur la prévention, le développement et le procès psychosocial de rétablissement. Le capital social semble jouer un rôle particulièrement important dans l’intégration des immigrants, qui présentent, à leur tour, une vulnérabilité accrue à la maladie mentale liée à des facteurs de stress psychosociaux. Dans cet article nous allons discuter de l’utilisation de ce concept dans l’étude des facteurs environnementaux de maladie mentale et, notamment, de la nécessité d’adaptation de ses indicateurs en fonction du contexte et des populations étudiées. The concept of social capital is useful to study the impact of the interpersonal relationships/networks on the development, outcome, prevention and recovery of mental disorders. Among migrant populations, it seems to play a protective role in mental health, associated to better social support, resilience and less exposure to discrimination. In this paper, we will present the current data on this subject. Then we will discuss the use of this concept in the study of environmental risk factors of mental disorders and the need to construct contextual indicators, especially in minority groups. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude Le poids et la taille tels qu’ils étaient à différents âges de la vie sont difficiles à obtenir. Afin d’améliorer la connaissance de l’historique du poids, Sörensen et al. en 1983, ont développé un outil à partir de silhouettes permettant d’évaluer la corpulence à différents âges de la vie. Les études de validité ont montré que le poids et la taille mesurés étaient corrélés à 80 % à la silhouette rapportée. D’autres études ont montré que l’évaluation des silhouettes est un bon moyen de retracer l’historique du poids d’un individu. Très peu d’études épidémiologiques ont utilisé cet outil. Une étude française a permis de mettre en évidence une diminution du risque de cancer du sein chez les fillettes qui étaient obèses entre l’âge de 8 ans et l’adolescence. Une autre étude a montré qu’un faible poids de naissance ou une silhouette mince avant l’âge adulte sont associées à une augmentation du risque de diabète. À partir de ces constatations, il nous a semblé intéressant d’évaluer la relation entre la silhouette à 20 ans et le risque d’hypertension à l’âge de 60 ans. Résultats On a observé que la prévalence de l’hypertension à l’âge de 60 était plus élevée chez les sujets obèses à 20 ans que chez les sujets minces (45,3 % vs 36,7 % ; p < 0,05). Conclusion Cet outil permet une classification pertinente entre minceur et obésité. L’historique de la corpulence est un élément important à considérer dans les déterminants d’une pathologie, en particulier dans celle de l’hypertension artérielle. Purpose of the study In epidemiological studies, recall of weight and height are not readily available at different ages of life. In order to improve the knowledge of the weight history, Sörensen et al. in 1983, developed a tool from silhouettes allowing an individual to evaluate his corpulence at different ages of life. Validity studies showed that measured weight and size were correlated to 80% in the reported silhouette. Studies have also shown that silhouettes are a good way to trace the weight history in an individual's life. Very few epidemiological studies have used this tool. A French study revealed a decrease of the risk of breast cancer in obese girls between the age of 8 and adolescence. Another study showed that a low birth weight or a thin silhouette before adulthood was associated with an increased risk of diabetes. On the basis of these findings, it was interesting to evaluate the relationship between the silhouette at 20 years and the risk of hypertension at the age of 60 years. Results It was shown that the prevalence of hypertension at age 60 was higher among obese subjects at 20 years than among thin subjects (45.3% vs 36.7% ( P < 0.05). Conclusion The classification between slimness and obesity is relevant using this tool. The history of corpulence is an important element to consider in the determinants of pathology, especially in hypertension. [ABSTRACT FROM AUTHOR]

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Résumé Objectifs Le fait d’avoir été maltraité durant l’enfance ou l’adolescence peut favoriser l’apparition ultérieure de symptômes physiques et socio-émotionnels, et notamment de consommations à risque. Cet article explore les liens entre la maltraitance de l’enfant et les consommations à risque au moment de l’entrée dans l’âge adulte, reconnue comme période de vulnérabilité psychologique accrue. Méthode Une revue de la littérature extensive a été effectuée sur les bases de données informatisées à partir de mots-clés prédéfinis. Ont été sélectionnées les études empiriques, prospectives ou rétrospectives, datant à partir des années 2000 et portant spécifiquement sur les effets à l’âge du jeune adulte des maltraitances infantiles en lien avec des consommations à risque. Résultats Cette revue soutient largement le lien entre la maltraitance vécue pendant l’enfance ou l’adolescence et un risque majoré de consommations de substances licites et illicites au début de l’âge adulte. Cependant, la plupart des études disponibles sont rétrospectives et/ou corrélationnelles et ne permettent pas, de ce fait, d’étudier prospectivement les processus par lesquels se font les liens entre ces phénomènes. Les principales hypothèses explicatives reposent sur les conséquences à long terme de l’exposition de l’enfant à un environnement psychosocial multirisques ou à des modèles parentaux dysfonctionnels, sur les perturbations de l’attachement, de la régulation émotionnelle et de la mentalisation, et sur l’impact neuro-développemental du traumatisme. Discussion Ainsi, malgré l’important corpus de recherches démontrant ses effets à long terme, la maltraitance est encore très répandue, souvent non reconnue, et l’enfant victime, non protégé ni soigné. Toutefois, relativement peu d’études proposent une analyse des consommations à risque en prenant en compte tous les types de mauvais traitements. La violence psychologique et la négligence peuvent être jugées comme moins dangereuses et/ou plus difficiles à identifier, ce qui aboutit à leur exclusion dans une partie des études qui considèrent uniquement les formes de maltraitance physiques, graves et/ou reconnues par la justice, ce qui constitue un biais certain. Conclusion Cette revue suggère non seulement la nécessité d’une amélioration de la prévention précoce auprès des parents et des personnels de soin, mais également la mise en place de programmes de prévention et de soins en direction des jeunes adultes ayant des antécédents de maltraitance. Aims Maltreatment during childhood or adolescence has been linked to later physical and social-emotional symptoms, and in particular to the use of risk-related substances. This paper draws up a review of the literature concerning the relationships between childhood maltreatment and risk-related substance use in young adulthood, which is known to be a period of increased psychological vulnerability. Method A comprehensive literature review was conducted on several online databases with a set of predefined keywords. Only empirical, prospective or retrospective studies, published from the year 2000 onwards and specifically relating to the effects of childhood maltreatment on risk-related substance use in young adulthood were selected. Results This literature review clearly supports the link between childhood maltreatment and an increased risk of legal and illegal substance use. However, most available studies are retrospective and/or correlational and therefore do not enable prospective exploration of the processes that link these two phenomena. The main explanatory hypotheses are based on the long-term consequences of childhood exposure to a multi-risk psychosocial environment or to dysfunctional parental models, on disturbances in the construction of attachment, on lack of emotional regulation and mentalisation, and on the neurodevelopmental impact of trauma. Discussion Despite the significant body of research demonstrating its long-term effects, child abuse is still widespread, often unrecognized, and the children concerned are not protected. However, relatively few studies provide an analysis of subsequent risk-related substance use taking into account all types of maltreatment. Emotional abuse and neglect may be deemed less harmful and/or may be more difficult to identify, leading to their exclusion from some of the studies that only consider physical, severe and/or legally established forms of abuse, which results in some bias. Conclusion This review stresses not only the need for improvement in early prevention strategies targeting parents and child care professionals, but also for implementation of prevention and support programs directed towards young adults with a past history of childhood abuse. [ABSTRACT FROM AUTHOR]

Résumé L’objectif de la présente recherche est de dégager des différences au niveau du risque de récidive entre des patients internés car se trouvant dans un état grave de déséquilibre ou de débilité mentale les rendant « incapables du contrôle de leurs actions » au moment des faits (art. 1 er de la loi de Défense Sociale, 1964) comparativement aux condamnés qui, au cours de leur détention, ont été soumis à la mesure de l’Article 21 par le fait qu’ils ont été reconnus dans une telle « incapacité, ou en état de démence ou dans un état grave de déséquilibre mental ou de débilité ». Les principaux résultats soulignent des niveaux de risque de violence plus élevés sur plusieurs dimensions chez les internés sous Article 21 comparativement aux autres internés. Les internés sous Article 21 sont plus jeunes au moment des faits, ils présentent plus d’antécédents délictueux, le passage à l’acte actuel ou antérieur est plus violent, ce qui entraîne des scores plus élevés aux instruments statiques. Au niveau du risque clinique structuré, sensible au changement et à la prise en charge clinique spécifique, les internés sous la mesure de l’Article 21 présentent davantage de problèmes de gestion, notamment de supervision et de traitement. In Belgium, the Article 21 of the Social Defense Law allows to transfer a sentenced to confinement when he presents a severe mental disturbance during his incarceration. We compared the scores of risk of violence of 44 internees under Article 21 to 351 others internees. The main findings revealed higher levels of violence risk on several dimensions among internees under Article 21 compared to other internees. The internees under Article 21 are younger at the time of the offense, present longer criminal career, with past and current offence being more violent, which contribute to higher static instrument scores. Concerning structured clinical risk instruments, the Article 21 presents more management problems in particular at the supervision and the treatment levels. [ABSTRACT FROM AUTHOR]

Résumé Cette communication porte sur une revue de l’ensemble des dossiers de patients atteints de schizophrénie et hospitalisés à l’UMD de Cadillac (Gironde) ( n = 54) en avril 2016. Seize (29,6 %) avaient commis un homicide, 42 (78 %) des violences physiques autres et 8 (14,8 %) une agression sexuelle. L’étude montre une bonne corrélation entre le score à la Historical, Clinical, Risk-20 (HCR-20) et les antécédents de violence physique envers les personnes, à l’exclusion de l’homicide. L’homicide apparaît négativement corrélé au facteur historique et au score total à la HCR-20. Par ailleurs, on ne retrouve pas de relation entre scores à la HCR-20 et agression sexuelle. This communication is a study of all records of schizophrenic patients in a high security hospital at Cadillac (France) ( n = 54) in April 2016. Sixteen (29.6%) patients had committed an homicide, 42 (78%) another type of physical violence and 8 (14.8%) a sexual aggression. The study showed a good correlation between Historical, Clinical, Risk-20 (HCR-20) score and antecedent of physical violence against persons when homicide was excluded. Homicide was negatively related to historical and total HCR-20 score. Moreover, there was no correlation between HCR-20 scores and sexual violence. [ABSTRACT FROM AUTHOR]

Résumé La violence interpersonnelle peut davantage conduire au développement d’un trauma complexe que d’un ESPT. Le trauma complexe compromet, voire altère le développement psychobiologique et socioémotionnel d’une personne, et cela plus lorsqu’il survient à des périodes développementales critiques. Ces expériences interpersonnelles de violence sont complexes parce qu’elles augmentent le risque de symptomatologie anxieuse, de développement de relations perturbées et de troubles comorbides, même si la relation causale n’est pas clairement établie. Dès lors, l’établissement du diagnostic et le traitement nécessitent des thérapeutes expérimentés aux connaissances approfondies. Selon certains auteurs (Van der Hart et al., 2016), les conséquences du trauma complexe ne peuvent être résolues que si le contenu des mémoires traumatiques a été intégré. En d’autres termes, le sujet ne peut se dire « résilient » que s’il peut se référer au souvenir traumatique tout en étant pleinement connecté au présent et le considérer comme un moment délimité et passé dans sa vie (Schnyder, 2005). Pour y parvenir, le processus thérapeutique implique une évolution par phases qui tiennent compte des spécificités du trauma complexe et qui correspondent à des étapes essentielles vers la reconstruction psychique et l’engagement sécurisé et cadré dans les relations interpersonnelles. Interpersonal violence can lead to the development of a complex trauma rather than to PTSD. Complex trauma compromises or alters the psychobiological and socioemotional development of a person, and certainly when it occurs at critical developmental periods. These interpersonal experiences of violence are complex because they increase the risk of anxiety symptomatology, the development of disturbed relationships and comorbid disorders, even if the causal relationship is not clearly established. Therefore, the establishment of diagnosis and treatment requires experienced therapists with in-depth knowledge. According to some authors (Van der Hart et al., 2016), the consequences of complex trauma can only be resolved if the contents of the traumatic memories have been integrated. In other words, the subject can only be said to be resilient if he can refer to the traumatic memory while being fully connected to the present and to consider it as a delimited and past moment in his life. To achieve this, the therapeutic process involves a phases oriented approach that takes the specificities of complex trauma into account and which constitute essential steps towards psychic reconstruction and secure and framed engagement in interpersonal relationships. [ABSTRACT FROM AUTHOR]

Résumé L’objectif de cette étude était de mettre en évidence la présence de variables émotionnelles telles que l’alexithymie et l’intensité des émotions ressenties et des variables psychopathologiques, telles que symptomatologie dépressive et/ou anxieuse dans les conduites tabagiques. Notre échantillon était constitué de 222 étudiants, 86 fumeurs et 136 non-fumeurs. Ils ont rempli un protocole permettant d’évaluer, par des échelles d’auto-évaluation, l’alexithymie (TAS-20), l’intensité émotionnelle (AIM) et la symptomatologie anxieuse et dépressive (HAD). Les résultats montrent que les fumeurs sont plus anxieux que les non-fumeurs et présentent un niveau général d’alexithymie inférieur. Néanmoins, les fumeurs ont plus de difficultés à identifier leurs émotions. Enfin, l’analyse des corrélations et de régression met en évidence des relations positives significatives entre nos variables. Ces résultats vont dans le sens de la littérature et notre évaluation du fonctionnement émotionnel dans les conduites tabagiques met en exergue le rôle que joue la consommation de tabac dans la régulation des émotions. Les limites et les perspectives de l’étude sont discutées. Objective The objective of this study was to support the existence of emotional dimensions like alexithymia and affective intensity and of psychopathological dimensions like anxiety and depressive symptoms in smoking. We think that smoking could be a manifestation of emotional helplessness. Alexithymia and affective intensity associated with anxiety and depressive symptoms could be a model of emotional functioning which is conducive to smoking. Patients and methods The study participants consisted of 222 students (37 males and 185 females; mean age = 22.6 + 5.13 years) from 1st to 5th year of Aix-Marseille University. The sample was divided into two groups: smoking ( n = 86) and no-smoking ( n = 136). We administered a protocol to the subjects consisting of three self-assessment scales to assess emotional and psychopathological dimensions. The alexithymia was assessed by the scale of the Twenty-items Toronto Alexithymia Scale (TAS-20). It allows an overall assessment of the level of alexithymia, as well as three dimensions as represented by specific sub scales: difficulty identifying emotions (DIE), difficulty differentiating emotions (DDE) and externally oriented thinking (EOT). The emotional intensity was assessed by the Affective Intensity Measure (AIM). The AIM is a 40-items questionnaire designed to measure the characteristic strength or weakness with which one experiences emotion. The anxiety and depressive symptoms were assessed by Hospital Anxiety and Depression scale (HAD). The HAD is a 14-items scale used to determine the levels of anxiety and depression, seven of the items relate to anxiety and seven relate to depression. These scales have been validated internationally. Statistical analysis We performed descriptive analysis, correlational analysis (Bravais-Pearson's correlation), linear multiple regression and binary logistic regression model using SPSS.17 software. Results The results showing that smoking subjects are more anxious (M = 9.10 + 3.94; P < 0.05) and have more difficulty identifying feelings (M = 17.02 + 5.14; P < 0.05) than no-smoking subjects (mean anxiety = 7.95 + 3.58; mean difficulty identifying feelings = 15.54 + 5.25). But smokers are less alexithymics, more specifically in difficulty differentiating emotions (M = 12.7 + 4.73; P < 0.001) and externally oriented thinking (M = 15.27 + 3.85; P < 0.01) dimensions than no-smokers (mean difficulty differentiating emotions = 16 + 3.89; mean externally oriented thinking = 17.22 + 3.38). The analysis of relationships between the different variables shows the existence of several significant connections. We find a moderate and positive correlation between depression/anxiety and alexithymia ( r > 25; P < 0.01), and a strong positive correlation between depression/anxiety and emotional dimensions of alexithymia: difficulty identifying feelings ( r > 50; P < 0.01). However only with no-smoking subjects, we also find a moderate positive correlation between depression/anxiety and emotional dimensions of alexithymia: differentiating emotions ( r > 25; P < 0.01). In smoker group, the regression analysis shows that only emotional dimensions of alexithymia: difficulty identifying feelings and smoking influence positively and significantly anxious and depressive symptoms ( P < 0.0001). Anxiety about, the daily consumption of cigarettes (β = 0.663) is more discriminating than difficulty identifying feeling (β = 0.225). We find the same observation for depression (mean Cig/day: β = 0.630; mean difficulty identifying feelings: β = 0.201). However, we note in no-smoker group that emotional dimensions of alexithymia: difficulty differentiating emotions also contribute significantly anxiety (B = 0.411, P < 0.0001). But in any case, alexithymia is more discriminated to emotional intensity. Moreover, the regression analysis shows the daily consumption of cigarettes about, that the terms of symptomatic expression are more discriminating than other variables (mean anxiety: β = 0.681; mean depression: β = 0.641, P < 0.0001). Finally, binary logistic regressions show that anxiety symptoms multiply by 1.5 the probability of smoking. Conclusions Our study reveals the role of smoking to emotional regulation. The fact that smokers differentiate more easily their emotions could be understood as an attempt to express emotions which cannot be psychical work out. Because, smokers however are more anxious and have more difficult to identify emotions than no-smokers. We think smoking would be an attempt to release psychological suffering through acting. The difficult to identify emotions would be defense against anxiety situation caused by smoking. The study limitations are discussed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: several risk factors including stavudine and age have been strongly associated with polyneuropathy. However, conflicting data exist on height as an independent risk factor in polyneuropathy. The objective of this study is to exclude height as an independent polyneuropathy risk factor in a cohort of human immunodeficiency virus (HIV)-infected Kenyan sex workers. METHODS: this was an analysis of prospectively collected data of treatment naive subjects initiating either stavudine or tenoforvir diphosphate fumerate or zidovudine based antiretroviral therapy (ART) regimens from January 2008 to August 2012. Polyneuropathy was characterised as burning sensation, numbness, or dysesthesia. The study used arithmetic means of weight (kg) and height (cm) measured in duplicates using calibrated scales. RESULTS: after exclusion of duplicate data sets and un-confirmed cases of polyneuropathy, the study identified 212 patients without polyneuropathy, 14 pre-ART and 94 post-ART related polyneuropathy cases. Polyneuropathy cases were older but did not differ in demographic, clinical and laboratory parameters at baseline. There was a significant difference in first-line ART regimen with more patients on tenofovir disoproxil fumarate in post-ART group (p=0.017). CONCLUSION: polyneuropathy is a common disorder among HIV-infected Kenyan sex workers. These data cannot support the postulated increased risk by height after matching for gender and ART duration. Though stavudine is associated with polyneuropathy, in this study many patients previously not exposed to stavudine developed polyneuropathy. This suggests the involvement of unknown risk factors such as genetic and metabolite differences in the development of polyneuropathy.

INTRODUCTION: aseptic loosening is the main long-term complication and indicates total hip replacement failure. There are many and often intricate causes for aseptic loosening. Incorrect placement of the implants is the most incriminated factor. Other patient and implant related factors may also predispose to loosening but to various degrees. METHODS: we conducted a retrospective study of 64 cases with aseptic loosening of total hip prosthesis to individuate patient, implant type and surgical technique related factors leading to aseptic loosening and to provide recommendations to minimize this risk. RESULTS: this was an analytic retrospective study of 64 cases with aseptic loosening. The classification is that used by the French Society of Orthopedic Surgery and Traumatology. The average age of the patients at the time of the first arthroplasty was 40 years, 62 years at the time of loosening. Charnley stem was implanted in 55 cases, Muller stem in 9 cases. Acetabular component was well positioned in 69% of cases with an average inclination of 47.8 . The stems were canal-filling in 86% of cases with Grade A cementation in 60% of cases. The mean time for loosening onset was 12 years. 72% of the prostheses had a survival longer than 10 years. Statistical analysis of the results identified risk factors leading to loosening, such as: age, body mass index, level of activity, cup inclination, femoral offset and cementation quality. CONCLUSION: a significant reduction in aseptic loosening of total hip prostheses may only be achieved by a more rigorous selection of patients, a greater security in the technical act and a better choice of the implant to be placed.

INTRODUCTION: breast cancer is the most common cancer in morocco women were it occupies the first place in term of incidence and mortality. The aim of the present paper is to evaluate the risk factors associated with a breast cancer in a population of Moroccan women. METHODS: a case-control study was conducted with population women whose age is less than 40 years during 2008-2010 at the National Institute of Oncology of Rabat.These women were interviewed for Epidemiological information and risk factor for breast cancer. RESULTS: included in this study were 124 cases and 148 age matched controls.No statistically significant case-contol difference was found for the early age of menarche (OR = 2.474; CI 95%: 1.354- 4.521), and family antecedents of first degree of breast cancer (OR = 11.556; 95% CI: 2.548-52.411). However physical activity (OR = 0.507; 95% CI: 0.339 -0.757) early maternity age (OR = 0.212; 95% CI: 0.087 - 0.514), multiparity (OR = 0.742; 95% CI: 0.359 -1.539) and breastfeeding than 6 months (OR = 0.739; 95% CI: 0.357 -1.523)appear as significant protective factors. CONCLUSION: this study show the criminalization of only part of the known risk factors of breast cancer in this age group and confirms the probable protective role of physical activity and factors related to life reproductive women in our study (early childbearing, multiparity and lactation).

Résumé L’expansion cutanée est un processus long et délicat au cours duquel peuvent apparaître des complications plus ou moins graves. Les données de la littérature retrouvent un taux global de complications variable allant de 13 à 37 %. Nous pouvons les classer en complications majeures pouvant aboutir à un échec du traitement voire à une aggravation de l’état antérieur et en complications mineures ne compromettant pas le protocole d’expansion mais pouvant le modifier. Les principales complications majeures sont l’infection, la souffrance cutanée et la nécrose pouvant aboutir à l’exposition de la prothèse, les fuites et les problèmes techniques avec dysfonction du matériel engendrant des difficultés et parfois même un échec des gonflages. Les principales complications mineures sont les hématomes et les séromes, l’exposition de la valve ou de la tubulure, les douleurs avec paresthésies par compression des organes de voisinage, les cicatrices pathologiques et inesthétique et un retentissement psychologique important. Ces complications peuvent résulter d’un état cutané précaire, d’un dysfonctionnement de matériel ou de problèmes techniques inhérents à la procédure mais également être liées à une mauvaise indication ou planification préopératoire. L’apparition d’une complication n’est cependant pas synonyme d’échec de la procédure ; une reconstruction satisfaisante peut-être tout de même obtenue dans près de ¾ des cas. Cet article a pour but d’aider à identifier les situations à risque de complications afin de pouvoir les prévenir, les dépister et les prendre en charge précocement. Summary Skin expansion is a difficult and long process in which can occur more or less serious complications. Overall complications rates describe in the literature vary between 13 and 37%. We can categorize them in major complications, which can lead to a failure maybe even an aggravation of the anterior status, and in minor complications that do not compromise the expansion process but can alter it. The main major complications are infection, skin suffering and necrosis which can lead to prosthesis exposition, leaks and technical problems with equipment dysfunctions that may cause difficulties or a failure of the inflations. The main minor complications are hematomas, seromas, valve or tube exposition, pains with paraesthesias caused by neighbouring organs compression, pathologic and unsightly scares and can lead to an important psychological impact. These complications can be due to a precarious skin's state, a material dysfunction or unpredictable technical problems but also by an inappropriate preoperative indication or planning. The emerging of a complication, however, is not synonymous to a failure of the procedure; a satisfactory reconstruction may still be obtained in 75% of all cases. The purpose of this article is to help to identify the situations at risk of complications in order to prevent, detect and treat them early. [ABSTRACT FROM AUTHOR]

Résumé En France, certains auteurs identifient le milieu de travail comme cause exclusive, sinon essentielle, de suicides sur le lieu de travail. Néanmoins, ces interprétations ne sont pas retrouvées dans des études empiriques et épidémiologiques. Objectif Nous avons étudié dans quelle mesure les difficultés professionnelles peuvent contribuer à un fardeau d’adversité qui contribue à augmenter la vulnérabilité suicidaire. Méthode Quatre-vingt-quatre participants, la moitié décédée d’un suicide, en emploi au moment du décès et l’autre moitié en vie et en emploi, ont été recrutés afin de comparer les parcours de vie professionnelle, les tentatives de suicide antérieures et le profil psychiatrique. Les données ont été récoltées selon une méthode d’autopsie psychologique et de calendrier de vie explorant toutes les sphères de vie. Résultats Significativement plus de diagnostics d’un trouble des axes I et II, de comorbidités des axes et de tentatives de suicide sont observés parmi les participants décédés par suicide. De plus, les participants vivants ont rencontré significativement plus d’adversité dans le domaine professionnel au cours de la vie et des cinq dernières années. Conclusion Des difficultés professionnelles ne constituent pas un facteur de risque aussi robuste que des troubles psychiatriques. Une application possible est d’orienter l’action contre le suicide par le développement de programmes de prévention de la santé mentale, adaptés à des environnements professionnels. Over 900,000 people die by suicide every year around the world. Suicide has been described as being a multidimensional act, resulting from a number of risk factors accumulating throughout the life course. Recently, in France, some authors have suggested that work environment is a major or a unique risk factor in the etiology of suicide death. This theoretical position is in contradiction with empirical and epidemiologic evidence. Objective On the base of data from life trajectories, we studied to which extent work difficulties may contribute to a burden of adversity, which contribute to suicidal vulnerability. Method Two groups of participants ( n = 84) were compared. Half ( n = 42) were suicide victims who were compared to ( n = 42) living controls. The individuals from the suicide group were employed at the moment of death and the living controls were employed at the moment of the study. Characteristics of participants were compared in regards to life trajectories (love relationships, social interactions, professional difficulties), past suicide attempts and psychiatric diagnosis. Data were collected according to a psychological autopsy and life calendar methods. Results Significantly more mental health disorders on axis I (DSM-IV), especially mood and substances disorders as well as disorders on axis II (especially Cluster C) were observed among deceased participants. Moreover, comorbid mental health disorders and past suicide attempts over the life course were significantly more prevalent among participants deceased by suicide. No significant differences are observed between groups concerning adversities in love relationships and social interactions. However, participants from the control group had significantly more adversities in professional domain over the life course and during the last 5 years. Conclusion Work difficulties are not a robust or direct risk factor of suicide, but psychiatric disorders are. These results are in contradiction with opinions of a debate in France concerning a direct link between work and suicides and should foster new debate. Application should promote the development of suicide prevention programs in work environments by focusing on protection and promotion the psychological health of workers. [ABSTRACT FROM AUTHOR]

SUICIDE IS THE TRAGIC RESULT OF A SEVERE MENTAL SUFFERING, A FATAL OUTCOME DUE TO A MULTITUDE OF RISK FACTORS TO WHICH WE ALL MUST BE ATTENTIVE REQUIRING US TO REACT APPROPRIATELY. IN LIGHT OF SUICIDE RATES AMONG VARIOUS AGE GROUPS, THOSE PERTAINING TO THE ELDERLY MAY SEEM ANECDOTIC. HOWEVER, THROUGH FURTHER ANALYSIS, WE NOTE THAT, IN ABSOLUTE NUMBERS, THE SUICIDE RATE OF THE ELDERLY IS MUCH MORE IMPORTANT THAN IT SEEMS. MANY RISK FACTORS CAN BE DECREASED OR MONITORED: DEPRESSION, SUBSTANCE ABUSE, TRANSITION TO RETIREMENT, INSTITUTIONALIZATION, LOSS AND MOURNING, BAD PHYSICAL HEALTH, PRECARIOUSNESS, LONELINESS. PROTECTIVE FACTORS SUCH AS THE FEELING OF SUPPORT, SOLIDARITY, SELF ESTEEM AND RESILIENCE SHOULD BE ENHANCED. FINALLY, POSTVENTION AIMS TO HELP, SUPPORT, AND HEAL THOSE IN MOURNING AND AFFECTED BY THE SUICIDE OF A LOVED ONE, IN ORDER TO PREVENT THE SHORT AND LONG TERM CONSEQUENCES. [ABSTRACT FROM AUTHOR]

Résumé Les études sur l’usage de substances chez les patients hospitalisés pour une schizophrénie sont nombreuses. Cependant, il n’existe pas d’études au Maroc. Objectifs Étudier la fréquence de l’usage de substances chez les patients ayant une schizophrénie et déterminer les facteurs de risque de cette association. Méthodes Étude transversale faite au centre psychiatrique de Fès ciblant les patients hospitalisés, chez qui le diagnostic de la schizophrénie a été posé selon les critères du DSM-IV. Un hétéro-questionnaire a été établi pour rechercher les données sociodémographiques exactes, les antécédents médicaux et psychiatriques, les données cliniques et thérapeutiques de la maladie schizophrénique ; l’âge et le mode de début, le traitement et la qualité de l’observance. L’usage de substances a été évalué selon les critères du DSM-IV à la recherche d’une dépendance ou d’un abus aux différents types de toxiques. Résultats L’échantillon comporte 108 patients ayant une schizophrénie diagnostiquée selon les critères de DSM-IV. La prévalence de l’usage de substances est de 60,2 % ( n = 65). Le tabac et le cannabis sont les substances les plus utilisées. La plupart des patients (71,1 %) ont commencé l’usage avant la maladie. Le sexe masculin (OR 13,95, p = 0,01) et la présence d’un antécédent judiciaire (OR 0,12, p = 0,05) se sont révélés des facteurs déterminants de l’usage de substances chez les patients ayant une schizophrénie. Conclusion L’identification précoce des facteurs de risque de consommation de substances chez les patients souffrant de schizophrénie pourrait améliorer le pronostic des patients en réduisant le nombre de rechutes et de promouvoir l’adhésion aux soins. Background Studies on substance use in patients hospitalized for schizophrenia are numerous. However, there are no studies in Morocco. Aims To investigate the frequency of substance use among patients with schizophrenia and to identify risk factors for this association. Methods Cross-sectional study completed in 2008 in one psychiatric center in Fez, Morocco, targeting patients hospitalized for relapse of schizophrenia. Substance abuse and dependency to the different types of substances was assessed with Mini International Neuropsychiatric Interview, according to the criteria of DSM-IV. Results The sample included 108 patients. Cannabis is the most frequent substance used by patients after tobacco. The life prevalence of the use of at least one substance is 60.2 %. Half of the cannabis users met dependence criteria. The life prevalence of alcohol consumption was 47.2 %, and consumption is occasional in 25 % of cases. Among users of at least one substance, 71.1 % began before the onset schizophrenia. Male gender (OR 13.95, P = 0.01) and history of judicial problem (OR 0.12, P = 0.05) were determinants of substance use in patients with schizophrenia. Conclusions Early identification of risk factors for substance use in patients with schizophrenia could improve the evolutionary course of the latter by reducing the number of relapses and promoting compliance to care. [ABSTRACT FROM AUTHOR]

Résumé La maladie de Crohn est une maladie inflammatoire chronique de l’intestin, caractérisée par l’alternance de phases de rechute et de rémission. L’étiologie méconnue des rechutes constitue pour les patients une source importante de stress et d’anxiété. L’objectif de notre étude est d’identifier les facteurs psychosociaux ayant un impact sur la rechute de la maladie. Nous avons mené une étude longitudinale sur une cohorte de 88 patients en rémission durant un an. À partir d’échelles génériques et spécifiques à la maladie, les facteurs de stress (PSS10, Machrostresseur, Hassles), les stratégies de coping (WCC) et la qualité de vie (Whoqol-bref, IBDQ) ont été évalués. L’activité de la maladie a été mesurée à partir du Harvey Bradshaw Index. Nos résultats montrent que le stress induit par les répercussions physiques de la maladie et la perte de ressources, les stratégies de coping centrées sur l’émotion ainsi que la qualité de vie relative aux maladies chroniques, représentent des facteurs de risque liés à la rechute. La stabilité et la spécificité des facteurs de risque nous interrogent quant à la présence de facteurs de vulnérabilité liés au vécu conscient et inconscient de la maladie chez les patients qui ont rechuté. Objectives Crohn's disease is a chronic inflammatory bowel disease characterized by alternating phases of relapse and remission. The unknown etiology of relapse is a major source of stress and anxiety for afflicted individuals. Some researchers have shown that daily hassles, perceived stress, and emotional coping can predict the observed fluctuations in Crohn disease's symptoms. In others studies, the patient's quality of life has been found to impact the risk of relapse. However, there is no consensus regarding the psychological factors influencing the relapse. The aim of our study was to identify the stress factors, coping strategies, and variations in quality of life affecting Crohn's disease relapse. First, we hypothesized that perceived stress, stressors relate to chronic somatic diseases, and daily hassles would be higher in relapsing patients 1 month prior to their relapse. Second, we assumed that relapsing patients use more emotion-focused coping than patients in remission and have a poorer quality of life. Patients or materials and methods We conducted a 1-year longitudinal study, relying on a cohort of 88 patients (32 males, 56 women) in remission in three services of gastroenterology. With generic and disease-specific scales, stressors (Perceived Stress Scale-10, Machrostresseur, Hassles), coping strategies (Ways of Coping Checklist) and the quality of life (World Health Organization Quality Of Life, brief version, Inflammatory Bowel Disease Questionnaire) were assessed. Each month during 12 months, patients defined their level of stress and their use of coping strategies, from autoquestionnaire. Quality of life was only assessed at inclusion time. The disease activity was measured with the Harvey Bradshaw Index. At inclusion time, all patients were in remission. Resection antecedents and frequency of relapse were controlled for. The patient sample was divided into two groups: a remission group and a relapsing group. Using Student's t test, we compared the stress, coping, and quality of life scores of the two groups at baseline and 1 month prior to the relapse. When significant between-groups differences were found, risk factors were estimated with odds ratios. Results Of the 88 patients, 26.1% relapsed. There was no between-group difference in disease duration, gender, resection antecedents, or relapse frequency. Our results showed that the specific stress induced by the physical impact of the disease (OR = 3.53; 95% CI: 1.07–11.68) and the loss of resources (OR = 4.98; 95% CI: 1.35–16.93) at baseline and 1 month prior to the relapse (OR = 2.91; 95%: 1.00–8.46; OR = 5.98; 95% CI: 1.80–19.77) were risk factors. We found no between-group difference regarding perceived stress and daily hassles. The use of emotion-focused coping strategies increased the risk of relapse 1 month prior to the relapse (OR = 5.63; 95% CI: 1.69–18.72), in contrast with problem-focused focus coping or social support seeking. Disease-specific, but not generic quality of life factors were risk factors for relapse (OR = 6.33; 95% CI: 1.79–22.39). Indeed, we observed that patients with a poorer quality of life related to digestive system problems were at increased risk of relapse (OR = 3.33; 95% CI: 1.06–10.44). Moreover, the quality of life related to emotions (OR = 8.80; 95% CI: 0.83–89.12) and social consequences (OR = 69.93; 95% IC: 2.03–23.63) appeared as risk factors for relapse. Conclusion The psychosocial factors associated with chronic disease are the best predictors of relapse in Crohn's disease. Except emotion-focused coping, the psychological risk factors for relapse are specific of chronic disease. A poorer quality of life increases the relapse of Crohn's disease, like the chronic disease stressors. Our study shows that the impact of stressors and quality of life on relapse is stable, at inclusion time and 1 month prior to the relapse. Concerning the stability and specificity of risk factors, the vulnerabilities related to the conscious and unconscious experience of the disease in patients who have relapsed are discussed. Stressors related to physical repercussions, loss of resources and emotion-focused coping could be explained by a difficulty in elaborating the experience of the illness. This study sheds new light on relapse vulnerabilities and on therapies for patients. [ABSTRACT FROM AUTHOR]

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Introduction: Aseptic loosening is the main long-term complication and indicates total hip replacement failure. There are many and often intricate causes for aseptic loosening. Incorrect placement of the implants is the most incriminated factor. Other patient and implant related factors may also predispose to loosening but to various degrees. Methods: We conducted a retrospective study of 64 cases with aseptic loosening of total hip prosthesis to individuate patient, implant type and surgical technique related factors leading to aseptic loosening and to provide recommendations to minimize this risk. Results: This was an analytic retrospective study of 64 cases with aseptic loosening. The classification is that used by the French Society of Orthopedic Surgery and Traumatology. The average age of the patients at the time of the first arthroplasty was 40 years, 62 years at the time of loosening. Charnley stem was implanted in 55 cases, Muller stem in 9 cases. Acetabular component was well positioned in 69% of cases with an average inclination of 47.8 °. The stems were canal-filling in 86% of cases with Grade A cementation in 60% of cases. The mean time for loosening onset was 12 years. 72% of the prostheses had a survival longer than 10 years. Statistical analysis of the results identified risk factors leading to loosening, such as: age, body mass index, level of activity, cup inclination, femoral offset and cementation quality. Conclusion: A significant reduction in aseptic loosening of total hip prostheses may only be achieved by a more rigorous selection of patients, a greater security in the technical act and a better choice of the implant to be placed. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) is an important health care problem in haemodialysis. Hepatitis C virus is both a cause and complication of kidney diseases. Yet there are limited information on antibody against HCV in patients on haemodialysis. The purpose of this study was to determine the prevalence of anti-HCV and the risk factors associated with HCV infection in a cohort of 100 participants on haemodialysis. They were consecutively recruited into the study, anti-HCV testing was made by the 3rd-generation ELISA System (C-100, C-33c, C-22). The prevalence of HCV antibody was 15%, risk factors associated with HCV antibody were history of blood transfusion and duration of session of haemodialysis; the risk increased with increased with the number of blood transfusion and seasons of haemodialysis. The observed high prevalence of HCV antibody among patients on haemodialysis reflect the quality of healthcare services and the standards of infection control practices in our haemodialysis units. Routine screening for HCV should be done before blood transfusion using third generation ELISA assays with high sensitivity and specificity. Safety measures should be taken in our haemodialysis units to prevent cross infection among patients and staffs. These safety measures include; discarding syringes, needles, gloves, bloodlines and dialysers after single use, and the use of sterile dressings on each patient visit.

Résumé But de l’étude L’objectif de notre travail était d’évaluer la fréquence de la cyberaddiction dans une population d’étudiants et de relever leurs principaux facteurs de risque. Patients et méthode Nous avons mené une étude transversale, descriptive et comparative auprès d’une population d’étudiants de la faculté des sciences d’El Manar. La population était constituée de 310 étudiants. Nous avons recueilli les données sociodémographiques et cliniques par l’intermédiaire d’un auto-questionnaire semi-structuré. Nous avons utilisé le MINI pour dépister la dépression, l’échelle d’anxiété de Beck et le questionnaire de Young de la cyberdépendance. Résultats Un peu plus d’un quart des étudiants présentait une cyberaddiction (26,8 %). Les facteurs corrélés à la cyberaddiction étaient l’âge, le lieu d’habitation, le parcours scolaire, les antécédents, la dépression, l’anxiété et la consommation d’alcool et de cannabis. Conclusion Notre étude est en faveur de la fréquence de la cyberaddiction parmi les étudiants enquêtés. Objective In this study, our aims were to find the cyberaddiction's prevalence among student's sample of Tunis scientific university and to seek for the most important cyberaddiction's risk factors. Methods Our study included 310 students from the scientific university of Tunis El Manar. All students completed a questionnaire. The questionnaire was composed by three parts: the first included the social and demographic data, the second included personnel and familiar data. We used the MINI to detect depressive symptoms during the last two weeks. We used the Beck anxiety scale to detect anxiety symptoms during the last week. Finally we used the Young cyberaddiction scale to seek for cyberdependency. Results The sample was composed by 57.4% girls ( n = 178) and 42.6% boys ( n = 132), the sex-ratio F/H was 1.34. Mean age was 21.9 years ± 1.4. A total of 27.7% ( n = 86) of students have a major depressive episode during the two last weeks (MINI criteria's). While, meanly the half of students (53.5%, n = 166) have anxiety symptoms (Beck anxiety scale). A total of 19.7% of students ( n = 61) present an alcohol use (19.7%, n = 61). Eight students use occasionally cannabis (2.6%). A total of 26.8%; n = 83 of students are addicted to Internet, if Young internet addiction criteria's was applied. All the students use frequently Internet. The most of them all days (82.3%, n = 255). The connexion mean time was 3.8 ± 2 hours/day. The most frequent activities on the net were the chat (online discussion, forums…) in 79.1% of cases. Meanly 25% of students of the sample have three activities on the net (chat, founding, save, games on line…). The age ( P < 0.001), the residence ( P = 0.017) and the scholar failure ( P < 0.001) were correlated to the cyberdependency (OR = 2.8; 2.3 and 2.8, respectively). Family history was also correlated to cyberaddiction ( P = 0.023). We also note most depression, anxiety symptoms, and alcohol and cannabis addictions among group of cyberaddicted students. The relative risk was estimated respectively to 4.6; 4.4; 3.2 and 8.5. Conclusion The cyberdependency was frequent among students. Depressive and anxiety symptoms were also important in case of net addiction. It is important to detect and prevent this cyberaddiction and those psychiatric comorbidities. [ABSTRACT FROM AUTHOR]