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Breaking the news of a patient's death is a defining moment in the process of caring for families. Making this announcement requires professionalism, taking into account the suffering of the loved one and the challenges specific to this moment. Beyond the theory and proposed benchmarks, the way this news is broken must be thought through by the departments and caregivers. It leaves room for the creativity, adaptability, and humanity of the announcer., (Copyright © 2019. Published by Elsevier Masson SAS.)

In the past, death was a family and community affair, but today it is institutional and entrusted to healthcare personnel. Thanks to a questionnaire on their feelings about prehospitalisation deaths, the experience and training needs for healthcare personnel at a mobile emergency and intensive care service were analysed. The majority of these professionals had been confronted with difficulties when faced with prehospitalisation deaths. There is little understanding of religious rites, even though this is an important point in dealing with the situation. There is a strong desire for training. The pedagogical support offered in response to the needs expressed was recognised as being useful and should be more widespread., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Caregivers are inevitably exposed to the death of the people they care for as almost all deaths occur in a health or medical-social facility. This generates emotional situations which naturally impact on caregivers in their everyday work. The healthcare manager must take into account this reality in the management of risks related to the issue of death., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

A matter of death and life, is the diary that Irvin Yalom and his wife Marilyn, two elderly people in the last act of life, write together, chapter after chapter, a few months before her death, suffering from myeloma. The testimony of a union that spans sixty-five years of life celebrated in the name of mutual knowledge and respect for each other's individuality, an irreplaceable ingredient of an interminable union. [ABSTRACT FROM AUTHOR]

Polémique, la remise en question permanente des mesures de contention et de leur dangerosité permet aujourd'hui d'améliorer et d'actualiser les recommandations de bonne pratique en psychiatrie. L'étude d'un cas de décès par asphyxie d'un patient hospitalisé en soin psychiatrique sous contrainte nous permet de questionner les méthodes et manœuvres pouvant être employées pour la contention des patients souffrant du « syndrome de délire agité » tel que décrit dans la littérature. Une discussion des recommandations actuelles à propos de la contention physique et chimique, ainsi que sur les méthodes dites non violentes de désescalade, semble indispensable dans une démarche d'amélioration des pratiques, qu'elles soient intra-hospitalières ou extrahospitalières (premier contact avec les forces de l'ordre). Controversial, the constant questioning of restraint measures and the dangers associated with their use makes it possible for us to improve and update the recommendations for good practice in psychiatry. The case study of the death by asphyxiation of a patient hospitalized in psychiatric care and who had been restrained allows us to question the methods and procedures that can be used to restrain patients suffering from "agitated delirium syndrome" as described in the literature. A discussion of the current recommendations on physical and chemical restraint, as well as the so-called non-violent de-escalation methods, seems essential for developing an approach to improving practices, whether intra-hospital or extra-hospital (an initial contact with the police). [ABSTRACT FROM AUTHOR]

The causes of death are of great importance in assessing the health status of the population and care'squality. Their study could guide health policies aimed at increasing life expectancy. Objectives: It was to determine the causes of death; to study the socio-demographic characteristics of deceased. Materials and methods: This was a retrospective and descriptive study of all deaths that occurred in the Medical Department of Sikasso Hospital from January 2018 to December 2020. Results: Among 265 deaths recorded, the mean age was 45.12 ± 17.5 years. The sex ratio was 1.59. They were mostly city dwellers and 51.64% lived in Sikasso city. The mean length of hospitalization was 7.09 ± 6.38 days. Kidney failure was the first reason for hospitalization. HIV infection was the leading cause of death (29.8%), followed by renal failure (24.2%). The male sex was predominant in all causes of death except HIV infection and anemia. Deaths linked to kidney failure have increased fivefold from 2018 to 2020. Conclusion: Deaths related to HIV/AIDS remain in the lead despite their strong reduction; those related to kidney failure have increased fivefold. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Case Law Review / Revista Română de Jurisprudenţă is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Goals We studied the socio-demographic and paraclinicalcharacteristics of tuberculosis patients to identify the factors associated with their deaths in Bamako. Materials and methods: A retrospective cohort study was carried out on tuberculosis patients registered in Bamako from October 1, 2017 to September 30, 2018. Quantitative variables were presented by their mean, qualitative ones by their proportions. Analysis was performed with R version 3.5.0. Results: Out of 2396 patients enrolled, 25 to 45-year olds represented 50.3% and children 4.51%; the average age 37.3 years; the sex ratio M/F 1.94 and co-infected TB/HIV 8.64%. 25 to 45 year olds (HR=2.58; 95% CI [1.35-4.92]; p=0,0042) and those ≥ 46 years (HR=4.64; 95% CI [2.39-9.01] ; p=5.69e-06) and positive HIV status (HR= 5.87 ; 95% CI [2.24-15.41] ; p= 0.0003) were associated with an increased risk of patient death. Conclusion: Tuberculosis affects young and old males. The risks of death identified were the patient's age and positive HIV status. We recommend specific monitoring of patients aged 25 to 45 and 46 and over and those with positive HIV status. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Case Law Review / Revista Română de Jurisprudenţă is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les admissions hospitalières pour anaphylaxie alimentaire augmentent dans tous les pays mais la mortalité reste stable. Analyser rétrospectivement les cas d'anaphylaxie alimentaire, létale/prélétale (grade 4 selon Ring et Messmer, inefficacité cardio-circulatoire ou arrêt respiratoire), du Réseau d'Allergo-Vigilance® (2002–2020) et rechercher les facteurs associés à la survie. Parmi 2475 anaphylaxies alimentaires (1,7 %), 42 patients [âge moyen : 22,2 ans (ET : 19,3) ; âge < 18 ans : 60 %] ont présenté une anaphylaxie de grade 4 ; 19 (45 %) sont décédés. Parmi les antécédents, 21 (50 %) avaient un asthme, 33 (79 %) une allergie alimentaire connue dont 21 (50 %) pour le même allergène responsable de l'anaphylaxie grade 4. Les principaux allergènes étaient : arachide (33 %), laits (19 %), crevette (7 %), noisette et blé (5 %, respectivement). Il existait un bronchospasme dans 26 (62 %) cas et un angio-œdème laryngé dans 6 (14 %) cas. Un cofacteur était identifié dans 16 (38 %) cas, effort (21 %) et alcool (14 %). La réaction allergique survenait au domicile (n = 11, 26 %), à l'école ou au restaurant (n = 4, 10 %, chacun). Nous n'avons pas identifié de facteur associé à la survie. Les enfants avaient plus souvent un antécédent d'asthme (64 % versus 29 %, p = 0,01) et moins de cofacteurs (20 % versus 65 %, p = 0,02) que les adultes. Ces données alertent sur la fréquence des anaphylaxies sévères souvent sous-estimées. Elles confirment l'importance de facteurs de risque (asthme, allergie arachide-laits) et des cofacteurs chez l'adulte. Il faut mieux préciser le phénotype des patients à haut risque de réaction allergique grave et sélectionner ceux qui pourront bénéficier d'une prise en charge personnalisée (immunothérapie, biothérapie). Hospital admissions for food-induced anaphylaxis are increasing in most countries but mortality remains stable. Analyze retrospectively cases of letal/preletal food-induced anaphylaxis (grade 4 among Ring and Messmer classification) recorded by the Allergy-Vigilance® network (2002–2020) and assess factors associated with survival. Forty-two patients (male sex : 57%) of 2475 food anaphylaxis (1.7%) were recorded as grade 4 [mean age: 22.2 y (CI: 19.3) ; age < 18y: 60%] and 19 (45%) died. Twenty-one (50%) had a history of asthma, 33 (79%) of food allergy [21% (50%) with the same index food allergen] and 13 (31%) of previous anaphylaxis. The most frequent allergens were: peanut (33%), milks (19%), shrimp (7%), hazelnut and wheat (5%, respectively). Food allergen was uncertain in 10%. Clinical symptoms were bronchospasm in 26 (62%) of cases and laryngeal oedema in 6 (14%). A cofactor was identified in 16 (38%) cases, mostly physical exercise (21%) and alcohol (14%). Allergic reaction occurred at home (26%), at school or in a restaurant (10%, each). No factor associated with survival was identified. Children were more likely to have a history of asthma (64% versus 29%, P = 0.01) and less cofactors (20% versus 65%, P = 0.02) than adults. These data highlight on the high frequency of preletal anaphylaxis cases that are underestimated in epidemiological studies and also on the importance of risk factors (asthma, milks-peanut allergy) and cofactors in adults. It is necessary to better phenotype patients with a high risk of severe anaphylaxis and select those who will benefit a personalized approach (immunotherapy, biologicals). [ABSTRACT FROM AUTHOR]

Copyright of Strategic Universe Journal / Univers Strategic is the property of Dimitrie Cantemir Christian University, Institute for Security Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bullous drug eruptions such as Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare but known adverse reactions of fluoroquinolones. Although uncommon, TEN can be life-threatening for the patient, especially in the context of delayed treatment and in fragile patients such as the pediatric population. In the present case, TEN occurred in a 13-year-old girl with no medical history following initiation of ciprofloxacin treatment for an inguinal cyst. We hope that the case report will make interrogate the practices concerning the use of antibiotics, in particular fluoroquinolones in the context of an use not prescribed by the Marketing Authorization of the drug in children. [ABSTRACT FROM AUTHOR]

Les certificats de décès doivent mentionner la présence d'une prothèse fonctionnant avec une batterie et ses possibilités d'explantation. Cet acte ne peut être pratiqué que par un médecin ou un thanatologue. L'existence d'une infection par le SARS-CoV-2 ne modifie pas les exigences légales. In France, every death certificate must mention the presence of a prosthesis operating by means of a battery and its explantation or not. The explantation must be made regardless of the burial. Explantation can only be performed by a doctor or a thanatopractor. The health emergency related to covid-19 does not affect these principles of ordinary law. [ABSTRACT FROM AUTHOR]

Introduction: mortality risk is high at the Intensive Care Units (ICU) in developing countries. We here report the deaths occurred in the ICU at the Mother and Child Center in Yaounde, Cameroon. Methods: we conducted a retrospective study on the clinical, socio-demographic features, the therapeutic strategy as well as some of the factors associated with deaths occurred in 200 patients aged 3-59 months between 2010 and 2014. Results: out of 2675 patients included in the study, 1807 were aged 3-59 months and 303 died. The overall and cause-specific mortality rate in this age group was 11.3% and 16.7% respectively. Most patients (152/200; 76.0%) died within 24 months and the median admission time was 7 days. More than half of patients (57.0%) presented to a health center and only 66 (33.0%) presented to a referral hospital. Severe malaria (41.5%), pneumonia (22.7%) and gastroenteritis (27.8%) were the most common diseases. Malnutrition and HIV/AIDS were the underlying causes of death in 23.0% and 20.5% of patients respectively. Gastroenteritis multiplied the risk of death of approximately 6 times (OR = 5.76; p = 0.000) in patients affected by malnutrition and HIV infection. Deaths mainly occurred (90.0%) within 72 hours of admission. Conclusion: despite limited resources, some diseases could have been easily treated avoiding complications which require reanimation. It is essential to intensify the fight against malaria, HIV infection and malnutrition. [ABSTRACT FROM AUTHOR]

Le décès est un évènement rare en pédopsychiatrie et il reste très peu étudié. Nous rapportons ici une recension de la littérature sur la mortalité en pédopsychiatrie et une série rétrospective depuis 2007 la mise en place des revues de mortalité et de morbidité réalisée dans un service hospitalo-universitaire disposant de plusieurs unités d'hospitalisation. La revue a colligé 73 études. Toutes concourent à confirmer la surmortalité des enfants et adolescents suivis en pédopsychiatrie qu'elle soit en population générale ou non spécifique (ex : patients hospitalisés) ou en population spécifique (ex : patients autistes). Les causes de surmortalité sont bien sûr le suicide mais également nombre de causes naturelles (ex : complications d'addiction ou d'anorexie mentale). Notre étude rétrospective collige 11 patients (âge moyen = 15,5 ans ; 9 filles pour 2 garçons) avec 5 décès et 14 situations engageant le pronostic vital (EPV). Là encore les suicides complétés et les tentatives de suicide graves sont très présents (n = 8 dont 2 décès), mais nous décrivons également des causes somatiques complications de conduites pathologiques (n = 5 : dénutrition dans un contexte d'anorexie, intoxication à l'eau) ou sous-tendues par une maladie somatique (n = 5, dont 2 décès liés à une maladie de Sanfilippo et un lymphome infiltrant du tronc cérébral). Tout comme en psychiatrie adulte, les enfants et adolescents atteints de troubles mentaux semblent avoir une espérance de vie diminuée par rapport à la population générale. Néanmoins, le décès en pédopsychiatrie reste un phénomène rare et ce d'autant plus lorsqu'il s'agit d'une prise en charge hospitalière. Notre étude met en évidence que les cas de décès ou d'EPV en pédopsychiatrie hospitalière sont dus à des maladies somatiques plus ou moins intriquées à des troubles psychiatriques, d'une part, et à des suicides, d'autre part. Death is a rare event in child psychiatry and still not widely studied. Here, we report a review of literature concerning mortality in child psychiatry and a retrospective study (begun in 2007) of the implementation of "mortality and morbidity reviews" carried out in a university hospital within several inpatient units. The review pulled together 73 studies, all of them confirming the excess mortality of children and adolescents in child psychiatry, whether in the general/non-specific populations (ex : hospitalized patients) or in specific populations (e.g. : autistic patients). The causes of excess mortality are undoubtedly suicide but also many natural causes (e.g. : complications due to addiction or anorexia nervosa). Our study includes 11 patients (mean average age = 15.5 years; 9 girls and 2 boys) and saw 5 deaths and 14 life-threatening situations. Again, suicides and serious suicide attempts were very common (n = 8 including 2 deaths), but the study also describes somatic causes, complications of pathological behaviour (n = 5 : undernutrition in the context of anorexia, water poisoning) or underlying somatic disease (n = 5, including 2 deaths related to Sanfilippo disease and infiltrative brain lymphoma). As with adult psychiatry, children and adolescents with mental disorders appear to have a lower life expectancy compared to the general population. Nevertheless, death in child psychiatry remains a rare phenomenon, especially when it happens in hospital care. Our study shows that cases of death or life-threatening situations in hospitalized child psychiatry are due to somatic diseases (that are more or less entangled with psychiatric disorders) or due to suicides. [ABSTRACT FROM AUTHOR]

The present study aimed to know the perceptions of health professionals about the death of patients. A descriptive and exploratory qualitative study was carried out. Data collection was carried out through semi-structured interviews and observations. Seventeen doctors and nurses, who work in the emergency department at a teaching hospital in Rio Grande do Sul, were interviewed. The data obtained were submitted to triangulation based on content analysis. The results showed that defensive strategies are used to face situations considered stressful. Furthermore, the feelings raised are not elaborated by the professionals. It was concluded that defensive strategies are used when the death of patients occurs, but this does not reduce the suffering of professionals, so it is important that death is a topic of initial and continuing training among health professionals. [ABSTRACT FROM AUTHOR]

Copyright of Revue Universitaire des Sciences Humaines et Sociales is the property of University of Kasdi Merbah Ouargla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To analyse and present the literature describing the health consequences of falsified medicines, focusing on mortality and morbidity, as well as the scale of the issue, the geographic extent, the medicines affected, and the harm caused at both the individual and population levels.Methods: We searched for articles in PubMed, using pre-optimized keywords '(counterfeit OR fake OR bogus OR falsified OR spurious) AND (medicine OR drug)'. Searches up to February 2017 yielded 2006 hits, of which 1791 were full-length articles in English. Among them, we found 81 papers that qualitatively or quantitatively described 48 incidents in which falsified medicines caused patients to suffer serious adverse effects, injury, symptoms or death.Results: The distribution of incidents was examined according to the economic status of the countries involved, regional location in the world, therapeutic category of the medicines, number of incidents and victims by year, and characteristics of the falsified medicines. Among the 48 reported incidents, 27 (56.3%) occurred in developing countries and 21 (43.7%) in developed countries. These incidents involved a total of approximately 7200 casualties including 3604 deaths.Conclusions: Despite the poor quality of much of the reported data, the results of this study indicate that all types of medications have been targeted for falsification, and falsified medicines have had a serious impact on the health of both adults and children worldwide, with similar numbers of incidents in developing and developed countries. [ABSTRACT FROM AUTHOR]

Résumé Le traitement de l'anaphylaxie en pratique courante repose, en première ligne, sur l'utilisation sans délai de l'adrénaline par voie intramusculaire. Les auto-injecteurs d'adrénaline permettent une injection dans des conditions d'efficacité et de sécurité optimales, mais dans une gamme de doses restreinte, entre 0,15 et 0,50 mg, par injection. Toutes les recommandations internationales sur le traitement de l'anaphylaxie en pratique courante valident une même posologie d'adrénaline de 0,01 mg/Kg de poids par injection intramusculaire (dose maximale de 0,5 mg par injection) malgré l'absence d'étude de qualité sur ce thème. Cette mise au point du groupe de travail « Anaphylaxie » de la Société française d'allergologie analyse les données actuelles concernant le traitement par adrénaline avec les auto-injecteurs, en insistant sur la problématique de la posologie. Abstract Intramuscular adrenaline is the first-line treatment for anaphylaxis. Adrenaline auto-injectors allow injection under conditions of optimal efficacy and safety, but commercially available formulations are restricted to a dose range of 0.15 and 0.50 mg per injection. All the international anaphylaxis guidelines recommend the administration of intramuscular adrenaline at a dose of 0.01 mg/Kg of body weight, with a maximum dose of 0.5 mg per injection, despite the lack of evidence-based data. This position statement, prepared by the Anaphylaxis working group of the French Allergology Society, attempts to analyse current data regarding the use of adrenaline auto-injectors as treatment of anaphylaxis with, in particular, emphasis on the dosage issue. [ABSTRACT FROM AUTHOR]

Introduction: In Congo, data on diabetic ketoacidosis (DKA) in children are old and rare. This study aims to describe the sociodemographic features of DKA and to identify risk factors for mortality. Patients and Methods: We conducted an analytical study on DKA in childred at the University Hospital in Brazzaville over the period from January 2013 to June 2016. We examined the socio-demographic, clinical, paraclinical and evolutionary variables. Chi-Square Test, Fisher's exact test and odds ratio were used in the univariate analysis process and logistic regression model in the multivariate analysis. Results: Out of 172 children hospitalized with diabetes 55 (31%) were hospitalized with ketoacidosis. They were girls (33; 60%) with an average age of 11.1± 4.9 years (ranging from 1 months to 17 years), 61.8% of parents came from low socioeconomic status. Ketoacidosis was the revealing symptom in 67.2 % of cases. The diagnosis made before hospitalization was wrong (50%). The triggering factor was often an infection (52.7%). Mortality rate was 12.7%. The risk factors for mortality in the univariate analysis were: age < 5 years (p=0,000006), average consultation time higher than 7 days (p= 0.001), severe dehydration (p = 0.0006), hemodynamic disorders (p= 0.0006), severe undernutrition (p= 0.02), Glasgow Coma Scale < 9 (p= 0.007) and diarrhea (p= 0.001). Conclusion: The importance and the seriousness of ketoacidosis impose preventive measures based on awareness, information and education campaigns as well as on the management of risk factors for mortality. [ABSTRACT FROM AUTHOR]

Résumé La cystinurie est une maladie génétique à transmission autosomique récessive due à un défaut de transport transtubulaire de cystine et d’autres acides aminés dibasiques (ornithine, arginine et lysine). Nous rapportons le cas atypique d’un enfant hospitalisé au service de pédiatrie et d’urologie du centre hospitalier régional de Saint-Louis du Sénégal. Il s’agit d’un garçon de 6 ans. Il a été hospitalisé pour la première fois à l’âge de 4 ans pour une infection urinaire à Escherichia coli multirésistante traitée et guérie. Il a été réhospitalisé à l’âge de 5 ans pour lithiases urinaires objectivées à l’échographie dans un contexte d’infection urinaire à Alkalenses dispar. Le patient a été réadmis à l’âge de 6 ans pour des douleurs abdominales, une toux sèche quinteuse et une rétention aiguë d’urine évoluant depuis 24 heures L’analyse chimique des urines montrait une cystinurie 420 mg/24 heures et une créatinine urinaire à 135 μmol/24 heures L’examen cytobactériologique des urines (ECBU) avait isolé E. coli sécrétrice de bêta-lactamase sensible seulement à l’imipenème. La tomodensitométrie de l’arbre urinaire montrait des lithiases multiples avec une densité à 560 unités Hounsfield (UH) aux niveaux vésicale et urétérale avec une uretéro-hydronéphrose bilatérale sans anomalies malformatives visualisées. La chirurgie ouverte avait permi l’extraction de 2 calculs jaunâtres, durs, pierreux. La spectrophotométrie infrarouge avait conclu à une lithiase de type cystinique. L’évolution était marquée par la persistance du syndrome infectieux et la survenue d’un choc septique avec défaillance multiviscérale et une hémorragie de grande abondance de survenue brutale ayant évolué vers le décès. Summary Cystinuria is an inherited autosomal recessive inherited disease caused by transtubular transport defect of cystine and other dibasic amino acids (ornithine, arginine and lysine). We report the atypical case of a hospitalized child in the Pediatrics and Urology Department of the Saint-Louis Regional Hospital Center in Senegal. This is a 6-year-old boy. He was hospitalized for the first time at 4 years of age for a multiresistant Escherichia coli infection treated and cured. He was rehospitalized at the age of 5 for urolithiasis objectified on ultrasound in a context of urinary infection at Alkalenses dispar. The patient was readmitted at 6 years of age for abdominal pain, a dry, hacking cough, and acute urine retention that had been occurring for 24 hours. The chemical analysis of the urine showed 420 mg/24 h cystinuria and urinary creatinine at 135 μmol/24 h. Cytobacteriological examination of urine (ECBU) isolated Escherichia coli secreting beta-lactamase sensitive only to imipenem. Computed tomography of the urinary shaft showed multiple lithiases with a density of 560 Hounsfield (UH) units at the vesical and ureteral levels with bilateral uretero-hydronephrosis without visual malformation abnormalities. Open surgery had allowed the extraction of 2 yellowish, hard, stony calculi. Infrared spectrophotometry concluded that there was cystine lithiasis. The evolution was marked by the persistence of the infectious syndrome and the occurrence of septic shock with multi-visceral failure and a haemorrhage of great abundance of sudden occurrence that progressed to death. [ABSTRACT FROM AUTHOR]

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Copyright of Réseaux (07517971) is the property of Editions La Decouverte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Les données concernant la mortalité par anaphylaxie sont rares et parfois conflictuelles. Notre objectif était de recueillir et d’analyser les cas de décès par anaphylaxie de cause alimentaire en France. Méthodes Ces données ont été obtenues : (1) du CépiDC (Inserm) à partir des certificats de décès sélectionnés par les codes CIM9/10 évocateurs d’anaphylaxie (1979–2011) ; (2) du Réseau d’Allergo-Vigilance ® pour préciser les caractéristiques de décès survenus par anaphylaxie alimentaire (2002–2017). Résultats (1) CépiDc : sur 1603 décès (1564 adultes ; 39 enfants < 19 ans) par anaphylaxie, 8 (sexe masculin, n = 6) étaient de cause alimentaire. Les aliments représentaient la cause la moins fréquente (0,6 %) de décès par anaphylaxie. Les causes iatrogènes représentaient 63 % des cas et les venins d’insectes 14 %, avec cependant 23 % des cas dont la cause n’était pas spécifiée. Sept patients avaient < 32 ans et 2 étaient des enfants (moyenne d’âge : 24,6 ans [DS : 6,2]). Le faible nombre de décès n’a pas permis de calculer de taux de mortalité par anaphylaxie alimentaire ; (2) Réseau d’Allergo-Vigilance ® : sur 1862 cas d’anaphylaxie alimentaire, 16 décès (sexe masculin, n = 10 ; enfants, n = 11) ont été enregistrés (10 en France ; moyenne d’âge : 23,5 ans [DS : 5,2]). Les allergènes étaient principalement : arachide ( n = 6), fruits à coque ( n = 3), lait de brebis/chèvre ( n = 2). Onze (69 %) patients décédaient après une exposition à un allergène connu et 9 (56 %) patients avaient un antécédent d’asthme. Conclusion Le nombre de décès par anaphylaxie de cause alimentaire est faible, bien que probablement sous-estimé, et ces décès surviennent plus fréquemment chez les sujets jeunes, de sexe masculin. Data about anaphylaxis mortality are limited and occasionally conflicting. Our aim was to collect and analyze cases of fatal food-induced anaphylaxis in France. Methods Data were obtained from: (1) the CepiDC unit (National Mortality Center) to collect fatal anaphylaxis cases (1979–2011) through death certificates using ICD9/10 codes related to anaphylaxis; (2) the Allergy-Vigilance network based on voluntary declarations to collect patterns of fatal anaphylaxis cases (2002–2017). Results (1) CepiDc data: of 1603 fatal anaphylaxis cases (1564 in adults; 39 in children aged < 19 yrs), 8 (male, n = 6) were food-induced. Food was the least frequent cause (0.6%) of fatal anaphylaxis. Iatrogenic causes accounted for 63% of cases and insect venom for 14% (no specific cause: 23%). Seven cases were recorded in persons aged < 32 yrs and 2 in children (mean age: 24.6 yrs [SD: 6.2]). The small number of food-induced fatalities ruled out statistical analysis of the mortality rate; (2) Allergy-Vigilance network data: in 1862 food anaphylaxis cases, 16 deaths (male, n = 10; 63%) were recorded (10 occurred in France). Eleven (69%) fatalities involved children aged ≤ 18 yrs (mean age: 23.5 yrs [SD: 5.2]). The main food allergens were: groundnuts ( n = 6), tree nuts ( n = 3), and goat/sheep's milk ( n = 2). Eleven (69%) persons died after exposure to a previously known food allergen and 9 (56%) had a history of asthma. Conclusion The number of food-related fatal anaphylaxis cases is low but may be underestimated. Food-induced fatalities occur chiefly in young patients and in males. [ABSTRACT FROM AUTHOR]

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hypertension in pregnancy has several forms that differ by their mechanisms and their consequences for mothers and fetus. Chronic hypertension is defined by systolic blood pressure (SBP) ≥ 140mm Hg or diastolic blood pressure (DBP) ≥ 90mm Hg before pregnancy or before the 20th week of amenorrhea. Gestational hypertension is defined by SBP≥140mmHg or DBP ≥ 90mm Hg during or after the 20th week of amenorrhea. Pre-eclampsia is the occurrence of hypertension and proteinuria after 20 weeks of amenorrhea. Severe pre-eclampsia is accompanied by clinical signs and symptoms indicating visceral pain. A pre-eclampsia develops in 1-2 % of pregnancies, but much more frequently (up 34 %) in the presence of risk factors. High blood pressure during pregnancy remains, by its complications, the leading cause of maternal morbidity and mortality. Although symptomatic management has improved, there is currently no specific curative treatment, and only childbirth and delivery of the placenta, usually prematurely, alleviate the mother's symptoms. In the first six months of pregnancy, the primary goal of treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension. Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk with moderate hypertension. A SBP goal <160 and a DBP goal between 85 and 100mm Hg is recommended in pregnancy. During the long-term followup, American and European scientific societies, French society of hypertension and French national college of gynecologists-obstetricians have recognized hypertension in pregnancy and pre-eclampsia as specific emerging risk of women. Pre-eclampsia is a specific risk factor of chronic hypertension, of coronary events, of stroke, of chronic renal failure and a specific risk factor of cardiovascular mortality. Paradoxically, information of these women at risk is insufficient to ignorance and lack of awareness among health professionals. The education of women has become a major issue of prevention, developing specific consultation after delivery, encouraging them to optimize their lifestyle with a coordinated follow-up. In the end, the implementation of structured care pathway, further monitoring of these women, aims to improve the practices of health professionals. This is what drove the French Society of Hypertension, in partnership with the French National College of Gynecologists-Obstetricians, to develop a consensus proposing easy-to-use guidelines. [ABSTRACT FROM AUTHOR]

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Résumé Les accidents domestiques sont peu connus et étudiés dans les pays en développement. Ce travail avait pour but de rapporter les aspects épidémiologiques et pronostics des accidents domestiques pris en charge dans le service de chirurgie pédiatrique du CHU Aristide Le-Dantec de Dakar, du 1 er novembre 2009 au 30 octobre 2010. Matériels et méthodes Les dossiers d’enfants victimes de traumatismes non intentionnels survenus à domicile ou dans ses abords immédiats étaient inclus. Nous avons noté l’âge et le sexe de l’enfant, le jour, l’heure et le mois de survenue de l’accident, le mécanisme de l’accident et le lieu de survenue. Nous avons aussi étudié le pronostic exclusivement considéré sous l’angle des décès. Résultats Les accidents domestiques constituaient 28,8 % de l’ensemble des consultations et 16 % des hospitalisations à l’unité des urgences du service de chirurgie pédiatrique. La moyenne d’âge était de 5,1 ans. Les patients d’âge préscolaire étaient les plus touchés (59,3 %) avec une prédominance masculine (sex-ratio de 1,5). Les accidents domestiques survenaient principalement dans la cour et le jardin (26,2 %), lieux suivis de la chambre (17,9 %) et des escaliers (11,6 %). La chute était le principal mécanisme de survenue des accidents domestiques (62,5 %). Sept cas de décès (1,2 %) tous liés à des brûlures ont été recensés. Conclusion Les accidents domestiques chez les enfants dans notre contexte sont fréquents et surviennent essentiellement dans la cour et le jardin. La brûlure est responsable de la totalité des décès. Summary Domestic accidents occur at home or immediate surroundings. They are less known and studied in developing countries. The aim of this search was to study the epidemiology and prognosis aspects of domestic accidents received in emergency unit of pediatric surgery service at the university hospital Aristide Le-Dantec in Dakar, period of 1 year from 1st November 2009 to 30th October 2010. Materials and methods Records of children victims of unintentional injuries occurred at home or in immediate surroundings were included. We noted the age and sex of the child, the arrival time, and the occurrence period of the accident, the mechanism of the accident and the occurrence place. We also studied the mortality. Results Domestic accidents constituted 28.8% of all visits and 16% in patients to the emergency unit of the pediatric surgery service. The average age was 5.1 years. Preschool patients were most affected (59.3%) with a male predominance (sex-ratio: 1.5). Domestic accidents occurred mainly in garden (26.2%), followed by rooms (17.9%) and stairs (11.6%). Fall was the main mechanism of occurrence of accidents at home (62.5%). Seven cases of death (1.2%) were identified, all related to burns. Conclusion Home accidents among children in our context are common and occur mainly in the yard and garden. Burning is the only cause responsible of all the deaths noted in our study. [ABSTRACT FROM AUTHOR]

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The prevention and control of infectious diseases through vaccination and also their elimination and eradication trend, when possible, remain one of the main health-related purposes worldwide. Unfortunately, the immunization coverage has not reached the optimal level and because o f its negative evolution, there are still sporadic cases, outbreaks or even epidemics o f vaccine-preventable diseases. One example recently seen in breaking news and headlines is represented by diphtheria, a toxin-mediated acute disease caused by Corynebacterium diphtheriae. A 6 year-old boy, from the Catalan city of Olot, province of Girona, died on the 27th of June 2015, after suffering complications o f diphtheria. The parents refused to vaccinate the child in the past. His first presentation to the doctor was a month before his death, on May 28,h. After 3 days, Spain announced through EWRS (Early Warning and Response System) the first case o f diphtheria in the country, from the last three decades. This dramatic event should represent a warning sign to public health authorities, civil society and mass media, in order to prevent future similar situations. [ABSTRACT FROM AUTHOR]

Résumé Introduction La santé néonatale demeure une préoccupation dans les pays à faible revenu. Ce travail vise à analyser le profil et le pronostic néonatal de l’asphyxie périnatale dans une structure sanitaire urbaine au sud du Sahara. Patients et méthodes Il s’agit d’une étude prospective transversale du 1er juin au 30 novembre 2013,portant sur les nouveau-nés à terme hospitalisés pour asphyxie périnatale, dans le service de pédiatrie médicale du centre hospitalier universitaire pédiatrique Charles-de-Gaulle. Résultats L’asphyxie périnatale a représenté 19,8 % des admissions. Le sex-ratio était de 1,6. Le liquide amniotique était anormal dans 61 cas (71,8 %). Les signes généraux étaient dominés par la détresse respiratoire et l’hyperthermie avec respectivement 65,9 % et 45,9 % des cas. Tous les nouveau-nés ont présenté des manifestations neurologiques dominées par les anomalies des reflexes archaïques (92,9 %), suivies de l’hypotonie (88,2 %) et des convulsions (35,3 %). Selon la classification de Sarnat, le stade 2 était dominant avec 45,9 %. Une insuffisance rénale souvent transitoire était notée chez 38 nouveau-nés (44,7 %) dont 26 (30,6 %) avaient une détresse neurologique de stade 2. Les troubles métaboliques étaient dominés par l’hypoglycémie (37,6 %) et l’hyperglycémie (28,2 %). Les échographies transfontanellaire et abdominale étaient anormales avec respectivement 17 (20 %) et 6 cas (7,1 %). Le taux de mortalité était de 6 (7,1 %) avec quatre nouveau-nés en insuffisance rénale. Conclusion L’asphyxie périnatale reste une pathologie grave. La mortalité élevée rappelle qu’il est impératif de renforcer la prévention par une préparation à une réanimation efficace et satisfaisante. Summary Introduction Newborn health remains a concern in low-income countries. This work aims to analyze the profile and neonatal prognosis of perinatal asphyxia in an urban health structure south of the Sahara. Patients and methods This is a prospective cross-sectional study from June 1 to November 30, 2013, on term newborns hospitalized for perinatal asphyxia in medical pediatric department of pediatric teaching hospital Charles de Gaulle. Results The perinatal asphyxia represented 19.8% of admissions. The sex-ratio was 1.6. Amniotic fluid was abnormal in 61 cases (71.8%). General signs were dominated by respiratory distress and hyperthermia with 65.9% and 45.9%, respectively. All newborns presented neurological manifestations dominated by archaic reflexes abnormalities (92.9%), followed by hypotonia (88.2%) and seizures (35.3%). According to Sarnat classification, stage 2 was dominant with 45.9%. Renal failure, which was often transient, was noted in 38 infants (44.7%), of which 26 (30.6%) had neurological distress stage 2. Metabolic disorders were dominated by hypoglycemia (37.6%) and hyperglycemia (28.2%). Transfontanellar and abdominal ultrasound were abnormal with 17 (20%) and 6 cases (7.1%). The mortality rate was 6 (7.1%) with four newborns kidney failure. Conclusion Perinatal asphyxia remains a serious pathology. The high mortality recalls the need to strengthen prevention by preparation of an efficient and satisfactory resuscitation. [ABSTRACT FROM AUTHOR]

Since 2005, forgoing live-support (FLS) is allowed by the French law (known as the Leonetti law) for end-of-life patients only. This study aims at describing the variations over time in the use of the following methods to end life: FLS, brain death and cardiopulmonary resuscitation failure (CPR failure). It is a single retrospective study from 2007 to 2012. The Cochran-Armitage trend test is used in the statistical analysis. Over six years, 263 of the 5100 children who were hospitalized in our intensive care unit died, which represents a 5.2% mortality rate. FLS increased yearly from 31% of the deaths in 2007, to 71% in 2012 (P = 0.0008). The rate of CPR failure decreased over the same period (P = 0.0015). The rate of brain death remained constant. Following to the Leonetti law, FLS increase, and palliative cares develop without any increase of mortality. [ABSTRACT FROM AUTHOR]

Objective: The objective of our study was to identify the prognostic factors of death by scorpion envenomation in the region of Marrakech. Methods: We conducted a case-control study. It involved children hospitalized in the pediatric intensive care unit of the University Hospital of Marrakech after a scorpion envenomation between 1 October 2009 and 31 October 2012. An operating sheet was filled with the records of hospitalizations designed by the Poison Control Center of Morocco. Cases (n = 30) are represented by the children living in the area and who died during their hospitalization. For each case, we selected four witnesses among the survivors. A descriptive analysis, bi- and multivariate, was performed. Results: The median age was 5 years [2 months-14 years]. The M/F sex ratio was 1.5. The median delay between the bite and admission to the intensive care unit (TPP2) was 3 h 40 min [30 min-25 h]. Clinical signs commonly reported were vomiting (83%), priapism (72%) and sweating (70%). Biologically, leukocytosis, the hemostasis disorders, hyperglycemia and hyperuremia were statistically related to the death. Multivariate analysis showed that TPP2 > 5 h increased the risk of progressing to death five times, adjusting for age and vital distress (CI 95% 1.6-17). Conclusion: The upgrade of technical equipment and specialized personnel in the provincial resuscitation units are key elements to reduce TPP2, which is an important prognostic factor of death by scorpion envenomation in the Marrakech-Tensift-Al Haouz region. [ABSTRACT FROM AUTHOR]

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Copyright of Population (00324663) is the property of Institut National d'Etudes Demographiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Introduction: La santé néonatale demeure une préoccupation majeure dans nos pays aux conditions d’accueil du nouveau-né très difficiles. Ce travail vise à analyser les facteurs de risque de décès des nouveau-nés de faible poids de naissance dans des structures sanitaires urbaines au sud du Sahara. Patients et méthodes: Il s’agit d’une étude rétrospective de type descriptif du 1er janvier 2006 au 31 décembre 2010, portant sur les antécédents gestationnels et les paramètres épidémiologiques cliniques de nouveau-nés de faible poids de naissance (<2500g), de 0 à 28jours, hospitalisés dans les trois unités de néonatologie de la ville de Ouagadougou. Résultats: Le taux de prématurité était de 60,8 %. Les nouveau-nés de faible poids de naissance ont constitué 64,8 % des hospitalisations avec un sex-ratio de 1,1. Trente-trois pour cent des mères étaient âgées de moins de 20ans et 77,6 % des parturientes étaient des femmes au foyer. L’hypertension artérielle était retrouvée dans 4,8. Le poids était compris entre 1500 et 2000g pour 33,2 %. Parmi les nouveau-nés, 25,7 % ont été réanimés. La mortalité était de 30,6 % et 50,8 % des décès survenaient dans les 48 premières heures d’hospitalisation. Le score d’APGAR était inférieur à 7 à une minute, l’accouchement par voie basse, le faible poids de naissance, la grossesse monofœtale, la durée d’hospitalisation inférieure ou égale à sept jours, la structure sanitaire de Saint-Camille ont été les facteurs de risque significativement associés à la mortalité. Conclusion: La mortalité néonatale précoce lors de faible poids de naissance demeure une préoccupation au Burkina Faso. Il est donc impératif d’entreprendre des actions plus soutenues dans le sens d’une meilleure prévention et d’une prise en charge adéquate des nouveau-nés (adoption de la méthode kangourou, renforcer les moyens de réanimation du nouveau-né…) [ABSTRACT FROM AUTHOR]

Background. Systemic sclerosis (SSc) is a complex autoimmune disease that involves various organs and systems and is associated with high mortality and morbidity rates. Objectives. To identify even from the first visit to the physician clinical and non-clinical parameters with predictive value for death, in patients with SSc. Methods. Demographic, clinical and non-clinical data were assessed (at each visit, according to EUSTAR recommendations) for all patients with SSc that visited our clinic between 2004-2012. Statistical analysis was done through SPSS 20.0, using chi-square and uni- and multivariate logistic regression. Results. 96 patients with SSc were included in the study, with a mean follow-up of 4.2±1.6 years. Throughout the follow-up period, there were 13 (13.5%) deaths, of whom 6 (6.2%) were of SSc cause and 7 (7.2%) of non-SSc cause. Sex- and age-adjusted univariate analysis identified the diffuse subset, a modified Rodnan score (mRSS) >14, digital ulcers, restrictive ventilatory syndrome, proteinuria, heart rhythm and conduction anomalies and hypo/ hyperpygmentation of the skin to be associated with increased mortality in all patients. Sex- and age-adjusted multivariate model identified a mRSS >14 and proteinuria as predictors of death. With regard to deaths that can be attributed to SSc, univariate analysis identified a mRSS >14, digital ulcers and proteinuria as predictive factors. Conclusions. The survival rate of patients included in the study was over 86% during a mean follow-up period of 5 years. Several clinical and non-clinical parameters which can be deemed predictive factors for death in patients with SSc were identified. Moreover, these can be detected early, from the patient's first visit to the physician, and can have an important role in developing a management strategy for the patient with SSc. [ABSTRACT FROM AUTHOR]