ABSTRACT
But : Evaluer les connaissances et les pratiques relatives a la prescription du fer dans le service de pediatrie du Centre Hospitalier Universitaire Gabriel Toure (CHU-GT) de Bamako; Mali. Materie( et methodes: Il s'agissait d'une etude transversale realisee du 1 er au 30 Juillet 2012 a la pediatrie. Nous avons soumis un questionnaire aux prestataires et analyse les dossiers des enfants ages de 1 a 60 mois hospitalises ayant recu du fer. Le consentement des prescripteurs a ete demande et obtenu au prealable. Resu(tats: nous avons enquete cinquante prestataires dont 10 pediatres (20%); 31 medecins CES de pediatrie (62 %); 2 medecins generalistes (4%); 7 etudiants en fin de cycle medical (14%) et analyse 100 dossiers. Trente pour cent des prestataires ont correctement defini le fer. Plus de la moitie des prestataires connaissaient les besoins en fer chez l'enfant. Les reserves en fer etaient connues de 42% des prestataires. Huit pour cent des prestataires savaient que les fers apportes par l'alimentation etaient le fer heminique ou le fer non heminique. Trente pourcent des malades ont recu le fer a la dose de 8 a 10mg/kg. La duree du traitement n'a pas ete precisee chez 92% des malades. Conc(us ion : Dans notre contexte la bonne connaissance theorique des indications et des regles de prescription du fer chez l'enfant n'excluait pas les mauvaises pratiques de sa prescription. D'autres travaux devraient analyser les raisons de cette discordance
Subject(s)
Drug Utilization Review , Iron , Knowledge , PediatricsABSTRACT
OBJECTIVES: More than 50% of patients with upper limb paresis after stroke face long-term impaired arm function and ensuing disability in daily life. This study aims to evaluate the effectiveness of a task-oriented mental practice (MP) approach as an addition to regular arm-hand therapy in patients with subacute stroke. METHODS: A multicenter, prospective, single-blind, randomized clinical trial was performed. Patients trained for 6 weeks, at least 3 times per day. In the experimental group, patients performed video-instructed MP. In the control group, patients performed neurodevelopmental therapy-based exercise therapy. The primary outcome measures are Fugl-Meyer test, Frenchay arm test, Wolf motor function test, and accelerometry. RESULTS: The patients did improve over time on Fugl-Meyer test and Wolf motor function test in both the control and the experimental group. A significant improvement on the Frenchay arm test was found after training (which was maintained at 12-month follow-up) only in the experimental group. However, no difference in training effects between groups was demonstrated. CONCLUSIONS: Training effects were demonstrated after MP training in patients with subacute stroke. However, the results of this study do not corroborate the hypothesis that the use of MP in addition to therapy as usual in patients with subacute stroke has an additional effect over neurodevelopmental therapy in addition to therapy as usual.
Subject(s)
Activities of Daily Living , Exercise Therapy/methods , Mental Processes , Stroke Rehabilitation , Upper Extremity/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Disability Evaluation , Female , Humans , Male , Middle Aged , Netherlands , Prospective Studies , Recovery of Function , Single-Blind Method , Statistics, NonparametricABSTRACT
BACKGROUND: Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia. The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of life. METHODS: In this cross sectional study, explaining factors for disability were studied based on a regression analysis with gender, mental health, physical and social functioning as independent variables. For the assessment of disability in fibromyalgia the FIQ was used. The levels of psychological distress in patients with fibromyalgia, Complex Regional Pain Syndrome (CRPS) and chronic low back pain (CLBP) were compared based on scores on the Symptom Checklist (SCL90). Quality of life of patients with fibromyalgia was compared with scores (SF36) of both patients with fibromyalgia and other health conditions as derived from the literature. RESULTS: Disability in fibromyalgia seemed best explained by a patients mental health condition (beta = -0.360 p = 0.02). The level of psychological distress was higher in patients with fibromyalgia as compared to patients with CRPS or CLBP (p < 0.01). The impact of fibromyalgia on quality of life appeared to be high as compared to the impact of other health conditions. CONCLUSION: Patients with fibromyalgia report a considerable impact on their quality of life and their perceived disability level seems influenced by their mental health condition. In comparison with patients with other pain conditions psychological distress is higher.
Subject(s)
Disability Evaluation , Fibromyalgia/psychology , Mental Health , Quality of Life , Adult , Aged , Chronic Disease/psychology , Complex Regional Pain Syndromes/physiopathology , Complex Regional Pain Syndromes/psychology , Cross-Sectional Studies , Female , Fibromyalgia/physiopathology , Health Status , Humans , Low Back Pain/physiopathology , Low Back Pain/psychology , Male , Middle AgedABSTRACT
This report describes 6 cases of Wilson's disease observed at the University Hospital Center in Conakry, Guinea. Presenting symptoms involved extrapyramidal syndrome in 4 cases, psychomotor epilepsy in 1, and confusional syndrome in 1 case. Diagnosis was based on neuropsychic manifestations, Kayser-Fleicher corneal ring, liver failure, and impaired copper metabolism. Brain CT-scan depicted normal features in 3 cases, symmetric hypodensity of the lenticular nucleus in one, discrete ventricular dilatation of in one a and cortico-subcoetical atrophy in one.
Subject(s)
Brain/pathology , Hepatolenticular Degeneration/pathology , Adolescent , Adult , Basal Ganglia Diseases/etiology , Child , Confusion/etiology , Epilepsy/etiology , Female , Guinea , Hepatolenticular Degeneration/complications , Hepatolenticular Degeneration/diagnosis , Humans , Male , Tomography, X-Ray ComputedABSTRACT
This rep o rt describes 6 cases of Wi l s o n 's disease observed at the Unive rsity Hospital Center in Conakry; Guinea. P resenting symptoms invo l ved ex t rapy ramidal syndrome in 4 cases; p s y chomotor ep i l epsy in 1; and confusional syndrome in 1 c a s e. Diagnosis was based on neuro p s y chic manife s t ations; Kayser- F l e i cher corneal ring; liver failure; and impaired copper metabolism. Brain CT-scan depicted normal fe at u res in 3 cases; s y m m e t ric hypodensity of the lenticular nu cleus in one; discrete ve nt ricular dilat ation of in one a and cortico-subcoetical atro p hy in one
Subject(s)
Copper , Hepatolenticular DegenerationABSTRACT
Thirty two cases of subacute sclerosing panencephalitis were reported. Diagnosis was based on epidemiological, clinical and electroencephalographic data; myoclonies and alterations of intellectual functions were the most frequent symptoms.
