[Vitamin D deficiency in recently pregnant women]. / La carence en vitamine d chez les femmes enceintes en région liégeoise: un problème méconnu.

We have evaluated the prevalence of the 25-hydroxy vitamin D (25VTD) deficiency in recently pregnant women and new mothers in the area of Liege, Belgium. The study took place in November 2006. Twenty four women who underwent a positive pregnancy test and 65 new mothers were enrolled. The level of 25VTD did not differ between the two groups. Only 12% of the pregnant women and 14% of the new mothers (>12 ng/ml) had an optimal level of 25VTD (>30 ng/ ml). We also observed a severe 25VTD deficiency in 21% of pregnant women and 32% of new mothers. Our results showed that more than 80% of pregnant women and new mothers in the area of Liege presented a deficiency in 25VTD. In Belgium, daily vitamin supplementation of pregnant women is common, but the level of vitamin D3 concentration range from 10 microg (400 UI) to zero microg. In our area, vitamin D production in the skin is not always important enough to achieve optimal levels. Our data show that vitamin D supplementation of pregnant women is not enough and that 25VTD deficiency is not diagnosed in this high-risk population. Children born from deficient mothers will present a higher risk of suffering from bone mineral diseases as well as other pathologies, as type 1 diabetes or neurological disorders. Of course, this insufficiency will also have an impact on mother's bone reserve, but these mothers will also be at higher risk for preeclampsia.

[Psychiatric disorders induced by drug dependence other than alcohol]. / Troubles psychiatriques induits par les conduites de dépendance autres que l'alcool.

Most of psychoactive substances abuse or dependence disorders are associated to another psychiatric disorders. Depression, anxiety and psychotic disorders are the more frequent comorbid disorders. Psychiatric comorbidity is induced by acute consumption of psychoactive agents, chronic consumption or withdrawal. Psychiatric disorders are more frequent when patient are assessed immediately after the withdrawal. Main biological factors implicated in the pathophysiology of psychiatric disorders associated to dependence disorders are: increase in norepinephrine activity, during withdrawal, activation of locus coeruleus, kinding induced by repeated withdrawals. Psychotic disorders in opiate dependent patients can be induced by withdrawals. These psychotic disorders are more often described after methadone discontinuation. Consumption of cocaine can provocate paranoid delusions. Phenylcyclidine provocates sensorial distortion or delusive disorders resembling schizophrenia. Flash backs, following withdrawal realized brief and transient psychotic disorders. They can occur up to one year after the end of the intoxication. The occurrence of depression in dependent patients is frequent. Depressed patients are at risk for suicide. Retrospective studies showed that near of 40% of the subjects died from suicide have presented alcohol or drug abuse or dependence. Withdrawal from opiates provocates depression. Clinical picture included apathy, blunting of the affects, sadness and loss of interest. Cocaine consumption provocates manic-like disinhibition at the beginning of the intoxication. Long term consumption and withdrawal increase the risk of depression.

[Prospective evaluation of antidepressant discontinuation]. / Evaluation prospective du sevrage des antidépresseurs.

The authors prospectively assessed symptoms induced by the interruption of antidepressants in 16 patients (11 women and 5 men), aged from 33 to 85 years (mean = 52.4 +/- 16.4), treated with antidepressants since at least two weeks. All patients were free of alcohol abuse or dependence disorder and of other dependence to psychoactive substances. None of them presented medical illness. Diagnosis were made by separate evaluations by two authors and confirmed with a semistructered assessment instrument: the Schedule for Affective Disorders and Schizophrenia (Lifetime Version). All patients were submitted to a brutal discontinuation of their antidepressant agent. Patients were assessed twice, before the interruption of the antidepressant, and 72 hours later. Effects of antidepressant interruption were assessed by several means. Modification of anxiety and depression were evaluated using the Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Scale. Symptoms of withdrawal were assessed with Cassano and al.'s scale SESSH including an evaluation of anxiety, agitation, irritability, anergy, difficulty on concentrating, depersonalization, sleep and appetite disorders, muscle pains, nausea, tremor, sweating, altered taste, hyperosmia, paresthesias, photophobia, motor incoordination, dizziness, hyperacousia pain, delirium. Fourteen of the 16 patients (87.5%) presented modifications of their somatic or psychic state 3 days after the interruption of the antidepressant treatment. Most frequent symptoms were: increase in anxiety (31%), increase in irritability (25%), sleep disorders (19%), decrease of anergia and fatigue (19%). Mean scores of anxiety and depression were not significantly modified by the withdrawal. Following TCAs interruption (7 patients) most frequent symptoms were sleep disorders; increase in anxiety, nausea. Among patients withdrawn from SSRIs (6 patients), most frequent symptoms were increase in anxiety, increase in irritability, headache. Patients also presented a decrease of nausea, and of anorexia.

Contribuiçäo com vinte elementos teórico-metodológicos constituídos em funçäo de um novo paradigma da saúde e educaçäo / Contribution of 20 theoric-methodological elements for a new paradigm in health and education

Aborda as correlaçöes de temas como educaçäo profissional, prática e exercício profissional e vinte elementos teórico-metodológicos para uma relaçäo igualitária solidária e participativa entre os três temas

Etudes des variations volumetriques de la dent en relation avec la fluorose endemique (a propos de 80 observations)

Etude qui porte sur le role du fluor dans les variations volumetriques des couronnes dentaires dans le cas d'indigestion chronique de doses toxiques de fluor; c'est-a-dire dans les cas de fluorose dentaire. L'echantillon est compose de 80 sujets repartis en deux groupes de 40 sujets chacun. Il y a un groupe cible et un groupe temoin. On a effectue des mesures au pied a coulisse sur les empreintes de tous les sujets; et; pour chaque type de dent; note les diametres mesio-distal (MD) et vestibulo-lingual (VL). Les resultats montrent que les dents atteintes de fluorose ont des volumes coronaires plus importants que ceux des dents indemnes de fluorose. On a conclu que la fluorose dentaire est sujette a une augmentation volumetrique de couronnes des dents atteintes; alors que l'ingestion de fluor; a des doses optimales (1 ppm/l); diminue les volumes dentaires

Some intermediate of fertility in Egypt.

PIP: Intermediate variables associated with high fertility rates among low socioeconomic groups in suburban areas in Egypt were identified. 220 women with children between the ages of 0-3 years were randomly selected from Maternal Health Center patients. The average total births for the group was 4.3 and the average total live births was 3.3. High rates of wastage are a suspected motivation for high fertility rates. The mean age at marriage for the group was 17.9 years; however, more than 60% were married at the age of 15. Lactation practices were irregular for a majority of women and may have some effect on resumption of ovulation. In 31.8% of the patients, menstruation began at 6-12 weeks postpartum usually at the beginning of weaning. The mean interpregnancy interval was shorter than 2 years. A majority of women, 71.8%, reported resuming sexual intercourse before the 40th day postpartum, which is prohibited among Moslims. Many women thought that lactation would prevent pregnancy and contraceptives were not widely used at this time. Among the group, noncontraceptors were in the majority, 58.2%. Oral contraceptives (OCs), used by 34.1% of the women, and IUDs, used by 5.9%, were the most common methods used. The use of OCs is thought to be related to early weaning. The results emphasixe the need for a postpartum program which offers contraceptive measures which do not interfere with the lactation practices among low socioeconomic groups.^ieng