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OBJECTIF: Le Programme de Développement Affectif et Social (PRODAS) est un programme de développement des compétences psychosociales des enfants ou adolescents mis en Åuvre depuis 2005 en milieu scolaire par une association française (le Planning familial). L'objectif de cet article était de synthétiser les connaissances sur les effets de ce programme, afin de contribuer à l'étude de sa transférabilité. MÉTHODES: La revue de littérature réalisée a porté sur des études datant de 1970 à 2017. Ont été interrogées les bases de données : ScienceDirect, PsycNET, ERIC, PsycINFO, erudit, ISIDOR, Cochrane. Les mots clés utilisés étaient « Human Development Program ¼ ou « PRODAS ¼. RÉSULTATS: Une amélioration, le plus souvent significative, des compétences émotionnelles et sociales des enfants et des adolescents était rapportée. Une relation de type dose-effet était également suggérée par certains résultats. Peu de données étaient disponibles chez les jeunes enfants (école maternelle) et aucune étude n'explorait les effets du programme à long terme. CONCLUSION: Cette synthèse a permis de mettre en lumière les principaux effets du PRODAS. Toutefois, considérant que ce programme est un des seuls à s'adresser aux enfants dès 4 ans en France, de futures études portant sur des enfants d'écoles maternelles, avec un suivi à long terme, seraient utiles pour compléter les données sur l'efficacité d'un tel programme.
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AIM: Management of teenagers with primary spontaneous pneumothorax (PSP) is not consensual. We report our experience over an 11-year period. METHODS: For each patient under 20 years hospitalised with PSP from 2008 to 2018, demographic data, smoking habits, clinical presentation, hospitalisation unit, radiological management and its results, therapeutic management (observation, needle aspiration, chest tube drainage and surgery), complications, length of stay, given advice at discharge and recurrence were collected. RESULTS: Seventy patients were included in different paediatric or adult surgery or pulmonology wards (82.9% boys; 16.8 ± 1.7 years; one severe presentation; 18/58 smokers). Chest CT-scan (n = 42/70, 60%) revealed blebs/bullae in 18/39 examinations (46.2%). Treatment consisted of observation (14/70, 20%), needle aspiration (2/70, 2.9%), chest tube (53/70, 75.7%) and video-assisted thoracoscopy surgery (27/70, 38.6%). Half patients with interventional procedure presented complications. A median of 10 chest X-rays was noted during a median stay of 8 days. Advice concerning sport practice, flying, smoking, etc., was variably delivered. PSP recurrence concerned 35/70 patients (50%) without identified predictive factors. CONCLUSION: Compared to recent recommendations of a more conservative approach, chest CT-scan and interventional strategy are overused in our teenagers with PSP. Observation, more or less needle aspiration, should be clearly the first-line treatments.
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Pneumotórax , Adolescente , Adulto , Tubos Torácicos , Criança , Drenagem/métodos , Feminino , Humanos , Masculino , Pneumotórax/cirurgia , Recidiva , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/métodos , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the reduction of perineal pain after vaginal deliveries by capacitive resistive radiofrequency therapy (RF). METHODS: We conducted a double-blind randomized study in University Hospital Centre in France. We included women presenting either perineal tears or an episiotomy after vaginal delivery (instrumental assisted or not). The participants were randomly assigned to RF or not at day 1 and day 2 postpartum. The primary outcome was pain evaluated as visual analog scale (VAS) score >4 at rest on day 2 after the treatment. Secondary outcomes included discomfort and pain while walking and seating two days after treatment, type of pain two days after treatment and analgesics intake two days after treatment, sexual intercourse retake and painful of intercourse were also assessed by phone call 30 days after delivery. We performed univariate analysis and multivariable regressions adjusting on the value of the outcome at baseline to improve precision of the estimated intervention effect. RESULTS: Between June 1, 2017 and October 8, 2017, the RF group included 29 women compared with 31 women in the group without RF. There was no significant difference on VAS >4 between the two groups (13.8% vs. 9.7% p = 0.69; difference = 4.1%, 95%CI -12.2%- 20.4%); consumption of paracetamol was lower in the RF group (978.3 mg (sd = 804.5) vs 1703.7 mg (sd = 1381.6), p = 0.035; difference = -725.3 mg, 95%CI -1359.6 - -91.3). Multivariate analysis showed no association between RF and pain. Nevertheless, we found an association between RF and discomfort while walking (adjusted OR 0.24, 95% CI 0.07-0.90; p = 0.03). CONCLUSION: VAS>4 at day 2 was not different in the experimental and the control groups but RF was associated with less perineal discomfort while walking and lower consumption of paracetamol after delivery. CLINICAL TRIAL REGISTRATIONS: The study was registered in the Clinical Government trial (https://clinicaltrials.gov/ct2/show/NCT03172286?term=bretelle&rank=2) under the number NCT03172286.
