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Subsequent total joint arthroplasty: Are we learning from the first stage?

World Journal of Orthopedics 2024年第3期15卷 230-237页

作者： Christine Jiang Wu Colin Penrose Sean Patrick Ryan michael paul bolognesi Thorsten Markus Seyler Samuel Secord Wellman Department of Orthopaedic Surgery Duke University HospitalDurhamNC 27710United States Department of Orthopaedic Surgery Midwest Center for Joint ReplacementIndianapolisIN 46241United States

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource *** degenerative conditions progress in multiple joints,many patients undergo multiple *** To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second *** The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were *** demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second *** metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)*** A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were *** was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 *** THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second ***,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second *** may

关键词： Staged total joint arthroplasty Asynchronous total joint arthroplasty Subsequent total joint arthroplasty Contralateral total joint arthroplasty Perioperative outcomes

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Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

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World Journal of Orthopedics 2024年第7期15卷 627-634页

作者： Billy Insup Kim Jeffrey O'Donnell Colleen M Wixted Thorsten Markus Seyler William A Jiranek michael paul bolognesi Sean Patrick Ryan Department of Orthopedic Surgery Hospital for Special SurgeryNew YorkNY 10021United States Department of Orthopedic Surgery New York UniversityNew YorkNY 10003United States Department of Orthopedic Surgery Duke University HospitalDurhamNC 27560United States

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative *** To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)*** A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of *** patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients *** Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to *** cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete *** who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(***)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision *** We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years *** undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and *** *** perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

关键词： Smoking cessation Total joint arthroplasty Outcomes Tobacco use Postoperative abstinence

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Application of a simplified ADM1 for full-scale anaerobic co-digestion of cattle slurry and grass silage:assessment of input variability

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Frontiers of Environmental Science & Engineering 2024年第4期18卷 125-139页

作者： Sofia Tisocco Sören Weinrich Gary Lyons michael Wills Xinmin Zhan paul Crosson Civil Engineering College of Science and EngineeringUniversity of GalwayGalwayH91 TK33Ireland Teagasc Animal and Bioscience Research Department Animal and Grassland Research and Innovation CentreDunsanyC15 PW93Ireland Biochemical Conversion Department Deutsches Biomasseforschungszentrum gemeinnützige GmbHLeipzig 04347Germany Faculty of Energy·Building Services·Environmental Engineering Münster University of Applied SciencesSteinfurt 48565Germany Agri-Food and Biosciences Institute HillsboroughBT266DRUK Ryan Institute University of GalwayGalwayH91 TK33Ireland MaREI Research Centre for Energy Climate and MarineRyan InstituteUniversity of GalwayGalwayH91 TK33Ireland

Mathematical modeling of anaerobic digestion is a powerful tool to predict gas yields and optimize the *** Anaerobic Digestion Model No.1(ADM1)is a widely implemented model for this ***,modeling full-scale biogas plants is challenging due to the extensive substrate and parameter characterization *** study describes the modification of the ADM1 through a simplification of individual process phases,characteristic components and required ***,the ability of the simplified model to simulate the co-digestion of grass silage and cattle slurry was evaluated using data from a full-scale biogas *** impacts of substrate composition(crude carbohydrate,protein and lipid concentration)and variability of carbohydrate degradability on simulation results were assessed to identify the most influential *** indicated that the simplified version was able to depict biogas and biomethane production with average model efficiencies,according to the Nash-Sutcliffe efficiency(NSE)coefficient,of 0.70 and 0.67,respectively,and was comparable to the original ADM1(average model efficiencies of 0.71 and 0.63,respectively).The variability of crude carbohydrate,protein and lipid concentration did not significantly impact biogas and biomethane output for the data sets *** contrast,carbohydrate degradability seemed to explain much more of the variability in the biogas and methane ***,the application of simplified models provides a reliable basis for the process simulation and optimization of full-scale agricultural biogas plants.

关键词： ADM1 Agricultural feedstocks Biogas technology Input variability Parameter estimation

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A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors(PPARCS)

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Journal of Sport and Health Science 2024年第1期13卷 81-89页

作者： Sarah J.Hardcastle Chloe Maxwell-Smith Vinicius Cavalheri Terry Boyle Marta Leyton Román Cameron Platell michael Levitt Christobel Saunders Frank Sardelic Sophie Nightingale Jacob McCormick Craig Lynch paul A.Cohen Max Bulsara Dana Hince Sport and Physical Activity Research Centre Sheffield Hallam UniversitySheffieldS102BPUK Institute for Health Research The University of Notre DameFremantleWA 6959Australia Curtin School of Population Health Curtin UniversityPerthWA 6845Australia Curtin School of Allied Health Curtin UniversityPerthWA 6845Australia Allied Health South Metropolitan Health ServiceMurdochWA 6150Australia Australian Centre for Precision Health University of South AustraliaAdelaideSA 5001Australia Department of Didactics of Musical Plastic and Body ExpressionUniversity of ExtremaduraCaceres 10071Spain St.John of God Subiaco Hospital PerthWA 6008Australia Department of Surgery University of MelbourneMelbourneVIC 3010Australia Tamara Private Hospital TamworthNSW 2340Australia Peter MacCallum Cancer Centre MelbourneVIC 3000Australia College of Health and Medicine Australian National UniversityCanberraACT 2600Australia Division of Obstetrics and Gynaecology Medical SchoolUniversity of Western AustraliaPerthWA 6009Australia

Background:Physical activity(PA)is important for cancer *** of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer *** objective of this study was to ascertain whether wearable technology,coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in ***:Cancer survivors from 5 states were randomized to intervention and control *** participants were given a Fitbit Charge 2TMand received up to 6 telephone health coaching *** participants received PA print *** assessments at baseline and 12 weeks measured moderate-to-vigorous PA(MVPA),light PA,and sedentary ***:Eighty-seven participants were recruited(age=63±11 years;74(85%)female).There was a significant net improvement in MVPA of 49.8 min/week,favoring the intervention group(95%confidence interval(95%CI):13.6-86.1,p=0.007).There was also a net increase in MVPA bouts of 39.5 min/week(95%CI:11.9-67.1,p=0.005),favoring the intervention *** groups improved light PA and sedentary behavior,but there were no between-group ***:This’s the first study to demonstrate that,when compared to standard practice(i.e.,PA education),a wearable technology intervention coupled with distance-based health coaching,improves MVPA in non-metropolitan cancer *** results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.

关键词： Behavior change Exercise Health disparities Oncology Wearable technology

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Demonstrating grating-based phase-contrast imaging of laser-driven shock waves

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Matter and Radiation at Extremes 2024年第4期9卷 90-97页

作者： Leonard Wegert Stephan Schreiner Constantin Rauch Bruno Albertazzi paulina Bleuel Eric Frojdh Michel Koenig Veronika Ludwig Artem SMartynenko Pascal Meyer Aldo Mozzanica michael Müller paul Neumayer Markus Schneider Angelos Triantafyllidis Bernhard Zielbauer Gisela Anton Thilo Michel Stefan Funk Plasma Physics Department GSI Helmholtzzentrum fur SchwerionenforschungPlanckstraBe 164291 DarmstadtGermany Erlangen Centre for Astroparticle Physics(ECAP) Friedrich-Alexander-Universität Erlangen-NurnbergNikolaus-Fiebiger-StraBe 291058 ErlangenGermany LULI-CNRS CEASorbonne UniversitésEcole PolytechniqueInstitut Polytechnique de ParisF-91120 Palaiseau CedexFrance paul Scherrer Institut(Psi) Forschungsstrasse 1115232VilligenSwitzerland Karlsruhe Institute of Technology Institute of Microstructure TechnologyHermann-von-Helmholtz-Platz 176344 Eggenstein-LeopoldshafenGermany

Single-shot X-ray phase-contrast imaging is used to take high-resolution images of laser-driven strong shock *** a two-grating Talbot interferometer,we successfully acquire standard absorption,differential phase-contrast,and dark-field images of the shocked *** agreement is demonstrated between experimental data and the results of two-dimensional radiation hydrodynamics simulations of the laser-plasma *** main sources of image noise are identified through a thorough assessment of the interferometer’s *** acquired images demonstrate that grating-based phase-contrast imaging is a powerful diagnostic tool for high-energy-density *** addition,we make a novel attempt at using the dark-field image as a signal modality of Talbot interferometry to identify the microstructure of a foam target.

关键词： interaction shock phase

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Targeted therapy for capillary-venous malformations

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3024-3039页

作者： Lola Zerbib Sophia Ladraa Antoine Fraissenon Charles Bayard Marina Firpion Quitterie Venot Sanela Protic Clément Hoguin Amandine Thomas Sylvie Fraitag Jean-paul Duong Sophie Kaltenbach Estelle Balducci Coline Lefevre Patrick Villarese Vahid Asnafi Christine Broissand Nicolas Goudin Ivan Nemazanyy Gwennhael Autret Bertrand Tavitian Christophe Legendre Nadia Arzouk Veronique Minard-Colin Caroline Chopinet michael Dussiot Denise MAdams Tristan Mirault Laurent Guibaud paul Isenring Guillaume Canaud UniversitéParis Cité ParisFrance INSERM U1151 Institut Necker-Enfants MaladesParisFrance Service d’Imagerie Pédiatrique Hôpital Femme-Mère-EnfantHCLBronFrance CREATIS UMR 5220 Villeurbanne 69100France Service de Radiologie Mère-Enfant Hôpital NordSaint EtienneFrance Service d’Anatomie pathologique Hôpital Necker-Enfants MaladesAP-HPParisFrance Laboratoire d’Oncohématologie Hôpital Necker-Enfants MaladesAP-HPParisFrance Pharmacie Hôpital Necker-Enfants MaladesAP-HPParisFrance Necker Bio-Image Analysis INSERM US24/CNRS UMS 3633ParisFrance Platform for Metabolic Analyses Structure Fédérative de Recherche NeckerINSERM US24/CNRS UMS 3633ParisFrance Plateforme Imageries du Vivant Universitéde ParisPARCCINSERMParisFrance Service de Néphrologie Transplantation AdultesHôpital Necker-Enfants MaladesAP-HPParisFrance Service de Transplantation Hôpital La PitiéSalpétrièreAP-HPParisFrance Department of Pediatric and Adolescent Oncology INSERM 1015Gustave RoussyUniversitéParis-SaclayVillejuifFrance Service de Physiologie&Explorations Fonctionnelles Cardiovasculaires CHU de LilleLille 59000France INSERM U1163 Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic ImplicationsLaboratoire d’Excellence GR-ExParisFrance Division of Oncology Comprehensive Vascular Anomalies ProgramChildren’s Hospital of PhiladelphiaPhiladelphiaPAUSA Service de Médecine Vasculaire hôpital Européen Georges-PompidouParisFrance Nephrology Research Group L’Hôtel-Dieu de Québec Research CenterDepartment of MedicineFaculty of MedicineLaval UniversityQuebecQC G1R2J6Canada Unitéde médecine translationnelle et thérapies ciblées Hôpital Necker-Enfants MaladesAP-HPParisFrance CNRS UMR8253 Institut Necker-Enfants MaladesParisFrance

Sporadic venous malformations are genetic conditions primarily caused by somatic gain-of-function mutation of PIK3CA or TEK,an endothelial transmembrane receptor signaling through *** malformations are associated with pain,bleedings,thrombosis,pulmonary embolism,esthetic deformities and,in severe cases,life-threatening *** authorized medical treatment exists for patients with venous ***,we created a genetic mouse model of PIK3CA-related capillary venous malformations that replicates patient *** showed that these malformations only partially signal through AKT *** compared the efficacy of different drugs,including rapamycin,a mTORC1 inhibitor,miransertib,an AKT inhibitor and alpelisib,a PI3Kαinhibitor at improving the lesions seen in the mouse *** demonstrated the effectiveness of alpelisib in preventing vascular malformations’occurrence,improving the already established ones,and prolonging *** these findings,we were authorized to treat 25 patients with alpelisib,including 7 children displaying PIK3CA(n=16)or TEK(n=9)-related capillary venous malformations resistant to usual therapies including sirolimus,debulking surgical procedures or percutaneous *** assessed the volume of vascular malformations using magnetic resonance imaging(MRI)for each *** demonstrated improvement in all 25 *** malformations previously considered intractable were reduced and clinical symptoms were *** showed a decrease of 33.4%and 27.8%in the median volume of PIK3CA and TEK malformations respectively,over 6 months on *** conclusion,this study supports PI3Kαinhibition as a promising therapeutic strategy in patients with PIK3CA or TEK-related capillary venous malformations.

关键词： PIK3CA malformations venous

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Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

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General Psychiatry 2024年第1期37卷 103-111页

作者： Viktor H Ahlqvist Christina Dardani paul Madley-Dowd Harriet Forbes Jessica Rast Caichen Zhong Renee M Gardner Christina Dalman Kristen Lyal cRAIG Newschaffer Torbjorn Tomson michael Lundberg Daniel Berglind Neil M Davies Brian K Lee Cecilia Magnusson Dheeraj Rai Department of Global Public Health Karolinska InstitutetStockholmSweden Medical Research Council Integrative Epidemiology Unit Bristol Medical SchoolUniversity of BristolBristolUK Centre for Academic Mental Health Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK Faculty of Epidemiology and Population Health London School of Hygiene and Tropical MedicineLondonUK A.J.Drexel Autism Institute Drexel UniversityPhiladelphiaPAUSA Department of Epidemiology and Biostatistics School of Public HealthDrexel UniversityPhiladelphiaPAUSA College of Health and Human Development Pennsylvania State UniversityState CollegePAUSA Department of Clinical Neuroscience Karolinska InstitutetStockholmSweden Centre for Epidemiology and Community Medicine Region StockholmStockholmSweden K.G Jebsen Center for Genetic Epidemiology Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway Division of Psychiatry University Collge LondonLondonUK Department of Statistical Sciences University Cllge LondonLondonK NIHR Biomedical Research Centre University of BristoBristolUK Avon and Wiltshire Partnership NHS Mental Health TrustBristolUK

Background Psychiatric comorbidities are common in patients with *** for the co-occurrence of psychiatric conditions and epilepsy remain poorly *** We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these *** Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with *** then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score ***,we assessed the potential bidirectional relationships using two-sample Mendelian *** In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric *** example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric *** Psychiatric comorbidities are common in patients with *** correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric *** findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psy

关键词： epilepsy Psychiat lifetime

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Storylines of family medicine Ⅲ:core principles—primary care,systems and family

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Family Medicine and Community Health 2024年第S3期12卷 23-32页

作者： William B Ventres Leslie A Stone Timothy A Joslin John W Saultz Sommer Aldulaimi paul R Gordon John C Lane Eric R Lee Jacob Prunuske Limor Gildenblatt michael H Friedman Colleen T Fogarty Susan H McDaniel Tessa Rohrberg Amy Odom Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine Oregon Health&Science UniversityPortlandOregonUSA Family and Community Medicine University of Arizona Medical Center–South CampusTucsonArizonaUSA Family and Community Medicine University of Arizona Medical Center–University CampusTucsonArizonaUSA UAMS West Regional Campus Family Medicine Residency Program Fort SmithArkansasUSA Medical College of Wisconsin–Central Wisconsin Campus WausauWisconsinUSA Family and Community Medicine Medical College of Wisconsin–Central Wisconsin CampusWausauWisconsinUSA Family Medicine Advocate Illinois Masonic Medical CenterChicagoIllinoisUSA Family Medicine Presence Saints Mary and Elizabeth Medical CenterChicagoIllinoisUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Psychiatry and Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family and Community Medicine University of Kansas School of Medicine-WichitaWichitaKansasUSA Sparrow/Michigan State University Family Medicine Residency Program LansingMichiganUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅲ:core principles—primary care,systems,and family’,authors address the following themes:‘Continuity of care—building therapeutic relationships over time’,‘Comprehensiveness—combining breadth and depth of scope’,‘Coordination of care—managing multiple realities’,‘Access to care—intersectional,systemic,and personal’,‘Systems theory—a core value in patient-centered care’,‘Family-oriented practice—supporting patients’health and well-being’,‘Family physician as family member’and‘Family in the exam room’.May readers develop new understandings from these essays.

关键词： individual Storyline principles

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Epidemio-Clinical Aspects of Ecrectile Dysfunction in Type 2 Diabetics at Abeche Chu

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Open Journal of Urology 2024年第2期14卷 50-60页

作者： Vadandi Valentin Mahamat Ali Mahamat Minguemadji Allah Siyangar Temga Ouang michael Vounouzia Barthelemy Ndormadjita Allah Siyangar Abdelmahamoud Chene Konan paul Gerard Rimtebaye Kimassoum Urology Department University Hospital Center Abeche Chad Urology Department University Hospital of National Reference N’Djamena Chad Urology Department University Hospital of Renaissance N’Djamena Chad Urology Department University Hospital Center Abidjan Cote d’Ivoire

Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.

关键词： Diabetes Erectile Dysfunction Screening

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Knowledge and Attitudes of Nursing Staff towards Obstetric Fistula at the Abeche University Hospital, Chad

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Open Journal of Urology 2024年第5期14卷 277-281页

作者： Vadandi Valentin Mahamat Ali Mahamat Temga Ouang michael Vounouzia Barthelemy Minguemadji Allah Siyangar Ndormadjita Allah Siyangar Abdelmahamoud Chene Konan paul Gerard Rimtebaye Kimassoum Department of Urology University Hospital Center Abeche Chad Department of Urology University Hospital of National Reference N&#8217Djamena Chad Department of Urology University Hospital of Renaissance N&#8217Djamena Chad Department of Urology University Hospital Center Abidjan Cote d&#8217Ivoire

Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché University Hospital. The survey took place from March to May 2023 and the sampling was exhaustive. Data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. Nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.

关键词： Obstetric Fistula Knowledge Attitudes CHU-A Abeche Chad

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