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Noninvasive Respiratory strategies in Patients with Acute Hypoxemic Respiratory Failure and COVID-19 in Gabon: A Prospective Observational study

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Open Journal of Emergency Medicine 2024年第1期12卷 18-27页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Fernande Manga stéphane Oliveira Jean Marcel Mandji-Lawson Romain Tchoua Department of Emergency Anesthesia Resuscitation Omar Bongo Ondimba Army Training Hospital Libreville Gabon Department of Anesthesia and Resuscitation Libreville University Hospital Center Libreville Gabon Department of Anesthesia and Resuscitation Akanda Army Training Hospital Libreville Gabon

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/FiO2 ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanic

关键词： Respiratory Failure COVID 19-Intensive Care Units Military Hospital Gabon

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Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter study

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Open Journal of Anesthesiology 2024年第1期14卷 1-12页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Pascal Christian Nze Obiang stéphane Oliveira Jean-Marcel Mandji-Lawson Romain Tchoua Department of Anesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia

关键词： Cesarean General Anesthesia Morphine Parietal Infiltration Epidural Catheter Transversus Abdominis Plane Block Intravenous Analgesia

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Dose-response associations,physical activity intensity and mortality risk:A narrative review

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Journal of Sport and Health Science 2024年第1期13卷 24-29页

作者： Ulf Ekelund Miguel Adriano sanchez-Lastra Knut Eirik Dalene Jakob Tarp Department of Sport Medicine Norwegian School of Sport SciencesOslo 0806Norway Department of Chronic Diseases Norwegian Institute of Public HealthOslo 0213Norway Department of Special Didactics Faculty of Education and Sports SciencesUniversity of VigoPontevedra 36005Spain Well-Move Research Group Galicia-Sur Health Research Institute(SERGAS-UVIGO)Vigo 36213Spain

Physical activity is consistently associated with reduced mortality,decreased risk for non-communicable diseases,and improved mental health in observational *** controlled trials and observational Mendelian randomization studies support causal links between physical activity and health ***,the scarcity of evidence from randomized controlled trials,along with their inherent challenges like exposure contrasts,healthy volunteer biases,loss to follow-up,and limited real-world dose-response data,warrants a comprehensive *** review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity,mortality risk,and other health ***,it summarizes recent research since the publication of current physical activity *** observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits,with vigorous-intensity potentially requiring lower volumes for substantial *** guidelines,informed by device-measured physical activity studies,may offer refined age-specific recommendations,emphasize vigorous-intensity physical activity,and include daily step counts as a simple,easily assessable metric using commercial wearables.

关键词： Accelerometers Non-communicable diseases Public health Sedentary behavior

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Distribution and Contamination of Arsenic in Fish, Gastropods and Bivalves in the Aby and Tendo Lagoons in East of Ivory Coast

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Journal of Environmental Protection 2024年第3期15卷 246-264页

作者： Kouakou Serge Kouassi stéphane Jean Claon Kossonou Roland N’Guettia Séri Kipré Laurent Dakouo Guei Jokebed Djaman Allico Joseph Laboratory of Biology and Health University of F&eacutelix Houphou&eumlt-Boigny Abidjan C&ocircte d’Ivoire Department of Analytical Sciences and Public Health Faculty of Pharmaceutical and Biological Sciences University of F&eacutelix Houphou&eumlt-Boigny Abidjan C&ocircte d’Ivoire Laboratory of Environmental Sciences (LSE) University of Nangui Abrogoua Abidjan C&ocircte d’Ivoire Department of Medical and Fundamental Biochemistry Institut Pasteur of C&ocircte d’Ivoire Abidjan C&ocircte d’Ivoire

Lagoons are ecosystems for biodiversity and the livelihoods of coastal communities. The main objective of the study was to analyze the variability of arsenic concentrations in gastropods and bivalves in the Aby and Tendo lagoons, taking into account spatial, seasonal and hydrological variations. The study was carried out in four stages spread over two successive hydroclimatic cycles, including two seasons during the rainy season and two more during the dry season. The samples were taken in two areas of the Aby and Tendo lagoons. Arsenic levels were measured by ICP-MS. The results showed that mean arsenic concentrations in the muscles of organisms in Aby Lagoon ranged from 0.01 to 1.26 μg As/g, with a mean and median of 0.17 and 0.06 μg As/g, respectively. Fish had the highest levels of arsenic, followed by crustaceans, while molluscs and plants had lower and comparable concentrations of As. Arsenic concentrations in tilapia and jawbones varied significantly between sites and seasons, with higher concentrations at Tendo and during the rainy season. Arsenic concentrations in gastropods and bivalves were significantly higher than those of other species, with averages of 0.74 and 1.03 mg As/kg, respectively.

关键词： Arsenic Pollution Fish Gastropods Lagoons Health Effect

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Intermediate Hip Arthroplasty in Gabon: Blood Loss and Risk Factor for Transfusion

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Open Journal of Anesthesiology 2024年第4期14卷 109-117页

作者： Ghislain Edjo Nkilly Pascal Christian Nze Obiang Raphael Okoue Ondo Arthur Matsanga stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-Lawson Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic Surgery Service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

关键词： Hip Arthroplasty Risk Factors Patients Hemiarthroplasty Gabon

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中华医学会-欧莱雅中国人健康皮肤/毛发研究项目成果总结——皮肤篇

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中华皮肤科杂志 2024年第5期57卷 464-467页

作者： Michele Verschoore 牛悦青 stéphane Commo Léopold Muller 魏宇昊甄雅贤刘玮欧莱雅研发和创新中心法国克里希92110 欧莱雅研发和创新中心上海201206 欧莱雅研发和创新中心法国欧奈苏布瓦93600 欧莱雅研发和创新中心美国克拉克07066 空军特色医学中心皮肤科北京100142

中华医学会和欧莱雅集团在2003-2018年间联合启动了“中国人健康皮肤/毛发研究项目”,该项目在助力提高中国皮肤科医生科研能力的同时,获得了大量宝贵的基于中国人群样本的临床和基础研究成果,并以期刊论文、会议报告等形式多次参与国... 详细信息

中华医学会和欧莱雅集团在2003-2018年间联合启动了“中国人健康皮肤/毛发研究项目”,该项目在助力提高中国皮肤科医生科研能力的同时,获得了大量宝贵的基于中国人群样本的临床和基础研究成果,并以期刊论文、会议报告等形式多次参与国内和国际学术交流。本文作者通过整理项目资料和已发表文献,对皮肤相关研究项目的主要成果做一总结.

关键词：皮肤生理学过程皮肤衰老皮肤色素沉着皮肤免疫研究报告

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The interaction of the structure-directing agent with the zeolite framework determines germanium distribution in SCM-15 germanosilicate

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Frontiers of Chemical Science and Engineering 2024年第5期18卷 105-114页

作者： stoyan P.Gramatikov Petko st.Petkov Zhendong Wang Weimin Yang Georgi N.Vayssilov Faculty of Chemistry and Pharmacy University of Sofia1126 SofiaBulgaria state Key Laboratory of Green Chemical Engineering and Industrial Catalysis Sinopec Shanghai Research Institute of Petrochemical Technology Co.Ltd.Shanghai 201208China

We report results from computational modeling of the relative stability of germanosilicate SCM-15 structure due to different distribution of germanium heteroatoms in the double four-member rings(D4Rs)of the framework and the orientation of the structure directing agent(SDA)molecules in the as-synthesized *** calculated relative energies of the bare zeolite framework suggest that structures with germanium ions clustered in the same D4Rs,e.g.,with large number of Ge–O-Ge contacts,are the most *** simulations of various orientations of the SDA in the pores of the germanosilicate zeolite show different stability order-the most stable models are the structures with germanium spread among all ***,for SCM-15 the stabilization due to the presence of the SDA and their orientation,is thermodynamic factor directing both the formation of specific framework type and Ge distribution in the framework during the *** relative stability of bare structures with different germanium distribution is of minor *** differs from SCM-14 germanosilicate,reported earlier,for which the stability order is preserved in presence of ***,even for zeolites with the same chemical composition and SDA,the characteristics of their framework lead to different energetic preference for germanium distribution.

关键词： zeolite density functional theory structure-directing agent SCM-15

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Empowerment in chronic wound care——exploring the scope for patient contribution

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Frontiers of Nursing 2024年第1期11卷 1-16页

作者： Benedikt Hackert Ewa Klara stürmer Ulrich Weger Department of Psychology and Psychotherapy University of Witten/HerdeckeAlfred-Herrhausen-Straße 5058448 WittenGermany Department for Vascular Medicine University Heart and Vascular Center HamburgUniversity Medical Center Hamburg-EppendorfMartinistreet 5220246 HamburgGermany

Objective:In this study,we investigated the concept of empowerment in chronic wound care and propose to facilitate patient control by making use of degrees of freedom(DOF):that is,shaping of everyday wound care tasks initiated by patients and based on their wishes,mostly in terms of patients executing treatment steps,requesting or directing health care professionals to under take changes,or modifications of internal ***:As a first step,we conducted a systematic literature search,followed by an inductive form of qualitative content analysis,which resulted in the identification of 5 dimensions as main elements of empowerment:education and shared decision making,adherence to self-care behaviors,responsibility and control,general call for empowerment,and ***,the latter are noticeably absent in the *** investigate patients'freedom in shaping the wound care process,we conducted a second literature ***:A number of possibilities for patients to influence the wound care process could be identified,but experimental or clinical evidence about their effects is missing,their variety is limited,and they are only inadequately ***:However,DOF should be an indispensable aspect of genuine empowerment,since they allow patients to occupy the role of the agent in the treatment process and give rise to the subjective experience of feeling ***,in the third part,we develop a research proposal on how to investigate and include DOF in the clinical practice of wound ***,limitations about implementations are discussed(e.g.,patients being reluctant to overcome their passive role,resulting in frustration for health care professionals).

关键词： adherence chronic wounds control degrees of freedom empowerment shared decision making

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Contribution of CT Scanning in the Investigation of Cranioencephalic Lesions in Bangui

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Open Journal of Radiology 2024年第3期14卷 156-165页

作者： Bangue Songrou Francky Kouandongui Timothée Mobima Borel Tambala Yannick Héritier Sombot-Soule stéphane Kouzou Judith Guiaba Kette Euloge Tapiade Bidan Richard Bazogo National Center of Medical Imaging of Bangui Bangui Central African Republic Maman Elisabeth DOMITIEN Hospital Bangui Central African Republic Community Hospital of Bangui Bangui Central African Republic

Introduction: Cranioencephalic exploration has always played a major role in CT scans. In the Central Africa Republic (CAR), the lack of cross-sectional imaging before the year 2020 meant that no study had focused on cranioencephalic lesions. The aim of this study was to contribute to improving the management of cranioencephalic pathologies in CAR. Patients and Method: The study took place at the Bangui National Medical Imaging Centre (CNIMB). It was a retrospective study over a two-year period (March 1, 2021 to February 30, 2023). All patients referred for cranioencephalic CT scans were included, regardless of age or sex. Results: 1745 CT scans were performed, 575 of which were cranioencephalic CT scans. The majority of patients were male (53%). Most lived in the capital Bangui (90.9%). Patients aged 61 and over were the most representative. The distribution of patients by requesting department showed that the reception and emergency department was one of the least requesting departments. The main abnormalities observed were strokes, 82.1% of which were ischaemic strokes and 17.9% haemorrhagic strokes. strokes were followed by degenerative lesions. Post-traumatic injuries included haemorrhagic contusions (38.3%), subdural haematomas in 20.5% of cases, and extradural haematomas (9.3%). Craniofacial lesions (fractures) were observed in 45.8% of cases. Conclusion: Cranioencephalic scans accounted for 1/3 of CT examinations performed during the study period. It revealed pathologies that could not be detected by conventional means. All in all, CT scans contributed to the diagnosis of cerebral pathologies.

关键词： Cranioencephalic Scan National Medical Imaging Centre Bangui

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Assessment of Selenium Contamination in Sediments of the Aby and Tendo Lagoons in Côte d’Ivoire

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International Journal of Geosciences 2024年第4期15卷 334-349页

作者： stéphane Jean Claon Kouakou Serge Kouassi Kossonou Roland N’Guettia M’bassidjé Arsène Seka Guei Jokebed Dakouo Allico Joseph Djaman Kouakou Luc Kouadio Analytical Sciences and Public Health Department University of F&#233lix Houphou&#235t-Boigny Abidjan C&#244te d&#8217Ivoire Water Quality Control and Analysis Laboratory (LACQUE) Office National de l&#8217Eau Potable (ONEP) Abidjan C&#244te d&#8217Ivoire Biology and Health Laboratory University of F&#233lix Houphou&#235t-Boigny Abidjan C&#244te d&#8217Ivoire Laboratory of Environmental Sciences (LSE) University of Nangui Abrogoua Abidjan C&#244te d&#8217Ivoire Department of Medical and Fundamental Biochemistry Institut Pasteur of C&#244te d&#8217Ivoire Abidjan C&#244te d&#8217Ivoire

Selenium is a trace element that can have both beneficial and harmful effects on aquatic life. The Aby Lagoon is a coastal environment in Côte d’Ivoire that receives selenium inputs from various natural and anthropogenic sources. The aim of this study was to assess the levels of selenium in the sediments of the Aby Lagoon and its tributaries, the Tanoe River and the Tendo Lagoon, and to examine the spatial and seasonal variations of selenium concentrations. Sediment samples were collected from different sites and seasons, and selenium concentrations were measured by atomic fluorescence spectrometry. The results showed that the average concentration of selenium in the sediments of the Aby Lagoon was 0.82 mg/kg, indicating moderate contamination. The concentration of selenium varied between sites and seasons, with higher values in the channel of the Tendo Lagoon and during the dry season. The study highlighted the complexity of selenium dynamics in aquatic ecosystems, and the need to take into account seasonal and spatial variability as well as interactions between environmental factors. The study also suggested potential ecotoxicological risks for some sensitive organisms in certain areas of the lagoon. This study contributes to the knowledge of the dynamics of selenium in lagoon ecosystems and to the assessment of the environmental risks associated with its presence.

关键词： Tropical Estuarine Selenium Sediments Aby Lagoon Seasonal Distribution

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