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Benefits of jejunostomy feeding in patients who underwent gastrectomy for cancer treatment

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2461-2473页

作者： romain Jaquet Emmanuel Rivkine Nicole De Souza Jean Roudié Department of Digestive and Visceral Surgery Nord Essonne Hospital Group-Longjumeau SiteLongjumeau 91160France Department of General and Digestive Surgery Pierre Zobda-Quitman HospitalUniversity Hospital CenterMartiniqueFranceFort de France 97261Martinique

BACKGROUND Gastric cancer is associated with significant undernutrition responsible for an increase in morbidity and mortality after *** To evaluate the impact of enteral nutrition by jejunostomy feeding in patients undergoing gastrectomy for *** Between 2003 and 2017,all patients undergoing gastrectomy for cancer treatment were included retrospectively.A group with jejunostomy(J+group)and a group without jejunostomy(J-group)were *** Of the 172 patients included,60 received ***,the two groups were comparable with respect to the nutritional parameters studied(body mass index,albumin,etc.).In the postoperative period,the J+group lost less weight and albumin:5.74±8.4 vs 9.86±7.5 kg(P=0.07)and 7.2±5.6 vs 14.7±12.7 g/L(P=0.16),*** morbidity was 25%in the J+group and 36.6%in the J-group(P=0.12).The J+group had fewer respiratory,infectious,and grade 3 complications:0%vs 5.4%(P=0.09),1.2%vs 9.3%(P=0.03),and 0%vs 4.7%(P=0.05),*** 30-day mortality was 6.7%in the J+group and 6.3%in the J-group(P=0.91).CONCLUSION Jejunostomy feeding after gastrectomy improves nutritional characteristics and decreases postoperative morbidity.A prospective study could confirm our results.

关键词： Feeding jejunostomy Gastric cancer Undernutrition Morbimortality Survival

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寻味法兰西

Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

2024年

主讲人： romain

本期课程适合法语零基础学员；对法国美食文化感兴趣、想自己动手烹饪法式美味的同学。敬请观看。

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来源：爱迪科森网上报告厅评论

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Open Journal of Nursing 2024年第4期14卷 127-138页

作者： Madjiadoumbeye romain Imar Djibrine Soudy Ministè re de la Sant&#233 Publique et de la Pr&#233vention (Tchad) N&#8217Djamena Tchad Laboratoire de Recherche en Sciences des Aliments et Nutrition Facult&#233 des Sciences de la Sant&#233 Humaine (FSSH) Universit&#233 de N&#8217Djamena N&#8217Djamena Tchad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

关键词： Integrated Management Child 6 - 59 Months SAM

Distribution of atrial cardiomyopathy markers and association with atrial fibrillation detected after ischaemic stroke in the SAFAS study

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Stroke & Vascular Neurology 2024年第2期9卷 165-173,I0426,I0427页

作者： romain Didier Lucie Garnier Gauthier Duloquin Alexandre Meloux Audrey Sagnard Mathilde Graber Geoffrey Dogon Karim Benali Thibaut Pommier Gabriel Laurent Catherine Vergely Yannick Bejot Charles Guenancia Cardiology CHU Dijon BourgogneDijonFrance Dijon Stroke Registry Department of NeurologyUniversity Hospital Centre DijonDijonFrance PEC 2 Universitéde BourgogneDijonFrance Cardiology CHU Saint EtienneSaint EtienneFrance

Background Atrial cardiomyopathy(AC)is an emerging concept explaining the pathophysiology of cardioembolic strokes in absence of atrial fibrillation(AF).A definition based on the presence of electrical abnormality(P-wave terminal force in lead V1(PTFV1)>5000µV×ms),N-Terminal pro-B-type natriuretic peptide(NT pro BNP)>250pg/mL and/or indexed left atrial diameter(LADI)>3cm/m^(2)is currently tested in the ARCADIA(AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenic stroke)*** set out to estimate the prevalence of AC as defined in the ARCADIA trial,its determinants and its association with AF detected after stroke(AFDAS).Methods Stepwise screening for silent Atrial Fibrillation After Stroke(SAFAS)study prospectively included 240 ischaemic stroke *** markers were complete for 192 of them and 9 were not included in this analysis because AF had been diagnosed on *** A total of 183 patients were analysed,of whom 57%(104 patients)met the AC criteria(79 NT-proBNP,47 PTFV1,4 LADI).In the multivariate logistic regression,C reactive protein>3mg/L(OR(95%CI)2.60(1.30 to 5.21),p=0.007)and age(OR(95%CI)1.07(1.04 to 1.10),p34mL/m^(2),OR 2.35(CI 1.09 to 5.06)p=0029).Conclusion AC as defined in ARCADIA is mostly based on NT pro BNP elevation(76%of patients)and is associated with age and ***,AC was not independently associated with AFDAS at *** ARCADIA trial,which compares aspirin to apixaban in patients with embolic strokes of undetermined source with AC markers and must,therefore be analysed in the light of these limitations.

关键词： atrial cardiomyopathy prevention

Comparative Study of the Widal Test against Stool Culture in the Diagnosis of Suspected Cases of Typhoid Fever in Some Low Income Communities in the Adamawa Region of Cameroon

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Journal of Biosciences and Medicines 2024年第6期12卷 178-190页

作者： Mariane Lucie Ngueguim Bernard Viban Tangwa Victor Ngu Ngwa Jules romain Ngueguim Abdoulmoumini Mamoudou School of Veterinary Medicine and Sciences University of Ngaoundere Ngaoundere Cameroon Department of Veterinary Medicine University of Buea Buea Cameroon Institute de Recherhe Agricole pour le Development (IRAD) Ngaoundere Cameroun

Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.

关键词： Salmonella Infections Stool Culture Widal Test Adamawa Region Cameroon

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

Cameroon Climate Predictions Using the SARIMA-LSTM Machine Learning Model: Adjustment of a Climate Model for the Sudano-Sahelian Zone of Cameroon

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Open Journal of Statistics 2024年第3期14卷 394-411页

作者： Joseph Armathé Amougou Isidore Séraphin Ngongo Patrick Forghab Mbomba romain Armand Soleil Batha Paul Ghislain Poum Bimbar Dpartement de Gographie Universit de Yaound 1 Yaound Cameroon Observatoire National sur les Changements Climatiques (ONACC) Yaound Cameroon Laboratoire dAnalyse et Modlisation Multidisciplinaire Statistique (SAMM) Universit de Paris 1 Panthon Sorbonne Paris France Ecole Nationale Suprieure Polytechnique de Yaound 1 Yaound Cameroon Dpartement de Mathmatiques Ecole Normale Suprieure de Yaound Yaound Cameroon Dpartement dInformatique Universit de Yaound 1 Yaound Cameroon

It is acknowledged today within the scientific community that two types of actions must be considered to limit global warming: mitigation actions by reducing GHG emissions, to contain the rate of global warming, and adaptation actions to adapt societies to Climate Change, to limit losses and damages [1] [2]. As far as adaptation actions are concerned, numerical simulation, due to its results, its costs which require less investment than tests carried out on complex mechanical structures, and its implementation facilities, appears to be a major step in the design and prediction of complex mechanical systems. However, despite the quality of the results obtained, biases and inaccuracies related to the structure of the models do exist. Therefore, there is a need to validate the results of this SARIMA-LSTM-digital learning model adjusted by a matching approach, “calculating-test”, in order to assess the quality of the results and the performance of the model. The methodology consists of exploiting two climatic databases (temperature and precipitation), one of which is in-situ and the other spatial, all derived from grid points. Data from the dot grids are processed and stored in specific formats and, through machine learning approaches, complex mathematical equations are worked out and interconnections within the climate system established. Through this mathematical approach, it is possible to predict the future climate of the Sudano-Sahelian zone of Cameroon and to propose adaptation strategies.

关键词： Adjustment Calibration Climate Sudano-Sahelian Zone Numerical Model

COVID-19 patient experiences in prehospital pathways:a processual approach using life-events calendar method and state sequence analysis shows detrimental delays

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Family Medicine and Community Health 2024年第1期12卷 45-56页

作者： romain Lutaud Sebastien Cortaredona Lea Delorme Patrick Peretti-watel Juliette Mirouse Manon Borg Lucie Cattaneo Didier Thery Gaetan Gentile Christian Pradier Touitou Irit Philippe Brouqui Sophie Tardieu Michel Carles Stéphanie Gentile Department of General Practice Aix-Marseille UniversityMarseilleFrance ADES MarseilleFrance Institut de Recherche pour le Développement(IRD) MarseilleFrance Assistance Publique-Hôpitaux de Marseille(AP-HM) MarseilleFrance INSERM MarseilleFrance Department of Public Health Archet University HospitalNiceFrance MEPHI MarseilleFrance CEReSS-Health Service Research and Quality of life Center MarseilleFrance Department of Infectious Diseases Centre Hospitalier Universitaire de NiceNiceFrance

Objectives To our best knowledge,no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19.‘Patients’voice is an excellent means to capture data on primary care *** aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences,and to test whether these clusters were associated with a higher risk of poor clinical *** Cross-sectional online survey using life-event *** All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in *** 312 patients responded to the *** outcome measures From the day of symptom onset to the day of hospitalisation,we defined a symptom sequence as the time-ordered vector of the successive symptom grades(grade 1,grade 2,grade 3).State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom *** logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit(ICU)and COVID-19 sequelae after *** Three clusters of symptom sequences were identified among 312 complete prehospital pathways.A specific group of patients(29%)experienced extended symptoms of severe COVID-19,persisting for an average duration of 7.5 days before *** group had a significantly higher probability of being admitted to ICU(adjusted OR 2.01).They were less likely to know a loved one who was a healthcare worker,and more likely to have a lower level of ***,this group of patients,who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time,may have been inclined to postpone reassessment when their health *** relatives played a decisive role in their *** and relevance This study h

关键词： admitted likely life

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