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Subxyphoid Pericardial Drainage for Tuberculous Pericardial Effusion in Antananarivo

World Journal of Cardiovascular Surgery 2024年第2期14卷 21-31页

作者： Tsirimalala Rajaobelison Zakarimanana Lucas Randimbinirina Maharo Ramifehiarivo Manoahasina Ranaliarinosy Rabarison Toky Mamin’ny Aina Rajaonanahary Andriamihaja Jean-Claude Rakotoarisoa Department of Cardiovascular Surgery Faculty of Medicine of Antananarivo University of Antananarivo Antananarivo Madagascar Department of Pathology Faculty of Medicine of Antananarivo University of Antananarivo Antananarivo Madagascar Department of Vascular Surgery Faculty of Medicine of Antananarivo University of Antananarivo Antananarivo Madagascar Department of Thoracic Surgery Faculty of Medicine of Antananarivo University of Antananarivo Antananarivo Madagascar

Introduction: Tuberculosis is the leading cause of pericardial effusion in sub-Saharan African countries. The aim of this study was to describe the diagnosis and the surgical management of tuberculous pericardial effusion in low-income country. Methods: This was a retrospective and descriptive study performed at Vascular Surgery Unit for 10 years-period (from January 2012 to December 2021), including all cases of drainage of pericardial effusion due to tuberculosis. Results: Sixty-seven cases were recorded, including 38 males (56.71%) and 29 women (43.28%). The average age was 35.47 years old. Patients lived in urban areas in 67.16% of cases. Thirteen patients (13.43%) had a previous history of pulmonary tuberculosis. The most common risk factors for tuberculosis infection were malnourishment (80.59%), indoor air pollution (77.61%) and close contact with tuberculosis patient (40.29%). The commonest symptom were dyspnea, (95.52%), chest pain (89.55%), fever (67.16%), tachycardia (95.52%) and cough (80.59%). Twenty-seven patients (39.02%) presented clinical signs of cardiac tamponade. Electrocardiogram showed sinus tachycardia (97.53%) with microvoltage (39.02%). Chest-X-ray showed cardiomegaly (100%) and pleural effusion (56.71%). Echocardiography showed moderate (43.28%) and large (56.71%) pericardial effusion. All patients underwent subxiphoid pericardial drainage. Mycobacterium tuberculosis detection via GeneXpert test of pericardial effusion were positive in 38.80% of patients. Pericardial biopsies confirmed the diagnosis of tuberculosis in 41.79%. The mortality rate was 8.95%. Conclusion: Subxiphoid pericardial drainage reduced thr risk of cardiac tamponade in patients with massive pericardial effusion. Histopathology of pericardial biopsies made a definitive diagnosis for tuberculosis.

关键词： Tuberculosis Echocardiography Pericardial Effusion Surgery Cardiac Tamponade

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Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

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World Journal of Cardiovascular Diseases 2024年第1期14卷 27-42页

作者： Komlavi Yayehd Tchaa Tcherou Hervé Libérus A. Edorh Agossou Defodji Mohamed Kpelafia Ekpé Togbossi Ablawa Adzodo Soulemane Pessinaba Machihude Pio Soodogoua Baragou Findibe Damorou Department of Cardiology Faculty of Health Sciences University of Lomé Lomé Togo Department of Cardiology Faculty of Health Sciences University of Kara Kara Togo

Introduction: Despite the rise of direct oral anticoagulants (DOACs), vitamin K antagonists (VKA) remain the most widely used oral anticoagulants in developing countries. The aim of this study was to estimate the prevalence of good anticoagulation in patients treated with VKA in Lomé and describe associated factors. Methods: This was a cross-sectional study conducted from November 2019 to October 2020 in the cardiology departments of two University teaching hospitals in Lomé (CHU Sylvanus Olympio and CHU Campus), involving patients on VKA for ≥3 months, with a target international normalized ratio (INR) of 2.5 and a therapeutic margin between 2 and 3. The quality of anticoagulation was assessed by the time in therapeutic range (TTR) which was assessed by the Rosendaal method. Good anticoagulation was defined by a TTR > 70%. Results: A total of 344 patients were included (mean age = 58 ± 13.8 years, women = 56.1%). Indications for VKA treatment were represented by venous thromboembolic disease (43.3%), supraventricular arrhythmia (28.2%), severe left ventricular systolic dysfunction (19.8%) and pulmonary hypertension (8.7%). The average TTR was 47.6 ± 20.8%. The rate of good anticoagulation was 17.7%. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol (OR = 11.17;95% CI: 3.2 - 39.6;p = 0.0002), concomitant low-dose aspirin (OR 4.44;95% CI: 1.4 - 13.9;p = 0.01) and INR monitoring exclusively by the patient himself (OR = 4.92;95% CI: 1.5 - 16.3;p = 0.008). The rate of thromboembolic and hemorrhagic complications was each 2.6% and was not correlated with the quality of anticoagulation. Quality of anticoagulation by VKAs was poor in our practice. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol, concomitant low-dose aspirin and monitoring of INR exclusively by the patient himself. Conclusion: The quality of oral anticoagulation by VKAs could be improved in our practice by the creation of antico

关键词： Vitamin K Antagonists Time in Therapeutic Range Lomé Togo

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Associations between health-related fitness and patient-reported symptoms in newly diagnosed breast cancer patients

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Journal of Sport and Health Science 2024年第6期13卷 851-862页

作者： Ki-Yong An Fernanda Z.Arthuso Myriam Filion Spencer J.Allen Stephanie M.Ntoukas Gordon J.Bell Jessica McNeil Qinggang Wang Margaret L.McNeely Jeff K.Vallance Lin Yang S.Nicole Culos-Reed Leanne Dickau John R.Mackey Christine M.Friedenreich Kerry S.Courneya faculty of Kinesiology Sportand RecreationCollege of Health SciencesUniversity of AlbertaEdmonton T6G 2H9Canada Department of Kinesiology School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNC 27412USA Department of Cancer Epidemiology and Prevention Research Cancer Care AlbertaAlberta Health ServicesCalgary T2S 3C3Canada faculty of Rehabilitation Medicine University of AlbertaEdmonton T6G 2H9Canada faculty of Health Disciplines Athabasca UniversityAthabasca T9S 3A3Canada Department of Oncology Cumming School of MedicineUniversity of CalgaryCalgary T2N 4N1Canada faculty of Kinesiology University of CalgaryCalgary T2N 1N4Canada faculty of Medicine and Dentistry University of AlbertaEdmonton T6G 2H9Canada

Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and *** and managing breast cancer-related symptoms soon after diagnosis is *** purpose of this study was to investigate the associations between health-related fitness(HRF)and patient-reported symptoms in newly diagnosed breast cancer ***:This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of *** measures included peak cardiopulmonary fitness(peak volume of oxygen consumption(VO_(2peak))),maximal muscular strength and endurance,flexibility,and body *** measures included depression,sleep quality,and *** multivariable logistic regression was performed for ***:Of 1458 participants,51.5%reported poor sleep quality,26.5%reported significant fatigue,and 10.4%reported moderate *** multivariable-adjusted models,lower relative VO_(2peak)was independently associated with a greater likelihood of all symptom measures,including moderate depression(p<0.001),poor sleep quality(p=0.009),significant fatigue(p=0.008),any symptom(p<0.001),and multiple symptoms(p<0.001).VO_(2peak)demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest *** strength of the threshold associations varied by the symptom measure with odds ratios ranging from-1.5 for poor sleep quality to-3.0 for moderate depression and multiple ***,lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner(p=0.001),and higher body weight was independently associated with poor sleep quality in an inverted U pattern(p=0.021).Conclusion:Relative VO_(2peak)appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diag

关键词： Breast cancer Fatigue Depression Sleep quality Cardiorespiratory fitness

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Problems and prospects of fish farming in the Chattogram Hill Tracts of Bangladesh:Community-based aquaculture might be a right choice

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Aquaculture and Fisheries 2024年第2期9卷 306-313页

作者： Saifuddin Rana MdNazmul Hasan Abdulla Al Bari Shahida Arfine Shimul SkIstiaque Ahmed Sk.Ahmad Al Nahid Department of Fisheries Resource Management Faculty of FisheriesChattogram Veterinary and Animal Sciences UniversityKhulshi4225ChattogramBangladesh Department of Oceanography University of ChittagongChittagong4331Bangladesh

The study was carried out in Matiranga Upazila,Bandarban district,which is considered one of Bangladesh’s major hill tract *** study aimed to identify present farming conditions,prospects,and problems and suitable solutions to the problems of fish *** participatory rapid appraisal tools such as focus group discussion,field visits,and farmers’interviews were used to collect relevant fish farming information in the study *** polyculture method was the most practised aquaculture *** the selected farms,eleven fish species were identified as culture *** transportation cost for seeds purchased from remote areas was high(11%of total seed cost).The average transportation-related mortality of fish fry and fingerlings was 7.2%and 2.8%.Feed cost was found as the major cost(58.4%)in *** and revenue for fish production per decimal varied from BDT 311 to 3528 and BDT 23 to *** of vacant lake,youth and women engagement,integrated aquaculture,the desire of people to engage in aquaculture,and available human resources were found as significant *** major problems identified were lack of hatchery,high feed cost,lack of stakeholder linkage,lack of capital for fish farming,and lack of proper knowledge,guidelines,and consultancy for fish culture.A community-based aquaculture model was proposed to overcome the present challenges and problems in the study *** model may help to expand aquaculture and thus improve the livelihood and socio-economic status of the people of the hilly areas of Bangladesh.

关键词： Hilly area Aquaculture model Tribal people Fish farming prospects

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Suicidal Behaviours in Sickle Cell Patients at the Douala Sickle Cell Care Centre in Cameroon

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Open Journal of Psychiatry 2024年第3期14卷 265-281页

作者： Christian Eyoum Léonce Kengno Kologne Charlotte Eposse Ekoube Annick Mélanie Magnerou Joséphine Manga Befolo Cindy Laura Ndepa Daniel Gams Massi Aurore Nzesseu Djomo Guy Jonas Basseguin Atchou Guy Calvin Mbongo’O Rihta Mbono Mbekoto Iyawa Hassanatou Fabiola Tchouankeu Kounga Christiane Medi Sike Josiane Essola Jacques Narcisse Doumbe Erero Njiengwe Callixte Kuate Tegueu faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon faculty of Health Sciences University of Buea Buea Cameroon faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon

Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.

关键词： Sickle Cell Disease Suicidal Behaviours Self-Harm

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住院患者认知障碍识别和信息管理的整合性综述

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International Journal of Nursing Sciences 2024年第1期11卷 120-132页

作者：熊蓓蓓 Daniel X.Bailey Paul Prudon Elaine M.Pascoe Leonard C.Gray Frederick Graham Amanda Henderson Melinda Martin-Khan Centre for Health Services Research Faculty of MedicineThe University of QueenslandBrisbaneAustralia Centre for Clinical Research Faculty of MedicineThe University of QueenslandRoyal Brisbane&Women’s HospitalBrisbaneAustralia Dementia and Delirium Division of MedicinePrincess Alexandra HospitalBrisbaneAustralia School of Nursing Faculty of HealthQueensland University of TechnologyBrisbaneAustralia Nursing Practice Development Unit Princess Alexandra HospitalBrisbaneAustralia School of Nursing Midwifery and Social SciencesCentral Queensland UniversityBrisbaneAustralia Griffith Health Griffith UniversityBrisbaneAustralia School of Nursing Midwifery and ParamedicineThe University of the Sunshine CoastBrisbaneAustralia Department of Health and Life Sciences University of ExeterExeterUnited Kingdom School of Nursing University of Northern British ColumbiaPrince GeorgeCanada

目的旨在对目前提供急性照护的医院识别认知障碍患者以及在病历中记录和管理认知相关信息的实际情况及政策要求和推荐方法进行综述。方法采用Whittemore和Knaf1的五步法,系统检索Medline,CINAHL和Scopus数据库,并检索了灰色文献来源。... 详细信息

目的旨在对目前提供急性照护的医院识别认知障碍患者以及在病历中记录和管理认知相关信息的实际情况及政策要求和推荐方法进行综述。方法采用Whittemore和Knaf1的五步法,系统检索Medline,CINAHL和Scopus数据库,并检索了灰色文献来源。纳人了提供急性照护的医院已实施的患者认知障碍识别和认知信息管理相关的文献。采用混合方法评价工具和灰色文献质量评估清单对文章质量进行评价。采用主题分析法呈现和整合结果。该综述已在PROSPERO预注册(CRD42022343577)。结果共22篇原始研究文献和10篇政府/行业文件被纳人分析。结果显示,实践和政策之间存在差距。尽管在政策层面上高度重视认知障碍的识别、认知相关信息的透明度,以及与患者、家属和照顾者(如适用)之间的互动,但有时在临床实践中,认知评估是非正式的,患者的认知相关信息未作记录,与患者、家属和照顾者的互动也存在不足。结论.通过整合认知评估,利用信息技术开发信息管理综合系统,建立相关法律法规,提供教育与和培训,并采用国家层面的策略,有可能显著改善对认知障碍患者的识别和护理。

关键词：急性照护认知功能障碍数据透明度谵妄痴呆健康信息管理与患者互动.

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Continuity of care by a primary midwife(caseload midwifery):a cost analysis using results from the COSMOS randomised controlled trial

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 94-101页

作者： Emily J Callander Hannah Jackson Helen L McLachlan Mary-Ann Davey Della A Forster University of Technology Sydney SydneyNew South WalesAustralia The Royal women's Hospital MelbourneVictoriaAustralia faculty of Health University of Technology SydneyBroadwayNew South WalesAustralia Judith Lumley Centre La Trobe UniversityMelbourneVictoriaAustralia School of Nursing and Midwifery a Trobe UniversityMelbourneVictoriaAustralia Department of Obstetrics and Gynaecology Monash UniversityClaytonVictoriaAustralia

Introduction Caseload midwifery(continuity of midwifery carer)offers benefits including lower caesarean section rates,lower risks of preterm birth and stilbirth,and improved maternal satisfaction of *** these advantages,concerns about additional costs hinder widespread *** study examinesthecost of caseload midwifery compared with standard maternity care from the perspective of both public hospitals and public *** A cost analysis was conducted using data from a randomised controlled trial of 2314 low-risk pregnant women in Melbourne,*** randomised to caseload care received antenatal,intrapartum and postpartum care from a primary midwife,with some care provided by a‘back-up'*** in standard care received midwifery-led care with varying levels of continuity,junior obstetric care or community-based medical *** cost analysis compared differences in mean costs of health resources to public hospitals and to public ***,a budget impact analysis estimated total costs to the health system between 2023 and *** For public hospitals,there was no significant difference in overall costs between women receiving caseload midwifery(n=1146)versus standard care(n=1151)($SA12363(SD:$A4967)vs$A12323(SD:$A7404);p=0.85).Conversely,public funders incurred lower expenditures for women receiving caseload midwifery($A20330(SD:$A8312))versus standard care($A21637(SD:$A11818);pwomen is cost-neutral to public hospitals and cost-saving to public *** abstract Continuity of midwifery for low-risk women reduces costs to public funders,with no additional costs to hospitals.

关键词： random continuity Continuity

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Predictive Factors for Pre-Eclampsia: A Case-Control Study in Two Hospitals in Yaounde

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 565-574页

作者： Junie Annick Metogo Ntsama Ines Winnie Gouanfo Claude Hector Mbia Wilfried Loic Tatsipie Pascal Mpono Madye Ngo Dingom Felix Essiben Claude Cyrille Noa Ndoua faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from February 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm women likely to develop pre-eclampsia before the onset of disease for timely interventions.

关键词： Pre-Eclampsia Predictive Factors Yaoundé

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The Hidden Side of the Story between the Placenta and Preeclampsia: Preliminary Results of a Prospective Cohort of Pregnant women in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 610-620页

作者： Junie Annick Metogo Ntsama Ambroise Merci Engounou Seme Urielle Julie Tchuente Sutchueng Wilfried Loic Tatsipie Christian Vagoda Henry-Leonard Chatelin Mol Madye Ngo Dingom Felix Essiben Cyrille Claude Noa Ndoua Yann chris Eng Odile Fernande Zeh faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was s

关键词： Pre-Eclampsia Doppler Ultrasound Placenta

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Physical activity volume,frequency,and intensity:Associations with hypertension and obesity over 21 years in Australian women

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Journal of Sport and Health Science 2024年第5期13卷 631-641页

作者： Gregore I.Mielke Ding Ding Shelley E.Keating Bruno P.Nunes Ruth Brady Wendy J.Brown School of Public Health The University of QueenslandBrisbaneQLD 4006Australia Sydney School of Public Health Faculty of Medicine and HealthThe University of SydneySydneyNSW 2006Australia The Charles Perkins Centre The University of SydneySydneyNSW 2006Australia School of Human Movement and Nutrition Sciences The University of QueenslandBrisbaneQLD 4072Australia School of Nursing Federal University of PelotasPelotasRio Grande do Sul 96010-610Brazil faculty of Health Sciences and Medicine Bond UniversityGold CoastQLD 4226Australia

Background:Optimal patterns of accrual of recommended levels of physical activity(PA)for prevention of hypertension and obesity are not *** overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 ***,we investigated whether,for the same weekly volume of PA,the number of sessions(frequency)and vigorousness of PA(intensity)were associated with a reduction in the occurrence of hypertension and obesity in ***:Data from the 1973-1978 and 1946-1951 cohorts of the Australian Longitudinal Study on women's Health were analyzed(n=20,588;12%-16%with a Bachelor's or higher degree).Self-reported PA,hypertension,height,and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/*** Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume(metabolic equivalent min/week)(none;33-499;500-999;≥1000,weekly frequency(none;1-2 times;3-4times;5-7 times;≥8 times),and the proportion of vigorous PA to total volume of PA(none;0%;1%-33%;34%-66%;67%-100%)with odds of hypertension and obesity from 2000 to ***:The cumulative incidence of hypertension was 6%in the 1973-1978 and 23%in the 1946-1951 cohort;27%of women in the 1973-1978;and 15%in the 1946-1951 cohort developed obesity over the ***,a higher volume of PA was associated with reduced odds of hypertension and *** the volume of PA was considered,the odds of hypertension did not vary according to the frequency or intensity of ***,increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obe ***:PA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and *** more sessions,particularly of vigorous-intensity PA,may provide extr

关键词： Physical activity Frequency Intensity Incidences Epidemiology women

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