[Evaluation of a referral protocol to primary health care for patients eligible for health service access points following hospitalization]. / Évaluation d'un protocole d'orientation vers le droit commun parmi des patients ayant été suivis en permanence d'accès aux soins de santé suite à une hospitalisation.

INTRODUCTION: PASS is a hospital care unit that provides access to health care for precarious persons and supports them as soon as they have obtained primary health care insurance. No details of this support had previously been described. A Hospital-to-Community protocol for referral to the public health system has been developed at the adult PASS unit of the Marseille public hospitals (AP-HM). The objectives of this study are to describe how this protocol is applied, to evaluate at six months the inclusion in general practice of patients having benefited (or not) from this protocol and to determine the key influencing factors. MATERIAL AND METHOD: This two-arm prospective observational study collected data on the primary care pathways of precarious patients six months after their having obtained health coverage, and found out whether or not the newly existing protocol had been effectively implemented. It was carried out on a cohort of people included in the PASS-MULTI study who had acquired complete health coverage. RESULTS: Sixty patients were included between November 2020 and August 2022, 35 of whom had availed themselves of the Hospital-to-Community protocol. Among them, 68.8% in the interventional group had consulted their referring general practitioner within six months, vs. 40% in the control group (p = 0.04). The initiation of follow-up in general medicine was associated with application of the protocol (p = 0.04). CONCLUSION: This study described an initial Hospital-to-Community protocol for referral to the primary healthcare system of patients followed up in the PASS unit and found an association between application of this protocol and initiation of follow-up in primary healthcare.

Programmed cell death: similarities and differences in animals and plants. A flower paradigm.

After an overview of the criteria for the definition of cell death in the animal cell and of its different types of death, a comparative analysis of PCD in the plant cell is reported. The cytological characteristics of the plant cell undergoing PCD are described. The role of plant hormones and growth factors in the regulation of this event is discussed with particular emphasis on PCD activation or prevention by polyamine treatment (doses, timing and developmental stage of the organism) in a Developmental cell death plant model: the Nicotiana tabacum (tobacco) flower corolla. Some of the effects of polyamines might be mediated by transglutaminase catalysis. The activity of this enzyme was examined in different parts of the corolla during its life span showing an acropetal trend parallel to the cell death wave. The location of transglutaminase in some sub-cellular compartments suggests that it exerts different functions in the corolla DCD.

Límites de referencia de las concentraciones de lípidos en embarazos no complicados / Reference limits for lipids during pregnancy without complications

Resumen OBJETIVO: Definir los límites de referencia de las concentraciones de lípidos en gestaciones no complicadas. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y analítico efectuado en pacientes embarazadas sanas atendidas en el servicio de Obstetricia del Hospital Churruca-Visca de Buenos Aires, Argentina. Criterios de inclusión: pacientes embarazadas con edad entre 14 y 43 años. Criterios de exclusión: pacientes en tratamiento farmacológico que pudiera afectar el metabolismo lipídico o tener complicaciones obstétricas o neonatales. RESULTADOS: Se estudiaron 163 embarazadas con edad promedio de 27.2 ± 6.5 años, que se categorizaron en cuatro grupos. En el primer trimestre el colesterol no HDL fue significativamente diferente entre las cuatro categorías de IMC (p < 0.05). En el segundo trimestre se encontraron iguales resultados para colesterol no HDL y LDL (p < 0.05) mientras que las concentraciones de triglicéridos fueron significativamente diferentes de acuerdo con las cinco categorías de edad (p < 0.05). En el tercer trimestre no se encontraron diferencias en las concentraciones de lípidos por edad ni por IMC. Tampoco se obtuvieron diferencias por ganancia de peso (menos o más de 10 kg). CONCLUSIONES: Las concentraciones de lípidos y lipoproteínas se incrementaron a lo largo del embarazo. No hubo diferencia significativa entre mujeres con bajo y peso normal versus sobrepeso-obesidad. Es necesario reunir más información de valores de referencia de lípidos y lipoproteínas para poder definir el estado de dislipidemia en las embarazadas.

Abstract OBJECTIVE: To define the reference limits of lipid concentrations in uncomplicated gestations. MATERIALS AND METHODS: Observational, retrospective and analytical study carried out in healthy pregnant patients treated in the obstetrics service of the Churruca-Visca Hospital. Inclusion criteria: being pregnant and between 14 and 43 years of age. Exclusion criteria: being in pharmacological treatment that could affect lipid metabolism or have obstetric or neonatal complications. RESULTS: 163 pregnant women were studied with an average age of 27.2 ± 6.5 years, which was categorized into four groups. In the first trimester non-HDL cholesterol was significantly different among the four categories of BMI (p <0.05). In the second quarter, the same results were found for non-HDL and LDL cholesterol (p <0.05), while triglyceride concentrations were significantly different according to the five age categories (p <0.05). In the third quarter there were no differences in lipid concentrations by age or BMI. Nor were differences obtained by weight gain (less or more than 10 kg). CONCLUSIONS: Lipid and lipoprotein concentrations increased during pregnancy. There was no significant difference between women with low and normal weight versus overweight-obesity. It is necessary to gather more information on reference values of lipids and lipoproteins in order to define the state of dyslipidemia in pregnant women.