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1.
Heliyon ; 10(8): e29316, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38638947

RESUMO

Background: Although the COVID-19 pandemic's impact on students has already been studied, its impact on nursing students' perception of their training and their conception of their future profession is unknown. Aims: To describe nursing students' perception of their involvement in reinforcement during the COVID-19 pandemic and the impact of working as reinforcement staff during the COVID-19 pandemic on nursing students. Design: Cross-sectional, comparative case/non-case study. Setting: nurse training institutions in France. Participants: "Cases" defined as nursing students who worked as reinforcement staff during the COVID-19 pandemic; "non-cases" defined as people who were in final year of nursing studies in 2018-2019 or 2019-2020 and so did not work as reinforcement staff during their nursing studies. Methods: questionnaire about representations of the nursing profession, role of the nurse in society, previous thinking of dropping out of nursing education. Results: 534 subjects included (310 cases; 214 non-cases). Cases reported feeling useful (38.6%) or very useful (25.7%) as reinforcement workers, while 91.5% concurred that nurses had an important role in the management of COVID-19 patients. Cases more frequently reported that the nursing profession is one where you save lives (61.5% vs 52.5%, p = 0.05). The desire to work as a nurse for a whole life had been more frequently expressed by cases (45.3% vs 34.8%, p = 0.05). Nursing education drop-out has been considered by 63.4% of subjects, without difference between "cases" and "non-cases" (p = 0.63). Subjects who considered dropping out of nursing education were younger (p = 0.01) and less often prone to think that the nursing profession was a profession personally rewarding (p = 0.01) and a life-saving profession (p = 0.03). Conclusion: The majority of nursing students reported feeling useful during the pandemic, and underlined the importance of the nurse's role in management of COVID-19 patients. Participation in reinforcement staff during the pandemic had no influence on dropping out of nursing education.

4.
J Cancer Educ ; 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38351431

RESUMO

In 2019, French health authorities extended the recommendation for human papillomavirus (HPV) vaccination to include boys aged 11 to 19 years. We describe HPV vaccination practices among French general practitioners (GPs) since this recommendation wasapplied. We also identified factors associated with the propensity to propose HPV vaccination to boys. Cross-sectional study, between May and August 2022, among French GPs using a questionnaire asking about the GPs, their practices, and opinions regarding HPV vaccination, including whether they systematically proposed HPV vaccination to eligible boys or not. We investigated factors associated with systematic proposal of HPV vaccination, using univariate and multivariate logistic regression. In total, 360 GPs participated (76.6% females; mean age 34.7 ± 7.8 years; 22.9% had additional training in gynecology or pediatrics); 5.5% reported that they systematically offered HPV vaccination to boys prior to the recommendation, whereas 61.2% do so systematically since the recommendation. Factors associated with systematic proposal to boys (post recommendation) were female GP sex (78.6% versus 66.2%; OR = 2.0 [95% confidence interval (CI) 1.2-3.3]; p = 0.007) and systematic proposal prior to the recommendation (8.5% versus 0.7%; OR = 13.3 [1.7-101.7]; p = 0.01). Protection against HPV-induced cancer was cited as an argument to vaccinate girls (98.3% versus 89.2%; p < 0.0001); while reducing the risk of transmission was more commonly an argument to vaccinate boys (78.1% versus 51.8%; p < 0.0001). This study underlines the positive impact of the official recommendation for HPV vaccination of boys on the attitude of GPs, with an increase in the systematic proposal of HPV vaccination to boys.

5.
Eur Arch Otorhinolaryngol ; 281(2): 925-934, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37917163

RESUMO

PURPOSE: The objective of our study was to evaluate the ability of preoperative MRI tractography to visualize and predict the path of the facial nerve with respect to an intra-parotid mass. METHODS: We performed an observational bicentric study from June 2019 to August 2020. All patients older than 18 years old, treated for a parotid mass with surgical indication, without MRI contraindication and who agreed to participate in the study were enrolled prospectively. All patients underwent a cervico-facial MRI with tractographic analysis. Postprocessed tractography images of the intra-parotid facial nerve were analyzed by two expert radiologists in head and neck imaging. The intraoperative anatomical description of the facial nerve path and its relationship to the mass was performed by the surgeon during the operation, with no visibility on MRI examination results. A statistical study allowed for the description of the data collected as well as the measurement of inter-observer agreement and agreement between tractography and surgery using kappa coefficients. RESULTS: Fifty-two patients were included. The facial nerve trunk and its first two divisional branches were visualized via tractography in 93.5% of cases (n = 43). The upper distal branches were visualized in 51.1% of cases (n = 23), and the lower branches were visualized in 73.3% of cases (n = 33). Agreement with the location described per-operatively was on average 82.9% for the trunk, 74.15% for the temporal branch, and 75.21% for the cervico-facial branch. CONCLUSION: Fiber tractography analysis by MRI of the intra-parotid facial nerve appears to be a good test for predicting the path of the nerve over the parotid mass and could be an additional tool to guide the surgeon in the operative procedure.


Assuntos
Nervo Facial , Neoplasias Parotídeas , Adolescente , Humanos , Nervo Facial/cirurgia , Imageamento por Ressonância Magnética/métodos , Pescoço/patologia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/cirurgia , Glândula Parótida/inervação , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , Neoplasias Parotídeas/patologia
6.
BMC Health Serv Res ; 23(1): 1442, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38124027

RESUMO

BACKGROUND: New healthcare professions are emerging due to scarce medical resources. The appearance of a new healthcare profession, advanced practice nurses (APNs), has raised questions about how general practitioners interrelate with them as primary care providers. The objective of this study was to explore the perceptions general practitioners have towards the services rendered by APNs to patients, to general practice and the role they play in the healthcare system. METHODS: A survey-based, cross-sectional study was conducted throughout the Grand Est region of France which covers 57,333km2 and has a population of approximately 5,562,651. The survey was compiled using pre-existing questionnaires and was carried out from July to September 2022 via email. Variables collected were rate of acceptability and socio-demographic characteristics. RESULTS: In total, 251 responses were included. The mean age of general practitioners was 41.7 years, most were women (58.2%) and worked in rural areas of the region (53.8%). Over 80% of respondents practiced in group structures (defined as either multi-professional health centers (n = 61) or in group practices (n = 143)). Most respondents (94.0%) were familiar with the APN profession and did not consider that APNs improved access to care (55.8%, percent of responders with score ≤ 3/10). Moreover, most did not believe that APNs were useful as a primary care provider for patients (61.8%). However, being a member of a territorialized healthcare community, known as Communautés Professionnelles Territoriales de Santé (CPTS), was associated with a positive appraisal of APNs' services (OR = 2.116, 95%CI: 1.223 to 3.712; p = 0.007). CONCLUSIONS: Encouraging shared and networked practice within a healthcare community may promote a positive perception of new actors. Further studies need to be conducted to show whether the integration of APNs into healthcare networks improves quality of care.


Assuntos
Medicina Geral , Clínicos Gerais , Profissionais de Enfermagem , Humanos , Feminino , Adulto , Masculino , Estudos Transversais , Papel do Profissional de Enfermagem , França
7.
BMC Psychol ; 11(1): 368, 2023 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-37924101

RESUMO

BACKGROUND: Around one in ten women will have a miscarriage in their lifetime. Miscarriage is often considered a trivial event by caregivers, but it is associated with a high burden of psychological morbidity, especially during the first 6 months. There is no validated psychological management strategy for women who have had a miscarriage. The MisTher study aims to evaluate the utility of early, short psychological care for women who have had early miscarriage, in terms of anxiety, depression and post-traumatic stress disorder. METHODS: This is a prospective, multicenter, randomized, controlled, superiority study. In total, 932 women who have experienced early miscarriage (spontaneous interruption of pregnancy prior to 14 weeks of gestation) will be randomly assigned to either the intervention or the control group. The intervention consists of 4 teleconsultations of 45 min with a psychologist. All women, regardless of their allocated group, will be encouraged to seek an early consultation with a general practitioner or midwife. The primary endpoint will be anxiety at 3 months after randomization evaluated using State Trait Anxiety Inventory. The secondary endpoints will be anxiety at 6 months evaluated using State Trait Anxiety Inventory, depression at 3 and 6 months evaluated with the Beck Depression Inventory, and post-traumatic stress disorder at 3 and 6 months, evaluated using the Posttraumatic stress disorder Checklist Scale. DISCUSSION: This project will validate the importance of early psychological management, based on primary care and accessible to most women, via teleconsultation, in reducing the frequency of psychological disorders after early miscarriage. Our results should provide a basis for new recommendations for the management of women who have experienced miscarriage, notably by recommending the involvement of trained psychologists in the management pathway for these women. TRIAL REGISTRATION: The trial is registered with ClinicalTrials.gov: NCT05653414. December 15th, 2022.


Assuntos
Aborto Espontâneo , Transtornos de Estresse Pós-Traumáticos , Gravidez , Feminino , Humanos , Aborto Espontâneo/terapia , Aborto Espontâneo/psicologia , Depressão/terapia , Depressão/psicologia , Estudos Prospectivos , Ansiedade/terapia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto
8.
Arch Pediatr ; 30(8): 550-557, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37777347

RESUMO

BACKGROUND: In 2021, the prevalence of signs of burnout among medical residents was reported to be 67%. Being on call is particularly stressful for residents, notably due to their lack of medical experience. When they are on call, several factors contribute to a mismatch between the residents' theoretical knowledge and the operationalization of that knowledge in a clinical reasoning process. Using the script and cognitive load theories as a basis, we hypothesized that training clinician-teachers in the supervision of clinical reasoning could improve residents' perception of the experience of being on call. METHODS: We performed a longitudinal, exploratory, controlled study with a cohort of medical residents who were on call in the pediatric emergency department during the semester from 1 November 2021 to 30 April 2022. During the night, the residents on call in the pediatric emergency department completed validated questionnaires investigating (1) mental effort, (2) cognitive weariness, (3) state anxiety, (4) feeling of self-efficacy, and (5) well-being. We compared the questionnaires of residents supervised by pediatricians trained in the supervision of clinical reasoning (supervision group) with those of residents in a control group, supervised by pediatricians with no specific pedagogical training. RESULTS: A total of 284 questionnaires (174 supervision group, 110 controls) were collected from 38 residents in three pediatric emergency departments. The results confirm that being on call is difficult for residents. Compared to the control group, residents in the supervision group had lower cognitive weariness scores (mean 3.0 ± 1.1 vs. 3.5 ± 1.3). There was no significant difference between groups for any of the other dimensions of the on-call experience. In the supervision group, mental effort was significantly lower at the end of the study semester (5 [5-6] when on call in month 6 of the semester vs. 6 [5-7] when on call in months 1-5 of the semester; p = 0.01) and was greater for more senior residents (7 [6-8] for those in the 4th or higher semester of residency vs. 6 [5-7] for residents in their 1st, 2nd, or 3rd semester of residency; ß = 0.92 ± 0.40; p = 0.02). CONCLUSION: Beyond the positive effects for residents, this study illustrates the feasibility of implementing training for clinicians in the supervision of clinical reasoning.


Assuntos
Internato e Residência , Criança , Humanos , Avaliação Educacional/métodos , Serviço Hospitalar de Emergência , Raciocínio Clínico , Percepção
9.
BMC Health Serv Res ; 23(1): 903, 2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37612678

RESUMO

BACKGROUND: Vaccination schedules differ from country to country. In France, the diphtheria, tetanus, pertussis, poliomyelitis (dTcaP) booster vaccine coverage for adults aged 25 has been lower than those recommended. We evaluated the impact of an awareness campaign undertaken by the French national health insurance system in 2021. METHODS: A randomized, controlled study with adults residing in the Ardennes region was conducted to evaluate the effect on vaccine coverage of the booster vaccine reminder campaign carried out via letter and/or email and/or SMS. The randomization unit was the municipal administrative area (canton). Ten cantons were grouped into the intervention group (INT) and nine were the control group (CON). Outcomes were the booster vaccine delivery and the consultation of a general practitioner (GP) within 12 months (since the French national health insurance running the campaign suggested patients to consult their GP). RESULTS: A total of 1,975 adults were included (INT: 67.3% vs. CON: 32.7%). Of them, 331 received a booster vaccine (INT: 17.4% vs. CON: 15.5%; p = 0.29), and 1,442 consulted a GP (INT: 73.7% vs. CON: 76.8%; p = 0.14). Those who consulted a GP had more frequent vaccine delivery (INT: 19.1% vs. CON: 10.5%; p < 0.0001). CONCLUSIONS: This study found that the awareness campaign run by the French national health insurance did not improve the uptake of the dTcaP booster and that there was a low rate of vaccinated adults aged 25 years. A GP consultation was associated with dTcaP booster vaccine delivery which may show that there is a need of involving GPs in vaccination follow-ups. Patients recognize GPs as providers of credible information and they may play a key role in individualized preventive healthcare actions. Systematic consultations with GPs for follow-up could be proposed to insured adults aged 25 years in the future.


Assuntos
Correio Eletrônico , Clínicos Gerais , Humanos , Adulto , Grupos Controle , França , Programas Nacionais de Saúde
10.
Arch Pediatr ; 30(7): 458-465, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37336698

RESUMO

BACKGROUND: In France, national guidelines recommend early detection and management of overweight and obesity in children, with multi-year systematic generation of children's body mass index (BMI) curves in primary care. It is important for the parents to understand the BMI curves displayed in the child's health notebook and to become involved in the care with health professionals. OBJECTIVE: The aim of the current study was to compare parents' understanding of a BMI curve displayed using color coding versus their understanding of the same curve displayed without color coding. METHODS: An observational, cross-sectional, comparative study was performed between February 1, 2021 and November 15, 2021. Adult parents with at least one child attending primary school were included. Two questionnaires testing parents' understanding were completed: one showing BMI curves without color coding (five questions) and one showing BMI curve with color coding (five questions). The primary endpoint was the proportion of parents achieving fully correct answers. Comparisons of endpoints between the color-coded and non-color-coded curve were performed using the McNemar test. Factors associated with the primary endpoint were investigated by mixed logistic regression models with the subject as a random effect. RESULTS: The 109 participants (45.4% response rate) had an average age of 39.4 ± 6.6 years; 81.7% were women. A total of 214 complete questionnaires were compared: The proportion of participants with fully correct responses was significantly higher using the BMI curve with color coding compared to the curve without color coding (86.0% vs. 54.2%, p<0.0001). In multivariate analysis, the use of color coding was significantly associated with a higher likelihood of achieving fully correct responses (odds ratio: 5.9, 95% CI: 3.0-11.2, p<0.0001). CONCLUSION: The use of color coding improved parents' understanding of BMI curves. Further research should explore equally the benefits and risks associated with weight loss and mental health when using a colored BMI curve for the detection and management of overweight and obese children.


Assuntos
Obesidade Infantil , Adulto , Criança , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Índice de Massa Corporal , Obesidade Infantil/diagnóstico , Sobrepeso/diagnóstico , Estudos Transversais , Pais/psicologia , Inquéritos e Questionários , Peso Corporal
11.
Hernia ; 27(5): 1165-1177, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36753035

RESUMO

PURPOSE: Groin hernia repair is one of the most frequent operation performed worldwide. Chronic postoperative inguinal pain (CPIP) is the most common and challenging complication after surgical repair with subsequent high socio-economic impact. The aim of this study was to compare the one-year CPIP rates between Lichtenstein, trans-inguinal pre-peritoneal (TIPP), trans-abdominal pre-peritoneal (TAPP) and totally extra-peritoneal (TEP) repair techniques on the French Hernia Registry. METHODS: Between 2011 and 2021, 15,161 primary groin hernia repairs with 1-year follow-up were available on the register. Using propensity score (PS) matching, matched pairs were formed. Each group was compared in pairs independently; Lichtenstein versus TIPP, TEP and TAPP, TIPP versus TEP and TAPP and finally TEP versus TAPP. RESULTS: After PS matching analysis, Lichtenstein group showed disadvantage over TIPP, TAPP and TEP groups with significantly more CPIP at one year (15.2% vs 9.6%, p < 0.0001; 15.9% vs. 10.0%, p < 0.0001 and 16.1% vs. 12.4%, p = 0.002, respectively). The 1-year CPIP rates were similar comparing TIPP versus TAPP and TEP groups (9.3% vs 10.5%, p = 0.19 and 9.8% vs 11.8%, p = 0.05, respectively). There was significantly less CPIP rate after TAPP versus TEP repair (1.00% vs 11.9%, p = 0.02). CONCLUSION: This register-based study confirms the higher CPIP risk after Lichtenstein repair compared to the pre-peritoneal repair techniques. TIPP leads to comparable CPIP rates than TAPP and TEP repairs.


Assuntos
Hérnia Inguinal , Laparoscopia , Humanos , Hérnia Inguinal/cirurgia , Hérnia Inguinal/complicações , Virilha/cirurgia , Laparoscopia/métodos , Pontuação de Propensão , Herniorrafia/métodos , Dor Pós-Operatória/etiologia , Sistema de Registros , Telas Cirúrgicas/efeitos adversos , Resultado do Tratamento
12.
BJGP Open ; 7(1)2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36517185

RESUMO

BACKGROUND: Spontaneous miscarriage (SM) is the most common complication of pregnancy. Its psychological repercussions are widely documented but few studies have investigated its effect on women's experience of a subsequent pregnancy. AIM: To evaluate the impact of prior SM on the level of stress experienced by pregnant women during the first trimester of pregnancy. DESIGN AND SETTING: Cross-sectional, observational study, which was conducted between June and October 2021 in France. METHOD: A self-report questionnaire was distributed to women in the first trimester of pregnancy. Stress was assessed using the Antenatal Perceived Stress Inventory to yield an overall score and a score for three dimensions ('medical and obstetric risks or fetal health'; 'psychosocial changes during pregnancy'; and the 'prospect of childbirth'). Women with a history of prior SM and those without were compared. RESULTS: In total, 93 women were included; 63 without and 30 with a history of prior SM. Prior SM was not associated with the overall score. The score for the dimension 'medical and obstetric risks or fetal health' was significantly higher in women with prior SM (3.00±0.86 versus 2.34±0.80; ß = 0.61 [95% confidence interval {CI} = 0.25 to 0.96]; P = 0.001). Prior SM was significantly associated with the items 'the baby's health' (P = 0.048) and 'the echography' (P = 0.002). CONCLUSION: This study shows a significant impact of prior SM on the level of stress of pregnant women during the first trimester, particularly relating to the medical and obstetric risks or fetal health, underlining the need for appropriate psychological support to be provided to women who experience SM.

13.
Eye (Lond) ; 37(4): 638-643, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35273350

RESUMO

PURPOSE: Altered glucose metabolism, along with low-grade inflammation, has been proposed to be involved in retinal detachment (RD)-induced cone loss. Here, we assessed intravitreal glucose and cytological profile in patients with macula-off RD. METHODS: Glucose concentration was analysed in vitreous samples from 137 non-diabetic patients undergoing vitrectomy for either primary macula-off RD (n = 73) or epiretinal membrane (ERM; n = 64). Cellularity was assessed in vitreous cytospin preparations by a semi-quantitative immunostaining approach. RESULTS: Intravitreal glucose concentration was higher in the RD group (2.28 mmol.L-1 n =73 vs 1.6 mmol.L-1 n = 64; p < 0.0001). Overall cellularity and density of macrophages were significantly higher in the vitreous of RD patients (respectively p = 0.003 and p < 0.0001). Among the RD patients, intravitreal glucose concentration correlated with macrophages density (p = 0.002): its levels remained significantly higher in eyes in which macrophages were innumerable compared to lower macrophages densities RD eyes (p = 0.0095). CONCLUSIONS: We observed a strong relationship between intravitreal glucose concentration and vitreous macrophage density. Additional indicators for vitreous glycation and low-grade inflammation should be further studied.


Assuntos
Membrana Epirretiniana , Descolamento Retiniano , Humanos , Vitrectomia , Membrana Epirretiniana/cirurgia , Inflamação , Glucose
14.
Eur Arch Otorhinolaryngol ; 280(4): 1661-1670, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36114332

RESUMO

PURPOSE: The primary objective was to determine whether the analysis of textural heterogeneity of vestibular schwannomas on MRI at diagnosis was predictive of their radiological evolutivity. The secondary objective was to determine whether some clinical or radiological factors could also be predictive of growth. METHODS: We conducted a pilot, observational and retrospective study of patients with a vestibular schwannoma, initially monitored, between April 2001 and November 2019 within the Oto-Neurosurgical Institute of Champagne Ardenne, Texture analysis was performed on gadolinium injected T1 and CISS T2 MRI sequences and six parameters were extracted: mean greyscale intensity, standard deviation of the greyscale histogram distribution, entropy, mean positive pixels, skewness and kurtosis, which were analysed by the Lasso method, using statistically penalised Cox models. Extrameatal location, tumour necrosis, perceived hearing loss < 2 years with objectified tone audiometry asymmetry, tinnitus at diagnosis, were investigated by the Log-Rank test to obtain univariate survival analyses. RESULTS: 78 patients were included and divided into 2 groups: group A comprising 39 "stable patients", and B comprising the remaining 39 "progressive patients". Independent analysis of the texture factors did not predict the growth potential of vestibular schwannomas. Among the clinical or radiological signs of interest, hearing loss < 2 years was identified as a prognostic factor for tumour progression with a significant trend (p = 0.05). CONCLUSIONS: This study did not identify an association between texture analysis and vestibular schwannomas growth. Decreased hearing in the 2 years prior to diagnosis appears to predict potential radiological progression.


Assuntos
Neuroma Acústico , Zumbido , Humanos , Neuroma Acústico/diagnóstico por imagem , Neuroma Acústico/complicações , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Audição
15.
Ann Cardiol Angeiol (Paris) ; 71(5): 276-282, 2022 Nov.
Artigo em Francês | MEDLINE | ID: mdl-36115722

RESUMO

OBJECTIVES: In 2013, the French National Health Insurance set up a programme to help patients with heart failure to return home and stay there (PRADO). During a hospitalization for cardiac decompensation, the medical team decides on the inclusion of the patient in the programme based on eligibility criteria defined. The objective of this study was to identify the factors most associated with the inclusion of heart failure patients in the PRADO program. MATERIALS AND METHODS: This was a monocentric retrospective analytical stratified case-control study. It focused on the analysis of patient records hospitalized for cardiac decompensation between 01/01/2017 and 31/12/2018 in the cardiology department of the Centre Hospitalier de Troyes. For each patient included in the PRADO Heart Failure programme, one or two controls, not included in the PRADO Heart Failure programme were matched. The matching was exact without discounting. It was performed on the following criteria: age in 10-year increments, sex, main diagnosis of the stay, major category of diagnosis of the stay and its type (medical or surgical), the severity score of the Homogeneous Group of Patients of the stay and the Charlson score. RESULTS: A total of 40 patients included in PRADO Heart Failure were matched to 56 controls not included in PRADO Heart Failure. Patients with respiratory disease (3.77 [1.07 - 13.29]), as well as patients on renin-angiotensin system inhibitors (2.24 [1.61 - 5.31]) were more often included in the PRADO Heart Failure programme. The most frequent criteria for non-eligibility were the need to transfer the patient to a specialised institution and significant impairment of higher functions. CONCLUSION: Respiratory comorbidity and renin-angiotensin system blocker treatment are the factors most associated with the inclusion of heart failure patients in the PRADO Heart Failure programme.


Assuntos
Insuficiência Cardíaca , Participação do Paciente , Humanos , Estudos de Casos e Controles , Estudos Retrospectivos , Insuficiência Cardíaca/terapia , Hospitalização
18.
Cancers (Basel) ; 14(8)2022 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-35454896

RESUMO

Adapted physical activity (APA) improves quality of life and cancer outcomes. The aim of this study was to assess the feasibility of an APA program in outpatients beginning medical anticancer treatment. The secondary objective was to assess the impact of APA on fatigue, anxiety, depression, and handgrip strength (HGS). This prospective study was conducted between January and July 2017. Among 226 patients beginning treatment in the unit for a digestive, lung, hematological, or dermatological cancer, 163 were included. Adherence to the APA program was defined as more than or equal to one one-hour session per week for 3 months. The first evaluation was conducted at 3 months (M3), and the second evaluation at 6 months (M6). A total of 163 patients were included (mean age 62.5 ± 14.3); 139 (85.3%) agreed to follow the APA program. At M3, 106 of them were evaluated, of which 86 (81.1%) declared that they had followed the program. Improvement in anxiety was observed at M3 (-1.0 ± 3.2; p = 0.002) but there was no significant change in fatigue or depression. HGS decreased significantly (-1.2 ± 5.5; p = 0.04). The APA program was feasible in cancer outpatients beginning medical anticancer treatment. APA should be part of standard support care.

19.
Ann Endocrinol (Paris) ; 83(2): 88-94, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35143750

RESUMO

BACKGROUND: Diabetes mellitus prevalence is increasing among women of child-bearing age. Diabetic pregnancy is associated with major maternal and fetal risks, and these can be reduced by preconception care. Pregnancy can be planned using appropriate effective contraception. The objective of this study was to assess diabetic patients' knowledge about pregnancy and to describe their contraceptive use. STUDY DESIGN: An observational study was conducted from February to July 2020 at Reims University Hospital, France. Inclusion criteria were: women aged 18 to 40years, with type 1 (T1D) or type 2 diabetes (T2D). Patients filled out a survey about contraceptive use and knowledge regarding diabetic pregnancy and data were completed from medical records. RESULTS: Eighty-nine T1D and 33 T2D patients were included, with mean ages of 27.9±6.3 and 32.6±4.6years, respectively. Seventy-five percent reported that they had been informed about pregnancy-related risks and 67% about the need to plan pregnancy. The preconception HbA1c target was known by 33% of patients. Appropriate knowledge about pregnancy was greater in T1D patients (65.9%, versus 36.4% in T2D patients; P=0.003). The rate of patients using an effective contraceptive method was 66.4%. Fifteen percent patients for whom contraception was recommended reported having no contraceptive method; 12.5% of contraception users were using a contraindicated method. CONCLUSION: A large majority of diabetic women were aware of pregnancy-related risks and the importance of pregnancy planning, but there are still gaps, especially in T2D patients. We need to improve our practices by providing more information and better access to appropriate effective contraception. GOV NUMBER: NCT04350879.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Gravidez em Diabéticas , Adulto , Anticoncepção/métodos , Anticoncepcionais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Gravidez , Gravidez em Diabéticas/epidemiologia , Adulto Jovem
20.
Acta Derm Venereol ; 102: adv00676, 2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35083494

RESUMO

Aggressive primary cutaneous T-cell lymphomas include advanced-stage mycosis fungoides (stage ≥ IIB mycosis fungoides), Sézary syndrome, gamma/delta cutaneous lymphoma, nasal type lymphoma, aggressive epidermotropic CD8+ T-cell lymphoma and some cutaneous lymphomas not otherwise specified. To evaluate their long-term prognosis, we conducted a retrospective cohort study of 85 patients diagnosed between 2005 and 2020 with advanced-stage mycosis fungoides (n = 48), Sézary syndrome (n = 28) or aggressive non-mycosis fungoides/Sézary syndrome subtypes (n = 9). The median survival times in these 3 groups were 118.7, 45.7 and 11.2 months, respectively, and the 5-year survival rates were 55.3%, 27.8% and 33.3%, respectively. Multivariate analyses in patients with mycosis fungoides/Sézary syndrome identified age ≥ 70 years, Eastern Cooperative Oncology Group Performance Status ≥ 2, and the high-risk group according to the Cutaneous Lymphoma International Consortium prognostic model, as adverse prognostic factors. Seven patients in this mycosis fungoides/ Sézary syndrome group were in complete long-term remission after treatment with bexarotene, including 4 patients living without any treatment for 16-101 months.


Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Idoso , Humanos , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/tratamento farmacológico , Micose Fungoide/diagnóstico , Micose Fungoide/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/tratamento farmacológico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico
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