RESUMO
BACKGROUND: The aim of this study was to determine the influence of medical and non-medical factors on perinatal health in an underpriviledged area, the ex-coal mines of Lens (Pas-de-Calais). POPULATION AND METHODS: This prospective study concerned 1,000 women who delivered in the maternity hospital of Lens between January 5, 1993 and May 13, 1993. The relationships between preterm delivery, low birth weight and maternal socioeconomic and cultural characteristics were analyzed. RESULTS: The women included presented adverse pregnancy outcomes. Preterm delivery, low birth weight and neonatal transfer rates were respectively 6.9%, 7.3% and 12.7% higher than the average regional rates. In contrast with these results, antenatal care could be considered correct or even better. The poor socioeconomic status of the population appeared to be a very significant perinatal risk factor. CONCLUSION: At present, in an unfavourable regional conjuncture, socioeconomic and cultural factors have adverse effects on perinatal morbidity and mortality independent of medical factors like prenatal care. The prevention of poor perinatal outcome should be based on these data. Not the access to the health care system but the manner of dispensing health care should require great consideration.
Assuntos
Política de Saúde , Bem-Estar do Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Adulto , Serviços de Saúde da Criança , Características Culturais , Feminino , França , Humanos , Recém-Nascido , Masculino , Serviços de Saúde Materna , Gravidez , Resultado da Gravidez , Classe SocialAssuntos
Anemia/prevenção & controle , Eritropoetina/uso terapêutico , Doenças do Prematuro/prevenção & controle , Recém-Nascido Prematuro , Anemia/sangue , Anemia/terapia , Peso ao Nascer , Eritropoetina/administração & dosagem , Idade Gestacional , Hemoglobinas/análise , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Proteínas Recombinantes , Fatores de Risco , Reação TransfusionalAssuntos
Cromossomos Humanos Par 15 , Cromossomos Humanos Par 9 , Aconselhamento Genético , Síndrome de Prader-Willi/genética , Translocação Genética/genética , Evolução Fatal , Feminino , Humanos , Lactente , Recém-Nascido , Cariotipagem , Masculino , Síndrome de Prader-Willi/diagnóstico , Gravidez , Diagnóstico Pré-NatalRESUMO
Three congenital fibromatosis are studied. Six years later, the subcutaneous and skeletal lesions of the first patient have disappeared with no recurrence. Regression was also observed in the second one, a generalized fibromatosis with skeletal, subcutaneous and almost certainly pulmonary and laryngeal lesions. The last case is now progressing (vertebral lesion) with a vascular invasion, the prognostic of which is unknown. A review is made about microscopical appearance, origin and difficulties in diagnosis.
Assuntos
Fibroma/congênito , Diagnóstico Diferencial , Feminino , Fibroma/patologia , Fibrossarcoma/patologia , Humanos , Recém-Nascido , Masculino , Neurofibromatose 1/patologiaRESUMO
Molecular methods for bacterial strain typing are becoming available outside teaching hospitals and large structures. Although it seems reasonable to use conventional markers, most notably the serotype, whenever possible, the limitations of these methods are particularly conspicuous with P. aeruginosa. Combined use of several methods such as quantitative antibiotic susceptibility testing and serotype determination has proved adequate for characterizing P. aeruginosa strains in some cases. In the case of the outbreak reported herein, this approach failed to provide high quality epidemiological data. In contrast, pulsed field gel electrophoresis ruled out epidemic spread of a P. aeruginosa strain in the clinical hematology department.