L’éducation thérapeutique du patient (ETP) a pour objectifs de diminuer l’impact de la maladie sur la vie quotidienne et faciliter l’observance aux traitements dans un but d’autonomie.
Élaborer un ...programme d’ETP portant sur les neuropathies périphériques inflammatoires (NI).
Enquête internet auprès des patients du réseau SINDEFI et de l’Association Française contre les Neuropathies Périphériques (AFNP) suivis pour NI. L’enquête visait à cerner les attentes et les besoins concernant l’éducation thérapeutique autour des neuropathies inflammatoires. Les dimensions de connaissances de la maladie et des traitements ainsi que du retentissement étaient évaluées.
Résultats Au total, 78 personnes répondirent à l’enquête (44 hommes, 34 femmes ; âge 60±14) dont : MMN n=5, PIDC n=29, Lewis-Sumner n=8, neuropathie anti-MAG n=3, de durée médiane d’évolution de 6ans 1–24. Trente-quatre avaient des neuropathies non inflammatoires. Plus de 60 % exprimaient un besoin très important de connaissance sur la maladie et les traitements, et d’améliorer la gestion des symptômes. Plus de la moitié considérait le retentissement de leur maladie important.
L’enquête montre que de nombreuses dimensions à l’impact important restent altérées chez les patients. Elles concernent les connaissances de la maladie et ses traitements et l’adaptation de la vie pour les relations familiales, sociales et professionnelles. L’enquête montre la persistance d’un retentissement psychologique et physique altérant la qualité de vie des patients et l’absence de ressources disponibles pour y remédier.
L’ETP du patient atteint de NI est une approche indispensable à développer visant à répondre aux attentes et aux besoins des patients concernant leur maladie et son retentissement général.
Avec le soutien institutionnel du laboratoire Octapharma.
L’éducation thérapeutique du patient (ETP) a été développée dans différentes maladies chroniques afin d’améliorer l’autonomie du patient. Aucun programme n’a été créé pour les neuropathies ...périphériques inflammatoires (NPI).
Réaliser une journée d’ateliers dans le cadre d’un programme d’ETP dédié aux patients atteints de NPI, sur la base d’une enquête des attentes et des besoins des patients.
Une journée d’ETP de patients atteints de NPI a été effectuée et divisée en plusieurs ateliers visant à développer des connaissances et des compétences : mieux connaître la maladie, mieux connaître les traitements, préparer sa consultation, estime de soi et activité physique adaptée. Une évaluation des ateliers a été effectuée en fin de journée ainsi qu’une évaluation à distance.
La journée réunit 6 patients (3 femmes et 3 hommes) d’âge moyen 58±8ans Les pathologies (polyradiculonévrites chroniques n=4, syndrome de Lewis-Sumner n=1, neuropathie anti-MAG n=1) évoluaient depuis 10ans 4–17. Aucun patient ne comprenait le terme de système nerveux périphérique, la notion d’inflammation ou incapacité. Plus de 70 % des patients considérèrent importants les ateliers sur les connaissances (maladie et traitements) et les compétences (préparer la consultation et activité physique).
La journée d’ETP a montré le manque de connaissances des patients sur la maladie et ses traitements, ainsi que leur manque de compétences sur l’évaluation de leur incapacité, la préparation du dialogue avec le neurologue et le mode de vie compatible avec la maladie. Elle a montré également l’attente des patients en termes d’ETP.
L’ETP du patient atteint de NPI répond à un besoin et une attente du patient aussi bien en termes de connaissances que de compétences face à la maladie.
Avec le soutien institutionnel du laboratoire Octapharma.
To provide an overview of non-specific modifications on whole-body post-mortem computed tomography (PMCT) images of infants and children.
69 infants and children underwent a whole-body PMCT scan at ...our institution following sudden unexpected death. Two paediatric radiologists reviewed the PMCT images, specifically focusing on non-specific postmortem modifications unrelated to the presumed cause of death.
Iatrogenic post-mortem modifications included focal infiltration of the legs (n=15) and hemopericardium (n=2). Vascular postmortem modifications included hypostasis (density in the posterior sagittal sinus was correlated with density in the dependent portion of the heart (p<0.001)), portal vein thrombosis (n=56, 75.3%), hyperattenuating aortic wall and reduced abdominal aortic diameter (n=69, 100%). Intravascular gas was detected in 40 subjects (57.9%). Ligamentum arteriosum calcification was seen in 42 children and was not correlated with age (p=0.68). Umbilical artery calcification was found in 30 children and was correlated with age (p<0.005). Gaseous distension of the stomach (n=45, 65.2%) and bowels (n=44, 63.7%) was a frequent finding. Mean liver density was 49.6±7.5HU and mean spleen density was 43.2±5.9HU. Ground-glass opacity was observed in 63 cases (91.3%) and mild bilateral consolidation in 16 cases (23.1%).
Non-specific post-mortem signs are rare and new to clinical paediatric radiologists. They should be aware of these signs when interpreting whole-body PMCT images in cases of sudden unexpected death in infancy or childhood in order to avoid pitfalls that may have a critical impact.
•Clinical paediatric radiologists should be aware of non-specific post-mortem signs.•Some non-specific post-mortem modifications in children are the same as in adults.•Whole-body PMCT has paediatric specificities.
Fish is a rich source of essential nutrients for fetal development, but in contrast, it is also a well-known route of exposure to environmental pollutants.
We assessed whether fish intake during ...pregnancy is associated with fetal growth and the length of gestation in a panel of European birth cohort studies.
The study sample of 151,880 mother-child pairs was derived from 19 population-based European birth cohort studies. Individual data from cohorts were pooled and harmonized. Adjusted cohort-specific effect estimates were combined by using a random- and fixed-effects meta-analysis.
Women who ate fish >1 time/wk during pregnancy had lower risk of preterm birth than did women who rarely ate fish (≤1 time/wk); the adjusted RR of fish intake >1 but <3 times/wk was 0.87 (95% CI: 0.82, 0.92), and for intake ≥3 times/wk, the adjusted RR was 0.89 (95% CI: 0.84, 0.96). Women with a higher intake of fish during pregnancy gave birth to neonates with a higher birth weight by 8.9 g (95% CI: 3.3, 14.6 g) for >1 but <3 times/wk and 15.2 g (95% CI: 8.9, 21.5 g) for ≥3 times/wk independent of gestational age. The association was greater in smokers and in overweight or obese women. Findings were consistent across cohorts.
This large, international study indicates that moderate fish intake during pregnancy is associated with lower risk of preterm birth and a small but significant increase in birth weight.
Growth charts are an essential clinical tool for evaluating a child's health and development. The current French reference curves, published in 1979, have recently been challenged by the 2006 World ...Health Organization (WHO) growth charts. To evaluate and compare the growth of French children who were born between 1981 and 2007, with the WHO growth charts and the French reference curves currently used. Anthropometric measurements from French children, who participated in 12 studies, were analyzed: 82,151 measurements were available for 27,257 children in different age groups, from birth to 18 years. We calculated and graphically compared mean z-scores based on the WHO and French curves, for height, weight and Body Mass Index (BMI) according to age and sex. The prevalence of overweight using the WHO, the French and International Obesity Task Force definitions were compared. Our population of children was on average 0.5 standard deviations taller than the French reference population, from the first month of life until puberty age. Mean z-scores for height, weight and BMI were closer to zero based on the WHO growth charts than on the French references from infancy until late adolescence, except during the first six months. These differences not related to breastfeeding rates. As expected, the prevalence of overweight depended on the reference used, and differences varied according to age. The WHO growth charts may be appropriate for monitoring growth of French children, as the growth patterns in our large population of French children were closer to the WHO growth charts than to the French reference curves, from 6 months onwards. However, there were some limitations in the use of these WHO growth charts, and further investigation is needed.
Purpose. The aim of this systematic review is to assess whether the anatomy of mental foramen is precisely evaluable with cone beam computed tomography (CBCT) before implantation in humans. Methods. ...A systematic review was carried out to evaluate the anatomy of mental foramen (size, position, symmetry, anterior loop, and accessory mental foramen or multiple mental foramina). According to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, an electronic search of three databases (Medline, Web of Science, and Cochrane Library) was undertaken until June 2020 and was supplemented by manual searching. Two reviewers will independently perform the processes of study inclusion, data extraction, and quality assessment. Systematic reviews, studies about children, and case reports were excluded. Only studies using CBCT to do preoperative evaluation were selected. Results. From 728 potentially eligible articles, 72 were included in the qualitative analysis and quantitative synthesis. This systematic review provided an assessment of the anatomy of the mental foramen. The mental foramen was located mostly between the two premolars (between 50.4% and 61.95%) or apically to the second premolar (from 50.3% to 57.9%). The mean diameter of the mental foramen was bigger in males than in females; the difference between them could reach 0.62 mm. The anterior loop seemed to be longer in males (between 0.87 ± 1.81 and 7.25 ± 2.02 mm) than in females (between 0.81 ± 1.18 and 6.52 ± 1.63 mm) and with the presence of teeth (from 0.91 ± 1.18 to 2.55 ± 1.28 for dentate people and from 0.25 ± 0.61 to 2.40 ± 0.88 mm for edentate population). The anterior loop and the accessory mental foramina were detected more frequently with CBCT than panoramic X-ray: only between 0.0 and 48.6% AMFs detected with CBCT were also seen with panoramic images. Clinical Significance. The mental foramen (MF) is an important landmark for local anesthesia and surgical and implantology procedures. Its location, morphology, and anatomical variations need to be considered to avoid mental nerve injury. The aim of this review is to evaluate the mental foramen using CBCT through a systematic literature review to improve knowledge of this complex area for the clinician.
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