Search

Provides definitions for 43 new French terms related to health and medicine. (AM)

The aim of the study is to show that one of the essential motifs of Kant’s critical philosophy is the issue of human health. Its starting point is therefore Kant’s reflections in the Metaphysics of Morals (1797) and the Conflict of the Faculties (1798), where Kant presented his concept of so-called “universal medicine,” which focuses on the problem of a healthy regimen. Since its basic assumption is that the body and mind of a person, however different they might be, are mutually connected so that the diseases of the body can be cured by way of the mind, it is the author’s interpretation that this concept is a peculiar attempt to overcome the substantive dualism of mind and body seen in Descartes’ Meditations on First Philosophy (1641). At the same time, however, Kant follows on from what Descartes himself attempted.

Introduction In the new globalized world, noise pollution has started to become a public health problem. We searched for publications about noise pollution in our study. In our study, we examined the noise pollution articles in the Web of Science (WoS) database. Material and Methods A total of 2722 papers were identified which were published between 2001 and 2020, finally, 1815 articles were analyzed. VOSviewer (version 1.6.11) tool used for bibliometric web visualizations. Results When trend analysis was applied to the number of articles by years, a statistically significant increase was detected. The United States contributed the most publications. The countries with the most articles per million population were determined to be Scotland, Singapore, and Ireland, respectively. Most articles on noise pollution were published in the journal Applied Acoustics. The three most used keywords are “noise pollution”, “noise” and “traffic noise”. Conclusions This study showed that there has been a trend of an increasing number of articles on noise pollution in recent years. Also it can be considered that this bibliometric study will help identify gaps in the current research data.

Introduction. The deregulated excessive pro-inflammatory cytokine secretion has a detrimental impact on the evolution of COVID-19, aggregating tissue impairment, organ failure, and increasing the risk for death. Several studies have demonstrated the beneficial effect of Tocilizumab (TCZ) in reducing hyperimmune response in severe forms of COVID-19. Materials and methods. This study is a retrospective cohort consisting of a sample of 66 patients hospitalized with COVID-19. The 1-st group consists of 33 patients treated with TCZ 200 mg IV once, and the 2-nd group – of 33 patients treated with TCZ 400 mg IV once. Results. The average age of the patients included in the study was 58,22±1,38 years. A decision regarding TCZ administration was made on average on the 11,34±0,31 day of the disease when the beginning of Cytokine Storm was suspected in the patients already on dexamethasone treatment. The dose of TCZ had significance on the duration of patients' disabilities, duration of oxygen therapy, and duration of hospitalization, with better results for TCZ 400 mg vs. TCZ 200 mg. However, we cannot prove that the dose of TCZ influences the percentage of patients transferred to the ICU for invasive or non-invasive ventilation. Conclusion. The 200 mg fixed dose of TCZ can be a life-saving option for severely ill patients with COVID-19 in the context of IL-6 inhibitor supply shortages.

Introduction: While some patients recovered, others died across the world thereby losing their loved ones. The objective of the current study is to determine statistical differences in means of the COVID-19 infected population (laboratory confirmed), discharged cases(recovered) and deaths resulting from the COVID-19 pandemic in Rivers State, Nigeria. Material and Methods: In this study, extraction of the infected population (laboratory confirmed), discharged cases, and deaths from COVID-19 was carried out from data obtained from the Nigeria Centre for Disease Control which covered 572 days (25th March 2020 - 17th October 2021). The test for the significance of means among the variables was done using a one-way Analysis of Variance (ANOVA) followed by the Tukey HSD test. The two variables whose means do not significantly differ were tested for strength of relationship and dependence using correlation analysis and cubic polynomial function respectively. Results: Results showed that there is a statistically significant difference between the infected population, discharged cases, and deaths from COVID-19 as obtained from one-way ANOVA (F(2, 1710) = 121.958, p = 0.000). Use of the Tukey HSD test indicated that the means of infected population and discharged cases do not differ from each other (p>0.01); however, mean deaths from COVID-19 significantly differ from others at 99% confidence intervals (p

Introduction. The evaluation of microbial biodiversity is an important step in the process of its conservation, and the identification of bacterial strains of biotechnological interest allows their application as support for the development of sustainable agriculture technologies. Material and methods. From the lakes of the "La Izvor" park, 213 types of bacteria, 148 of them pathogenic, were isolated. From the non-pathogenic ones, those of biotechnological interest were determined the enzymatic properties, and antimicrobial activity and were identified by molecular biological methods after that preserved by the lyophilization method with the determination of viability before and after lyophilization. Results. The microbial biodiversity of the "La Izvor" lakes was studied, 213 types of bacterial colonies were isolated in pure culture, which of 148 proved to be enteropathogenic belonging to the genera Escherichia, Salmonella, Shigella, Enterobacter and Klebsiella and other strains from the Enterobacteriaceae family. The purpose of the research consisted of the isolation and identification of non-pathogenic bacteria of biotechnological interest with different properties that could serve to elaborate and improve the development of sustainable agriculture technologies. Nineteen strains with enzymatic properties and high antifungal activity against phytopathogenic fungi were selected for molecular identification, passported, submitted to the NCNM and preserved by the lyophilization method for determination of valuable properties for a long time. Conclusions. In the lakes of "La Izvor" park, there is a very large variety of microorganisms, especially bacteria, some of which are enteropathogenic bacteria that can cause diseases in the population. Selected non-pathogenic strains stored in the NCNM can be applied against phytopathogens that cause dangerous diseases and damage in agriculture's major crops. As a result of lyophilization, we found that all strains showed osmotic and thermal shock tolerance and had a viability of over 75%.

Introduction. Contemporary researchers have suggested and demonstrated the hypothesis that the elevated level of D-dimers, which is a valuable marker of coagulation and fibrinolysis activation, can predict the severity of COVID-19, pulmonary complications, and thromboembolic events before they occur. Material and methods. The bibliographic resources were analyzed and selected from databases such as PubMed, Hinari, SpringerLink, and Google Search using keywords such as “COVID-19,” “SARS-CoV-2,” “coronavirus,” “D-dimers,” “biomarkers,” and “severity prediction,” which were used in various combinations to maximize search efficiency. Therefore, the manuscript contains 51 representative articles for this synthesis article. Results. The D-dimer levels are significantly higher in patients with severe forms of COVID-19 compared to those with non-severe forms, in patients with acute respiratory distress syndrome compared to those without acute respiratory distress syndrome, and in deceased patients compared to those who have survived. D-dimers positively correlate with the degree of severity and the increased risk of progression to severe disease, inversely proportional to the survival rate. They can predict prognosis, determine therapeutic strategies, prevent complications, positively influence the disease’s course, and monitor the prognosis. Conclusions. D-dimers should be used as a pre-radiographic screening tool as early as possible after admission and as an indicator for risk stratification of venous thromboembolism in hospitalized patients with COVID-19. Based on the increase in D-dimer levels, adjusting therapeutic doses of anticoagulants is more beneficial for patients compared to administering prophylactic doses.

Introduction. Contemporary armed conflicts are characterized by a multifaceted blend of combat strategies, encompassing conventional and unconventional weaponry, regular and irregular forces, terrorist actions and acts of organized crime, indiscriminate violence and outside international law. Material and methods. A retrospective bibliographic study was conducted on the evolution of combat strategies employed by the U.S. Armed Forces, NATO member countries, and international UN Peacekeeping Operations over the past 25 years. Results. The way of organizing and providing medical assistance in local military conflict differs from the principles governing medical support in major armed conflicts. The staging of the treatment system and the evacuation of the wounded follows a crucial time-based framework known as the '10-1-2(+2)' rule: "10"– immediate measures to stop bleeding within 10 minutes of the injury; "1" – evacuation to the medical treatment facility capable of performing resuscitation and stabilizing vital functions.; "2" – timely transfer to a medical formation equipped for Damage Control Surgery and Resuscitation within 2 hours of the injury; "+2" – performing the surgical intervention, stabilization of vital functions, and diagnostic preparations for strategic evacuation within 4 hours of the injury. Conclusions. Resulting from the specific particularities of the local military conflict, the planning of medical support as well as the complex treatment and evacuation measures, force health protection, and medical logistics, require adaptation to the real tactical and medical situation created.

Objectif : Etudier les aspects diagnostics, thérapeutiques et évolutifs des affections rhumatismales inflammatoires de l’enfant au Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA (CNHU-HKM) de Cotonou. Patients et méthodes : Il s’agissait d’une étude transversale, descriptive et analytique à recueil rétrospectif sur cinq ans (avril 2017 à avril 2022), et portant sur des enfants âgés de 0 à 18 ans suivis en rhumatologie au CNHU-HKM de Cotonou pour un rhumatisme inflammatoire évoluant depuis au moins trois mois.. Résultats : Cent cinq enfants ont été inclus dans notre étude. Leur âge moyen était de 14±3 ans et le sex-ratio était de 0,75. Seuls trente-huit (36,2%) enfants bénéficiaient d’une couverture sanitaire. Les différentes affections rhumatismales inflammatoires rencontrées étaient les arthrites juvéniles idiopathiques (AJI) (associées à une enthésite : 27,6%, oligoarticulaires : 23,8%, polyarticulaires : 23,8%, systémiques : 4,8%), les connectivites (lupus érythémateux systémique : 6,7%, sclérodermie : 1%, dermatomyosite juvénile : 1%) et les rhumatismes articulaires aigus (7,6%). Vingt-cinq (23,8%) enfants nécessitaient une hospitalisation. Les traitements symptomatiques utilisés étaient les anti-inflammatoires non stéroïdiens (93,3%), les corticoïdes (70,7%), les antalgiques (54,3%). Le traitement de fond le plus utilisé était le méthotrexate dans 79% des cas. Aucun enfant n’a eu besoin d’une intervention chirurgicale. L’évolution sous traitement a été favorable avec une rémission partielle ou complète chez 77 (73,3%) enfants. Il y avait eu aggravation de l’état clinique chez 15 (14,3%) enfants et 13 (12,4%) enfants ont été perdus de vue. Le taux d’aggravation de la maladie était significativement plus élevé chez les enfants âgés de plus de 12 ans que chez ceux âgés de 12 ans et moins (p : 0,004), chez les enfants de sexe masculin que chez ceux de sexe féminin (p : 0,007), chez les enfants mal suivis que chez ceux suivis régulièrement (p : 0,004), chez les enfants sans couverture sociale que chez ceux avec couverture sociale (p : 0,008). Conclusion : Dans notre étude, les AJI et connectivites étaient les rhumatismes les plus observés et le méthotrexate était le traitement de fond le plus utilisé. On observait une rémission partielle ou complète chez 73,3% des patients, et une aggravation clinique dans 14,3% des cas.

Objectif : Les manifestations neurologiques et psychiatriques comptent parmi les atteintes viscérales les plus sévères et sont regroupées sous le terme général de « neurolupus ». Nous rapportons le cas d’un patient ayant présenté un accès psychotique aigue révélant un neurolupus. Observation : Patient de 21 ans, sans antécédents psychiatriques personnels ni familiaux connus suivi depuis janvier 2022 pour un LES hospitalisé à quelques reprises dans le service de rhumatologie dont la dernière remonte en juillet 2022. Il fut traité par de l’hydroxychloroquine et une corticothérapie à faible dose. Deux mois après sa dernière hospitalisation le patient a présenté des troubles cognitifs, un refus de s’alimenter et un ralentissement psychomoteur. L’examen psychiatrique notait une humeur labile, un mutisme, une insomnie de maintien, un syndrome confusionnel fait d’amimie, de regard figé, d’écholalie et de désorientation temporo-spatiale. L’exploration de la pensée a révélé un cours continu marqué par un délire passionnel à mécanisme hallucinatoire. Ces hallucinations étaient auditives et visuelles en dehors de toute période confusionnelle « il y a des gens qui jouent et qui me demandent de danser et de chanter ». L’examen neurologique était sans particularité. L’imagerie par résonance magnétique cérébrale a objectivé une atrophie cortico sous corticale sévère. Le patient a bénéficié d’un bolus de corticoïdes pendant trois jours puis relayé par voie orale et de l’hydroxychloroquine. Sur le plan psychiatrique, le patient fut traité par du rispéridone comprimé. Conclusion : Le neurolupus chez les sujets jeunes de sexe masculin sont extrêmement rares posant véritablement problème de diagnostic différentiel dans notre contexte. Il doit être recherché systématiquement même en absence de signes neurologiques afin d’améliorer la prise en charge.

Objectif : déterminer la place des Anti-Inflammatoires Non Stéroïdiens (AINS) chez les rhumatisants âgés au Centre Hospitalier Régional Tsévié. Patients et méthodes : Une étude rétrospective à visée descriptive et analytique a été menée de décembre 2022 à octobre 2023 portant sur des patients âgés (≥60 ans) ayant été traités par des anti-inflammatoires non stéroïdiens. En cas d’infection, les AINS ont été utilisés comme traitement adjuvant et à distance de l’antibiothérapie. Résultats : Deux cent quarante- trois des 882 patients (27,6%) examinés au cours de la période d’étude et âgés d’au moins ­60 ans avaient utilisé des AINS. Ils se répartissaient en 77 hommes (32%) et 166 femmes (68%). L’âge moyen était de 69 ans (extrêmes de 65 ans et 98 ans). L’hypertension artérielle était présente chez 118 patients (49%), une insuffisance rénale chez 6 (2,5%) et une hémorragie digestive chez 9 (3,7%). La pathologie dégénérative du rachis (137 cas, 5­6%), la gonarthrose (43 cas, 18%), les métastases osseuses (22 cas, 9%), les pathologies périarticulaires (23 cas, 9%), les pathologies microcristallines (4 cas, 1,6%), les rhumatismes inflammatoires (5 cas, 2%), l’algodystrophie (2 cas, 0,8%) et les infections (7 cas, 2,9%) ont été les affections ayant motivé l’usage d’AINS. Les pathologies associées telles que : la pathologie dégénérative du rachis et gonarthrose (4,1%), la pathologie périarticulaire et la pathologie dégénérative du rachis (1,5%) étaient également retrouvées. Le traitement par AINS a été instauré à posologie minimale dans 64,7% des cas sur une durée inférieure à 10 jours dans 46% des cas. Les inhibiteurs de la pompe à proton ont été associés dans 20% des cas. Les inhibiteurs sélectifs de la cyclooxygénase 2 (coxibs) représentaient 49,8% des cas et les Arylacétates dans 28,4% des cas Vingt-sept patients souffraient d’Ulcère gastro duodénal (11,11%), Deux cents vingt-six patients étaient perdus de vue une fois le traitement entamé. Conclusion : La prise en charge de la douleur et de l’inflammation chez les personnes âgées est nécessaire et passe parfois par des anti-inflammatoires non stéroïdiens qui sont l’une des causes de morbidités liées aux médicaments. Les prescriptions d’AINS chez cette population doivent répondre à leurs besoins spécifiques tout en améliorant non seulement les résultats thérapeutiques mais, surtout, minimisant le risque iatrogène.

Objectif : Étudier le profil clinique de la goutte de 2028 à 2023 au Bénin. Patients et méthodes : Il s’est agi d’une étude transversale rétrospective ayant porté sur des patients atteints de goutte dans le service de rhumatologie du Centre National Hospitalier Universitaire Hubert Koutoukou Maga (CNHU HKM) de Cotonou. Résultats : Quatre-vingt-deux (82) patients goutteux ont été enregistrés sur 4035 patients suivis dans le service de rhumatologie soit une fréquence hospitalière de 2,03% et une incidence annuelle de 20 goutteux pour 1000 patients-années. L’âge moyen était de 59,2 ± 2,7 ans 22, 82 et le sex-ratio était de 1,5. Le genou était l’articulation la plus touchée au membre pelvien (70,7%). L’épaule était la plus touchée au membre thoracique (45,2%). L’atteinte de la première métatarso phalangienne était de 24,4%. Une hyper uricémie était retrouvée chez 62% des patients. La présence de monocristaux d’acide urique a été mise en évidence chez tous les patients goutteux (100 %). En cas de crise, 44 patients étaient traités par de la colchicine (53,7%), deux patients par des corticoïdes pers os (2,4%), et 40 patients par des anti-inflammatoire non stéroïdiens. L’allopurinol était le seul traitement de fond prescrit chez 32 patients (39%). Conclusion : La goutte représente 2,03% des affections rhumatologiques à Cotonou. Le profil clinique et la prise en charge thérapeutique restent classiques. Cependant l’atteinte de la première métatarso phalangienne n’est pas la plus fréquente dans notre contexte.

Objectif : Il n’existe actuellement aucune définition de la spondyloarthrite axiale difficile à traiter (D2TaxSpA) contrairement à la polyarthrite rhumatoïde qui a été proposée par l’EULAR, l’objectif de ce travail était de décrire les caractéristiques épidémio-cliniques des patients dit difficiles à traiter (D2T), et d’identifier les facteurs associés à ce groupe. Patients et méthodes : Il s’est agi d’une étude monocentrique transversale à visée descriptive et analytique menée sur les patients suivis pour spondyloarthrite dans le service de rhumatologie de l’Hôpital NOVO (site de Pontoise, région Ile de France) de juillet à novembre 2023. La D2T AxSpA a été définie comme définie de la manière suivante : prescriptions successives d’au moins trois traitements ciblés, sans limite de temps entre les rotations de traitement, ou prescriptions successives d’au moins deux traitements ciblés de mécanismes d’actions différents (anti-TNF, anti-IL17, JAKi). Nous avons comparé les patients D2T aux patients non D2T. Résultats : Sur les 134 patients ont été inclus dans l’étude, 47 (35%) étaient D2T et 87 (65%) ND2T. Une CRP > 5mg/l (63% vs 42%, p=0,026), la présence d’enthésites (79%vs 61%, p=0,036) et la fibromyalgie et/ou dépression (40% vs 12%, p 5mg/l OR ajusté 8,8 (IC 95% [2,1-37,7] et p = 0,003) était associée à la D2T AxSpA. Il n’y avait pas de différence quant à l’âge moyen des patients, aux comorbidités comme l’HTA et le diabète sucré et l’ancienneté de l’AxSpA. Conclusion : D2T AxSpA a concerné 35% des patients de notre étude, elle a été associée à l’inflammation biologique, à la présence d’enthésites et à la fibromyalgie/dépression.

Optimizing vitamin D levels poses a significant challenge in healthcare, characterized by varying guidelines, recent changes in testing coverage and widespread vitamin D deficiency. In Switzerland, where 59% of primary care patients have insufficient vitamin D levels and 12% are deficient, the complexity is heightened by the discontinuation of health insurance coverage for vitamin D testing without risk factors, as of July 1, 2022. This article explores the multifaceted landscape of vitamin D management, addressing the intricacies of testing, supplementation and guideline implementation. Through an analysis of the current guidelines and the pathophysiology of vitamin D, we aim to equip clinicians with the insights needed to navigate these complexities, optimize patient care and improve outcomes. PEER REVIEWED ARTICLE Dr Joël Capraro, Kantonsspital, Aarau, Endokrinologie, Diabetologie und Metabolismus Dr Stefan Zechmann, Stoffwechselzentrum, St. Gallen, friendlyDocs AG Received on November 19, 2024; accepted after peer review on December 20, 2024; published online on December 23, 2024.

In older adults with type 2 diabetes (T2DM), tight glycaemic control (HbA1c 7%) can result in more harm than benefit, especially when using insulin or sulfonylureas. Older adults are at higher risk for adverse drug events, especially hypoglycaemia, which may cause falls, confusion and hospitalisations. This Therapeutic Letter evaluates the risks of tight glycaemic control in older adults with T2DM, focusing on deprescribing diabetes medications in those over 65, especially those with multimorbidity and polypharmacy. It assesses the evidence from clinical trials and guidelines, with a focus on preventing hypoglycaemia and improving patient-centred care through relaxed HbA1c targets. Large randomised controlled trials show that intensive glycaemic control (HbA1c ≤ 7%) does not reduce cardiovascular risk, but increases hypoglycaemia and mortality, particularly in older adults. Instead, glycaemic targets should be adjusted based on the patient’s overall health and life expectancy. Deprescribing may be considered, starting with drugs most likely to cause hypoglycaemia (sulfonylureas or insulin). Regular reassessment and patient involvement in creating individualised treatment plans are essential.

Background: Oral pre-exposure prophylaxis (PrEP) uses antiretroviral medication to reduce HIV risk in HIV-negative individuals. Despite its effectiveness, global uptake faces policy and accessibility challenges. In Eswatini, PrEP introduction in 2017 showed promise despite stigma and COVID-19 disruptions. Aim: This study compared PrEP uptake and retention during and after COVID-19. Setting and Methods: An analytical cross-sectional study was conducted among clients accessing HIV testing services in selected Eswatini facilities. Data from the HIV testing register, PrEP register, and Client Management Information System (CMIS) were analysed. Uptake, retention, and client outcomes were measured during COVID-19 (March 2020–March 2021) and post-COVID-19 (April 2021–April 2022). Results: Of 5286 clients, 45% (n = 2380) initiated PrEP during COVID-19, while 55% (n = 2906) initiated post-pandemic. Facility 3 had the highest initiations during COVID-19 (844), while Facility 5 had the lowest (7). Retention was lower among clients aged 15–29 years. Females initially showed higher retention odds (odds ratio [OR]: 1.50), but this was insignificant after adjusting for confounders. Clients initiated post-COVID-19 had higher retention odds (OR: 2.96). Conclusion: COVID-19 impacted PrEP uptake in Eswatini, emphasising the need for flexible healthcare delivery. Targeted campaigns and tailored interventions are crucial for sustaining HIV prevention efforts and addressing demographic shifts. Contribution: This study highlights the importance of responsive healthcare systems and tailored approaches to maintaining HIV prevention during public health crises.

The theme of safety holds a special place in Jacques Leplat's work, as it spans his entire career (Leplat, 1985, 2011; Leplat & Cuny, 1974). From the 1980s onward, it became closely linked to the concept of complexity, which has become essential for describing the world around us (Leplat & De Terssac, 1990; Morin, 2008; Woods, 1988). Leplat's work on complexity stems directly from his guiding model for activity analysis, based on coupling (Leplat, 1997, 2000b). This model emphasizes how individuals handle complex tasks by integrating their specific characteristics (Leplat, 1988). It has opened significant research pathways and new prevention perspectives focused on competencies (Leplat, 2000a, 2008; Leplat & de Montmollin, 2001). While new schools of thought and models have emerged (particularly around resilience engineering (Hollnagel, Woods, & Leveson, 2006)), this article revisits the unique contributions of Jacques Leplat’s work within the evolving and sometimes fragmented landscape of safety sciences. It is a programmatic and theoretical article that lays the groundwork for future research.

The double regulation model, also known as the five-square model proposed by Leplat and Cuny in 1977, remains central to activity analysis in ergonomics as it constitutes an open framework and a matrix for understanding activity in real-world situations. This model, based on a systemic approach, defines the main categories of variables and relationships through which any activity can be characterized. More specifically, it aims to identify the determinants that shape and influence activity, as well as its effects on the individual being observed and the surrounding system. This article seeks to trace the emergence of this activity modeling in Jacques Leplat's work, explain the key principles of the model, and illustrate its essential role as a guiding tool for ergonomics training at the university level, using a case study conducted in the hospital sector.

In very small apple orchards, most pesticide preparation and spraying is the responsibility of the owner. Compliance with the prescribed preventive measures does not eliminate exposure, which can lead to health effects. The purpose is to describe the professional practices developed by apple growers. They aim to limit exposure to pesticides while producing quality fruit, thus contributing to the growth of their business. The intervention research, based on ecotoxicology approach, was carried out with apple growers in Quebec. The diversity of professional practices presented falls within the activity domains of strategic management (e.g. business development) and production management (e.g. spray application). These practices are influenced by external forces, resulting in trade-offs. They are complementary to current prevention measures and could be mobilized to better support the prevention of pesticide exposure in very small agricultural enterprises.

Focusing on the Dictionnaire de médecine of the Encyclopédie méthodique, this article examines the issues involved in organising and providing access to knowledge about mineral waters at the turn of the eighteenth and nineteenth centuries. The tension between alphabetical order, the chronological scope of the editorial enterprise and the evolution of medical knowledge represents a major challenge that is apparent in the successive introductory texts. The entries relating to mineral waters reflect the importance of the field for a public that is not restricted to doctors, as shown by the place given to history. This article compares the constraints and editorial choices made in encyclopaedic projects at the end of the eighteenth century with the context in which the Metadictionary was produced.

This paper presents the practical aspects of the production of the Multilingual Medical Metadictionary of the Medica Digital Library, a project funded by the Collex-Persée research infrastructure. We highlight how, during the process of selectively tagging in TEI XML the OCRised text of several ancient medical dictionaries, the principles adopted (provide reliable data from a philological point of view, stick to the analyses provided by the dictionaries, preserve unprocessed information) interacted with digital practice. We describe the trade-offs that have been made in order to deliver already quite comprehensive results as quickly as possible, while trying to maintain philological accuracy, and we indicate the areas for improvement that have been identified.

The article deals with formal and semantic neological terms in the field of medicine as a domain with a dynamically developing interdisciplinary terminology. The official French terminological database FranceTerme, available online, has been used as a corpus: namely a closed group of the 175 terms that have been added since 2011 under the heading Health and Medicine. The analysis of formal terminogenic means deals with derivation, composition, abbreviation, syntactic formation, and borrowing, which are commented upon and complemented via relevant examples. The article further deals with semantic neology, manifesting itself as terminologization of words from everyday language and their figurative use. The metaphors detected in the corpus are based both on analogies of form and function, and the most frequently occurring metonymies are based on a cause–effect relationship. The analysis is mainly qualitative, as the variability and multiplicity of terminological means involved in term formation constitute the principal limiting factors for a deeper quantitative analysis.

This Therapeutic Letter considers the evidence for inhaled corticosteroids (ICS) as a treatment for Chronic Obstructive Pulmonary Disease (COPD). Drug therapy aims to alleviate symptoms, enhance functional capacity and prevent exacerbations, but has not consistently shown to reduce mortality or improve quality of life based on randomised trials.Inhaled corticosteroids have shown limited benefits for COPD symptoms and exacerbations but increased risks of serious harms. Guidelines recommend limiting ICS to severe COPD and only for repeated exacerbations. Studies show withdrawing ICS can be done safely for stable COPD patients with infrequent exacerbations, especially those with lower eosinophil counts. Provincial, national and international guidelines now recommend limiting ICS prescriptions to severe COPD stages. Long-term ICS use may lead to serious side effects, including pneumonia and fractures. Initial COPD therapy should focus on short-acting bronchodilators, not ICS. Adding long-acting bronchodilators is recommended before considering ICS because of limited benefits and risks of serious harms. For persistent symptoms, long-acting muscarinic antagonists (LAMA) or long-acting beta2 agonists (LABA) are recommended, with the addition of ICS reserved for those with repeated exacerbations and severe COPD. Deprescribing ICS can be considered in clinically stable patients, particularly for those with infrequent exacerbations and mild COPD. When applicable, tapering ICS over several months is advised for patients with elevated eosinophil counts. Overall, the risks of serious harms from ICS typically outweigh their limited benefits for mild COPD patients in primary care.

Background: Village health workers (VHWs), popularly known as community health workers (CHWs) in some contexts and settings, should effectively complement health care providers in primary health care (PHC) delivery in Zimbabwe. However, they continue to offer services that do not address current and emerging health issues. Aim: This study aims to review the literature and develop a conceptual framework to improve the effectiveness and efficiency of VHWs in service delivery. Method: Rodgers’ evolutionary framework was used to analyse the concept of ‘strategies for effective and efficient delivery of PHC by VHWs’. Articles and reports published in English from 2010 to 2022 in peer-reviewed journals from the PUBMED, EBSCO, ScienceDirect and Google Scholar databases were reviewed. Results: After screening and removal of duplicates a total of 52 articles and two reports were reviewed to identify antecedents, attributes and consequences of strategies to improve PHC services by village health workers. The antecedents included an enabling work environment, community participation, motivation, incentives, integration of community health into national health systems, and information and communication technology. The attributes consisted of ongoing training and skills development, mutual respect and trust, enhanced contact between VHWs and communities and supportive supervision. The consequences were equitable access to and improved quality of PHC service delivery. Conclusion: The concept of PHC service delivery by VHWs has evolved from health promotion to curative care through task shifting and is now an integral part of the health system. A supportive and enabling work environment, anchored in community participation, empowers VHWs to deliver equitable services effectively and efficiently. Contribution: The development of strategies for improving VHW service delivery and a conceptual framework informed by findings from the reviewed literature.

Background: For continuity and quality of care, accurate record-keeping is crucial. Complete care is facilitated by completing a child’s Road to Health Booklet (RTHB) as well as prompt interpretation and appropriate action. This could result in a decrease in child morbidity and mortality. Aim: The study was aimed at assessing the completeness of the RTHB of children younger than 5 years. Setting: Temba Community Health Centre (CHC), Tshwane District, South Africa. Methods: A cross-sectional study was conducted using a data collection sheet adopted from previous studies. Results: Children less than 1-year-old accounted for 70.2% of the 255 RTHBs. The mean ± s.d. age was 11.5 ±10.76 months. The study finding showed no section was 100% fully completed. Of the 255 records studied, 38 (14.9%) human immunodeficiency virus (HIV)-exposed babies were recorded at birth, 39.5% were negative at 6 weeks and 60.5% were not recorded. Ninety-one (35.7%) children were unexposed. The HIV status of 126 (49.4%) children was not recorded. Sixty-six per cent (66%) of recorded maternal syphilis was negative. Immunisations, weight-for-age, neonatal information, and details of the family and child were fully completed in 80% of the booklets. Developmental screening was 17.2% completed, and oral health was 1.6% partially completed. The overall completeness was 40.3%. Conclusion: The completeness of RTHBs was found to be suboptimal. Contribution: The present study’s findings should serve as a reminder that healthcare practitioners must complete RTHBs in their totality in order to improve continuity and care quality, as the results indicated that RTHB completion was below ideal.

Background: Tuberculosis (TB) remains a leading cause of mortality in low-resource settings and poses a diagnostic challenge in human immunodeficiency virus (HIV)-negative populations because of limitations in traditional diagnostic methods such as sputum smear microscopy (SSM) and sputum Xpert Ultra. There is a lack of effective, non-invasive diagnostic options for TB diagnosis in HIV-negative populations. This scoping review explores the potential of urinary lipoarabinomannan (ULAM) as a point-of-care diagnostic tool for Mycobacterium tuberculosis (MTB) in HIV-negative individuals. Aim: To evaluate the diagnostic performance of ULAM in detecting TB among HIV-negative populations and assess its feasibility as a rapid, non-invasive diagnostic method. Method: A systematic search was conducted across PubMed, Google Scholar and Scopus. Articles were selected based on relevance to the topic. Results: The search yielded 210 articles, with 11 meeting our inclusion criteria. These studies reported varying diagnostic performance metrics for ULAM: sensitivity ranged from 10.0% to 66.7% and specificity from 90.0% to 98.1% among different assays. Notably, the studies demonstrated that the novel assays such as Electrochemiluminescence LAM and the second-generation FujiLAM showed higher sensitivities of 66.7% and 53.2%, respectively. Despite these advancements, the overall effectiveness of ULAM in HIV-negative populations remains limited, with standard assays exhibiting sensitivities as low as 10.0%. Conclusion: While ULAM holds potential as a diagnostic tool in HIV-associated TB, its application in HIV-negative populations is constrained by low sensitivity of the currently available assays. Contribution: The development and validation of high-sensitivity assays are crucial for broadening the utility of ULAM in these populations.

The training of Family Medicine residents in the West Africa College of Physicians (WACP) has steadily upscaled to a competency-based approach over the years. The latest review of the curriculum (2022) includes self-directed online modules on clinical postings, health management, patient safety, quality assurance research and medical education among others. The operationalisation of the revised curriculum involves the use of workplace-based tools for formative assessments. However, some shortcomings of the traditional work place based assessment (WPBA) have been observed, including a lack of standardisation, time consumption, variability in the assessors’ judgements and systematic biases. These shortcomings can be mitigated through the adoption of entrustable professional activities (EPA) along with the use of WPBA.

N/A

Background: Maternal clinical guidelines (MCGs) provide evidence-based recommendations for skilled birth professionals (SBPs) at the point of care. The dissemination strategies and use of MCGs are inconsistent among skilled birth providers despite their potential to improve the maternal care outcomes. Aim: This study examined the effectiveness of dissemination strategies of MCGs by SBPs in a primary care setting. Method: We searched in Medline, PubMed, CINAHL and Google Scholar. Search terms were effectiveness, dissemination and use, MCGs, SBPs and primary health care facilities. Studies published in English, conducted between 2010 and 2023 and focussing on dissemination strategies and use of MCGs were included. The final articles were presented in narrative format. Results: The search yielded 212 studies. After removing duplicates, seven articles that met the inclusion criteria for the review were included. The narrative review summarised the findings as: Use of MCGs which showed the barriers and enablers for the use of maternal guidelines. The level of adherence to MCGs was summarised, and one study showed the use of support supervision and collaboration improved aspects of MCGs. Conclusion: The findings show how skilled attendants acknowledge that MCGs can contribute to improving maternal outcomes. They further describe how, in practice, they are rarely used at the facility level. There is a need for more research on dissemination strategies to ensure improved use of MCGs in primary health care facilities. Contribution: We highlight the key gap in the dissemination of MCGs at primary health care facilities which if improved can potentially improve the use of MCGs.

Background: Interprofessional education (IPE) during undergraduate training (UGT) is considered important for new graduates to collaborate inter-professionally. There are, however, well-documented workplace challenges that hinder their involvement in interprofessional collaborative practice (IPCP) such as professional hierarchy, poor role clarification and communication challenges. Aim: This article explores graduates’ perceptions of the value rural undergraduate IPE had on their IPCP during their first year of work. Setting: Graduates were based in seven different provinces of South Africa ranging from tertiary-level institutions to community day clinics. Methods: A qualitative case study was conducted with 16 first-year graduate participants from 5 different health professions who participated in undergraduate IPE while placed on a rural platform. Individual semi-structured interviews were conducted in 2023. Results: Key factors related to UGT that facilitated IPCP during graduates’ first year of work were interprofessional relationship development, practice-based IPE and the focus on holistic patient-centred care. Graduates were, however, challenged by self-doubt, communication barriers and hierarchy in the workplace. Their recommendations for undergraduate IPE included role modelled and contextually relevant interprofessional skills development, practical advocacy and communication training, longer placements or shared learning spaces. Conclusion: Findings indicate that IPE during undergraduate rural clinical placements promotes interprofessional relationship development that extends into the workplace after graduation. However, IPE must be role modelled in the clinical environment and aligned to the reality of the healthcare system for students to develop the skills required to navigate IPCP as graduates. Contribution: This article offers recommendations for responsive undergraduate IPE to promote IPCP after graduation.

Background: According to the United Nations Fund for Population Activities, sexuality education (SE) requires building a multisectoral team and developing an operational plan. Hence, teaching comprehensive sexuality education (CSE) in collaboration with relevant stakeholders is a managerial approach to provide school-going adolescents with the knowledge and skills to make informed decisions that will safeguard their health. Aim: To report on Life Orientation (LO) teachers’ perspectives on intersectoral collaboration management of SE in secondary schools in KwaZulu-Natal (KZN) province, South Africa. Setting: Four selected secondary schools in the sub-district of uMhlathuze, KZN. Methods: The study employed a qualitative design. The population of this study comprised of 16 LO teachers who were selected by means of homogeneous sampling through focus group discussions. Emerging patterns were observed once the data were transcribed and subjected to thematic analysis. Results: The study revealed that schools were not being supported in the management of intersectoral collaboration in SE implementation in secondary schools in KZN province, South Africa. Conclusion: The results made it evident that more needs to be done to enhance and fortify intersectoral collaboration management to strengthen CSE in secondary schools. Contribution: The study recommended innovative and improved SE programmes and projects throughout the implementation and evaluation process to identify successes and promptly correct errors, to guarantee appropriate coordination of intersectoral collaboration management.

The first textbook on midwifery written in Icelandic was published in 1749. Its origin can be traced to several late seventeenth- and early eighteenth-century European pioneers in obstetrics and anatomy. Despite its scientific background, the book received mixed reactions from its readers,which demonstrates a culture of scepticism towards change and innovation in eighteenth-century Iceland.

Introduction. The intestinal microbiocenosis is the most complex and important bio-tope of the body formed in the process of individual development. Material and methods. The study was conducted on groups of 20-25-day-old chicks. The first group was housed under standard vivarium conditions with artificially maintained optimal climatic parameters. The second group was raised in a rural homestead in the Kyiv region, on pasture with access to water, and fed twice daily with a blend of grains supplemented with kitchen wastes. Samples of chicken droppings (10 per group) were analyzed according to current international ISO standards using certified nutrient media and equipment. Results. Escherichia coli, Klebsiella spp., Enterococcus spp. were isolated from 100% of samples from chickens kept in simulated conditions of an industrial poultry house, and Pseudomonas aeruginosa was isolated from 70% of samples. E. coli and Enterococcus spp. were isolated from free-range chickens in 100% of cases. The analysis revealed that in pasture-raised chickens, Klebsiella spp. and P. aeruginosa were absent from the litter, with significantly higher levels of normal microflora (Enterococcus spp.). Conclusions. Backyard-raised chickens showed no pathogenic zoonotic bacteria, in contrast to those raised under controlled conditions with optimal climate and standard diets.

Introduction. Dental caries is a significant public health issue due to its high incidence among the population. While modern scientific research highlights effective treatments for this condition, prevention remains crucial, directly impacting health and quality of life, especially when early preventive habits are instilled. This study aims to explore how parents' educational levels and other factors influence the acquisition, use, and proper application of oral hygiene knowledge among primary school children. Material and methods. The study surveyed 678 parents of primary school children across 9 administrative regions, including both urban and rural areas of the Republic of Moldova. It employed a randomized approach, involving respondents from all social groups. Results. This study found that parental education level is a crucial factor influencing the proper development of oral hygiene skills, which can prevent dental conditions. Higher parental education was positively associated with urban living environment and family income. Additionally, well-educated parents tend to visit dentists more regularly, which also reflects in better oral hygiene practices at home for their children. Conclusions. Children's oral hygiene habits are strongly shaped by socioeconomic fac-tors and the care parents show. Increasing parental education levels, whether in urban or rural settings, plays a pivotal role in fostering correct dental hygiene practices early in life, thereby ensuring long-term oral health habits into adulthood.

Introduction. Sexual health is a fundamental aspect of overall well-being, quality of life, and a sense of fulfillment. A significant percentage of men with spinal cord injury (SCI) experience ejaculatory issues (95%), poor semen quality (75%), and erectile dysfunction (80%), making it impossible for them to conceive without medical assistance. Material and methods. The bibliographic resources were analyzed and selected from databases such as PubMed, SCOPUS, HINARI, and Web of Science to identify studies on the desired topic. Following the initial research, 128 items were identified, and 32 representative articles were selected for this synthesis article. Results. Damage to the spinal cord can result in partial or complete loss of function below the level of the injury. These injuries lead to impaired ejaculatory and erectile function in addition to reproductive issues, which might include abnormal sperm motility, morphology, and viability, as well as reduced spermatogenesis. Challenges such as loss of bladder and bowel function, changes in physical appearance, spasms, lack of communication, and stereotypes can affect sexual life of men with SCI. Conclusions. Studying sexual dysfunction in disabled men is essential for promoting comprehensive healthcare, supporting mental health, fostering healthy relationships, and advocating for the rights and inclusion of individuals with disabilities. Understanding the mechanisms affecting sexual function in people with SCI is of particular practical interest both in medical practice and in subsequent studies on patients.

Introduction. Efficient learning transfer is crucial for training specialists to ensure the provision of quality medical services. This study investigates the impact of simulation-based training on the transfer of medical students' clinical competencies in parenteral drug administration: subcutaneous (SC), intramuscular (IM), and intravenous (IV). Material and methods. Using a quasi-experimental design, the research incorporates pre- and post-intervention testing, observational assessments, and a satisfaction survey to evaluate the educational impact. Results. The results indicate significant improvements in theoretical knowledge and practical skills post-intervention, with notable score increases for all types of injec-tions (SC: from 50% to 83.33%, IM: from 57.14% to 85.71%, IV: from 42.86% to 85.71%; p

Introduction. Influenza-like illness (ILI), Acute Respiratory Infections (ARI), and Severe Acute Respiratory Infections (SARI) are the most common infectious diseases globally, causing severe forms annually, especially in at-risk groups. The aim of this paper is to analyse the epidemiological and virological data on ILI, ARI, and SARI in the Republic of Moldova during the 2014/2015 to 2022/2023 epidemic seasons. Material and methods. The descriptive-retrospective epidemiological study analysed morbidity due to ILI, ARI, and SARI, as well as laboratory results for the presence of influenza viruses during the 2014/2015 to 2022/2023 epidemic seasons. Results. ILI has been of low to medium intensity except for two seasons, while ARI has been of very high intensity in one season. ILI, ARI, and SARI primarily affected children aged 0-14 years. During the nine seasons (except 2020/2021), influenza virus types A(H1N1) pdm09, A(H3N2), and B have been identified, with the percentage of positives decreasing considerably in the last two seasons. During the period under review, each influenza virus type dominated, and in three seasons, two to three virus types co-dominated. Genetic characterization of the identified strains demonstrated that influenza viruses fully fit the phylogenetic tree constructed for the nominated period, do not differ antigenically from strains identified in other regions of the northern hemisphere, and are susceptible to antivirals. Conclusions. The national surveillance system for ILI, ARI, and SARI makes it possible to monitor the evolution of the epidemic process in real-time and geographic space, facilitating prompt intervention with control and response measures.

In our article, we analyse the image physicians presented of themselves in their professional discourse during the 19th century, to map the complex negotiation of their professional identity as, at the same time, elite, masculine, and essentially Spanish. We contrast this with the representations of physicians in the contemporary urban visual culture, in Spain and in Europe, as a space of transimperial circulation of discourses and images. Physicians strove to shape and control these representations, with limited success. Moreover, we pay attention to how colonial context shaped professional discourse. We introduce comparisons with the patterns of gendered redefinition of the medical profession in France, as this neighbouring country—which was also another global empire—was a constant point of comparison and reference for Spanish physicians, but also because French and Spanish physicians shared the same space of knowledge circulation, practices, and institutional models for centuries.

Copyright of Movement & Sport Sciences / Science & Motricité is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of PiscoMed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Menopause and the symptoms often associated with it are still a taboo subject. However, around two thirds of all women suffer from more or less severe symptoms during the peri- and postmenopause. Hormonal and non-hormonal therapies are available to treat them. Zusammenfassung Wechseljahre und die oft damit verbundenen Symptome sind häufig immer noch ein Tabuthema. Dabei leiden rund zwei Drittel aller Frauen in der Peri- und Postmenopause unter mehr oder weniger starken Beschwerden. Zu deren Behandlung stehen hormonelle und nicht-hormonelle Therapien zur Verfügung. PEER REVIEWED ARTICLE Peer reviewers: Dr. med. Lea Köchli, Frauengesundheits-Zentrum (FGZR), Rämistrasse 35, 8001 Zürich Ein anonymer Peer-Reviewer Erhalten am 19. August 2024; akzeptiert am 31. Oktober 2024; veröffentlicht am 1. November 2024.

Background: Prematurity and low birth weight (LBW) are the main causes of neonatal mortality in South Africa (SA). Home visits by lay health workers (LHWs) may be effective in addressing this. Aim: To inform a national guideline on LHW home visits as part of the Global Evidence, Local Adaptation (GELA) project, we conducted a rapid qualitative evidence synthesis exploring the acceptability, feasibility and equitability of this intervention for preterm and LBW babies. Setting: We included studies conducted in SA. Methods: We searched PubMed and Embase until 15 September 2023 and identified eligible studies independently and in duplicate. We synthesised evidence using thematic analysis, assessed study quality using an adaptation of the Critical Appraisal Skills Programme tool and assessed confidence in the review findings using GRADE-CERQual. Results: The 16 eligible studies included diverse settings and populations in SA. Factors facilitating mothers’ acceptance included the knowledge and skills gained, the psychosocial support offered and improved healthcare access and relationships with facility staff. Distrust in LHWs and stigma associated with home visits were barriers to acceptance. Lay health workers’ acceptance was facilitated by them feeling empowered. The emotional burden of home visits for LHWs, coupled with insufficient training and support, undermined the feasibility of home visits. Conclusion: A complex range of interacting contextual factors may impact on the implementation of home visit programmes for preterm and LBW infants in SA. Contribution: This country profile provides insights into how home visits for preterm and LBW infants in SA might be contextually tailored to increase local relevance and in turn effectiveness, with potential relevance for other African countries.

Combining key elements from the learning tools of reflection, feedback and debriefing into a single reflective event is a novel concept. This powerful combination amalgamates into a tool useful in experiential learning. Linking the three concepts in a way that combines self-reflection in a debriefing framework, powered by trusted peer feedback resulted in a new teaching tool. It was piloted within the clinical setting of the primary health care (PHC) clinics in the Saldanha Bay sub-district in South Africa among final (6th) year undergraduate medical students of the University of Cape Town. This sub-district is a peri-urban community and encompasses a district health care system with less resources in both human and infrastructure than in an urban area. Being intentional and analytical as to optimal use of every resource not only impacts the students but also alleviates the pressure on clinician supervisors of activities. Pairing students alleviates the pressure of the insufficient number of consultation rooms for solo consultations and the pressure on the single supervising clinician when the consultations are conducted simultaneously. Using this tool at the end of the session facilitates the reflection and experiential learning of both the students individually. Self-reports indicated this tool kept both students engaged throughout all consultations and facilitated peer learning Alternating between being the doctor and the observer and knowing what roles entailed, the students never felt victimised in the reflection and feedback on their performance. And individually they developed their self-reflection and providing feedback as life skills.

Background: Despite scientific evidence of a rapid increase in the number of men who have sex with men (MSM) who test positive for HIV, many African states continued to ignore and exclude MSM in healthcare planning and provision, resulting in their reluctance and refusal to access healthcare services. Aim: This study aimed to explore, the lived experiences of MSM in accessing HIV Counselling and Testing services within the primary health care system in a township in South Africa. Setting: Mdantsane Township, outside East London, Eastern Cape province. Methods: This qualitative study was placed within the interpretive paradigm and employed a descriptive phenomenological research design. A non-probability purposive sampling technique was used to recruit participants. The study was inductive and utilised semi-structured in-depth interviews and an interview guide to collect data. A descriptive phenomenological data analysis method was employed to process and analyse the data. Results: Five main themes emerged from the study, namely, (1) individual factors related to MSM’s experiences of nearby healthcare centres providing HCT; (2) interpersonal factors related to their experiences inside the clinic; (3) institutional factors related to lack of sensitisation; (4) community factors related to the role of public-private partnerships in improving healthcare services for MSM; and (5) public policy factors related to the role of government in ensuring accessibility of HCT policy to MSM. Conclusion: Access to HCT services for MSM in Mdantsane was levels and there is an urgent need influenced by a myriad of complex factors at different socio-ecological levels, and there was an urgent need for tailormade interventions at all these socio-ecological levels to address challenges. Contribution: This study contributes to scientific knowledge by bringing forth the voices of sexual minorities regarding the quality of healthcare service provision they expect to receive from their local clinics.