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The anaesthetic consultation is a medical procedure designed to assess anaesthetic and surgical risk. The aim of ourstudy wasto describe the biological work-up of patients attending an anaesthetic consultation forscheduled surgery. This was a longitudinal, descriptive, prospective study covering 4 months. All patients attending an anaesthesia consultation for scheduled surgery at Yaoundé Central Hospital were included. Sampling was consecutive. The informations were collected using a data sheet. Variables included age, sex, indication for surgery, history, biological work-up, ASA classification and anaesthetic technique. Data were analysed using Epi info version 3.5.2 and Microsoft Office Excel 2013. Three hundred and ninety-five patients were included. The majority were male, with a sex ratio of 1.09. The mean age was 35.9 ± 22.4 years. Anaesthesia consultation for neurosurgery was the most frequent (23.3%). Hypertension was the most common comorbidity (38.5%). The Full blood count was the most frequently performed test (99.5%). Biological abnormalities were found in 16.8% (n=355/2109). The main abnormalities were impaired renal function (54.1%) and anaemia (28.4%). Patients were classified as ASA 1 (64.8%). The most indicated anaesthetic technique was general anaesthesia (68.4%). Anaesthetic consultation is essential for assessing the operative risk. The full blood count and hemostasis tests are the most realized biological tests [ABSTRACT FROM AUTHOR]

Résumé Le suivi et l’orientation des femmes enceintes par les sages-femmes ont pour objectif d’aider au suivi de la grossesse et de dépister les situations à risques de complications maternelles obstétricales et fœtales afin de réduire la morbimortalité maternelle et infantile. La profession de sage-femme est une profession médicale à compétences limitées avec un droit de diagnostic et de prescription. Elle réalisera donc les prescriptions concernant les analyses biologiques nécessaires au dépistage et au diagnostic des pathologies en périnatalité. La sage-femme prescrira les examens obligatoires, les examens non obligatoires mais systématiquement proposés et les examens recommandés en fonction de la clinique. Au-delà de ces missions, le rôle de la sage-femme a également un rôle très important de prévention. Cet article recense certaines situations à risque au cours desquels la sage-femme va prendre en charge les femmes enceintes. Summary Monitoring and orientation of pregnant women by midwifes aim to help monitor pregnancy and to detect risk situations from obstetric and fetal maternal complications to reduce maternal and infant morbidity and mortality. The profession of midwife is a medical profession with limited skills to exercise diagnosis and prescription. So the midwife will carry out the requirements for biological analysis necessary for the screening and the diagnosis of perinatal pathology. The midwife prescribes mandatory testing, non-compulsory routinely offered and recommended tests depending on the clinic. Beyond these tasks the role of the midwife also has a very important role in prevention. This article lists some risk situations in which the midwife will take care of pregnant women. [ABSTRACT FROM AUTHOR]

Abstract: Implementation of a generalized screening program for neonatal diseases obeys precise guidelines. The disease must be severe, recognizable at an early stage, accessible to an effective treatment, detected with a non expansive and widely applicable test and it must represent an important health problem. In case of positive results, treatment or prevention shall be offered immediately and any screening program has to be regularly evaluated. There is in France since 1978 a national screening program that depends on a private association (“Association française pour le dépistage et la prévention des handicaps de l''enfant”) and is supervised by the “Caisse nationale d''assurance maladie” and the “Direction Générale de la Sante”. Presently, five diseases are included in the screening program: phenylketonuria, hypothyroidism, congenital adrenal hyperplasia, cystic fibrosis and sickle cell disease, the latter only in at risk newborns. Toxoplasmosis represents a particular problem because screening takes place only in children of mothers that have not been controlled during their pregnancy or in case of seroconversion. Neonatal screening of phenylketonuria and hypothyrodism is unanimously recommended. That of congenital adrenal hyperplasia is approved in most countries. The cases of sickle cell disease and cystic fibrosis are more complex because: 1) all the children that carry the mutations are not affected with a severe disease; 2) there is no curative treatment; 3) parents given information are made anxious, sometimes wrongly if the disease is mild or asymptomatic. The supporters of the screening insist on the interest of an early diagnosis which makes longer the life time of these children, the possibility for the parents to utilize prenatal screening in case of a future pregnancy, and the information given to the heterozygous carriers following a familial screening. The question is raised of the extension of neonatal screening to other diseases. This is now possible due to technical progresses such as the tandem mass spectrometry that can detect about 50 diseases in an only testing. In addition of its cost and of the difficulty to ensure an efficient organization, increasing the number of the screened diseases will raise ethical problems including how the parents will be informed of an incurable disease or a late-onset disease or an entirely asymptomatic disease. It is unanimously admitted that only mendelian diseases should be detected excluding genetic polymorphisms. Analysis of the present situation suggests the following developments: 1) to actualize the guidelines for deciding of a new neonatal screening; 2) to experiment on a local scale any new screening before its extension to the whole country; 3) to create an evaluation committee including paediatricians and epidemiologists and to evaluate on the long term the future of the children; 4) to precisely define the conditions in which the heterozygous carriers will be informed following a familial investigation; 5) to store in a resource biological centre the blood samples in order to utilize this bank for epidemiology studies. [Copyright &y& Elsevier]

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Background: Determining the performance level of hemodialysis facilities, including an evaluation of biological tests, is a prerequisite for quality assessment of these healthcare structures., Objective: The purpose of this work was to evaluate the compliance and adequacy of biological tests performed in 2014 in Center-East Tunisia hemodialysis units., Methods: Data were collected using an analysis grid for 15 biological indicators including 11 process items and four results items used to determine the compliance and adequacy rates respectively., Results: This study included 660 hemodialysis patients (sex ratio 1.16; mean age 53.9±15.32 years). A low level of compliance was noted for several biological tests (blood glucose: 0.8%; hemoglobin 34.5%). The rate of adequacy of the biological results was insufficient, especially for anemia (32.7%) and calcium-phosphorus surveillance (41.8%). Intercenter and inter-region variability was noted, both for compliance and for adequacy of biological tests., Conclusion: This study demonstrated low compliance of biological tests performed for hemodialysis patients and the non-adequacy of the results obtained. It is thus urgent to institute a quality management system for biological tests performed in hemodialysis units., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)