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Background: In emergency departments (EDs), the staff continually face stressful situations requiring staff to adopt various coping strategies. Aims: The study aimed to assess work-related stress in ED during the COVID-19 outbreak. Method: The study was a monocentric investigation based on a questionnaire survey that elicits general information and uses the Karasek model to analyse the data. Findings: A total of 117 forms were collected for analysis. The score for decision latitude (or autonomy and skills at work) was 70 (IQR: 64–74) and the score for psychological demand was 25 (IQR: 23-27). The score for social support by the management team was 11 (IQR: 9–12) and the score for social support by colleagues 12 (IQR: 10–12). Of the total number of respondents, job strain was assessed as affecting 24.8%. Conclusion: The study shows high levels of stress among the ED workforce. The findings indicate that it is imperative to develop simple management tools that are capable of measuring the internal causes of stress in order to develop an adapted wellness programme in ED. [ABSTRACT FROM AUTHOR]

The pearl culture is one of the most lucrative aquacultures worldwide. In many South Pacific areas, it depends on the exploitation of the pearl oyster Pinctada margaritifera and relies entirely on the environmental conditions encountered in the lagoon. In this context, assessing the impact of climatic stressors, such as global warming and ocean acidification, on the functionality of the resource in terms of renewal and exploitation is fundamental. In this study, we experimentally addressed the impact of temperature (22, 26, 30 and 34 °C) and partial pressure of carbon dioxide p CO 2 (294, 763 and 2485 μatm) on the biomineralization and metabolic capabilities of pearl oysters. While the energy metabolism was strongly dependent on temperature, results showed its independence from p CO 2 levels; no interaction between temperature and p CO 2 was revealed. The energy metabolism, ingestion, oxygen consumption and, hence, the scope for growth (SFG) were maximised at 30 °C and dramatically fell at 34 °C. Biomineralization was examined through the expression measurement of nine mantle's genes coding for shell matrix proteins involved in the formation of calcitic prisms and/or nacreous shell structures; significant changes were recorded for four of the nine ( Pmarg -Nacrein A1 , Pmarg -MRNP34, Pmarg -Prismalin 14 and Pmarg -Aspein). These changes showed that the maximum and minimum expression of these genes was at 26 and 34 °C, respectively. Surprisingly, the modelled thermal optimum for biomineralization (ranging between 21.5 and 26.5 °C) and somatic growth and reproduction (28.7 °C) appeared to be significantly different. Finally, the responses to high temperatures were contextualised with the Intergovernmental Panel on Climate Change (IPCC) projections, which highlighted that pearl oyster stocks and cultures would be severely threatened in the next decade. [ABSTRACT FROM AUTHOR]

Background: French Guiana (FG) is a French territory located in South America with the highest rate of armed assaults. FG presents a poorly developed road system and a young and precarious population that makes the geographical and socio-demographic characteristics specific. No data concerning the firearm injury management are available in this country. Studying thesis trauma could permit to improve the management of victims. The objective of this study is to investigate the epidemiology of firearm injuries in FG, to define characteristics of the victims, and to assess factors associated with death. These identified factors could enable target primary prevention and intensification of medical management., Methods: From January 2016 to December 2019, we conducted a retrospective study at the Cayenne General Hospital (CGH), including all patients admitted for firearm injuries in the emergency department, the medical emergency and resuscitation service, and the forensic service. A bivariate analysis was performed to assess relevant clinical data that were entered into a logistic regression model to assess factors associated with death., Results: A total of 871 files were analyzed concerning 340 patients included after cross-checking. Victims were mainly males (90%) and young (30 ± 11 years old). The injury occurred mainly at night (60%), in a context of assaults (83%) and with long-barreled guns (82%). Among the 290 patients managed at the CGH, 60% were hospitalized including 12% that were in the intensive care unit, 41% that required surgical treatment, and 7% that died in hospital. The overall average length of stay was 10 ± 18 days. Overall mortality (n = 71, 21%) is statistically associated with male gender (p = 0.007) and suicide context (p < 0.001). In multivariate analysis, the sites of wounds (head and neck, thorax; p < 0.001) as well as induced organ injuries (neurological, respiratory, and vascular; p < 0.005) were independent factors associated to mortality., Conclusions: This work underlines the high incidence of ballistic trauma in FG. This mainly involves a young and male population linked to the use of long arms and assaults. Despite the geographical difficulties of the territory and the technical platform deficits (no neurosurgery, no cardiothoracic surgery, no interventional radiology), the mortality is comparable to other studies, but remains more than twice as high as in mainland France. Finally, despite a change in legislation restricting access to firearms, our results show that gunshot firearm injuries remain a major public health concern requiring greater political actions., (© 2024. The Author(s).)

Indonesia and French Guiana share many geographic and medical concerns regarding access to care. The organisational needs in emergency management, particularly in the prehospital phase, are similar. Whereas emergency medicine (EM) is an academic and entire speciality in France, it is still under construction in Indonesia. In the framework of the French and Indonesian academic cooperation, the Medical school in Jakarta University and the French Guiana University in Cayenne signed a Memorandum of Understanding encompassing education programmes, joint research work and students' and health professionals' exchanges in EM. This partnership represented the first medical cooperation programme between the two countries. The first student class was launched in August 2022 and involved 50 Indonesian doctors who graduated in August 2023. The implementation and success of this Franco-Indonesian cooperation were supported by political and academic partners from the two sides. Given the first student class's success, we aim to continue this programme, in line with Indonesia and World Health Organization's plan to establish a multi-country training hub for health emergency operational readiness and Emergency Medical Teams., (© 2024 Australasian College for Emergency Medicine.)

Introduction: Sexual violence is a major public health issue, including in French Guiana. The feeling of insecurity is significant in this part of France. Sexual violence is an important reason for consultation in forensic and emergency medicine. The challenge is to provide care within the first 72 hours, particularly in medicolegal terms and for infectious disease management. The objectives of our study were, firstly, to establish the epidemiology of sexual assaults at Cayenne General Hospital (CGH), and secondly, to evaluate the management of these victims., Materials and Methods: From January 1st, 2019 to December 31st, 2020, we conducted a single-center retrospective descriptive study including patients who were consulted for sexual assaults in the Forensic medicine and the Emergency departments of CGH., Results: Over this period, 400 sexual assault victims were consulted. Most of them, were women (87%) with a median age of 13 years-old [8; 17.5]. The aggressor was mostly male (99%) frequently known by the victim (87%) and from her family (39%). Suspected assaults represented 19% of consultations. The most frequent assault on women was penile-vaginal penetration (82%) and penile-anal penetration (77%) on men. The delay of consultation was superior to 72 hours in 60% of the cases. A psychological follow-up was recommended for 62% of these victims., Conclusion: This work allowed to identify a young and female population at risk, most often assaulted by a male known to her. Most of the patients consulted more than 72 hours after the assault. Our study highlights the need for prevention actions in French Guiana focusing on this population at risk., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Menseau et al.)

Introduction: French Guiana is a hub for drugs trafficking between South America and Europe. In Corpore transport, or Body-packing, is one of the options favored. In 2018, 577 people were arrested for smuggling cocaine from French Guiana to mainland France. The objective of this study was to update the epidemiological data and to evaluate the overall management of body-packers., Methods: A monocentric retrospective and observational study included patients admitted to the emergency department of the Cayenne General Hospital from January 1st, 2016 to December 31st, 2019 after ingestion of cocaine pellets., Results: During the period, 668 people were referred to Cayenne hospital's emergency department by for suspected body-packing. Two hundred nineteen were excluded due to the absence of cocaine pellets in the initial X-ray or because they were carrying cannabis pellets. The mean age was 25.2 years with a sex ratio of 2.21 males per female. Among them, 13.7% of cases were complicated without endangering the vital prognosis. The mean number of pellets was similar between the population with and without complications (respectively 54.1 [50.9-57.4] and 57.8 [48.9-66.6], p = 0.22). The presence of cocaine in the urine was not significantly associated with the risk of complications (OR = 0.5, [95%CI = 0.1-1.8], p = 0.23). Compared to the CT-scanner which has the highest diagnostic accuracy (Se 100%, Sp 94%), the sensitivity of the Abdominal X-ray was 44%., Conclusion: This study showed that complications were rare, most of which were digestive stagnation requiring endoscopy. Given the low rate of complications and their low severity the average duration of hospitalization was relatively short. The type 3, micro-industrial quality packaging, almost exclusively used in body-packing in French Guiana, seems to be the main factor in this reduction of complications. This observation suggests possible adaptations of the current protocol for body-packers monitoring., Competing Interests: Declaration of competing interest Authors have no conflicts of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana., (Copyright © 2023 SFMTSI.)

In French Guiana, a French overseas region partly located in the Amazon, "Africanized" bees, a hybrid species of Brazilian bees known as "killer bees," have been observed since 1975. Since then, several cases requiring long hospitalization times have been described, allowing for a better understanding of the physiopathological mechanisms of this particular envenomation. Here, we report on a series of 10 cases of patients simultaneously attacked by hundreds of killer bees and immediately treated by a prehospital medical team already on site. Between 75 and 650 stingers were removed per victim. The reference treatment for anaphylaxis using intramuscular injection of epinephrine, vascular filling, and oxygen therapy was administered to all patients without delay. A clinical description was provided, and biological tests were performed immediately after the envenomation. We therefore observe the existence of a two-phase, medically well-controlled systemic toxic reaction. Thus, all our patients left the hospital after 44 hours of monitoring with no complications or sequelae, despite levels of intoxication described as potentially fatal elsewhere in the literature.

A hybrid species of Brazilian bee has proliferated on the South American continent since 1956. We describe a "killer bee" swarm attack on a 2-year-old girl in French Guiana. The patient weighed 10 kg, and approximately hundreds of bees' stingers were removed, that is, 10 stings/kg. Our patient survived without long-term sequelae. The management of her condition required admission into intensive care for renal failure due to acute tubular necrosis and severe rhabdomyolysis. We emphasize the importance of early medical intervention, clinical surveillance, and biological monitoring at the hospital to prevent a toxic chain reaction that could prove fatal within 72 hours.