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Depuis la chute du régime de MOBUTU et la guerre de l 'AFDL en 1996, dans la partie Est de la RDC. La province du sud –Kivu connait des mouvements d‘exode rural sans précèdent, suite à l’insécurité et manque des infrastructures routières dans les huit territoires qui composent celle-ci. La prolifération des groupes armés ou milices entretenues par les hommes politiques en mal de positionnement est à la base de l’exode rural dans les territoires de la province du sud – Kivu. Les pauvres paysans sont souvent victime de viole, d’insécurité;de tuerie et d’assassinat ciblé à tel enseigne qu’ils sont obligés de fuir leurs villages laissant habitations ; champs et élevage pour aller s’installer dans la ville de Bukavu, Chef-lieu de la province du Sud-Kivu. A cette cause principale, ajoutons les manques des routes pour écouler les produits agricoles des villages vers la ville et ceux-ci a pour corolaire les produits qui pourrissent dans les champs, décourageant les cultivateurs qui finissent par quitter les villages pour aller s’installer en ville où ils rêvent de trouver une activité rentable. L’objectif de cette étude est d’analyser les conséquences socio-économiques de la surpopulation dans la ville en question.

Additional file 1: S1. Comparison between patients with or without prior lipid profiles. The results are expressed as percentages for categorical variables and medians (interquartiles) for continuous variables [95% CI]. D1: day 1; SOFA score: Sequential Organ Failure Assessment score; SAPSII score: Simplified acute physiology II score; KDIGO AKI stage: Kidney Disease: Improving Global Outcomes Acute Kidney Injury stage; RRT: renal replacement therapy; ICU: Intensive Care Unit.

Additional file 2: S2. Margins plot of the mixed model for repeated measures adjusted predictions of lipoprotein levels for mortality at day 28. All models were statistically significant (p

Additional file 4: S4. Kaplan–Meier estimates of survival in the 28 days after the onset of sepsis for patients with different initial levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the bacteremia, intra-abdominal sepsis, and pleuropulmonary sepsis subgroups. HDL: High-density lipoprotein; LDL: Low-density lipoprotein.

Appendix 1 Univariate analysis of risk factors for in-hospital mortality with P

Additional file 3: S3. Kaplan–Meier estimates of survival in the 28 days after the onset of sepsis for patients with different initial levels of lipoproteins in the septic shock subgroup. TC: Total cholesterol; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; TG: Triglycerides.

Additional file 2 Table S2. Anatomical characteristic of non-invasive wounds and invasive thoracic wounds.

Additional file 1 Table S1. Anatomical characteristics of all types of non-invasive and invasive wounds.

Rawéléguinbasba Armel Flavien Kabore,1 Ibrahim Alain Traore,2 Salah Idriss Séif Traore,3 Cheik Tidiane Hafi Wind-Pouiré Bougouma,1 Pascal Augustin,4 Aboudoul-Fataou Ouro-Bang’na Maman5 1Department of Anesthesia, University Hospital Blaise Comparoé, Ouagadougou, Burkina Faso; 2Department of Anesthesia, Uiversity Hospital Sourou Sanou, Bobo Dioulasso, Burkina Faso; 3Department of Anesthesia, District Hospital of Bogodogo, Ouagadougou, Burkina Faso; 4Department of Anesthesia, Intercommunity Hospital of Meulan, Les Mureaux, Meulan en Yvelines, France; 5Department of Anesthesia, Ales-en-Cévennes Hospital, Alès-en-Cévennes, France Abstract: The occurrence of a needle breaking is a very rare complication of spinal anesthesia (SA). We report a case of a broken spinal needle occurring in a morbid obese pregnant woman during SA indicated for an emergent cesarean section. Multiple puncture attempts due to difficult identification of lumbar spine, associated with an inadequate use of the introducer, contributed to this complication. The recognition of predictive factors for difficult neuraxial anesthesia, the use of ultrasound in obese patients, and a properly executed technique may have allowed avoiding this complication. Keywords: spinal anesthesia, needle breaking, cesarean section, obesity

Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks. This is a retrospective analysis of five clinical cases, who underwent lung transplantation and a femoro-femoral venoarterial (VA) ECLS. The patients presented severe hypoxemia (SpO2 < 85%) measured through photoplethysmography on a right hand finger. From the patients' medical records and anesthesia flowcharts, hemodynamic, right heart catheterization, echocardiography variables, and arterial blood gas results were noted before and after injection of esmolol. Mechanical ventilation and VA ECLS function variables were optimized and unchanged before and after esmolol injection. All patients had terminal respiratory failure with pulmonary hypertension and conserved LV systolic function. Immediately following esmolol injection (1.3 ± .7 mg/kg; mean ± 1 SD), SpO2 increased from 73% ± 12 to 95% ± 6; blood to arterial partial pressure in CO2 (PaCO2) decreased from 52 ± 18 to 35 ± 7 mmHg systolic pulmonary artery pressure decreased from 61 ± 8 to 50 ± 12 mmHg; the pulmonary artery oxygen saturation (SvO2); increased from 51% ± 24 to 77% ± 12; systemic arterial pressure or catecholamine requirements were unchanged. In conclusion, these results suggest that injection of esmolol allowed rapid correction of regional hypoxemia occurring during lung transplantation despite femoro-femoral VA ECLS. The mechanism is probably a decreased cardiac output of the native LV due to esmolol-induced negative inotropic and chronotropic effects without significant adverse effects on systemic tissue perfusion.