0000000000352751
AUTHOR
Silvia Iacobelli
La “Donna di Ostuni”, a case of eclampsia 28,000 years ago?
La "Donna di Ostuni", the Lady from Ostuni (fortified medieval city, on the southern Italian Adriatic coast) is the skeleton of "the human most ancient mother" ever found by paleoanthropologists, grave dated of 28,000 years BP. It concerns a 20-years-old woman buried with her baby in her womb estimated at 8 months gestation. To date, the cause of the maternal-fetal deaths is qualified of unknown origin. We propose that eclampsia may be a possible explanation for these deaths (mother and baby together). Eclampsia (convulsions), the curse of human births (non-existent in other mammals), has been described since writings has existed 5000 years ago in all civilisations. This plausible descripti…
Étude de prévalence de l’endométriose à la Réunion et en métropole à partir du PMSI
Introduction Objectif principal : determiner la prevalence des hospitalisations pour endometriose a la Reunion et en metropole. Objectif secondaire : apprecier l’evolution des soins chirurgicaux pour cette pathologie dans l’ile comparee a la metropole. L’endometriose est une maladie de la femme reglee. Les principaux modes de decouverte sont la douleur et l’infertilite. Le diagnostic de certitude repose sur la cœlioscopie et donc sur une hospitalisation. Methodes Du 1/01/2008 au 31/12/2012, a partir du PMSI national, nous avons releve les codes de diagnostic principal concernant l’endometriose (N800 a N809). Dans cette population, nous avons consulte les actes realises et ceux qui concernai…
Total plasma protein in very preterm babies: prognostic value and comparison with illness severity scores
International audience; OBJECTIVE: We aimed to investigate the predictive value for severe adverse outcome of plasma protein measurements on day one of life in very preterm infants and to compare total plasma protein levels with the validated illness severity scores CRIB, CRIB-II, SNAP-II and SNAPPE-II, regarding their predictive ability for severe adverse outcome. METHODS: We analyzed a cohort of infants born at 24-31 weeks gestation, admitted to the tertiary intensive care unit of a university hospital over 10.5 years. The outcome measure was "severe adverse outcome" defined as death before discharge or severe neurological injury on cranial ultrasound. The adjusted odd ratio (aOR) and 95%…
Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
International audience; OBJECTIVE: We aimed to investigate the relationship between day-1 hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available. RESULT: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level \textless40 g l(-1)) on day 1 of life occurred in 19.5 % of all patients. The …
Hémorragie sévère du post-partum et distance domicile-hôpital : étude en population à partir des données hospitalières
Introduction Afin de diminuer la mortalite et morbidite severe maternelle, une attention particuliere merite d’etre portee a l’hemorragie severe du post-partum (HPP), notamment a la recherche de nouveaux facteurs de risque. L’objectif de l’etude etait d’estimer le risque d’HPP severe lie a la distance entre le domicile et le service d’obstetrique et de decrire les facteurs de risque de l’HPP severe identifies par le Programme de medicalisation des systemes d’information (PMSI). Methodes Une cohorte retrospective en population a ete realisee a partir de la base nationale du PMSI de 2011, via le code Z37. La variable d’interet etait l’HPP severe par atonie uterine identifiee par le code corre…
Successful control of a Methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit: a retrospective, before-after study
International audience; Background : Aim of this study was to provide a detailed description of a Methicillin-resistant Staphylococcus aureus (MRSA) outbreak management strategy in the neonatal intensive care unit of a university hospital.MethodsThis was a retrospective, “before-after” study, over two consecutive 18-month periods. The outbreak management strategy was performed by a multidisciplinary team and included: extensive healthcare workers (HCW) involvement, education, continuous hand-hygiene training and active MRSA colonization surveillance. The actions implemented were identified based on an anonymous, voluntary, reporting system, carried out among all the HCW, and regular audit a…
Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
International audience; Background: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks ofgestational age (GA).Methods: This nation-wide population-based study used the French medico-administrative database to assess thefollowing outcomes in singleton live-born infants (32–43 weeks) without congenital anomalies (year 2011): neonatalhospitalization (day of life 1 – 28), post-neonatal hospitalization (day of life 29 – 365), and 1-year in-hospital mortalityrates. Marginal models and negative binomial regressions were used.Results: The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks,the lower the…
Routine Probiotic Use in Very Preterm Infants: Retrospective Comparison of Two Cohorts
International audience; OBJECTIVE: Evidence supports the efficacy of probiotics in reducing necrotizing enterocolitis (NEC) in very low-birth-weight infants, although concerns remain with regard to their routine use. Since 2008 in our neonatal intensive care unit, a low dose of probiotics (unique strain) is administered as standard of care in all preterm babies born at 24 to 31 weeks' gestation. This study reports outcomes in infants receiving probiotic cohort (PC) compared with the historical cohort. DESIGN: Treatment with Lactobacillus rhamnosus Lcr35 (Lcr Restituo) (2 × 108 colony-forming units/12 h) was started early after birth and intention to treat was up to 36 weeks' gestation. The …