Dénutrition de la personne âgée : de la sarcopénie à la cachexie

Because of metabolic changes due to ageing, malnutrition is accompanied by a preferential loss of fat free mass in the elderly and it exaggerates the physiological loss of body cell mass, muscle mass and muscle function observed in the aged. Exercise training has positive anabolic effects even in the frail elderly and may improve the effect of renutrition in malnourished elderly patients.     

Introduction à la psychothérapie analytique de groupe

International Journal of Public Health - Faisant suite à une brève énumération des différentes techniques de psychothérapie collective, méthodes purement...     

Le tétanos à porte d’entrée obstétricale à Dakar : aspects épidémiologiques et pronostiques à propos de 21 cas observés à la clinique des maladies infectieuses du CHU de Dakar

Objective – The aim of this study was to describe the epidemiological pattern and the prognosis of obstetrical tetanus and to suggest preventive measures. Methods – A retrospective study was carried out in the Dakar Fann Hospital between 1994 and 1999. Results – Nineteen cases of post-abortum tetanus and two post-partum cases were observed. Ages ranged from 15 to 34 years with a mean age of 20.8 years. Most of the patients were single (85.71%) and 66.66% had very low socio-economic status. Most of the illegally induced abortions (78.94%) had been performed at home. The mean delay before hospitalization was short (2.4 days). Mild forms were the most common presentation with 85.7% of grade II tetanus. The death rate was 23.8%. Conclusion – The current Senegalese immunization program excludes a large proportion of women of reproductive age. Family planning services are needed to reduce the morbidity of this disease.     

Conduite à tenir devant des troubles de la déglutition

Swallowing disorders are frequent in daily practice. They could involve liquids or solid diets or both, and are mainly caused by neurological or ENT diseases. They impair patients or their relatives’ quality of life and increase the risks of aspiration, undernutrition and dehydration. Assessment includes careful interview and physical examination. The DePippo's test is a key examination. Additionally, endoscopy or video fluoroscopy, which remains the gold standard for swallowing assessment, could be needed. Nutritional and respiratory assessments are mandatory. The management of swallowing disorders should be multidisciplinary, involving physicians, speech therapist, dietician, sometimes dentist or surgeon, and needs a strong contribution of the paramedical staff and the patient's relatives.