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121.
Distribution of human papillomavirus genotypes,assessment of HPV 16 and 18 viral load and anal related lesions in HIV positive patients: A cross‐sectional analysis
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122.
Emmanuelle?BélangerEmail author Charo?Rodríguez Danielle?Groleau France?Légaré Mary?Ellen?Macdonald Robert?Marchand 《BMC palliative care》2014,13(1):63
Background
Conversations about end-of-life care remain challenging for health care providers. The tendency to delay conversations about care options represents a barrier that impedes the ability of terminally-ill patients to participate in decision-making. Family physicians with a palliative care practice are often responsible for discussing end-of-life care preferences with patients, yet there is a paucity of research directly observing these interactions. In this study, we sought to explore how patients and family physicians initiated decision-making conversations in the context of a community hospital-based palliative care service.Methods
This qualitative study combined discourse analysis with ethnographic methods. The field research lasted one year, and data were generated through participant observation and audio-recordings of consultations. A total of 101 consultations were observed longitudinally between 18 patients, 6 family physicians and 2 pivot nurses. Data analysis consisted in exploring the different types of discourses initiating decision-making conversations and how these discourses were affected by the organizational context in which they took place.Results
The organization of care had an impact on decision-making conversations. The timing and origin of referrals to palliative care shaped whether patients were still able to participate in decision-making, and the decisions that remained to be made. The type of decisions to be made also shaped how conversations were initiated. Family physicians introduced decision-making conversations about issues needing immediate attention, such as symptom management, by directly addressing or eliciting patients’ complaints. When decisions involved discussing impending death, decision-making conversations were initiated either indirectly, by prompting the patients to express their understanding of the disease and its progression, or directly, by providing a justification for broaching a difficult topic.Conclusions
Decision-making conversations and the initiation thereof were framed by the organization of care and the referral process prior to initial encounters. While symptom management was taken for granted as part of health care professionals’ expected role, engaging in decisions regarding preparation for death implicitly remained under patients’ control. This work makes important clinical contributions by exposing the rhetorical function of family physicians’ discourse when introducing palliative care decisions.123.
Irja Lutsar Corine Chazallon Francesca Ippolita Calò Carducci Ursula Trafojer Ben Abdelkader Vincent Meiffredy de Cabre Susanna Esposito Carlo Giaquinto Paul T. Heath Mari-Liis Ilmoja Aspasia Katragkou Carine Lascoux Tuuli Metsvaht George Mitsiakos Emmanuelle Netzer Lorenza Pugni Emmanuel Roilides Yacine Saidi Kosmas Sarafidis Mike Sharland Vytautas Usonis Jean-Pierre Aboulker 《European journal of pediatrics》2014,173(8):997-1004
Late onset neonatal sepsis (LOS) has a high mortality and the optimal management is poorly defined. We aimed to evaluate new expert panel-derived criteria to define LOS and characterize the current management and antibiotic susceptibility of LOS-causing organisms in Europe. A prospective observational study enrolled infants aged 4 to 90 days in five European countries. Clinical and laboratory findings as well as empiric treatment were recorded and patients were followed until the end of antibiotic therapy. Failure was defined as a change of primary antibiotic, no resolution of clinical signs, appearance of new signs/pathogens or death. Antibiotic therapy was considered appropriate if the organism was susceptible to at least one empiric antibiotic. 113 infants (median age 14 days, 62 % ≤1500 g) were recruited; 61 % were culture proven cases (28 CoNS, 24 Enterobacteriaceae, 11 other Gram-positives and 6 Gram-negative non-fermentative organisms). The predictive value of the expert-panel criteria to identify patients with a culture proven LOS was 61 % (95 % CI 52 % to 70 %). Around one third of Enterobacteriaceae were resistant to ampicillin + or cefotaxime + gentamicin but only 10 % to meropenem. Empiric treatment contained a total of 43 different antibiotic regimens. All-cause mortality was 8 % with an additional 45 % classified as failure of empiric therapy, mainly due to change of primary antibiotics (42/60). Conclusions: The expert panel—derived diagnostic criteria performed well identifying a high rate of culture proven sepsis. Current management of LOS in Europe is extremely variable suggesting an urgent need of evidence-based guidelines. 相似文献
124.
Thibaud Damy Vronique Benedyga Tho Pezel Emmanuelle Berthelot Jacques Gauthier Gilbert Habib Marie-Christine Iliou Jean-Franois Aupetit Guillaume Baudry Pascal De Groote Damien Logeart Laure Chaufourier Vlad Ciobotaru Franoise Pousset Florence Beauvais Fabrice Bauer Florian Zores Olivier Lairez Kevin Richard Luc Hittinger Emmanuel Teiger Charles Taieb Etienne Audureau 《Nutrients》2022,14(2)
(1) Background: There is much debate about the use of salt-restricted diet for managing heart failure (HF). Dietary guidelines are inconsistent and lack evidence. (2) Method: The OFICSel observatory collected data about adults hospitalised for HF. The data, collected using study-specific surveys, were used to describe HF management, including diets, from the cardiologists’ and patients’ perspectives. Cardiologists provided the patients’ clinical, biological, echocardiography, and treatment data, while the patients provided dietary, medical history, sociodemographic, morphometric, quality of life, and burden data (burden scale in restricted diets (BIRD) questionnaire). The differences between the diet recommended by the cardiologist, understood by the patient, and the estimated salt intake (by the patient) and diet burden were assessed. (3) Results: Between March and June 2017, 300 cardiologists enrolled 2822 patients. Most patients (90%) were recommended diets with <6 g of salt/day. Mean daily salt consumption was 4.7 g (standard deviation (SD): 2.4). Only 33% of patients complied with their recommended diet, 34% over-complied, and 19% under-complied (14% unknown). Dietary restrictions in HF patients were associated with increased burden (mean BIRD score of 8.1/48 [SD: 8.8]). (4) Conclusion: Healthcare professionals do not always follow dietary recommendations, and their patients do not always understand and comply with diets recommended. Restrictive diets in HF patients are associated with increased burden. An evidence-based approach to developing and recommending HF-specific diets is required. 相似文献
125.
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127.
Amlie Lombes Rmy A. Bonnin Frdric Laurent Hlne Guet-Revillet Emmanuelle Bille Vincent Cattoir Marie-Sarah Fangous Ccile Le Brun Vincent Fihman Frdric Janvier Marie-Pierre Otto Anais Potron Stphane Corvec Louise Ruffier dEpenoux Assaf Mizrahi Laurent Dortet 《Antimicrobial agents and chemotherapy》2022,66(2)
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130.
Thomas Wirth MD MSc Louise Laure Mariani MD PhD Gaber Bergant MD Michel Baulac MD PhD Marie-Odile Habert MD Nathalie Drouot MSc Emmanuelle Ollivier MSc Alenka Hodžić PhD Gorazd Rudolf MD Patrick Nitschke MSc Gabrielle Rudolf PhD Jamel Chelly MD PhD Christine Tranchant MD PhD Mathieu Anheim MD PhD Emmanuel Roze MD PhD 《Movement disorders》2020,35(5):880-885