Study of the Frequency of Cardiovascular Diseases and Their Risk Factors in the Emergency Units of Two Hospitals in Dakar (Senegal)

Introduction: Cardiovascular diseases constitute the deadliest pathology in the world with 31% of global mortality in 2018. This is how we felt it necessary to conduct a study on cardiovascular diseases in emergency units of Senegal, more precisely in Dakar, in order to know epidemiological profile of these patients. Methods: The study setting was the reception and emergency units of the Hôpital de Pikine and Hôpital Principal de Dakar. This was an observational, descriptive cross-sectional study with an analytical aim to search for factors associated with the occurrence of cardiovascular disease. The study ran from January 25th to February 5th, 2018 at the Hôpital de Pikine and from February 25th to March 5th, 2018 at Hôpital Principal de Dakar. The source population consisted of patients over 18 years of age and not in a state of pregnancy, who were been received there and had given their free and informed consent to participate in the survey. A representative sample had drawn and a consecutive recruitment of eligible patients were been carried out. The data collection tools were been based on the WHO STEPwise survey questionnaire. Data collection was been carried out in accordance with ethical rules. Results: The study involved 615 patients. The proportions of sedentary lifestyle, low daily consumption of fruits/vegetables, overweight and obesity were 72.4%, 96.4%, 22.7% and 17.3% respectively. This was 55.5% of women who had a waist circumference that corresponded to a high risk of a cardiovascular event and 10.2% for men. 38.9% of patients had blood pressure above 140/90mmhg and 32.2% said they had never controlled their blood pressure in their life. The use of a consultation in a health structure to control his blood pressure was by far the most frequent modality with 61.4%. The proportion of people with cardiovascular disease was 50.1%. Hypertensive flare-ups/hypertensive emergencies were the leading complications diagnosed with 33.33%. Factors associated with the occurrence of cardiovascular disease were sex, age, professional status and body mass index. Discussion & Conclusion: The risk factors for cardiovascular disease are highly represented in our emergency units. In addition to the available care offer, the identification of factors associated with the occurrence of cardiovascular diseases in patients who are been seen there will allow targeted preventive actions within this fragile and vulnerable population. All this to help achieve target 3.4 of the Sustainable Development Goals (SDGs) by 2030. Furthermore, according to the associated factors identified, it appears that achieving SDG 8 will greatly contribute to the prevention of cardiovascular disease. This proves the urgency and interest of an integrated multi-ministerial vision in our strategic plans for the prevention against major non-communicable diseases and cardiovascular diseases in particular.

Clinical analysis of central venous catheter-related infections in patients in the emergency ICU

BACKGROUND:Catheter-related infection(CRI)of the central vein is a common cause of nosocomial infection.This study was undertaken to investigate the pathogen culturing and risk factors of CRI in emergency intensive care unit(EICU)in order to provide the beneficial reference.METHODS:From January 2008 to December 2010,a total of 1 363 patients were subjected to catheterization.In these patients,the peak CRI rate of the patients was determined by bacterial cultivation and blood bacterial cultivation.RESULTS:CRI happened in 147 of the 1 363 patients using the central venous catheter.The peak rate of CRI was 10.79%,with an incidence of 3.05 episodes per 1 000 catheter days.Of the147 patients,46.94%had gram-negative bacilli,40.14%had gram-positive cocci,and 12.92%had fungi.Unconditional logistic regression analysis suggests that multiple catheterization,femoral vein catheterization,the application of multicavity catheter,and the duration of catheterization were the independent risk factors for CRI.CONCLUSION:The risk factors for catheter-related infections should be controlled to prevent the occurrence of nosocomial infection.

A decade of job realignment movement at large Chinese and American academic libraries from 1998 to 2007

Based on a questionnaire survey,the paper made a comparative study on the changes of traditional library positions within the context of the emerging professional positions and functional units at some large academic libraries in China and in the United States from 1998 to 2007.It describes how some of the library professional positions and functional units have gone through a time period of intensified and proactive position allocation realignment in terms of their rise,decline,fission and/or fusion within the administrative context of their library's evolving changes in missions,objectives and service delivery structure under the impact of the rapid development of information technologies.Such changes are graphically demonstrated in several charts in this paper to highlight the evolutionary development of academic librarianship in general and the waves of changes for library position reallocations in specific in the ten-year period under study.It is believed that such a study can be useful for discerning the overall developing trend of academic librarianship,especially in the area of the rising professional and social status of academic librarianship during this period.The movement of library position allocation realignment was a corresponding response at the time to the influx of applicable information technologies to the library scene.It not only made the library operation to become'leaner and meaner,' but also gave added impetus to the rise of the professional and social status of their practitioners in the society due to the latter's enhanced service delivery innovations and capabilities for meeting their constituencies' timely information needs more satisfactorily.

A new charging scheme in an emergency department observation unit under Beijing＇s basic medical insurance

Background The new medical insurance policy （JRSYF（2010） No.255） was released by the Beijing Municipal Government and became effective on January 1,2011.Medical expenses incurred during a stay in an emergency department （ED） observation unit can be reimbursed as a hospital admission.The aim of this study was to evaluate the impact of a new charging scheme during stays in ED observation unit under Beijing＇s Basic Medical Insurance.Methods Data for those patients who had stayed in ED observation unit in 2010 （before the implementation of a new charging scheme） and 2012 （after the implementation of this policy） were retrospectively analyzed in terms of length of stay,patients who were observed （PO）,and median medical costs.Results After the implementation of a new charging scheme,compared with the year of 2010,in year of 2012,there were statistically significant longer lengths of stay at the observation unit （6 （4-9） vs.5 （4-7） days; P〈0.001）,more PO （2 257vs.1 783; P〈0.001）,and more median medical costs （RMB 6 026 vs.3 650 Yuan; P〈0.01）.The proportion of elderly patients （≥60 years of age） in 2012 was larger than that in 2010 （70.22% vs.63.71%; P〈0.01）.It was performed on those patients who were admired after the implementation of a new charging scheme.Compared with patients who were not admired had stayed in ED observation units,the patients who were admired had stayed in ED observation units that had a higher proportion for 〉15 days （36.22% vs.5.61%; P〈0.01）; they had higher median medical costs RMB （9 186 vs.5 668Yuan; P〈0.001） and they were more elderly （≥60 years of age） （86.10% vs.66.39%; P〈0.01）.Conclusions The new charging scheme under Beijing＇s Basic Medical Insurance allows patients to get access to inpatient admission more easily.It lowers patients＇ financial burden in ED observation unit.Since more people stay at ED observation unit,it increases ED payments by the insurance system.However,it slows the turnover rate of ED observation unit and causes overcrowding in ED.Hence,the advantages and disadvantages of the new policy are obvious.