Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest f...Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.展开更多
Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation o...Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.展开更多
Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as ...Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .展开更多
Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional st...Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional study carried out between July 1<sup>st</sup> 2015 and June 30 2016, i.e. a duration of one year. Results: A total of 551 patients received advice on various contraceptive methods. Most of this advice was given in the post-partum period (40.2%) and during antenatal care (39.1%). Of the patients advised, 87 (15.8%) used the intrauterine device. The majority of users (93%) were married and uneducated (63.2%), and 39.1% were poor. The majority (56.3%) of intra-uterine devices were inserted in the immediate post-partum period. The majority of women had no adverse events either during the first six weeks (n = 57;65.5%) or at 3<sup>rd</sup> months (n = 75;86.2%) or 6<sup>th</sup> months (n = 76;87.4%) after IUD insertion. Most users remained complication-free throughout the follow-up period (n = 76;87.4% at 6<sup>th</sup> weeks and 3<sup>rd</sup> months, and n = 77;88.5% at 6<sup>th</sup> months). The continuation rate was 89.7% at 6 weeks and 3<sup>rd</sup> months, and 87.4% at 6<sup>th</sup> months after insertion. The majority of users (87.0%) were satisfied with the care they received. Conclusion: This study showed very few complications among intrauterine device users, and high continuation and satisfaction rates. The intrauterine device is a long-acting, effective, reversible and safe contraceptive that can be used by most women for birth spacing in Guinea, where women do not regularly visit health facilities.展开更多
Hepatitis B virus (HBV) infection is a major public health problem worldwide. The aim of this study was to document the dynamics of HBV viral load during the follow-up of chronic hepatitis B patients at the Saint Cami...Hepatitis B virus (HBV) infection is a major public health problem worldwide. The aim of this study was to document the dynamics of HBV viral load during the follow-up of chronic hepatitis B patients at the Saint Camille Hospital in Ouagadougou (HOSCO) from 2017 to 2021. This descriptive retrospective study was carried out in the Hepato-Gastro-Enterology Department of HOSCO and focused on patients who were undergoing treatment for chronic viral hepatitis B. A total of 260 cases of chronic hepatitis B were included in the study. The most affected age group was 21 to 30 years, accounting for 48.08% of the cases. Lifestyle factors included alcohol consumption (3.08%) and tobacco use (2.69%). Major risk factors for transmission included lack of vaccination (98.46%), family history of HBV infection (68.00%) and engagement in high-risk activities (28.00%). Patients requiring treatment were prescribed Tenofovir 300 mg tablets. FibroScan<sup>®</sup> showed the presence of stage F3-F4 fibrosis (2.14%) and S3 steatosis (13.33%). After one year of follow-up, 6.92% of patients achieved an undetectable viral load with normalized transaminase levels. The majority of other patients had a detectable viral load but below 20,000 IU/mL. The prevalence of viral hepatitis B remains significant worldwide. Although effective and well-monitored treatment can lead to undetectable viremia, prevention remains the most effective strategy for successful management of this disease.展开更多
Congenital pure kyphosis due to failure of vertebral body segmentation is a relatively rare entity, and surgical intervention is infrequent compared to that for failure of vertebral body formation [1] [2]. There are v...Congenital pure kyphosis due to failure of vertebral body segmentation is a relatively rare entity, and surgical intervention is infrequent compared to that for failure of vertebral body formation [1] [2]. There are very few reports of long-term follow-up of surgical treatment in patients with congenital pure kyphosis, and all the reported cases were diagnosed as failure of formation and had an age at the time of surgery of less than 18 years. It is important for orthopedic surgeons to follow the postoperative course of rare cases over 30 years. Here, we present a surgically treated case with ultra-long term follow-up of a 50-year-old patient with congenital pure kyphosis of the lumbar spine. Imaging of the lumbar spine showed six vertebrae and an unsegmented bar at L3-4 causing a pure kyphosis of 54°. The wedge-shaped block vertebra had 4 pedicles with the neural foramen between the pedicles without concomitant disc space, with compensatory thoracic hypokyphosis and lower lumbar hyperlordosis. One-stage correction and fusion surgery using anterior opening and posterior closing osteotomy was successfully performed. Both clinical and radiographic results were excellent and have been maintained for over 30 years postoperatively. The basic principle in the surgical treatment of adult spinal deformity is to achieve and maintain a good global sagittal balance over time. This case reaffirms the importance of spinopelvic harmony.展开更多
Background and objectives: Breast Imaging Reporting and Data System in Category 3 (BIRADS-3) includes probably benign lesions which need a short-term imaging follow-up. However, in our context, the lesions graded BIRA...Background and objectives: Breast Imaging Reporting and Data System in Category 3 (BIRADS-3) includes probably benign lesions which need a short-term imaging follow-up. However, in our context, the lesions graded BIRADS-3 remain insufficiently evaluated. We therefore conducted this study to assess the cancer occurrence and associated factors in BIRADS-3 lesions during the follow-up in order to propose an adaptation of the management for lesions in this category in our setting. Patients and methods: A retrospective longitudinal study of patients with lesions initially classified as BIRADS-3 and who realised each at least one additional imaging check-up between January 2014 and December 2022 in five Yaoundé hospitals. All clinical and imaging data were analysed using SPSS<sup>®</sup> 21.0 software with a significant p-value Results: Patients were aged 13 to 73 (33.0 ± 13.4) years, with a history of breast mass (315 cases;79.7%), breast pain (25 patients;6.3%), nipple discharge (20 patients;5.1%) or past family history of breast cancer (25 cases;6.3%). The most common baseline abnormalities were mammogram opacities (64.8%) and microcalcifications (48.6%), whereas initial breast ultrasound showed solid masses (77.0%) and cystic lesions (11.1%). Compliance with imaging appointment periods was low with only 23.9% of all patients performing an imaging control at the scheduled moment. During the follow-up, 115 patients (29.1%) were upgraded to BIRADS-4 and histology performed revealed 43 cancers (10.9% of overall initial BIRADS-3 sample). The presence of malignancies was associated to age above 40 years (p = 0.0001) and to the presence of nipple discharge (p = 0.0375). Conclusion: The frequency of malignancies among initial BIRADS-3 lesions in our series is higher than that described in the guidelines. This study highlights the need to be more proactive in the management of BIRADS-3 lesions in our setting as the compliance with follow-up is low. So, biopsy should be considered as an alternative to long-term follow-up for patients above 40, non-compliant with imaging check-ups and presenting with nipple discharge.展开更多
Introduction: Despite the known benefits of newborn follow-up clinics, attendance has historically been difficult. Infants with reported follow-up difficulty have a greater incidence of severe sensorimotor and cogniti...Introduction: Despite the known benefits of newborn follow-up clinics, attendance has historically been difficult. Infants with reported follow-up difficulty have a greater incidence of severe sensorimotor and cognitive deficits and poorer access to early intervention programs. Our objective was to determine the parent-reported reasons for loss-to-follow up in patients hospitalised at the neonatology unit of Laquintinie Hospital. Methodology: We carried out a cross-sectional study through phone interviews with parents/caregivers of patients hospitalised at Laquintinie over a 2-year period from 1st January 2021 to 31st December 2022. A non-standardised structured interview guide was used for data collection. Loss-to-follow up referred to absence to at least one visit as recorded in the neonatal follow-up chart. All necessary administrative and ethical considerations were duly respected. Results: Most neonates were born through vaginal delivery (n = 313, 69.45%). The neonates were admitted at a median gestational age of 33 weeks (Q1-Q3;32 - 35) and the median duration of hospitalisation was 12 days (Q1 - Q3;8 - 18). A total of 23 neonates had died at the time of interview giving a mortality rate of 5.1%. The three most reported reasons for loss-to-follow-up was lack of money (n = 310, 68.13%), assumption that follow-up had ended (n = 37, 8.13%), and newborn that died (n = 23, 5.1%). Conclusion: This study highlights the significant impact of financial constraints and absence of a robust follow-up system on poor uptake of neonatal follow-up post-discharge in resource limited settings like Cameroon. Our results serve as advocacy for national health insurance especially in neonates.展开更多
This article investigates a multi-circular path-following formation control with reinforced transient profiles for nonholonomic vehicles connected by a digraph.A multi-circular formation controller endowed with the fe...This article investigates a multi-circular path-following formation control with reinforced transient profiles for nonholonomic vehicles connected by a digraph.A multi-circular formation controller endowed with the feature of spatial-temporal decoupling is devised for a group of vehicles guided by a virtual leader evolving along an implicit path,which allows for a circumnavigation on multiple circles with an anticipant angular spacing.In addition,notice that it typically imposes a stringent time constraint on time-sensitive enclosing scenarios,hence an improved prescribed performance control(IPPC)using novel tighter behavior boundaries is presented to enhance transient capabilities with an ensured appointed-time convergence free from any overshoots.The significant merits are that coordinated circumnavigation along different circles can be realized via executing geometric and dynamic assignments independently with modified transient profiles.Furthermore,all variables existing in the entire system are analyzed to be convergent.Simulation and experimental results are provided to validate the utility of suggested solution.展开更多
The issue of achieving prescribed-performance path following in robotics is addressed in this paper,where the aim is to ensure that a desired path within a specified region is accu-rately converged to by the controlle...The issue of achieving prescribed-performance path following in robotics is addressed in this paper,where the aim is to ensure that a desired path within a specified region is accu-rately converged to by the controlled vehicle.In this context,a novel form of the prescribed performance guiding vector field is introduced,accompanied by a prescribed-time sliding mode con-trol approach.Furthermore,the interdependence among the pre-scribed parameters is discussed.To validate the effectiveness of the proposed method,numerical simulations are presented to demonstrate the efficacy of the approach.展开更多
Cam-followers provide reliable and controlled motions in various mechanical systems. Due to the highly fluctuating load between the cam and follower in operation, the cam-follower may be subjected to a high risk of co...Cam-followers provide reliable and controlled motions in various mechanical systems. Due to the highly fluctuating load between the cam and follower in operation, the cam-follower may be subjected to a high risk of contact fatigue failure. This paper assesses the fatigue life of a cycloidal displacement cam and a flat-faced follower under the defined loads and constraints. Computer-aided design (CAD) model of the cam-follower is developed in CATIA software and imported to ANSYS software for finite element analysis (FEA) of fatigue life. MATLAB programming is developed for determining the appropriate spring constant and pre-load force to always keep the cam and follower in contact. The fatigue life of the cam-follower has been estimated under the specified operating conditions. The analysis method can be applied to investigate the fatigue life of cams with other profiles, including the modified trapezoidal functions, polynomial functions, etc.展开更多
AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study ...AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study was performed to investigate the prevalence of NAFLD at baseline, and then the participants were followed for 8 years to investigate risk factors for the development of NAFLD.RESULTS: A total of 1948 participants were enrolled at baseline, of whom 691 were diagnosed with NAFLD. During the 8-year follow-up, 337 baseline NAFLD-free participants developed NAFLD. They had a greaterincrease in body mass index(BMI), serum uric acid, fasting plasma glucose, very low-density lipoprotein cholesterol and a considerable decrease in high-density lipoprotein cholesterol. 123 participants who had NAFLD at baseline lost NAFLD during the 8-year follow-up period. They had a greater decrease in BMI, fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase.CONCLUSION: NAFLD is prevalent in Chinese population with a rapidly increasing tendency. It can be reversed when patients lose their weight, control their hyperlipidemia and hyperglycemia, and reduce the liver enzyme levels.展开更多
Gastric cancer remains the second most frequent cause of cancer-related mortality in the world. Screening programs in some Asian countries are impractical in the majority of other countries worldwide. Therefore, follo...Gastric cancer remains the second most frequent cause of cancer-related mortality in the world. Screening programs in some Asian countries are impractical in the majority of other countries worldwide. Therefore, follow-up of precancerous lesions is advisable for secondary gastric cancer prevention. Intestinal metaplasia (IM) is recognized as a precancerous lesion for gastric cancer, increasing the risk by 6-fold. IM is highly prevalent in the general population, being detected in nearly 1 of every 4 patients undergoing upper endoscopy. The IM prevalence rate is significantly higher in patients with Helicobacter pylori (H. pylori) infection, in first-degree relatives of gastric cancer patients, in smokers and it increases with patient age. IM is the "breaking point" in the gastric carcinogenesis cascade and does not appear to regress following H. pylori eradication, although the cure of infection may slow its progression. Gastric cancer risk is higher in patients with incomplete-type IM, in those with both antral and gastric body involvement, and the risk significantly increases with IM extension over 20% of the gastric mucosa. Scheduled endoscopic control could be cost-effective in IM patients, depending on the yearly incidence of gastric cancer in IM patients, the stage of gastric cancer at diagnosis discovered at surveillance, and the cost of endoscopy. As a pragmatic behavior, yearly endoscopic control would appear justified in all IM patients with at least one of these conditions: (1) IM extension > 20%; (2) the presence of incomplete type IM; (3) first-degree relative of gastric cancer patients; and (4) smokers. In the remaining IM patients, a less intensive (2-3 years) could be proposed.展开更多
Background: The value of Epstein-Barr virus(EBV) DNA assay during posttreatment follow-up of the patients with nasopharyngeal carcinoma(NPC) presenting with different pretreatment plasma EBV DNA levels remains unclear...Background: The value of Epstein-Barr virus(EBV) DNA assay during posttreatment follow-up of the patients with nasopharyngeal carcinoma(NPC) presenting with different pretreatment plasma EBV DNA levels remains unclear. In the present study, we aimed to evaluate the prognostic value of plasma EBV DNA assay during posttreatment followup in the patients with NPC who have undergone intensity-modulated radiotherapy.Methods: The medical records of 385 NPC patients treated with intensity-modulated radiotherapy between November 2009 and February 2012 were reviewed. All patients underwent plasma EBV DNA assays before treatment, within3 months after treatment, and then every 3-12 months during posttreatment follow-up period. The recurrence rates for patients with different pretreatment and posttreatment follow-up plasma EBV DNA levels were analyzed.Results: Of the 385 patients, 267(69.4%) had detectable pretreatment plasma EBV DNA(> 0 copy/mL) and 93(24.2%) had detectable posttreatment EBV DNA during a median follow-up of 52.8 months(range 9.3-73.8 months).Detectable EBV DNA during posttreatment follow-up was found in 14.4%(17/118) and 28.5%(76/267) of patients with undetectable and detectable pretreatment EBV DNA, respectively, and was significantly associated with tumor recurrence in both patient groups. EBV DNA was detectable in 12.8%(40/313) of patients who remained disease-free,56.4%(22/39) of patients with locoregional recurrence alone, and 93.9%(31/33) of patients with distant metastasis as the first recurrence event(P < 0.001); 6.5%(19/292) of patients with undetectable EBV DNA and 57.0%(53/93) of patient with detectable EBV DNA during posttreatment follow-up experienced tumor recurrence. Compared with other cut-off values, the cut-off value of 0 copy/mL for EBV DNA during posttreatment follow-up had the highest area under the ROC curve(AUC) value(0.804,95% confidence interval 0.741-0.868) for predicting tumor recurrence(sensitivity, specificity, and accuracy: 73.6%, 87.2%, and 84.7%, respectively).Conclusion: Plasma EBV DNA level during posttreatment follow-up is a good marker for predicting distant metastasis but not locoregional recurrence in the patients with NPC irrespective of the pretreatment EBV DNA levels.展开更多
INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefor...INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission展开更多
Objective: To study the clinical therapy and prognosis in children with transient congenital hypothyroidism (CH).Methods: Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage le...Objective: To study the clinical therapy and prognosis in children with transient congenital hypothyroidism (CH).Methods: Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine (L-T4).Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients (DQ). A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared (16.25±3.87) μg/d. Mean duration of therapy was (28.09±9.56) months. No significant difference was found between study group and control group in the DQ test (average score (106.58± 14.40) vs (102.4±8.6), P>0.05) and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion: A L-T4 dosage of and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2~3 years of follow-up.展开更多
文摘Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.
文摘Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.
文摘Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .
文摘Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional study carried out between July 1<sup>st</sup> 2015 and June 30 2016, i.e. a duration of one year. Results: A total of 551 patients received advice on various contraceptive methods. Most of this advice was given in the post-partum period (40.2%) and during antenatal care (39.1%). Of the patients advised, 87 (15.8%) used the intrauterine device. The majority of users (93%) were married and uneducated (63.2%), and 39.1% were poor. The majority (56.3%) of intra-uterine devices were inserted in the immediate post-partum period. The majority of women had no adverse events either during the first six weeks (n = 57;65.5%) or at 3<sup>rd</sup> months (n = 75;86.2%) or 6<sup>th</sup> months (n = 76;87.4%) after IUD insertion. Most users remained complication-free throughout the follow-up period (n = 76;87.4% at 6<sup>th</sup> weeks and 3<sup>rd</sup> months, and n = 77;88.5% at 6<sup>th</sup> months). The continuation rate was 89.7% at 6 weeks and 3<sup>rd</sup> months, and 87.4% at 6<sup>th</sup> months after insertion. The majority of users (87.0%) were satisfied with the care they received. Conclusion: This study showed very few complications among intrauterine device users, and high continuation and satisfaction rates. The intrauterine device is a long-acting, effective, reversible and safe contraceptive that can be used by most women for birth spacing in Guinea, where women do not regularly visit health facilities.
文摘Hepatitis B virus (HBV) infection is a major public health problem worldwide. The aim of this study was to document the dynamics of HBV viral load during the follow-up of chronic hepatitis B patients at the Saint Camille Hospital in Ouagadougou (HOSCO) from 2017 to 2021. This descriptive retrospective study was carried out in the Hepato-Gastro-Enterology Department of HOSCO and focused on patients who were undergoing treatment for chronic viral hepatitis B. A total of 260 cases of chronic hepatitis B were included in the study. The most affected age group was 21 to 30 years, accounting for 48.08% of the cases. Lifestyle factors included alcohol consumption (3.08%) and tobacco use (2.69%). Major risk factors for transmission included lack of vaccination (98.46%), family history of HBV infection (68.00%) and engagement in high-risk activities (28.00%). Patients requiring treatment were prescribed Tenofovir 300 mg tablets. FibroScan<sup>®</sup> showed the presence of stage F3-F4 fibrosis (2.14%) and S3 steatosis (13.33%). After one year of follow-up, 6.92% of patients achieved an undetectable viral load with normalized transaminase levels. The majority of other patients had a detectable viral load but below 20,000 IU/mL. The prevalence of viral hepatitis B remains significant worldwide. Although effective and well-monitored treatment can lead to undetectable viremia, prevention remains the most effective strategy for successful management of this disease.
文摘Congenital pure kyphosis due to failure of vertebral body segmentation is a relatively rare entity, and surgical intervention is infrequent compared to that for failure of vertebral body formation [1] [2]. There are very few reports of long-term follow-up of surgical treatment in patients with congenital pure kyphosis, and all the reported cases were diagnosed as failure of formation and had an age at the time of surgery of less than 18 years. It is important for orthopedic surgeons to follow the postoperative course of rare cases over 30 years. Here, we present a surgically treated case with ultra-long term follow-up of a 50-year-old patient with congenital pure kyphosis of the lumbar spine. Imaging of the lumbar spine showed six vertebrae and an unsegmented bar at L3-4 causing a pure kyphosis of 54°. The wedge-shaped block vertebra had 4 pedicles with the neural foramen between the pedicles without concomitant disc space, with compensatory thoracic hypokyphosis and lower lumbar hyperlordosis. One-stage correction and fusion surgery using anterior opening and posterior closing osteotomy was successfully performed. Both clinical and radiographic results were excellent and have been maintained for over 30 years postoperatively. The basic principle in the surgical treatment of adult spinal deformity is to achieve and maintain a good global sagittal balance over time. This case reaffirms the importance of spinopelvic harmony.
文摘Background and objectives: Breast Imaging Reporting and Data System in Category 3 (BIRADS-3) includes probably benign lesions which need a short-term imaging follow-up. However, in our context, the lesions graded BIRADS-3 remain insufficiently evaluated. We therefore conducted this study to assess the cancer occurrence and associated factors in BIRADS-3 lesions during the follow-up in order to propose an adaptation of the management for lesions in this category in our setting. Patients and methods: A retrospective longitudinal study of patients with lesions initially classified as BIRADS-3 and who realised each at least one additional imaging check-up between January 2014 and December 2022 in five Yaoundé hospitals. All clinical and imaging data were analysed using SPSS<sup>®</sup> 21.0 software with a significant p-value Results: Patients were aged 13 to 73 (33.0 ± 13.4) years, with a history of breast mass (315 cases;79.7%), breast pain (25 patients;6.3%), nipple discharge (20 patients;5.1%) or past family history of breast cancer (25 cases;6.3%). The most common baseline abnormalities were mammogram opacities (64.8%) and microcalcifications (48.6%), whereas initial breast ultrasound showed solid masses (77.0%) and cystic lesions (11.1%). Compliance with imaging appointment periods was low with only 23.9% of all patients performing an imaging control at the scheduled moment. During the follow-up, 115 patients (29.1%) were upgraded to BIRADS-4 and histology performed revealed 43 cancers (10.9% of overall initial BIRADS-3 sample). The presence of malignancies was associated to age above 40 years (p = 0.0001) and to the presence of nipple discharge (p = 0.0375). Conclusion: The frequency of malignancies among initial BIRADS-3 lesions in our series is higher than that described in the guidelines. This study highlights the need to be more proactive in the management of BIRADS-3 lesions in our setting as the compliance with follow-up is low. So, biopsy should be considered as an alternative to long-term follow-up for patients above 40, non-compliant with imaging check-ups and presenting with nipple discharge.
文摘Introduction: Despite the known benefits of newborn follow-up clinics, attendance has historically been difficult. Infants with reported follow-up difficulty have a greater incidence of severe sensorimotor and cognitive deficits and poorer access to early intervention programs. Our objective was to determine the parent-reported reasons for loss-to-follow up in patients hospitalised at the neonatology unit of Laquintinie Hospital. Methodology: We carried out a cross-sectional study through phone interviews with parents/caregivers of patients hospitalised at Laquintinie over a 2-year period from 1st January 2021 to 31st December 2022. A non-standardised structured interview guide was used for data collection. Loss-to-follow up referred to absence to at least one visit as recorded in the neonatal follow-up chart. All necessary administrative and ethical considerations were duly respected. Results: Most neonates were born through vaginal delivery (n = 313, 69.45%). The neonates were admitted at a median gestational age of 33 weeks (Q1-Q3;32 - 35) and the median duration of hospitalisation was 12 days (Q1 - Q3;8 - 18). A total of 23 neonates had died at the time of interview giving a mortality rate of 5.1%. The three most reported reasons for loss-to-follow-up was lack of money (n = 310, 68.13%), assumption that follow-up had ended (n = 37, 8.13%), and newborn that died (n = 23, 5.1%). Conclusion: This study highlights the significant impact of financial constraints and absence of a robust follow-up system on poor uptake of neonatal follow-up post-discharge in resource limited settings like Cameroon. Our results serve as advocacy for national health insurance especially in neonates.
基金supported in part by the National Natural Science Foundation of China under Grant Nos.62173312 and 61803348in part by the National Major Scientific Instruments Development Project under Grant No.61927807+3 种基金in part by the Program for the Innovative Talents of Higher Education Institutions of ShanxiShanxi Province Science Foundation for Excellent Youthsin part by the Shanxi"1331 Project"Key Subjects Construction(1331KSC)in part by Graduate Innovation Project of Shanxi Province under Grant No.2021Y617。
文摘This article investigates a multi-circular path-following formation control with reinforced transient profiles for nonholonomic vehicles connected by a digraph.A multi-circular formation controller endowed with the feature of spatial-temporal decoupling is devised for a group of vehicles guided by a virtual leader evolving along an implicit path,which allows for a circumnavigation on multiple circles with an anticipant angular spacing.In addition,notice that it typically imposes a stringent time constraint on time-sensitive enclosing scenarios,hence an improved prescribed performance control(IPPC)using novel tighter behavior boundaries is presented to enhance transient capabilities with an ensured appointed-time convergence free from any overshoots.The significant merits are that coordinated circumnavigation along different circles can be realized via executing geometric and dynamic assignments independently with modified transient profiles.Furthermore,all variables existing in the entire system are analyzed to be convergent.Simulation and experimental results are provided to validate the utility of suggested solution.
基金supported by the National Natural Science Foundation of China(62073019)。
文摘The issue of achieving prescribed-performance path following in robotics is addressed in this paper,where the aim is to ensure that a desired path within a specified region is accu-rately converged to by the controlled vehicle.In this context,a novel form of the prescribed performance guiding vector field is introduced,accompanied by a prescribed-time sliding mode con-trol approach.Furthermore,the interdependence among the pre-scribed parameters is discussed.To validate the effectiveness of the proposed method,numerical simulations are presented to demonstrate the efficacy of the approach.
文摘Cam-followers provide reliable and controlled motions in various mechanical systems. Due to the highly fluctuating load between the cam and follower in operation, the cam-follower may be subjected to a high risk of contact fatigue failure. This paper assesses the fatigue life of a cycloidal displacement cam and a flat-faced follower under the defined loads and constraints. Computer-aided design (CAD) model of the cam-follower is developed in CATIA software and imported to ANSYS software for finite element analysis (FEA) of fatigue life. MATLAB programming is developed for determining the appropriate spring constant and pre-load force to always keep the cam and follower in contact. The fatigue life of the cam-follower has been estimated under the specified operating conditions. The analysis method can be applied to investigate the fatigue life of cams with other profiles, including the modified trapezoidal functions, polynomial functions, etc.
基金Supported by the National Natural Science Foundation of China,No.81372425 and No.81460634the Key Lab Project of the Xinjiang Science and Technology Bureau,No.2014KL002
文摘AIM: To investigate the prevalence of and risk factors for non-alcoholic fatty liver disease(NAFLD) in a Chinese population.METHODS: A total of 1948 adults from China was followed for 8 years. A cross-sectional study was performed to investigate the prevalence of NAFLD at baseline, and then the participants were followed for 8 years to investigate risk factors for the development of NAFLD.RESULTS: A total of 1948 participants were enrolled at baseline, of whom 691 were diagnosed with NAFLD. During the 8-year follow-up, 337 baseline NAFLD-free participants developed NAFLD. They had a greaterincrease in body mass index(BMI), serum uric acid, fasting plasma glucose, very low-density lipoprotein cholesterol and a considerable decrease in high-density lipoprotein cholesterol. 123 participants who had NAFLD at baseline lost NAFLD during the 8-year follow-up period. They had a greater decrease in BMI, fasting plasma glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase.CONCLUSION: NAFLD is prevalent in Chinese population with a rapidly increasing tendency. It can be reversed when patients lose their weight, control their hyperlipidemia and hyperglycemia, and reduce the liver enzyme levels.
文摘Gastric cancer remains the second most frequent cause of cancer-related mortality in the world. Screening programs in some Asian countries are impractical in the majority of other countries worldwide. Therefore, follow-up of precancerous lesions is advisable for secondary gastric cancer prevention. Intestinal metaplasia (IM) is recognized as a precancerous lesion for gastric cancer, increasing the risk by 6-fold. IM is highly prevalent in the general population, being detected in nearly 1 of every 4 patients undergoing upper endoscopy. The IM prevalence rate is significantly higher in patients with Helicobacter pylori (H. pylori) infection, in first-degree relatives of gastric cancer patients, in smokers and it increases with patient age. IM is the "breaking point" in the gastric carcinogenesis cascade and does not appear to regress following H. pylori eradication, although the cure of infection may slow its progression. Gastric cancer risk is higher in patients with incomplete-type IM, in those with both antral and gastric body involvement, and the risk significantly increases with IM extension over 20% of the gastric mucosa. Scheduled endoscopic control could be cost-effective in IM patients, depending on the yearly incidence of gastric cancer in IM patients, the stage of gastric cancer at diagnosis discovered at surveillance, and the cost of endoscopy. As a pragmatic behavior, yearly endoscopic control would appear justified in all IM patients with at least one of these conditions: (1) IM extension > 20%; (2) the presence of incomplete type IM; (3) first-degree relative of gastric cancer patients; and (4) smokers. In the remaining IM patients, a less intensive (2-3 years) could be proposed.
基金supported by grants from the Natural Science Foundation of Guangdong Province,China(No.2015A030310033)the Health&Medical Collaborative Innovation Project of Guangzhou City,China(No.201400000001)the Key Laboratory Construction Project of Guangzhou City(No.121800085)
文摘Background: The value of Epstein-Barr virus(EBV) DNA assay during posttreatment follow-up of the patients with nasopharyngeal carcinoma(NPC) presenting with different pretreatment plasma EBV DNA levels remains unclear. In the present study, we aimed to evaluate the prognostic value of plasma EBV DNA assay during posttreatment followup in the patients with NPC who have undergone intensity-modulated radiotherapy.Methods: The medical records of 385 NPC patients treated with intensity-modulated radiotherapy between November 2009 and February 2012 were reviewed. All patients underwent plasma EBV DNA assays before treatment, within3 months after treatment, and then every 3-12 months during posttreatment follow-up period. The recurrence rates for patients with different pretreatment and posttreatment follow-up plasma EBV DNA levels were analyzed.Results: Of the 385 patients, 267(69.4%) had detectable pretreatment plasma EBV DNA(> 0 copy/mL) and 93(24.2%) had detectable posttreatment EBV DNA during a median follow-up of 52.8 months(range 9.3-73.8 months).Detectable EBV DNA during posttreatment follow-up was found in 14.4%(17/118) and 28.5%(76/267) of patients with undetectable and detectable pretreatment EBV DNA, respectively, and was significantly associated with tumor recurrence in both patient groups. EBV DNA was detectable in 12.8%(40/313) of patients who remained disease-free,56.4%(22/39) of patients with locoregional recurrence alone, and 93.9%(31/33) of patients with distant metastasis as the first recurrence event(P < 0.001); 6.5%(19/292) of patients with undetectable EBV DNA and 57.0%(53/93) of patient with detectable EBV DNA during posttreatment follow-up experienced tumor recurrence. Compared with other cut-off values, the cut-off value of 0 copy/mL for EBV DNA during posttreatment follow-up had the highest area under the ROC curve(AUC) value(0.804,95% confidence interval 0.741-0.868) for predicting tumor recurrence(sensitivity, specificity, and accuracy: 73.6%, 87.2%, and 84.7%, respectively).Conclusion: Plasma EBV DNA level during posttreatment follow-up is a good marker for predicting distant metastasis but not locoregional recurrence in the patients with NPC irrespective of the pretreatment EBV DNA levels.
基金Scientific Research Foundation,State Health Commission,No.96-2-128
文摘INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission
文摘Objective: To study the clinical therapy and prognosis in children with transient congenital hypothyroidism (CH).Methods: Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine (L-T4).Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients (DQ). A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared (16.25±3.87) μg/d. Mean duration of therapy was (28.09±9.56) months. No significant difference was found between study group and control group in the DQ test (average score (106.58± 14.40) vs (102.4±8.6), P>0.05) and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion: A L-T4 dosage of and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2~3 years of follow-up.