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Book Description
Introduction: La fièvre est le premier motif de consultation chez l'enfant en ambulatoire. La densité des pédiatres étant faible en France, les médecins généralistes sont en première ligne dans la prise en charge. Entre 2004 et 2014, la consommation d'antibiotique a baissé de 7%, mais elle a augmenté de 2,8% depuis 2010. La France est le plus gros consommateur de pénicillines à large spectre. L'objectif de cette étude est de déterminer les facteurs influençant la prescription d'antibiotique en cas de fièvre chez l'enfant âgé de plus de 3 mois en médecine générale. Matériel et méthodes : Nous avons réalisé une étude observationnelle auprès de médecins généralistes d'Ile-de-France par l'envoi d'un questionnaire entre novembre 2014 et février 2015. Résultats : Vingt-huit médecin ont inclus 101 patients pendant la durée de l'étude. Un antibiothérapie a été prescrite dans 47% des cas. Dans 67% des cas cette prescription n'était pas conforme aux recommandations. L'utilisation des antibiotiques à large spectre était importante. En analyse multivariées, les facteurs liés à une prescription d'antibiotique non comnforme aux recommandations étaient l'âge du médecin, l'incertitude diagnostique entre une étiologie bactérienne ou virale et l'anxiété des patients. Conclusion : La prescription antibiotique reste élevée. L'analyse des résultats suggère que la décision médicale n'est pas seulement le résultat d'un raisonnement basé sur des faits objectifs mais aussi sur des fait subjectifs. Le développement d'outils d'aide au diagnostic, l'éducation des parents, les campagnes d'information sont des mesures intéressantes pour réduire la prescription inappropriée d'antibiotique.
Book Description
Introduction: La fièvre est le premier motif de consultation chez l'enfant en ambulatoire. La densité des pédiatres étant faible en France, les médecins généralistes sont en première ligne dans la prise en charge. Entre 2004 et 2014, la consommation d'antibiotique a baissé de 7%, mais elle a augmenté de 2,8% depuis 2010. La France est le plus gros consommateur de pénicillines à large spectre. L'objectif de cette étude est de déterminer les facteurs influençant la prescription d'antibiotique en cas de fièvre chez l'enfant âgé de plus de 3 mois en médecine générale. Matériel et méthodes : Nous avons réalisé une étude observationnelle auprès de médecins généralistes d'Ile-de-France par l'envoi d'un questionnaire entre novembre 2014 et février 2015. Résultats : Vingt-huit médecin ont inclus 101 patients pendant la durée de l'étude. Un antibiothérapie a été prescrite dans 47% des cas. Dans 67% des cas cette prescription n'était pas conforme aux recommandations. L'utilisation des antibiotiques à large spectre était importante. En analyse multivariées, les facteurs liés à une prescription d'antibiotique non comnforme aux recommandations étaient l'âge du médecin, l'incertitude diagnostique entre une étiologie bactérienne ou virale et l'anxiété des patients. Conclusion : La prescription antibiotique reste élevée. L'analyse des résultats suggère que la décision médicale n'est pas seulement le résultat d'un raisonnement basé sur des faits objectifs mais aussi sur des fait subjectifs. Le développement d'outils d'aide au diagnostic, l'éducation des parents, les campagnes d'information sont des mesures intéressantes pour réduire la prescription inappropriée d'antibiotique.
Book Description
La fièvre chez l’enfant de moins de 3 ans est un motif très fréquent en médecine générale. Les médecins de SOS médecins sont très sollicités pour cette indication. Les dernières recommandations de l’HAS concernant la prise en charge de la fièvre chez l’enfant datent de 2005. Il a été décidé de réaliser une étude qualitative pour analyser les pratiques des médecins généralistes face à une fièvre chez le jeune enfant et les freins éventuels à l’application des recommandations. Il s’agit d’une étude qualitative par entretiens individuels semi-dirigés auprès de douze médecins de SOS Médecins. Bien que la plupart des médecins de SOS Médecins ne connaissent pas précisément les recommandations, leurs pratiques y sont conformes. La prescription d’antibiotiques de façon probabiliste est négligeable. Les médecins de garde, en cas de doute sur l’origine de la fièvre, préfèrent demander l’avis d’un spécialiste et faire hospitaliser l’enfant. Le paracétamol est prescrit en première intention par tous les médecins. Les médecins de SOS Médecins, qui ont été pour la plupart sensibilisés à la pédiatrie au cours de leur formation initiale, se sentent à l’aise pour prendre en charge les enfants de moins de 3 ans, et leurs pratiques sont conformes aux données actuelles de la science.
Author: Neil L. Schechter Publisher: Lippincott Williams & Wilkins ISBN: 9780781726443 Category : Medical Languages : en Pages : 924
Book Description
This Second Edition is a significant revision of the leading text and clinical reference on pediatric pain. Written by an international group of experts from all relevant disciplines, this new edition is a vital reference for all pain practitioners, and for nurses, psychologists, PTs, anesthesiologists, and pediatricians dealing with acute and chronic pediatric pain. This edition includes new and expanded information on NSAIDs, opioids, and regional anesthesia. New chapters cover sedation, pain in the ICU, multidisciplinary pain services, palliative care, and the long-term consequences of pain. User-friendly new features include many more illustrations of techniques.
Author: Deryle Lonsdale Publisher: Routledge ISBN: 1135973504 Category : Foreign Language Study Languages : en Pages : 974
Book Description
A Frequency Dictionary of French is an invaluable tool for all learners of French, providing a list of the 5000 most frequently used words in the language. Based on a 23-million-word corpus of French which includes written and spoken material both from France and overseas, this dictionary provides the user with detailed information for each of the 5000 entries, including English equivalents, a sample sentence, its English translation, usage statistics, and an indication of register variation. Users can access the top 5000 words either through the main frequency listing or through an alphabetical index. Throughout the frequency listing there are thematically-organized lists of the top words from a variety of key topics such as sports, weather, clothing, and family terms. An engaging and highly useful resource, the Frequency Dictionary of French will enable students of all levels to get the most out of their study of French vocabulary. Former CD content is now available to access at www.routledge.com/9780415775311 as support material. Designed for use by corpus and computational linguists it provides the full text in a format that researchers can process and turn into suitable lists for their own research work. Deryle Lonsdale is Associate Professor in the Linguistics and English Language Department at Brigham Young University (Provo, Utah). Yvon Le Bras is Associate Professor of French and Department Chair of the French and Italian Department at Brigham Young University (Provo, Utah).
Author: W. Michael Scheld Publisher: ASM Press ISBN: 9781555819446 Category : Medical Languages : en Pages : 0
Book Description
Essential resource for the fight against emerging infectious diseases Incidences such as the 2014 Ebola epidemic in West Africa and the 2015 appearance of Zika in Brazil provide dramatic evidence of the continued ability of microbes to emerge, spread, adapt, and threaten global health. The challenge facing infectious disease specialists and public health professionals is to improve and find new diagnostic, therapeutic, and prevention strategies. The editors of the 10th installment of the Emerging Infections series have compiled the perspectives of leading infectious disease experts into 22 chapters that provide important updates on a broad range of emerging and reemerging bacterial, viral, parasitic, and fungal infectious diseases in the United States and globally. In addition to focusing on MERS, Ebola virus disease, chikungunya, and Zika virus disease, Emerging Infections 10 explores the global threat of antimicrobial resistance in reviews on carbapenem-resistant Enterobacteriaceae, multiply-resistant gonococcal infections, non-typhoidal Salmonella infections, and artemisinin-resistant Plasmodium falciparum malaria. Topics include both recently- and long-recognized diseases that pose challenges for the clinical, laboratory, research, public health, and animal health communities. Emerging Infections 10 presents new and emerging strategies to prevent, control, and eradicate infectious diseases and guides readers to the primary literature where they can explore individual topics in greater depth. This book is a valuable reference for professionals in microbiology, epidemiology, public health, and clinical and veterinary medicine.
Author: Lee A. Fleisher Publisher: Elsevier Health Sciences ISBN: 032377847X Category : Medical Languages : en Pages : 595
Book Description
Addressing both routine and complex situations with practical decision-making tools, Evidence-Based Practice of Anesthesiology, 4th Edition, helps anesthesiologists make sound decisions in everyday practice. World-renowned authority, Dr. Lee A. Fleisher, takes an evidence-based approach to a variety of high-impact topics related to effective perioperative patient management: preoperative assessment; monitoring and administration of anesthesia during surgery; postoperative intensive care management; and postoperative pain management. The 4th Edition has been updated from cover to cover, helping you make informed clinical decisions based on reliable, up-to-date guidance in every aspect of patient care. - Explores important issues in perioperative management, discussing the available options, examining the relevant research, and presenting practical recommendations. - Features concise, to-the-point chapters with numerous quick-reference tables for fast and effective decision making. - Includes decision trees throughout to provide visual guidance and a logical flow of key decision points. - Contains nine new chapters on how to identify patients at risk for postoperative neurocognitive disorder; the best strategy for perioperative ACE and ARB agents; emergency laparotomy; optimal postoperative analgesia and the opiate naïve patient; the best method for perioperative handoffs; myocardial injury after non-cardiac surgery (MINS); and more. - Helps you master the current best practices you need to know for successful day-to-day practice and oral board review. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Author: World Health Organization Publisher: World Health Organization ISBN: 9241547006 Category : Health & Fitness Languages : en Pages : 284
Book Description
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Author: Marc E. de Broe Publisher: Springer Science & Business Media ISBN: 1402025866 Category : Medical Languages : en Pages : 719
Book Description
To you the reader, the joy of discovery begins, for We continue in our goal of providing a text which us the job is done. In this edition, we have corrected is useful, not only to the clinician, but of equal interest past deficiencies, added new topics, expanded infor- to the investigator. The selection of content has been mation regarding the pediatric age group, provided directed at topics of current interest rather than those up to date (March 2003) references, while remaining of historic contribution. We have stressed the cont- true to our concept of a multi-national author book. bution of cell biology and pathophysiology, were it We continue to believe that scientific information is an exists, believing it provides both a better understa- international commodity whose interpretation and ap- ing of toxic injury when known, and a rational dir- plication are strongly influenced by both the cultural tion for therapy and prevention. and ethnic background of the observer. The oppor- nity to share in the rich diversity of the international We are encouraged by the accumulation of rec- scientific community remains a fundamental goal of nized risk factors, which allow pre-treatment strati- this endeavor. To participate as equals leads to mu- cation of our patients’ relative risk and allow us to - tual respect and peer appreciation. The sharing of in- cus our preventative techniques on the individuals tellectual resources fostered by this effort should and most likely to gain the greatest benefit.
Author: Yasmina Ferfar
Author: Yasmina Ferfar
Author: Paul-Etienne Guigo
Author: Neil L. Schechter
Author: Konrad Bork
Author: Luregn J. Schlapbach
Author: Deryle Lonsdale
Author: W. Michael Scheld
Author: Lee A. Fleisher
Author: World Health Organization
Author: Marc E. de Broe