Recent Articles

INTRODUCTION: The gaol of this work was to determine the hemodialysis’ prevalence in emergency situations, indications, clinical, paraclinical, evolutionary and patient future. PATIENTS AND METHODS: It was a prospective monocentric descriptive and analytical study over a period of one year (01 March 2018 to 30 April 2019) carried out at the regional hospital of Thiès. Was included all patients with acute or chronic renal failure who were under emergency hemodialysis sessions. RESULTS: Out of 263 patients, 107 patients underwent emergency hemodialysis with a prevalence of 40.68%. The average age of our patients was 46.39 ± 17.13 years and the sex ratio was 1.05. The main indications for emergency hemodialysis were poorly tolerated uremia in 54 patients (50.47%) followed by hyperkalemia in 43 patients (40.19%). Chronic renal failure (CRF) was the most noted type of renal disease in 74 patients (69.15%) with nephroangiosclerosis as the primary cause (25.2%). Acute renal failure (ARF) was found in 33 patients (38.85%) with acute tubular necrosis (10.8%) as the main etiology. The most frequently used approach was the femoral route in 87 patients (81.3%). Nineteen patients (17.8%) died including 13 patients outside dialysis and 6 patients on dialysis. CONCLUSION: In Senegal, patients are seen most often in the late stages and the inaccessibility to treatment of extra-renal treatment make that the hemodialysis is most often started in a context of urgency.

Nowadays, the Internet is developing rapidly, while in the context of the mobile Internet Making photos to make money, a kind of self-service service mode currently has the problem of unreasonable task pricing, which leads to the failure of commodity inspection. Hence, in order to solve the problem, on the basis of a set of completed project task data and the whole registered member information provided by the company, we set up Multiple regression model and Bayesian equilibrium model by means of the mechanism analysis to determine models, big data statistical to determine parameters and considering the various factors that can affect the price of task. Not only can the models established in this paper greatly optimize the task pricing scheme, but also them do improve the task completion degree as much as possible and play a positive role in the efficiency of program operation under the premise that the total cost is basically unchanged.

Two recent articles in the American Psychologist (Vol 74, no. 7, 2019) on the Stanford Prison Experiment induced me to re-read Hannah Arendt’s The Human Condition (1958), On Totalitarianism (1973). and Eichmann in Jerusalem (Arendt and Kroh, 1964). This re-reading and reflection deepened my understanding of the value and role of social psychology and Arendt’s deep understanding of human speech and action as it relates to the Human Sciences and understanding our role in the social and political world. The review includes an experiment by Arthur Asch on “Opinion and social pressure” published in 1955 and then looks at Stanley Milgram’s experiment on obedience published in 1963. The review of these articles provides a context for looking at Philip Zimbardo’s Sanford Prison Experiment (1973) and a critique of that experiment which led to my re-reading Hannah Arendt. This article continues an exploration of my efforts (Morehouse, 2012; Morehouse, 2015; Morehouse et al, 2019) at integrating some elements of psychology and philosophy with the goal of deepening understanding of contemporary issues.

Background: Factor XII is part of the intrinsic pathway. the activity of this pathway is assessed by measuring the activated partial thromboplastin time (aPTT). Deficiency of Factor XII is rare, often inherited as autosomal recessive, nevertheless autosomal dominant pattern has also been reported. congenital deficiency is associated with mutations in the F12 gene on chromosome 5. Here we report a patient with factor XII deficiency which is considered as a rare inherited coagulation disorder. Case report: we report the case of a 37 years old gentleman known to have Diabetes mellitus, hypertriglyceridemia, past history of pancreatitis and an episode of gingival bleeding a year prior to this presentation which was attributed to periodontitis. He presented to the emergency room complaining of epigastric pain radiating to the back as well as non-projectile vomiting. He used to drink alcohol but stopped 6 years ago. physical examination showed epigastric tenderness, poor dental hygiene and periodontitis. investigations showed neutrophilic leucocytosis, high lipase and raised triglycerides level of 11.3 mmol/L. He was treated successfully for triglycerides induced pancreatitis with IV insulin, Dextrose 5% infusion and fenofibrates. Isolated prolonged aPTT was detected incidentally which was corrected with mixing study indicating a factor deficiency. Factor assays revealed factor XII deficiency (5.8%) with other factors being within normal ranges. Past records did not show any thrombotic event. No specific treatment was given for Factor XII deficiency. Conclusion: Factor XII deficiency is associated with an isolated prolonged aPTT without increasing risk of bleeding. patients with this condition should be offered regular follow up because of the increased rate of thromboembolic complications.

Background: Combined factor V and factor VIII deficiency (F5F8D) is a rare autosomal recessive inherited coagulopathy. It has a higher prevalence in the Mediterranean region (1:100,000) compare to its prevalence in the general population which is estimated to be (1:1000,000). Case report: We report a 59 years old Lebanese lady who was referred from the general surgery clinic with an asymptomatic prolongation of prothrombin time (PT), international normalized ratio (INR) and activated partial thromboplastin time (aPTT) detected during preoperative work up for an elective umbilical hernia repair. The patient had history of bleeding following dental procedures since childhood as well as easy bruising with minimal trauma. Physical examination was unremarkable. haematological investigations were normal apart from the prolonged PT, INR and aPTT which were corrected following mixing studies. Factor assay revealed factor V level of 5.5% and factor VIII level of 11.9% with other factors within normal ranges confirming the diagnosis of combined F5F8D. Conclusion: Combined factor V and factor VIII deficiency should be suspected in patients with prolonged PT, INR and aPTT especially if they are of Mediterranean, Middle east or Arabic origin with a history of consanguineous marriages. Treatment is generally not indicated unless the patient has recurrent serious bleeding manifestations.

The phenomenon of workplace bullying is pervasive and exposure to bullying leads to long-term, systemic and individual negative impacts to targets of bullying and the organizations in which they work. Multiple studies confirm that workplace bullying is associated with psychological trauma and serious negative long-term outcomes for targets including mental health disorders and in extreme cases suicide. Emergency service organizations by design are hierarchical in nature, creating power structures that can lead to increased potential for bullying. The literature shows that first responders who work in emergency service organizations report rates of workplace bullying at upwards of 60% (six times the National average). The prevalence of workplace bullying amongst first responders, given their already high stress jobs, along with the long term negative impacts to a targets health, mental health and wellbeing are significant and constitute a serious crisis within the emergency services community.

“Internet Finance” is an organic combination of contemporary information, network technology and financial transactions. At the same time, it is also a new type of financial model. E-commerce has made a huge contribution to the development of Internet finance, providing massive amounts of customer data and e-commerce for the development of Internet finance. Platforms and Internet technologies, and Internet finance’s role in promoting e-commerce are also obvious. The development of Internet finance based on e-commerce in China has been rapid, and it has now become an important force in the financial industry, and has maintained a rapid development. Through analysis, this article proposes countermeasures for Internet finance development for e-commerce platforms.

Objective: To explore the demand of long-term care in China. Methods: First, based on the data collected from multiple channels, the number of disabled elderly in China and the long-term care demand were predicted by the macro simulation demand model and markovdo state transition model. The second is to compare and analyze the implementation plan of the long-term care insurance system in China’s pilot areas, discuss the existing problems, and put forward Suggestions. Results: From 2020 to 2050, the number of disabled elders in China will rise from 33813 700 to 60 535 700, and the total long-term care costs will rise from 6.73 billion yuan to 29.12 billion yuan. Conclusion: In the future, China should build a multi-level long-term care guarantee system, actively explore the long-term care insurance system, and improve the long-term care service supply system.

Introduction: Hemodialysis is a renal replacement technique that uses extracorporeal blood circulation (ECC) to purge the blood of patients with renal failure. It is used urgently in severe acute kidney injury (AKI) and complicated end stage renal disease (ESRD). The objective of this work was to determine the prevalence of each indication of emergency hemodialysis and its prognosis. Methods: We conducted a prospective, mono-centric study of descriptive and analytical type over a period of 6 months at the hemodialysis center of Aristide Le Dantec University Hospital. All patients with acute or chronic renal failure who underwent hemodialysis during an emergency were included. These emergencies were for the AKI or Chronic Kidney disease (CKD) the existence of one or more severity criteria: pulmonary œdema, hyperkalemia, severe metabolic acidosis, poorly tolerated uremia, persistent anuria and / or symptomatic hyponatraemia. Results: Eighty-one emergency hemodialysis patients were received during the study period out of a total of 660 hemodialysis patients serving a hospital prevalence of 12.2%. The mean age of the patients was 39.31 ± 18.78 years with a sex ratio of 1.02. The first indication of emergency hemodialysis was poorly tolerated uremia in 46 patients (56.7%) followed by threatening hyperkalemia with 43.2%. The evolution was highlighted by a complete recovery in 53% of patients with AKI whereas for patients with ESRD lifting the emergency was the rule. Fifteen patients (18.50%) had died, including 12 patients (14.80%) outside dialysis and 3 patients (3.75%) on dialysis. The occurrence of death was statistically correlated with hyperkalemia (p = 0.003) and metabolic acidosis (p = 0.001). Conclusion: Hemodialysis was performed urgently in 12.2% of cases. Poorly tolerated urine was the most common indication (56.7%). In the majority of cases we noted a good evolution with the emergency lifting. However we noted 15 deaths (18.5%).

Introduction: Alzheimer’s disease (AD) is a chronic degenerative disease that compromises the physical, mental and social integrity of the elderly, and therefore leads to an increasing dependence on care, and almost always linked to family dynamics and performed at home. Objectives: The main objective of this research is to analyze the daily lives of family caregivers of patients with AD. Methodology: The qualitative approach was used. Data were collected in the municipality of Tamandaré/PE, through semi-structured interviews with ten family caregivers of patients with Alzheimer’s disease. In addition to the interview, a structured questionnaire with closed-ended questions was applied, referring to the general and personal characteristics of each interviewee. For data analysis, the verbatim reports were fully transcribed, where relevant aspects were observed and organized into two categories: impact of diagnosis and challenges in caring. Results: The results showed that all coexistence and adaptation to this new reality modify the style and quality of life of those involved. The changes are significant and need to be understood and incorporated into the family routine. Negative emotional reactions involving impotence, fear and anger are common, besides a deep feeling of injustice. Conclusion: The study showed the need for assistance that includes all affected family members. The nurse should support and contribute to overcoming the difficulties faced from the moment of diagnosis to the most advanced stages of the disease.