Chronic illness needing palliative care in Kinshasa hospitals, Democratic Republic of the Congo (DRC).

Background: Chronic illnesses are a major public health problem in low-income countries. In the Democratic Republic of the Congo (DRC), few data are available, especially in palliative care. In this context, the present study aimed at describing the patterns of diseases in Kinshasa hospitals as well as risk factors associated with patients' evolving status and length of hospital stay.

[Geriatric day hospital: what evidence? A systematic review].

A systematic review of the international literature concerning the organisation of the Geriatric Day Hospital (GDH) was performed. From 1987 till now, few papers were found describing the activity and the effectiveness of the GDH. All the studies comparing specific geriatric approaches to regular medicine demonstrate the efficiency of geriatric care, particularly the geriatric assessment.

The Belgian geriatric day hospitals as part of a care program for the geriatric patient: first results of the implementation at the national level.

Purpose: In order to deliver individual, specialized and multidisciplinary care for older people, the Belgian national health authorities developed the care program for the geriatric patient. In that context, 48 geriatric day hospitals (GDHs) have been financed by the government since January 1st 2006. The main objective of this study is to describe the patient characteristics, facility features and activities related to the Belgian GDHs.

Assessing the causes inducing lengthening of hospital stays by means of the Appropriateness Evaluation Protocol.

Objectives: The objective is to evaluate the use of the Appropriateness Evaluation Protocol (AEP) as a screening tool for determining the causes of the non-justified days to help hospitals to decrease the length of stay while preserving the quality of care.

Methods: Three successive cross-sectional surveys were conducted from 2003 till 2005, in 23 Belgian hospitals. During this period, 10921 days were audited by means of the AEP.

Development and validation of nursing resource weights for the Belgian Nursing Minimum Dataset in general hospitals: a Delphi questionnaire survey approach.

Background: Internationally, nursing is not well represented in hospital financing systems. In Belgium a nursing weight system exists to adjust budget allocation for differences in nurse staffing requirements, but there is a need for revision. Arguments include the availability of a nursing minimum dataset and the adverse consequences of the current historically based nursing weight system.

Revision of the Belgian Nursing Minimum Dataset: From data to information.

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liège to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases.

Age- and sex-stratified prevalence of physical disabilities and handicap in the general population.

Background And Aims: Our aim was to provide age- and sex-stratified prevalence estimates of physical disabilities and handicap in the general Belgian population.

Methods: A cross-sectional and demographically representative health interview survey was conducted nationwide in Belgium in 1997. The 8836 persons aged 15 years and over who answered the health interview were included in this study.

Cardiac risk assessment before vascular surgery: a prospective study comparing clinical evaluation, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy.

Preoperative evaluation for cardiac risk assessment before peripheral vascular surgery remains controversial. Between January and June 1994, a prospective open study was carried out in 156 patients scheduled for elective vascular procedures (63 carotid endarterectomies, 34 abdominal aortic aneurysms, 29 aortoiliac and 30 infrainguinal reconstructions) to compare the ability of clinical data, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy to predict postoperative cardiac events. Pharmacological stress testing consisted of incremental dobutamine infusion (+/-1 mg atropine to achieve 85% of age-predicted maximal heart rate, with continuous echocardiographic monitoring, and injection of Tc-99m sestamibi after dobutamine infusion).

Kinking of the internal carotid artery: clinical significance and surgical management.

The authors report on 62 surgical corrections for kinking of the internal carotid artery during a 13-year period (1980-1993). This represents 2.8% of all carotid operative procedures (n = 2188) in the same period.

Hemostatic effects of two oral contraceptives containing low doses of ethinyl estradiol and either gestodene or norgestimate: an open, randomized, parallel-group study.

Objective: To determine effects on blood clotting of two modern low-dose monophasic oral contraceptives.

Subjects And Methods: We measured in vivo markers of intravascular coagulatory and fibrinolytic activity in 40 volunteers randomly assigned to one of two low-dose oral contraceptives (OCs) for 6 months; one contained 35 micrograms of ethinyl estradiol (EE) plus 250 micrograms of norgestimate and the other, 30 micrograms of EE plus 75 micrograms of gestodene.

Results: Both formulations increased coagulatory as well as fibrinolytic activity over baseline: circulating reactive products of thrombin increased by 40%, and plasmin activity by 60%, after 3 months of treatment.

Variations of luteinizing hormone serum concentrations after exogenous human chorionic gonadotropin administration during ovarian hyperstimulation.

Changes in luteinizing hormone (LH), estradiol, and progesterone (P) serum levels before and after preovulatory administration of human chorionic gonadotropin (hCG) were assayed in 30 patients stimulated with clomiphene citrate (CC) and human menopausal gonadotropin (hMG) and compared with LH variations in 43 patients submitted to pharmacological hypophysectomy with a gonadotropin-releasing hormone agonist (GnRH-a) and stimulation with hMG. In CC + hMG-treated patients, an endogenous LH surge occurred systematically 4.25 +/- 2.

Hemostasis profile in women taking low-dose oral contraceptives.

Thirty-six young, healthy, nonsmoking women have been selected to check the effect of low-dose oral contraceptives on hemostasis. Two identical groups were treated by Marvelon (a monophasic oral contraceptive containing ethinyl estradiol and desogestrel) or Trigynon (a triphasic oral contraceptive containing ethinyl estradiol and levonorgestrel) for a 6-month period. In the absence, previously controlled, of substantial differences between the effects of each treatment on hemostasis, all the results were pooled at the third and sixth month of the study.

[Male infertility and medically assisted procreation].

Three hundred thirty patients underwent in vitro fertilization in our centre since 1985. Fifty two percent of them presented an abnormal spermogram (sperm count less than or equal to 20 X 10/ml; mobility less than 40%; teratospermia greater than 60%). In those cases, lack of fertilization is statistically increased but pregnancy rate per transfer is similar to this observed with pure female cases.

Laminin and type III procollagen peptide in human preovulatory follicular fluid.

The levels of laminin P1 fragment, a marker of basement membrane, and of the aminoterminal sequence of type III procollagen, a marker of interstitial connective tissue, were measured in human preovulatory follicular fluids. The concentrations of these peptides correlated with progesterone levels but not with those of estradiol or testosterone. Immunocytochemical studies confirmed the remodeling of the perifollicular basement membrane and interstitial matrix during oocyte maturation.

Serum lipid and lipoprotein changes induced by new oral contraceptives containing ethinylestradiol plus levonorgestrel or desogestrel.

Changes in serum lipid and lipoprotein levels were evaluated in a randomized prospective study conducted in matched healthy young women before and after 6 months' use of three oral contraceptives (OCs): Trigynon (preparation A, n = 13), a triphasic OC containing low doses of ethinylestradiol (EE) and levonorgestrel (LNG); Marvelon (preparation B, n = 14), a monophasic OC containing low doses of EE + Desogestrel (DOG, a new progestogen derived from LNG); and Ovidol (preparation C, n = 11), a sequential OC containing higher doses (50 micrograms) of EE + DOG. After 6 months of use, total triglyceride levels were non-significantly increased by preparations A (+ 29% from basal values) and B (+21%), and very significantly increased by preparation C (+90%). Total cholesterol and phospholipids were unchanged by preparations A and B, whereas phospholipids were significantly increased by preparation C.

Ovarian function is effectively inhibited by a low-dose triphasic oral contraceptive containing ethinylestradiol and levonorgestrel.

For various metabolic and clinical reasons, it has been strongly advocated to reduce the dose of both the estrogen and progestogen components of oral contraceptives (OCs). In this study, we compared after 6 months of treatment, the action on various hormonal parameters of a standard-dose combined OC containing ethinylestradiol (EE) 0.050 mg and levonorgestrel (LNg) 0.

Plasma hormone levels in women receiving new oral contraceptives containing ethinyl estradiol plus levonorgestrel or desogestrel.

The changes in plasma hormone levels were evaluated in matched healthy female volunteers investigated before and after 6 months' use of three new oral contraceptives (OCs): TrigynonR (n = 13), a triphasic OC containing low doses of ethinylestradiol (EE) + levonorgestrel (LNg); MarvelonR (n = 14), a monophasic OC containing low doses of EE + desogestrel (DOG, a new progestogen derived from LNg); and OvidolR (n = 10), a sequential OC containing higher doses (50 micrograms) of EE + DOG. Serum levels of FSH, LH, estradiol and progesterone were decreased in all cases to levels incompatible with ovulation. Prolactin concentrations were unchanged.