Download or read book Comparaison du diagnostic chez une cohorte de patients adress s aux urgences par un m decin lib ral entre leur arriv e et leur sortie de la structure d urgences et facteurs ayant entra n cette volution written by Guillaume Chenel and published by . This book was released on 2010 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: @CONTEXTE : De nombreux patients sont admis aux urgences après un contact avec un médecin libéral, qui pose fréquemment un premier diagnostic. Il n'existe que peu d'études comparant le diagnostic posé par le médecin libéral, le médecin urgentiste et le médecin hospitalier. Nous avons également cherché à déterminer le rôle des examens complémentaires dans cette évolution et quels étaient ceux qui devaient être réalisés. METHODE : Etude rétrospective et descriptive des dossiers de patients admis aux urgences de l'hôpital de Saint Dizier après contact médical entre mai et novembre 2007. RESULTATS : L'étude a porté sur 221 patients. 43,43% étaient des hommes et 56,56% des femmes. 140 patients sur les 221 ont été adressés avec un diagnostic. Ce diagnostic a été confirmé dans 50,70% des cas et une concordance d’organe a été retrouvée dans 19,71% des cas. Aucun diagnostic n’a finalement été retenu dans 9,86% des cas. Dans les cas où aucun examen complémentaire n’a été réalisé, 74% des diagnostic étaient similaires. Les pathologies les plus représentées ont été la cardiologie (36%) et la gastro-entérologie (18%). Seulement 41 examens complémentaires ont été réalisés avant l’admission aux urgences. 91,4% des patients admis aux urgences ont bénéficié d’examens complémentaires. 20 patients n’ont eu qu’un examen complémentaire (9,05%), 45 en eu 2 (20,36%), 62 en ont eu 3 pour 60% des patients. Il sera confirmé chez 56% des patients hospitalisés et une concordance d’organe sera retrouvée dans 16% des cas. Nous avons pu définir quels sont les examens complémentaires à réaliser dans la structure d’urgence en fonction de la pathologie suspectée.
Download or read book Comparaison des parcours de soins entre les patients adress s par le m decin traitant en hospitalisation directe versus ceux adress s par les urgences sur la r hospitalisation written by Michaël Gaston and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : En France la population est vieillissante et cela s’accroit avec le temps. Cette population âgée nécessite une attention médicale particulière de par le concept de fragilité qu’elle introduit et le risque de décompensation de ses comorbidités. Cela a pour conséquence des passages aux urgences et des hospitalisations évitables et délétères pour le patient âgé fragile avec un risque de réhospitalisation accru. Des moyens tels que le mode d’hospitalisation en entrée direct plutôt que via le SAU sont mis en place pour une meilleure efficience de soin. L’objectif de notre travail est de comparer le taux de ré-hospitalsiation à 30 jours entre les patients de plus de 75 ans fragiles hospitalisés via la filière entrée direct versus la filière urgence. Matériel et méthode étude de cohorte rétrospective multicentrique au sein du CH Troyes et CH Chaumont sur l’année 2018 2019 des patients de plus de 75 ans. Résultats Sur 1018 patients appariés et aucunes différences significatives entre les deux cohortes. Il n’y a pas été retrouvé de différence sur le taux de réhospitaliation avec 143/1018 (14.0%) patients réhospitalisés à 30 jours pour les entrées directes contre 116/1018 (11,4%) patients réhospitalisés pour la filière urgence. Une différence significative est objectivée avec une diminution de la durée totale de séjour chez les patients hospitalisés via l’entrée directe montrant son caractère efficient sur l’organisation hospitalière. Le nombre de traitements et maladies totales entre l’entrée en hospitalisation et la sortie au sein de chaque cohorte et entre elles n’ont pas montré de différences significatives. En revanche avec un OR = 0.93 (0.87-0.98) (p = 0,01) l’hypoalbuminémie est relevé comme un facteur associé à la réhospitalisaion à 30 jours. Conclusion Le mode d’hospitalisation en entrée directe facilite l’organisation hospitalière mais il n’a pas été prouvé ici qu’il s’associe à un moindre risque de réhospitalsiation à 30 jours chez le patient âgé fragile. Dans la littérature il existe des facteurs de risque de réhospitalisation tel que la dénutrition que nous avons objectivé mais celui-ci est tardif et apparait quand le patient a quasiment épuisé ses réserves physiologiques. Il est nécessaire de rechercher avant ce stade avancé des critères de fragilité réversibles et traitables dès les prises en charge ambulatoires par le médecin généraliste. Les scores et grilles de dépistage telles que la grille SEGA sont des exemples de scores permettant aux acteurs de santé un langage commun et uniforme afin d’améliorer ce dépistage ambulatoire perfectible.
Download or read book Diff rences de prise en charge aux urgences entre les patients adress s par un m decin lib ral et les patients tout venant written by Sébastien Blanchard (médecin).) and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Le système de santé français est réputé l'un des meilleurs au monde. Pourtant celui-ci doit faire face à l'un de ses plus grands défis. La diminution prochaine du nombre de médecins généralistes, de par leur départ à la retraite, va accroître les disparités d'accès aux soins sur l'ensemble du territoire et plusieurs patients vont se retrouver sans médecin traitant. Face à la pénurie de cet accès aux soins, de nombreuses personnes utilisent les services d'urgences comme soins de premiers recours, augmentant le nombre de passages et avec eux le nombre de patients venant pour des motifs relevant de la médecine générale. Cependant les médecins libéraux (généralistes ou non) ont parfois besoin d'adresser un patient aux Urgences en fonction du contexte clinique. Il y a donc deux types de patients se présentant aux Urgences, ceux venant spontanément et ceux adressés par un médecin. L'objectif de cette étude est de déterminer s'il existe une différence de prise en charge et de gravité chez les patients se présentant par leur propre moyen aux Urgences, en fonction du fait qu'ils soient adressés par un médecin libéral ou non. Il s'agit d'une étude rétrospective descriptive, monocentrique, réalisée dans le service des Urgences de Hautepierre, aux Hôpitaux Universitaires de Strasbourg, qui s'est déroulée sur la semaine du 13 au 19 mai 2019. Au total, 443 dossiers ont été analysés. Nous observons parmi les patients se présentant spontanément aux Urgences, adressés par un médecin, qu'ils sont plus âgés et bénéficient de plus d'examens de biologie ainsi que de plus d'examens d'imagerie. De plus, ils sont plus souvent hospitalisés que les patients non adressés. Cependant, comme notre étude est monocentrique, sur le site de l'hôpital d'Hautepierre, certains motifs de consultation n'ont pas pu être étudiés, notamment les motifs cardio-vasculaires. En conclusion, le recours aux services d'accueil des Urgences par les médecins généralistes apparaît justifié et semble être un facteur prédictif d'hospitalisation. Mais il résulte parfois d'un défaut d'organisation et d'accessibilité au réseau de soins primaires. Une étude prospective incluant de pair les dossiers des patients se présentant aux Urgences du Nouvel Hôpital Civil et d'Hautepierre pourrait être une bonne suite à donner à notre travail.
Download or read book Africa Since 1935 written by Unesco. International Scientific Committee for the Drafting of a General History of Africa and published by Univ of California Press. This book was released on 1999 with total page 1076 pages. Available in PDF, EPUB and Kindle. Book excerpt: The hardcover edition of volume 8 was published in 1994. This paperback edition is the eighth and final volume to be published in the UNESCO General History of Africa. Volume 8 examines the period from 1935 to the present, and details the role of African states in the Second World War and the rise of postwar Africa. This is one of the most important books in the entire series, and as such, it is an unabridged paperback.
Download or read book Historical Dictionary of Iran written by John Henry Lorentz and published by Historical Dictionaries of Asia, Oceania, and the Middle East. This book was released on 2007 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides an overview of specific events, movements, people, political and social groups, places, trends, and chronology. Allows for considerable exploration of a number of historical and contemporary topics and issues. The modern period, defined as 1800-present, is covered extensively.
Download or read book The African Shore written by Rodrigo Rey Rosa and published by Yale University Press. This book was released on 2013-10-22 with total page 159 pages. Available in PDF, EPUB and Kindle. Book excerpt: Originally published as La Orilla Africana. F&G Editores.
Download or read book Historical Dictionary of Pakistan written by Shahid Javed Burki and published by . This book was released on 1999 with total page 472 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pakistan is unlike most other countries in the emerging world. It is one of the two nations – the other being the state of Israel – founded on the basis of religion. Although it was created to provide a homeland for the Muslim community of British India, in its original form it was able to accommodate only about half of the people of Islamic faith who lived in the subcontinent. Pakistan’s birth in 1947 resulted in one of the largest movements of people in human history when some 14 million people left their homes, with 8 million Muslims leaving India for what is now Pakistan and 6 million Hindus and Sikhs moving in the opposite direction. This was the first large-scale incidence of ethnic cleansing the world was to witness. --
Download or read book The Simone Weil Reader written by Simone Weil and published by . This book was released on 1977 with total page 584 pages. Available in PDF, EPUB and Kindle. Book excerpt: The immediate and guiding aim of this book is to introduce the contemporary reader to the work and thought of Simone Weil.
Download or read book Pr histoire africaine written by Colette Roubet and published by . This book was released on 1981 with total page 386 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Midsummer s Nightmare written by Garry Kilworth and published by Gateway. This book was released on 2011-09-29 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sherwood Forest, home of Oberon, Titania, Puck, Cobweb, Peaseblossom and the rest of the mob, has been whittled away by urban development. It's time to move on, the fairies decide. Sid, their captive, a kindly if gruff young car mechanic, teaches Titania to drive, and on Midsummer's Eve the party sets off in a battered and smelly old bus. They're bound for the New Forest, where they hope to be able to regenerate their magic. The fairies' journey is full of excitement. At a village fair, they show the morris dancers how to cut previously undreamt-of capers. Titania falls in love with a human baby and steals her from her pram, starting a nationwide search for the missing infant. The fairies then link up with a group of New Age travellers on their way to Stonehenge, who befriend them almost without question. Finally, a fight to the death between Titania and the terrifying and sadistic Morgan-le-Fey must take place before everyone can settle down into some form of harmony and peace.
Download or read book The Man With the Golden Torc written by Simon R. Green and published by Penguin. This book was released on 2007-06-05 with total page 406 pages. Available in PDF, EPUB and Kindle. Book excerpt: New York Times bestselling author Simon Green introduces a new kind of hero, one who fights the good fight against some very old foes in the first novel in the Secret Histories series. The name’s Bond. Shaman Bond. Actually, that's just his cover. His real name is Eddie Drood, but when your job includes a license to kick supernatural arse on a regular basis, you find your laughs where you can. For centuries, his family has been the secret guardian of Humanity, all that stands between all of you and all of the really nasty things that go bump in the night. As a Drood field agent he wore the golden torc, he killed monsters, and he protected the world. He loved his job. Right up to the point where his own family declared him rogue for no reason. Now, the only people who can help Eddie prove his innocence are the people he used to consider his enemies...
Download or read book The Dark Design written by Philip Jose Farmer and published by Tor Books. This book was released on 2010-06-08 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: A New York Times bestsesller, The Dark Design is the third novel in Hugo and Nebula award-winning science fiction legend Philip José Farmer's Riverworld series. Milton Firebrass, once Mark Twain's enemy and now his greatest ally, plans to build a giant airship that can fly to the North Pole of Riverworld. Once there, he hopes to learn the secret of the mysterious tower that dominates the landscape and find the answer to his most urgent question: could the tower contain the Ethicals, the enigmatic beings that created Riverworld? Meanwhile, Jill Gulbirra is challenged for the job of piloting the airship by none other than Cyrano de Bergerac. As if there were not enough challenges facing the crew, they soon suspect there is an agent of the Ethicals among their number, plotting their destruction.... At the Publisher's request, this title is being sold without Digital Rights Management Software (DRM) applied.
Download or read book Sweet Silver Blues written by Glen Cook and published by Penguin. This book was released on 1990-05-01 with total page 324 pages. Available in PDF, EPUB and Kindle. Book excerpt: It should have been a simple job. But for Garrett, a human detective in a world of gnomes, tracking down the woman to whom his dead pal Danny left a fortune in silver is no slight task. Even with the aid of Morley, the toughest half-elf around, Garrett isn't sure he'll make it out alive from a land where magic can be murder, the dead still talk, and vampires are always hungry for human blood.
Download or read book Shovel Ready written by Adam Sternbergh and published by Broadway Books. This book was released on 2014 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the dirty bomb hit Times Square and the city became a shell of itself, Spademan has become a hitman, not a garbage man. But when he's hired to kill the daughter of a powerful evangelist, his unadorned street life is upended.
Download or read book The Outlaws written by Ernst Von Salomon and published by Arktos. This book was released on 2013 with total page 436 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is November 1918. Germany has just surrendered after four years of the most savage warfare in history. It is teetering on the brink of total social and economic collapse, and the German people now lie at the mercy of new, liberal politicians who despise everything Germany once stood for. The Communists are rioting in the streets, threatening to topple the new government in Weimar and bring about their own revolution. The frontline soldiers are returning from the hell of the war to find an unrecognizable land, the principles and traditions they had sacrificed so much to defend now the stuff of mockery. The narrator of The Outlaws, a 16-year-old military cadet, is too young to have served in the trenches, but feels the sting of this betrayal no less than they. Since Germany's armies have been all but disbanded, he joins the paramilitary Freikorps - groups of veterans who refuse to lay down their arms, and who have pledged to stop the Communists - and begins fighting, first in the streets of Germany's cities, and then in the Baltic states, defending Germany's eastern frontiers from Communist subversion while ignoring the calls to disengage by the meek politicians at home. After months of intense fighting abroad, the Freikorps soldiers return to settle scores with their enemies in Germany, dreaming of a nationalist counter-revolution, and, their trigger fingers still itchy, fix their sights on bringing down the hated new government once and for all... The Outlaws is a chronicle of the experiences of the men who fought in the Freikorps, but it is also an adventure and a war story about an entire generation of soldiers who loved their homeland more than peace and comfort, and who refused to accept defeat at any price. "What we wanted we did not know; but what we knew we did not want. To force a way through the prisoning wall of the world, to march over burning fields, to stamp over ruins and scattered ashes, to dash recklessly through wild forests, over blasted heaths, to push, conquer, eat our way through towards the East, to the white, hot, dark, cold land that stretched between ourselves and Asia - was that what we wanted? I do not know whether that was our desire, but that was what we did. And the search for reasons why was lost in the tumult of continuous fighting." - p. 65 Ernst von Salomon (1902-1972) was one of the writers of the German Conservative Revolution of the 1920s. Like the narrator of The Outlaws, he was a military cadet at the end of the First World War, and joined the Freikorps, participating in many of the events described in the book, including the assassination of Foreign Minister Walther Rathenau, for which he was imprisoned. He went on to write many books and film scripts.
Download or read book Intergenerational Solidarity written by European Foundation for the Improvement of Living and Working Conditions and published by Strange Chemistry. This book was released on 2012 with total page 23 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Psychology of Socialism written by Gustave Le Bon and published by . This book was released on 1899 with total page 438 pages. Available in PDF, EPUB and Kindle. Book excerpt:
