Diagnostic et Soins Primaires des Patients infectes au VIH Symposia (French) given at Hôpital Sacré Coeur in Milot, Haiti, 2011.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Cours soins infirmiers en chirurgie (3éme partie)SANAA TOUZAMI
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Cette partie comporte la prise en charge infirmière devant quelques pathologies chirurgicales
Toxidermie à la métformine: à propos d’un cas Drug eruption associated with m...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Cours soins infirmiers en chirurgie (3éme partie)SANAA TOUZAMI
Cours enseigné et élaboré par TOUZAMI Sanaa (Enseignante permanente à l'ISPITS de Settat)
Cette partie comporte la prise en charge infirmière devant quelques pathologies chirurgicales
Toxidermie à la métformine: à propos d’un cas Drug eruption associated with m...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
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Primo-infection et tests rapides - François Simon - Rencontre du Crips/Vih.orgVih.org
Cette présentation a eu lieu dans le cadre de la Rencontre du Crips, organisée avec Vih.org : «La primo-infection VIH : Actualités 2009 et impact sur la prévention».
Syndrome de lyse tumoral Dr Mouad Boutadghart NaciriMouad Boutadghart
En médecine (oncologie et hématologie), le syndrome de lyse tumorale désigne l'ensemble des complications métaboliques observées dans certaines pathologies néoplasiques avec une masse tumorale volumineuse. Ces complications sont provoquées par la destruction massive des cellules cancéreuses et se manifestent par une hyperkaliémie, une hyperphosphatémie, une hyperuricémie et une hyperuricosurie, une hypocalcémie, et une insuffisance rénale aiguë (néphropathie uratique / acidosurique aigüe, nécrose tubulaire aigüe).
Memorias Conferencia Científica Anual sobre Síndrome Metabólico 2016 - Programa Científico
Aspectos clínicos y terapéuticos de la neuropatía vegetativa
y las otras neuropatías periféricas en el paciente con diabetes
Pr. Dr. Henri Gin
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HYPERTENSION ARTERIELLE: EVALUATION ET PRISE EN CHARGE Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
The Burden of Diabetes in Haiti (French) - The CRUDEM FoundationThe CRUDEM Foundation
The Burden of Diabetes in Haiti (French) Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Diabetes and the Eye (French) Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Care of Diabetic Patients in a Hospital Setting Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Care of Diabetic Patients in a Hospital Setting (French) Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Malaria in Haiti Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Tetanus in Haiti Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Care of the Patient with Diabetes in Haiti (French) Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Outpatient Diabetes Education - Haiti presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Outpatient Diabetes Education (French) - Haiti presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Nutrition Presentation - Diabetes Symposium - Haiti presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Nutrition Presentation - Diabetes Symposium - Haiti (French) presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Neuropathy and Foot Exam - Diabetes Symposia presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Neuropathy and Foot Exam - Diabetes Symposia (French) presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Care of the Patient with Diabetes in Haiti Symposia - The CRUDEM FoundationThe CRUDEM Foundation
Care of the Patient with Diabetes in Haiti Symposia, presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Diabetes in Pregnancy (French) Symposia - The CRUDEM FoundationThe CRUDEM Foundation
Diabetes in Pregnancy Symposia (French) presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Heart Failure in Haiti (French) Symposia - The CRUDEM FoundationThe CRUDEM Foundation
Heart Failure in Haiti (French) Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Diabetic Complications in Haiti Symposia presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Diabetic Crises in Haiti Symposia presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Pediatric Diabetes Symposia presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Basic EKG and Rhythm Interpretation Symposia presented at Hôpital Sacré Coeur in Milot, Haiti.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Joignez-vous aux lauréates 2024 des Bourses d’application des connaissances pour étudiants du Centre de collaboration nationale en santé publique (CCNMO) afin de prendre directement connaissance de leurs travaux essentiels permettant de combler l’écart entre la recherche et la pratique. Ces étudiantes et ces nouvelles diplômées dirigent des stratégies d’application des connaissances novatrices. Cette séance souligne leur excellence scolaire et met de l’avant des stratégies uniques et transférables pour s’attaquer aux priorités actuelles en matière de santé publique.
Hannah Bayne, Université de l’Alberta – Supporting tomorrow’s stewards: A knowledge mobilization project for climate-health literacy in Alberta elementary schools [Soutenir les intendants et intendantes de demain : un projet de mobilisation des connaissances en faveur de la littératie climat-santé dans les écoles primaires de l’Alberta]
Miranda Field, Université de Regina – Decolonized theory of place [La théorie du lieu décolonisée]
Jordan Chin, Université McMaster – The art of creation: An arts-based knowledge translation method to promote and advocate for a healthy start to life [L’art de la création : une méthode d’application des connaissances fondée sur les arts pour promouvoir et défendre un bon départ en santé]
Diagnostic et Soins Primaires des Patients infectes au VIH Symposia - The CRUDEM Foundation
1. Diagnos(c
et
Soins
Primaires
des
Pa(ents
infectes
au
VIH
Nephtalie
R.
MESIDOR,
MD
Universite
Notre
Dame
d’Hai2
Programme
Post-‐Gradue
de
Forma2on
en
Maladies
Infectueuses
2. Diagnos(c
de
l’Infec(on
a
VIH
• Depistage
du
HIV
1:
– Tests
serologiques
(rapides)
• ConfirmaAon:
– 2eme
Test
rapide
– Western
Blot
ou
Indirect
ImmunoFluorecence
Assay
3. Primo-‐Infec(on
HIV:
Frequence
des
Signes
et
symptomes
associes
Signes et Symptomes Frequence (%)
Fievre 96
Cephalee 32
Lymphadenopathie 74
Nausee / vomissement 27
Pharyngite 70
Hepatosplenomegalie 14
Rash 70
Perte de poids 13
Myalgie ou arthralgie 54
Muguet 12
Diarrhee 32
Signes neurologiques 12
Ulceres orales ou genitales 5-20
5. Depistage
du
Degre
d’Exposi2on
• A
chaque
visite,
rechercher:
– Comportements
a
haut
risque
(habitudes
sexuelles)
– Symptomes
d’IST
6. Evalua(on
Ini(ale
Elements
Importants
• Interrogatoire
et
Examen
Physique
• EvaluaAon
Psychosociale
• Examens
de
Laboratoire
• EvaluaAon
de
l’eligibilite
au
Traitement
7. BILAN BIOLOGIQUE INITIAL DU PVVIH
Hemogramme Complet
CD4 et
- Charge Virale
- Genotype HIV
Ionogramme, Bilan Renal, Bilan Hepatique, Bilan lipidique, G6PD
RPR ou VDRL
PPD
Serologie des Hepatites A, B et C
Considerer:
- erologie pour Toxoplasmose, CMV, VZV
S
- HLA-B 5701
- Radiographie de base
8. Associa8on
entre
le
compte
absolu
de
CD4
et
le
risque
pour
les
infec8ons
opportunistes
9. Determiner
l’Eligibilite
au
Traitement
• Severite
des
Symptomes
• Severite
de
l’Immunosuppression
• Degre
de
preparaAon
/
d’engagement
du
PaAent
• Autres
ConsideraAons
psychosiales
29. Protocole
Hai(en
2010:
ARVs
• 1ere
Lignee
– TDF
+
3TC
ou
FTC
+
EFV
ou
NVP
– AZT
+
3TC
ou
FTC
+
EFV
ou
NVP
30. Visites
de
Suivi
• EvaluaAon
de
Toxicite
Medicamenteuse
• EvaluaAon
de
l’Adherence,
Counseling
• EvaluaAon
de
la
reponse
au
traitement
• Rechercher
l’appariAon
de
nouvelles
InfecAons
Opportunistes
31. Effets
Secondaires
des
ARVs
Agent Effets secondaires particuliers a Effets secondaires
l’agent communs a la Classe de
Medicament
Inhibiteurs Nucleosidiques et Nucleotidiques de laTranscriptase Inverse
Zidovudine (AZT, ZDV) Anemie, Neutropenie, Myopathie Acidose Lactique avec
Steatose hepatique (srt D4T)
Lipodystrophie
Didanosine (ddI) Neuropathie peripherique, Pancreatite
Zalcitabine (ddC) Neuropathie peripherique
Stavudine (D4T) Neuropathie peripherique
Lamivudine (3TC) Minime
Abacavir (ABC) Reaction d’Hypersensibilite
Tenofovir (TDF) Syndrome de Fanconi
Inhibiteurs non Nucleosidique de la Transcriptase Inverse
Nevirapine (NVP) Hepatite Rash
Delavirdine Rash
Efavirenz (EFV) Symptomes du SNC
32. Inhibiteurs de la Protease
Agent Effets secondaires particuliers a Effets secondaires communs a
l’agent la Classe de Medicament
Indinavir Nephrolithiase, Lipodystrophie, Symptomes
Hyperbilirubinemie non conjuguee digestifs, Hyperglycemie,
anomalies lipidiques
Ritonavir Symptomes
diges2fs,
hepatotoxicite
Hyperglycemie
resistante
a
l’insulin,
anomalies lipidiques
Lopinavir-ritonavir Diarrhee,
eleva2on
des
Resitance
a
l’insulin,
transaminases
anomalies lipidiques
Atazanavir Hyperbilirubinemie non conjuguee
Darunavir Rash,
Hepatotoxicite
Inhibiteurs de Fusion
Enfurvitide Reac2on
au
site
d’injec2on
Inhibiteurs de l’Integrase
Raltegravir minime
Inhibiteur de CCR5
Maraviroc Symptomes
diges2fs,
hypotension
33. Monitoring
Paraclinique
Tests
de
2
semaines
1
mois
2
mois
3
mois
6
mois
1
an
Base
CD4
CD4
CD4
Hgm
Hb
si
sous
sous
sous
AZT
sous
AZT
sous
AZT
AZT
AZT
Glucose
a
Apres
ini2a2on
Chez
les
Tous
jeun
ARV
diabe2ques
Bilan
Si
Grossesse
Sous
NVP
Sous
Sous
NVP
Tous
Hepa8que
sous
NVP
ou
NVP
si
CD4>
250
Bilan
Renal
Sous
TDF
Sous
TDF
Tous
Bilan
Apres
ini2a2on
Tous
lipidique
ARV
RPR
Tous
PPD
Tous
34. Screening
de
Rou8ne
chez
le
PVVIH
• Hommes
– TR,
PSA
• >
50
ans
– Colonoscopie
,
Densitometrie
Osseuse
• Quelque
soit
la
tranche
d’age
– Tes2ng
Gonorrhee
-‐
Chlamydia
– Examen
Ophtalmologique
– Screening
de
la
Depression
35. Considera(ons
Speciales
pour
les
Femmes
• Soins
preconcepAonnels
et
familiaux
• Test
de
Grossesse
• Depistage
du
Cancer
du
Col
• Depistage
du
Cancer
du
Sein
• Menopause
36. Considera(ons
Speciales
:
PTME
et
Enfants
• Gestantes
infectees
au
VIH
– Recommanda2on:
ARVs
!!!
• Enfants
exposes
in
utero
– Prophylaxie
post-‐exposi2on
au
HIV
– Test
Virologique
37. Soins
Preven(fs
• Prophylaxie
au
Cotrim
• Prophylaxie
pour
MAC
• Prophylaxie
a
l’INH
• VaccinaAon
38. Cas
de
PCP
en
RelaAon
au
compte
absolu
de
CD4
recent
Kovacs J and Masur H. N Engl J Med 2000;342:1416-1429
39. • ReducAons
des
cas
de
pneumonie/pathologies
respiratoires,
de
diarrhee
(isospora),
et
de
malaria
1 Lancet 1999; 353: 1463–68
2 Lancet 1999; 353: 1469 – 75
40. Prophylaxis
au
Co-‐Trimoxazole
• Protocole
HaiAen
(2010)
– TMS
a
vie
pour
tous
les
PVVIH
• 480
mg
/
jr
• Independamment
du
taux
de
CD4
41. Mul8vitamines
• Peut
avoir
un
certain
effet
dans
certains
groupes
– Femmes
enceintes
– TB
• Insister
sur
apport
alimentaire
adequat
• Certaine
uAlite
dans
la
preparaAon
au
traitement
42. Preven8on
de
Pathologie
Specifique
:
Prophylaxie
pour
MAC
• Mycobacterium
avium
complex
– Ubiquitaire
dans
l’environnement
– Prevalence
incertaine
en
Hai2
– CD4<50
• Azithromycin
ou
clarithromycin
• Con2nuer
jusqu’a
un
taux
de
CD4
maintenu
>100
43. Preven8on
de
Pathologie
Specifique
:
Prophylaxie
de
Cryptococcose
• Prospec2ve
controlled
trials
– Prophylaxie
aux
azoles
reduit
la
frequence
de
l’infec2on
primaire
quand
le
CD4<50
• Prophylaxie
primaire
Non
recommandee
• Prophylaxis
Secondaire
– Fluconazole
200
mg
OD
jusqu’a
ce
que
CD4>200
pendant
6
mois
44. Preven8on
de
Pathologie
Specifique
:
TB
Prophylaxie
• BCG
a
la
naissance
• Prophylaxie
a
l’INH
– 300mg
/
jr
pendant
au
moins
6
mois
pour
tous
les
PVVIH
dans
les
pays
ou
le
TB
est
endemique
(OMS
2010)
– y
compris
les
femmes
enceintes
– Combine
a
la
pyridoxine
(vitamin
B6)
25mg/jr
– Toujours
eliminer
une
TB
ac2ve
au
prealable
45. Vaccins
de
Rou8ne
des
PVVIH
• Tous:
– Vaccin
contre
la
Grippe
• Groupes
a
risque
– Vaccin
contre
Haemophilus
influenzae
type
B
• Pa2ents
asplenic
et
recurrence
infec2on:
– Vaccin
contre
HepaAte
A,
B;
Tetanos
Toxoid:
• Professionnels
de
sante…
– Vaccin
contre
HPV
• Jeune
Fille
Non
sexuellement
ac2ve
(
9
–
26
ans):
– Vaccin
contre
Varicelle,
Pneumococcal
• CD4>
200