scholarly journals COVID-19 Pandemic: Perspective From Italian Pediatric Emergency Physicians

2020 ◽  
Vol 14 (5) ◽  
pp. 648-651
Author(s):  
Alice Monzani ◽  
Luca Ragazzoni ◽  
Francesco Della Corte ◽  
Ivana Rabbone ◽  
Jeffrey M. Franc
Keyword(s):  
Physical Examination ◽  
Lived Experience ◽  
Structured Interview ◽  
Pediatric Emergency ◽  
University Hospital ◽  
Clinical Approach ◽  
Emergency Physicians ◽  
Essential Interventions ◽  
Number Of Patients ◽  
Self Protection

ABSTRACTObjectives:To document the lived experience of Italian pediatric emergency physicians during the coronavirus disease 2019 (COVID-19) pandemic.Methods:We developed a structured interview to collect the lived experience of the staff of the pediatric emergency department (PED) of a tertiary referral university hospital in Northern Italy. The open-ended questions were draft according to the suggestions of Canadian colleagues and administered by 1 interviewer, who was part of the PED staff, at the end of March 2020. All the PED staff was interviewed, on a voluntary basis, using purposive sampling.Results:Most respondents declared to be afraid of becoming infected and of infecting their families. The number of patients seen in the PED has decreased, and the cases tend to be more severe. A shift in the clinical approach to the ill child has occurred, the physical examination is problem-oriented, aiming to avoid un-necessary maneuvers and to minimize the number of practitioners involved. The most challenging aspects reported are: (1) performing a physical examination in personal protective equipment (PPE), (2) being updated with rapidly evolving guidelines, and (3) staying focused on the possible COVID-19 clinical presentation without failing in differential diagnosis.Conclusions:During the COVID-19 pandemic, it seems that pediatric emergency physicians are radically changing their clinical practice, aiming at prioritizing essential interventions and maneuvers and self-protection.

scholarly journals Familiares e representações do medo e sofrimento emocional da criança na emergência: reeducação colaborativa no cuidado

2021 ◽  
Vol 2 (6) ◽  
pp. 1530-1549
Author(s):  
Silvia Helena Oliveira Da Cunha ◽  
Eliane Ramos Pereira ◽  
Rose Mary Costa Rosa Andrade Silva ◽  
Renata Carla Nencetti Pereira Rocha
Keyword(s):  
Positive Reinforcement ◽  
Emotional Health ◽  
Participant Observation ◽  
Social Representations ◽  
Child Death ◽  
Structured Interview ◽  
Pediatric Emergency ◽  
University Hospital ◽  
The Family ◽  
Culture Of Fear

Problema: Relações entre família e criança hospitalizada no contexto da emergência, reforçam frequentemente a cultura do medo por meio de condutas que a amedrontam demasiadamente, especialmente quando submetidas aos procedimentos dolorosos. Objetivos: analisar representações sociais da família acerca do sofrimento da criança na emergência; identificar a cultura do medo no contexto das representações da família e implicações; elaborar cartilha aos familiares como ferramenta facilitadora na minimização do estresse psicológico da criança. Método: Estudo descritivo, abordagem qualitativa, pautada na Teoria das Representações Sociais, utilizou-se técnicas de evocação livre, entrevista semiestruturada e observação participante. Os dados foram submetidos à análise de Bardin e classificados em cinco categorias: 1) profissionais de saúde; 2) objetos estranhos; 3) evento indesejável; 4) bactéria e infecção hospitalares e 5) medo da morte da criança. O estudo realizado na emergência pediátrica de um hospital universitário no município de Niterói/RJ e cujos sujeitos foram os familiares que acompanharam as crianças hospitalizadas. Conclusão: Percebe-se no cotidiano da emergência, que crianças sofrem dor emocional, antes da dor física, visto que medo excessivo da criança é culturalmente incentivado e aceito pelas famílias. Desconstruí-lo com educação e reforço positivo é eficaz ferramenta estratégica de promoção da saúde emocional ao binômio criança-família.   Problem: Relationships between hospitalized family and child in the emergency context often reinforce the culture of fear through behaviors that frighten her too much, especially when subjected to painful procedures. Objectives: to analyze social representations of the family about the suffering of the child in the emergency; Identify the culture of fear in the context of family representations and implications; To elaborate a booklet for the family as a facilitating tool in minimizing the psychological stress of the child. Method: Descriptive study, qualitative approach, based on Social Representations Theory, we used free evocation techniques, semi-structured interview and participant observation. The data were submitted to the analysis of Bardin and classified into five categories: 1) health professionals; 2) foreign objects; 3) undesirable event; 4) hospital bacterium and infection; and 5) fear of child death. The study carried out in the pediatric emergency of a university hospital in the city of Niterói / RJ and whose subjects were the relatives who accompanied the hospitalized children. Conclusion: It is noticed in the daily emergency that children suffer emotional pain, before physical pain, since excessive fear of the child is culturally encouraged and accepted by families. Deconstructing it with education and positive reinforcement is an effective strategic tool for promoting emotional health to the binomial child-family.

Clinical approach to the patient with acute kidney injury

2018 ◽  
Author(s):  
Norbert Lameire ◽  
Raymond Vanholder ◽  
Wim Van Biesen
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Urinary Tract ◽  
Physical Examination ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Clinical Approach ◽  
Volume Depletion ◽  
Number Of Patients ◽  
Fractional Excretion Of Sodium

The prognosis of acute kidney injury (AKI) depends on early diagnosis and therapy. A multitude of causes are classified according to their origin as prerenal, intrinsic (intrarenal), and post-renal.Prerenal AKI means a loss of renal function despite intact nephrons, for example, because of volume depletion and/or hypotension.There is a broad spectrum of intrinsic causes of AKI including acute tubular necrosis (ATN), interstitial nephritis, glomerulonephritis, and vasculitis. Evaluation includes careful review of the patient’s history, physical examination, urinalysis, selected urine chemistries, imaging of the urinary tree, and eventual kidney biopsy. The history should focus on the tempo of loss of function (if known), associated systemic diseases, and symptoms related to the urinary tract (especially those that suggest obstruction). In addition, a review of the medications looking for potentially nephrotoxic drugs is essential. The physical examination is directed towards the identification of findings of a systemic disease and a detailed assessment of the patient’s haemodynamic status. This latter goal may require invasive monitoring, especially in the oliguric patient with conflicting clinical findings, where the physical examination has limited accuracy.Excluding urinary tract obstruction is necessary in all cases and may be established easily by renal ultrasound.Distinction between the two most common causes of AKI (prerenal AKI and ATN) is sometimes difficult, especially because the clinical examination is often misleading in the setting of mild volume depletion or overload. Urinary chemistries, like calculation of the fractional excretion of sodium (FENa), may be used to help in this distinction. In contrast to FENa, the fractional excretion of urea has the advantage of being rather independent of diuretic therapy. Response to fluid repletion is still regarded as the gold standard in the differentiation between prerenal and intrinsic AKI. Return of renal function to baseline or resuming of diuresis within 24 to 72 hours is considered to indicate ‘transient, mostly prerenal AKI’, whereas persistent renal failure usually indicates intrinsic disease. Transient AKI may, however, also occur in short-lived ATN. Furthermore, rapid fluid application is contraindicated in a substantial number of patients, such as those with congestive heart failure.‘Muddy brown’ casts and/or tubular epithelial cell casts in the urine sediment are typically seen in patients with ATN. Their presence is an important tool in the distinction between ATN and prerenal AKI, which is characterized by a normal sediment, or by occasional hyaline casts. There is a possible role for new serum and/or urinary biomarkers in the diagnosis and prognosis of the patient with AKI, including the differential diagnosis between pre-renal AKI and ATN. Further studies are needed before their routine determination can be recommended.When a diagnosis cannot be made with reasonable certainty through this evaluation, renal biopsy should be considered; when intrarenal causes such as crescentic glomerulonephritis or vasculitis are suspected, immediate biopsy to avoid delay in the initiation of therapy is mandatory.

scholarly journals “Guboow”—child abuse or traditional medical treatment? a case report

2021 ◽  
Author(s):  
N. Lange-Herr ◽  
A. Rindlisbacher ◽  
F. Romano ◽  
C. Jackowski
Keyword(s):  
Medical Treatment ◽  
Child Protection ◽  
Child Protective Services ◽  
Pediatric Emergency ◽  
University Hospital ◽  
Emergency Physicians ◽  
Protective Services ◽  
Child Protection Services ◽  
The Family ◽  
Clear Information

AbstractThe examination of children suspected of being abused poses a great challenge for forensic pathologists. The risk of misjudgment is high and can have serious consequences for the child and the family. In unclear cases, an assessment should always be carried out on an interdisciplinary basis with the involvement of the relevant disciplines such as pediatrics, dermatology, or radiology. We present the case of a 2.5-year-old boy who was presented by his parents at the Pediatric Emergency Department of a Swiss University Hospital due to fever and weight loss. During the physical examination, conspicuous findings on the abdomen were present, and the responsible emergency physicians informed the child protective services. A clinical forensic examination occurred on behalf of the child protection services. The abdomen of the child showed several symmetrical scars. The initial questioning of the parents did not provide clear information about the origin of the injuries. Further professional questioning of the family by the child protective services concluded that the injuries were the result of a traditional medical treatment in Somalia, which occurred several weeks before.

scholarly journals Síndrome do jaleco branco em crianças na emergência: estudo descritivo

2021 ◽  
Vol 2 (6) ◽  
pp. 1515-1529
Author(s):  
Silvia Helena Oliveira Da Cunha ◽  
Eliane Ramos Pereira ◽  
Rose Mary Costa Rosa Andrade Silva ◽  
Daniela Chaves Costa ◽  
Vivian Moreira Mencari
Keyword(s):  
Participant Observation ◽  
Structured Interview ◽  
Pediatric Emergency ◽  
Point Of View ◽  
University Hospital ◽  
White Coat ◽  
Whole Process ◽  
The Family ◽  
Making Friends ◽  
Child's Death

O momento na hospitalização da criança gera uma mudança brusca na vida de uma família, pois envolvem circunstâncias, como a interrupção do cotidiano, onde ela se vê longe de seus irmãos, do pai e amigos; de seu lar e de seus hábitos. É um evento social que mobiliza todos, tem seu caráter segregante, pois afasta  a criança e sua família da vida em sociedade, mas por outro lado, tem-se o desafio de conhecer novos ambientes, outras pessoas e por que não dizer, a possibilidade de fazer amizades e de retornar ao lar com a saúde restaurada. A criança hospitalizada passa por todo este processo e precisa do suporte familiar e educativo, a fim de que entenda aos poucos o processo no qual está inserida. Objetivos: descrever o fenômeno de extremo medo apresentado pela criança quando está na presença do jaleco branco. Visa também, apontar contribuições na minimização de manifestações de medo extremo e da síndrome do jaleco branco em crianças. Método: Estudo descritivo, com abordagem qualitativa e adotando conceitos da visão fenomenológica desenvolvido no setor de emergência pediátrica de um hospital universitário. Utilizou-se a técnica da entrevista semiestruturada, evocações livres e observação participante com treze familiares, a fim de produzir dados acerca da cultura do medo reproduzida pela família nas crianças hospitalizadas. Resultados: Os dados foram submetidos à análise de Bardin, onde se estabeleceram cinco categorias: Profissionais de saúde; objetos estranhos; evento indesejável; infecções e bactérias hospitalares e medo da morte da criança. Detectou-se o fenômeno de intenso medo pela criança comparado à “síndrome do jaleco branco em adultos” no qual foi interpretado sob o ponto de vista fenomenológico. Conclusão: Concluiu-se que a articulação de estratégias terapêuticas, é ferramenta indispensável tanto na prevenção da síndrome do jaleco branco em crianças, quanto no fortalecimento do estado de resiliência e no enfrentamento do medo pela criança e família.   The moment a child is hospitalized generates an abrupt change in the life of a family, because it involves circumstances, such as the interruption of daily life, where the child is far from his/her siblings, father and friends; from his/her home and habits. It is a social event that mobilizes everyone; it has its segregating character, as it distances the child and his family from life in society, but on the other hand, there is the challenge of getting to know new environments, other people, and why not say, the possibility of making friends and returning home with his health restored. The hospitalized child goes through this whole process and needs family and educational support, so that he/she can gradually understand the process in which he/she is inserted. Objectives: to describe the phenomenon of extreme fear presented by the child when in the presence of the white coat. It also aims to point out contributions to minimize manifestations of extreme fear and the white coat syndrome in children. Method: A descriptive study, with a qualitative approach and adopting concepts from the phenomenological view, developed in the pediatric emergency department of a university hospital. We used the technique of semi-structured interview, free evocations and participant observation with thirteen family members, in order to produce data about the culture of fear reproduced by the family in hospitalized children. Results: The data were submitted to Bardin analysis, where five categories were established: health professionals; foreign objects; undesirable event; hospital infections and bacteria and fear of the child's death. The phenomenon of intense fear for the child was detected, compared to the "white coat syndrome in adults", which was interpreted from a phenomenological point of view. Conclusion: It was concluded that the articulation of therapeutic strategies is an indispensable tool both in the prevention of white coat syndrome in children and in the strengthening of the state of resilience and coping with fear by the child and the family.  

scholarly journals “COVID-19: The final nail in coffin for physical examination” Evaluation of the effects of COVID-19 pandemic on physical examination habits of residents in a university hospital: a cross-sectional survey

2021 ◽  
Author(s):  
Mehmet Erdevir ◽  
Oğuz Uyaroğlu ◽  
Murat Özdede ◽  
Mine Durusu Tanriover
Keyword(s):  
Physical Examination ◽  
Online Survey ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Internal Medicine Residents ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
Self Protection ◽  
And Training

Aims: It is evident that COVID-19 pandemic have affected the medical practice and training of residents. In this study, we evaluated the Physical Examination (PE) habits of residents working in a university hospital and how their PE practices did change during the pandemic. Methods: This single-center, non-interventional, cross-sectional descriptive study was conducted in a university hospital using an online survey questionnaire from 5 to 20 October 2020. Results: 308 residents participated in the study of whom 172 of them (55.8%) were female and the median age was 27 (IQR:3). Among all, 263 participants (85.4%) declared that they have worked in the areas where suspected/confirmed COVID-19 patients were being served. A total of 262 (85%) residents stated that PE habits have changed generally during the pandemic. There was a significant difference between those residents who have worked in the COVID-19 areas (n=230,87.5%) and those who have not (n=32, 71.1%) (p=0.004). PE habits of Internal Medicine Residents were more changed than others (p<0.001). The main reason for the change in PE habits in general (77.9%) and during the examination of suspected/confirmed COVID-19 patients (89.7%) were ‘’self-protection”. Reliance on laboratory and radiologic investigations during practice and not having a thought that less PE will disrupt the diagnosis and course of COVID-19 were also independent risk factors for performing less PE in suspected/confirmed COVID-19 patients. Discussion: This study clearly demonstrated that the COVID-19 pandemic has had a serious impact on the PE habits of the residents while examing patients in general and with COVID-19.

Effects of Observer Variation on Performance in Probabilistic Diagnosis of Jaundice

1981 ◽  
Vol 20 (03) ◽  
pp. 163-168 ◽  
Author(s):  
G. Llndberg
Keyword(s):  
Physical Examination ◽  
System Performance ◽  
Transition Matrix ◽  
Bayes Theorem ◽  
Observer Variation ◽  
Kappa Statistics ◽  
Diagnostic Categories ◽  
Number Of Patients ◽  
Probability Transition Matrix ◽  
Probabilistic Diagnosis

A system for probabilistic diagnosis of jaundice has been used for studying the effects of taking into account the unreliability of diagnostic data caused by observer variation. Fourteen features from history and physical examination were studied. Bayes’ theorem was used for calculating the probabilities of a patient’s belonging to each of four diagnostic categories.The construction sample consisted of 61 patients. An equal number of patients were tested in the evaluation sample. Observer variation on the fourteen features had been assessed in two previous studies. The use of kappa-statistics for measuring observer variation allowed the construction of a probability transition matrix for each feature. Diagnostic probabilities could then be calculated with and without the inclusion of weights for observer variation. Tests of system performance revealed that discriminatory power remained unchanged. However, the predictions rendered by the variation-weighted system were diffident. It is concluded that taking observer variation into account may weaken the sharpness of probabilistic diagnosis but it may also help to explain the value of probabilistic diagnosis in future applications.

scholarly journals Impact of the COVID-19 pandemic and its related psychological effect on orthopedic surgeries conducted in different types of hospitals in Taiwan

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199607 ◽  
Author(s):  
Chia-Lung Shih ◽  
Peng-Ju Huang ◽  
Hsuan-Ti Huang ◽  
Chung-Hwan Chen ◽  
Tien-Ching Lee ◽  
...  
Keyword(s):  
Community Hospital ◽  
University Hospital ◽  
Total Knee Arthroplasties ◽  
Peak Period ◽  
Number Of Patients ◽  
Total Knee ◽  
Investigation Period ◽  
Orthopedic Diseases ◽  
The University ◽  
The Impact

Aim: Taiwan’s response to the coronavirus disease 2019 (COVID-19) differed in that it successfully prevented the spread without having to shutdown or overburden medical services. Patients’ fear regarding the pandemic would be the only reason to reduce surgeries, so Taiwan could be the most suitable place for research on the influence of psychological factors. This study aimed to assess the impact of patients’ fear on orthopedic surgeries in Taiwan amid the peak period of the COVID-19 pandemic. Patients and Methods: The investigation period included the COVID-19 pandemic (March 2020 to April 2020) and the corresponding period in the previous year. The following data on patients with orthopedic diseases were collected: outpatient visits, hospital admission, and surgical modalities. Results: The COVID-19 pandemic led to a 22%–29% and 20%–26% reduction in outpatients, 22%–27% and 25%–37% reduction in admissions, and 26%–35% and 18%–34% reduction in surgeries, respectively, at both hospitals. The weekly mean number of patients was significantly smaller during the COVID-19 pandemic for all types of surgery and elective surgeries at the university hospital, and for all types of surgery, elective surgeries, and total knee arthroplasties at the community hospital. Further, patients visiting the community hospital during the pandemic were significantly younger, for all types of surgery, elective surgeries, and total knee arthroplasties. Conclusions: The reduction in orthopedic surgeries in Taiwan’s hospitals during COVID-19 could be attributed to patients’ fear. Even without restriction, the pandemic inevitably led to a reduction of about 20%–30% of the operation volume.

scholarly journals A multicenter randomized trial to assess the efficacy of CONvalescent plasma therapy in patients with Invasive COVID-19 and acute respiratory failure treated with mechanical ventilation: the CONFIDENT trial protocol

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Benoît Misset ◽  
Eric Hoste ◽  
Anne-Françoise Donneau ◽  
David Grimaldi ◽  
Geert Meyfroidt ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Neutralizing Antibodies ◽  
Ethical Issues ◽  
High Titer ◽  
Passive Immunization ◽  
University Hospital ◽  
Optimal Time ◽  
Relative Reduction ◽  
Number Of Patients

Abstract Background The COVID-19 pandemic reached Europe in early 2020. Convalescent plasma is used without a consistent evidence of efficacy. Our hypothesis is that passive immunization with plasma collected from patients having contracted COVID-19 and developed specific neutralizing antibodies may alleviate symptoms and reduce mortality in patients treated with mechanical ventilation for severe respiratory failure during the evolution of SARS-CoV-2 pneumonia. Methods We plan to include 500 adult patients, hospitalized in 16 Belgian intensive care units between September 2020 and 2022, diagnosed with SARS-CoV-2 pneumonia, under mechanical ventilation for less than 5 days and a clinical frailty scale less than 6. The study treatment will be compared to standard of care and allocated by randomization in a 1 to 1 ratio without blinding. The main endpoint will be mortality at day 28. We will perform an intention to treat analysis. The number of patients to include is based on an expected mortality rate at day 28 of 40 percent and an expected relative reduction with study intervention of 30 percent with α risk of 5 percent and β risk of 20 percent. Discussion This study will assess the efficacy of plasma in the population of mechanically ventilated patients. A stratification on the delay from mechanical ventilation and inclusion will allow to approach the optimal time use. Selecting convalescent plasmas with a high titer of neutralizing antibodies against SARS-CoV-2 will allow a homogeneous study treatment. The inclusion in the study is based on the consent of the patient or his/her legal representative, and the approval of the Investigational Review Board of the University hospital of Liège, Belgium. A data safety monitoring board (DSMB) has been implemented. Interim analyses have been planned at 100, 2002, 300 and 400 inclusions in order to decide whether the trail should be discontinued prematurely for ethical issues. We plan to publish our results in a peer-reviewed journal and to present them at national and international conferences. Funding and registration The trial is funded by the Belgian Health Care Knowledge Center KCE # COV201004 Trial registration Clinicaltrials.gov registration number NCT04558476. Registered 14 September 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04558476

Sonographic Evaluation of Hidradenitis Suppurativa with Smartphone-Linked Portable Ultrasound

Dermatology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Maximillian A. Weigelt ◽  
Yuval Hilerowicz ◽  
Jeffrey A. Leichter ◽  
Hadar Lev-Tov
Keyword(s):  
Hidradenitis Suppurativa ◽  
Wound Care ◽  
University Hospital ◽  
Clinical Staging ◽  
Routine Practice ◽  
Portable Ultrasound ◽  
Number Of Patients ◽  
Staging Systems ◽  
Conventional Ultrasound ◽  
Potential Benefits

Background: Clinical staging systems for hidradenitis suppurativa (HS) have poor interrater reliability and may underestimate disease activity. Sonographic staging systems may overcome these challenges, but conventional ultrasound (US) machines are expensive and bulky. Portable (p)US may facilitate the integration of sonography into routine practice. Objectives: To assess the ability of a novel smartphone-linked pUS device to identify key sonographic lesions of HS. Methods: The charts of 16 patients with HS who were assessed with pUS at the outpatient Dermatology and Wound Care Clinics of a university hospital center were retrospectively reviewed. Clinical and sonographic images of the affected areas were examined. The main outcome measures were the number of patients with identifiable sonographic lesions and the number of patients with subclinical lesions detected by pUS. Results: All 3 key sonographic lesions of HS were identifiable with pUS. Sonographic lesions were identified in 10 patients (62.5%). Subclinical lesions were identified in 2 patients (12.5%); in both cases, this affected management decisions. Conclusions: We demonstrate the ability of pUS to identify the key sonographic lesions of HS. pUS is a simple and affordable way to integrate HSUS into clinical and research settings, with clear potential benefits to patients.

Prospective Assessment of Helicobacter Pylori Infection and Gastric Pathologies in Sidi Bel Abbes region, Western Algeria

2018 ◽  
Vol 7 (5) ◽  
pp. 217-224
Author(s):  
Zouaouia Chama ◽  
Khedoudj Kanoun ◽  
Fatima Zohra Elkadi ◽  
Kara Turqui Douidi ◽  
Noria Harir ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Histological Study ◽  
Helicobacter Pylori Infection ◽  
University Hospital ◽  
Infection Prevalence ◽  
Gastric Diseases ◽  
Number Of Patients ◽  
H Pylori ◽  
The Impact

Helicobacter pylori infection concerns half of the world’s population, mainly in developing countries. It causes several gastrodudenal pathologies such as gastritis, ulcer and gastric adenocarcinoma. The aim of our study was to determine the prevalence of H.pylori infection and to assess the impact of different epidemiological factors as well as principal gastric diseases associ-ated to this infection. We underwent a prospective study during 18 months (month 2016-month 2017) which implicated 201 symptomatic patients for gastric fiboptic endoscopy at the level of Sidi Bel Abbes University hospital. We collected patients’ biopsies to perform a histological study and H. pylori culture. H. pylori identification was carried out based on bacteriological and biochemical analysis. The middle age of our population was (47.29 ±15.97ans) and the sex-ratio =0,8. The global prevalence of Helicobacter pylori infection is of 61.2% (123/201). This rate, after a statistic analysis, seems to be significantly related to age. It is particularly high especially for patients belonging to age range (20-30)-(51-60) years. The gender did not affect the infection prevalence that is more frequent in the gastritis case. We noticed also that HP infection prevalence was important in SBA the hospital. The range age (20-30)-(51-60) years had the highest prevalence of H. pylori and of gastritis which might be a risky ground of gastric cancer appearance. The ulcer pathology maximal rate concerned the group of 51 to 60 years. Above this age, this rate dropped whereas the number of patients suffering from gastric cancer, which presents an important rate in our study, increase for the group of 61-70 years.

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