Edited, memorised or added to reading list

on 09-Feb-2020 (Sun)

Do you want BuboFlash to help you learning these things? Click here to log in or create user.

#40 #Aménorrhée #Cours #Facultaires #Gynécologie #Médecine

Après un interrogatoire et un examen clinique soigneux, un bilan hormonal couplé à une échographie pelvienne doit être réalisé devant un trouble du cycle.

  • Ce bilan est à réaliser au moment des règles (J2–J5 du cycle) afin de pouvoir être interprété correctement.
    En cas de test à la dydrogestérone négatif, le bilan pourra être réalisé en aménorrhée.

  • Le bilan hormonal comprendra :
    • Le dosage de l'hCG pour éliminer une éventuelle grossesse
    • Le dosage de la FSH plasmatique associé à l'œstradiolémie
    • Le dosage de la prolactine plasmatique
    • Éventuellement le dosage de la LH

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#37 #Cours #Facultaires #Gynécologie #Médecine #Stérilité
En cas de dysovulation, un dosage de la prolactine et de la TSH est effectué

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

Diagnostic

Classiquement, les signes d'appel associent une aménorrhée vers l'âge de 50 ans à des signes climatériques :

  • Bouffées vasomotrices (ou bouffées de chaleur)
  • Crises de sueurs nocturnes
  • Sécheresse vaginale

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

D'autres signes seront recherchés :

  • Troubles du sommeil
  • Céphalées
  • Arthralgies
  • Troubles de l'humeur et du caractère
  • Troubles de libido

Il est théoriquement nécessaire d'attendre 12 mois d'aménorrhée pour parler de ménopause.
En fait, la prise en charge ne se justifie que si les signes climatériques altèrent la qualité de vie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

Autres troubles climatériques

  • D'autres troubles sont parfois ressentis par les femmes en période ménopausique.
  • Ces troubles ne sont pas toujours liés à la carence œstrogénique.
  • Il s'agit :
    • De troubles de l'humeur (irritabilité, état dépressif, anxiété, tristesse) chez 40 % des femmes
    • D'insomnie
    • De pertes de mémoire
    • De sécheresse vaginale pouvant être à l'origine de dyspareunie
    • De modifications de la libido
    • De modifications de la voix, etc

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

Contre-indications du THM.

  • Contre-indications absolues
    • Cancer du sein (actuel et antécédent personnel de cancer du sein)
    • Antécédent personnel de :
      • Pathologie thrombotique artérielle (AVC ischémique, infarctus du myocarde)
      • Pathologie thromboembolique veineuse (antécédents de phlébite profonde inexpliquée, d'embolie pulmonaire, d'accidents emboligènes inexpliqués)
    • Maladies plus rares
      • Lupus
      • Tumeur hypophysaire
      • Porphyrie
      • Affections hépatiques graves et évolutives
      • Hyperlipidémies sévères
      • HTA grave

  • Contre-indications relatives (nécessitent une discussion en fonction de leur sévérité et du contexte : désir de THM, possibilités de surveillance)
    • Pathologies pelviennes : myome, endométriose
    • Mastopathies bénignes à risque
    • Facteurs de risque vasculaires : HTA, diabète insulinodépendant, tabagisme, dyslipidémie, obésité, migraines, etc
    • Autres : cholestase

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

Le THM associe un œstrogène naturel (œstradiol ou valérate d'œstradiol, afin de compenser la carence responsable des symptômes) à un progestatif (afin de contrôler le risque de cancer de l'endomètre lié à une exposition prolongée aux œstrogènes seuls).

En cas d'hystérectomie, le traitement comporte uniquement un œstrogène

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

THM - Maladies thromboemboliques veineuses

  • Le risque est multiplié par 2 à 4 lorsque le THM comporte l'administration des œstrogènes par voie orale.
  • En revanche, ce risque est minime, voire inexistant lorsqu'il s'agit d'œstrogènes naturels par voie extra-orale (shunt de l'effet de 1 er passage hépatique des œstrogènes).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#120 #Cours #Facultaires #Gynécologie #Médecine #Ménopause

THM - Cancers hormonodépendants

  • Une œstrogénothérapie pouvant aggraver l'évolution du cancer du sein lorsqu'il existe déjà, il importe d'examiner soigneusement les seins et de disposer d'une mammographie de moins d'un an avant d'instaurer le THM

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4846354828556

Tags
#knowledge-base-construction #machine-learning #unfinished
Question
A mention is a span of text that refers to an [...].
Answer
entity


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
A mention is a span of text that refers to an entity.

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4871283412236

Tags
#knowledge-base-construction #machine-learning #unfinished
Question
Fonduer: lightweight supervision rules [...] and programmatically label subsets of candidates.
Answer
capture a user’s do- main knowledge


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
n> no devel- opment cycles are spent on feature engineering. Users only need to specify candidates, the potential entries in the target KB, and provide lightweight supervision rules which capture a user’s do- main knowledge and programmatically label subsets of candidates, which are used for training Fonduer ’s deep-learning model (see Section 4.3). <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4887117434124

Tags
#machine-learning #software-engineering #unfinished
Question
It’s worth noting that glue code and pipeline jungles are symptomatic of integration issues that may have a root cause in [...]
Answer
overly separated “research” and “engineering” roles.


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
It’s worth noting that glue code and pipeline jungles are symptomatic of integration issues that may have a root cause in overly separated “research” and “engineering” roles. When machine learning packages are developed in an ivory-tower setting, the resulting packages may appear to be more like black boxes to the teams that actually employ them in practice.

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4896586075404

Tags
#knowledge-base-construction #machine-learning #unfinished
Question
During develop- ment, labeling functions are [...]
Answer
iteratively improved.


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
During develop- ment, labeling functions are iteratively improved through error analysis

Original toplevel document (pdf)

cannot see any pdfs







#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie

  • Sur le versant expressif, le babillage notamment canonique (redoublement des syllabes qui apparaît entre 6 et 7 mois) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois.

L'augmentation du nombre de mots est variable d'un enfant à l'autre.

  • En moyenne, l'enfant à 15 mois possède dix mots
  • Entre 18 à 24 mois, l'enfant arrive à une masse critique de cinquante mots, il est alors capable d'apprendre entre quatre et dix mots nouveaux par jour.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4965953572108

[unknown IMAGE 4763923909900]
Tags
#MLBook #has-images #machine-learning #pmf #probability-distribution #probability-mass-function
Question
Describe what is a probability mass function.
Answer
The probability distribution of a discrete random variable is described by a list of probabilities associated with each of its possible values. This list of probabilities is called a probability mass function (pmf). For example: \(\operatorname{Pr}(X=red) = 0.3\), \(\operatorname{Pr}(X=yellow) = 0.45\), \(\operatorname{Pr}(X=blue) = 0.25\). Each probability in a probability mass function is a value greater than or equal to 0. The sum of probabilities equals 1 (Figure 3a).


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
The probability distribution of a discrete random variable is described by a list of probabilities associated with each of its possible values. This list of probabilities is called a probability mass function (pmf). For example: \(\operatorname{Pr}(X=red) = 0.3\), \(\operatorname{Pr}(X=yellow) = 0.45\), \(\operatorname{Pr}(X=blue) = 0.25\). Each probability in a probability mass function is a value greater than or equal to 0. The sum of probabilities equals 1 (Figure 3a).

Original toplevel document (pdf)

cannot see any pdfs







Communalist Approach The historians of this school, relying completely on the colonial historiography of medieval India and colonial era textbooks, viewed Hindus and Muslims as permanent hostile groups whose interests were mutually different and antagonistic to each other.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Dupleix was, in fact, the originator of the practice of subsidiary alliance in India. He placed a French army at Hyderabad at the expense of the subahdar.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Dupleix was recalled in 1754 due to the initial defeat of the French army in the Second Carnatic War and the heavy cost incurred by the company due to Dupleix’s political decisions

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




In China, Japan and the Indonesian archipelago, Indian cotton was popular for its lightweight, yet strong qualities. When the Dutch, English and French acquired materials from India, it was not only for their home countries, but for transport to Malacca or Java, for example, where they were traded for spices.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




When the French East India Company started trading in India, they entered an already well established, complex economic system, an intricate network of production, negotiation, delivery, and distribution. Large commercial fleets as well as prosperous shore-based businesses were run by Indian merchants. Weavers and merchants worked with overland freight operators and brokers, who worked with exporters and ship owners. These agents had also to negotiate with local state officials for commercial privileges. The European traders had to learn well established rules and practices and successfully collaborate with indigenous envoys.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Danes are better known for their missionary activities than for commerce.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Danes The Danish East India Company was established in 1616 and, in 1620

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The world’s first central bank—the Bank of England—was established to sell government debt to the money markets on the promise of a decent return on Britain’s defeating rival countries like France and Spain.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




the Indian brand of socialism is a ‘democratic socialism’ and not a ‘communistic socialism’ (also known as ‘state socialism’) which involves the nationalisation of all means of production and distribution and the abolition of private property.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




polity, as stipulated in the Preamble, is based on the doctrine of popular sovereignty, that is, possession of supreme power by the people.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




A republic also means two more things: one, vesting of political sovereignty in the people and not in a single individual like a king; second, the absence of any privileged class and hence all public offices being opened to every citizen without any discrimination.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Preamble declares that fraternity has to assure two things—the dignity of the individual and the unity and integrity of the nation

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Preamble is neither a source of power to legislature nor a prohibition upon the powers of legislature. 2. It is non-justiciable, that is, its provisions are not enforceable in courts of law.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Preamble has been amended only once so far, in 1976, by the 42nd Constitutional Amendment Act, which has added three new words— Socialist, Secular and Integrity—to the Preamble

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Legally, sale, storage, transportation and usage of unapproved GM seeds is a punishable offence under the Rules of Environmental Protection Act 1989. Also, sale of unapproved seeds can attract action under the Seed Act of 1966 and the Cotton Act of 1957.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




anada and the US allowed GM crops to be grown commercially in 1996

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




GM cotton permitted to be grown in India are hybrids/varieties that contain ‘cry1Ac’ and ‘cry2Ab’ genes, isolated from the soil bacterium Bacillus thuringiensis (Bt) and coding for proteins toxic to bollworm insect pests.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




GEAC established under Ministry of Environment, Forest and Climate Change (MoEFCC) is the apex body for approval of activities involving large scale use of hazardous microorganisms and recombinants in research and industrial production from the environmental angle. • The GEAC is also responsible for approval of proposals relating to release of genetically engineered organisms and products into the environment including experimental field trials. Ht-bt cotton

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Article 2 relates to the admission or establishment of new states that are not part of the Union of India. Article 3, on the other hand, relates to the formation of or changes in the existing states of the Union of India. In other words, Article 3 deals with the internal re-adjustment inter se of the territories of the constituent states of the Union of India. PARLIAMENT’S POWER TO REORGANISE THE STATES Article 3 authorises the Parliament to: (a) form a new state by separation of territory from any state or by uniting two or more states or parts of states or by uniting any territory to a part of any state, (b) increase the area of any state, (c) diminish the area of any state, (d) alter the boundaries of any state, and (e) alter the name of any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendation of the President; and two, before recommending the bill, the President has to refer the same to the state legistature concerned for expressing its views within a specified period. Further, the power of Parliament to form new states includes the power to form a new state or union territory by uniting a part of any state or union territory to any other state or union territory 3 . The President (or Parliament) is not bound by the views of the state legislature and may either accept or reject them, even if the views are received in time.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4995747024140

Question
Article 2 relates to the admission or establishment of new states that are not part of the Union of India. Article 3, on the other hand, relates to the formation of or changes in the existing states of the Union of India. In other words, [...] deals with the internal re-adjustment inter se of the territories of the constituent states of the Union of India. PARLIAMENT’S POWER TO REORGANISE THE STATES Article 3 authorises the Parliament to: (a) form a new state by separation of territory from any state or by uniting two or more states or parts of states or by uniting any territory to a part of any state, (b) increase the area of any state, (c) diminish the area of any state, (d) alter the boundaries of any state, and (e) alter the name of any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendation of the President; and two, before recommending the bill, the President has to refer the same to the state legistature concerned for expressing its views within a specified period. Further, the power of Parliament to form new states includes the power to form a new state or union territory by uniting a part of any state or union territory to any other state or union territory 3 . The President (or Parliament) is not bound by the views of the state legislature and may either accept or reject them, even if the views are received in time.
Answer
Article 3


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
ishment of new states that are not part of the Union of India. Article 3, on the other hand, relates to the formation of or changes in the existing states of the Union of India. In other words, <span>Article 3 deals with the internal re-adjustment inter se of the territories of the constituent states of the Union of India. PARLIAMENT’S POWER TO REORGANISE THE STATES Article 3 authorises the P

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995748597004

Question
Article 2 relates to the admission or establishment of new states that are not part of the Union of India. Article 3, on the other hand, relates to the formation of or changes in the existing states of the Union of India. In other words, Article 3 deals with the internal re-adjustment inter se of the territories of the constituent states of the Union of India. PARLIAMENT’S POWER TO REORGANISE THE STATES Article 3 authorises the Parliament to: (a) form a new state by separation of territory from any state or by uniting two or more states or parts of states or by uniting any territory to a part of any state, (b) increase the area of any state, (c) diminish the area of any state, (d) alter the boundaries of any state, and (e) alter the [...] of any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendation of the President; and two, before recommending the bill, the President has to refer the same to the state legistature concerned for expressing its views within a specified period. Further, the power of Parliament to form new states includes the power to form a new state or union territory by uniting a part of any state or union territory to any other state or union territory 3 . The President (or Parliament) is not bound by the views of the state legislature and may either accept or reject them, even if the views are received in time.
Answer
name


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
ts of states or by uniting any territory to a part of any state, (b) increase the area of any state, (c) diminish the area of any state, (d) alter the boundaries of any state, and (e) alter the <span>name of any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendat

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995750169868

Question
Article 2 relates to the admission or establishment of new states that are not part of the Union of India. Article 3, on the other hand, relates to the formation of or changes in the existing states of the Union of India. In other words, Article 3 deals with the internal re-adjustment inter se of the territories of the constituent states of the Union of India. PARLIAMENT’S POWER TO REORGANISE THE STATES Article 3 authorises the Parliament to: (a) form a new state by separation of territory from any state or by uniting two or more states or parts of states or by uniting any territory to a part of any state, (b) increase the area of any state, (c) diminish the area of any state, (d) alter the boundaries of any state, and (e) alter the name of any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendation of the [...]; and two, before recommending the bill, the President has to refer the same to the state legistature concerned for expressing its views within a specified period. Further, the power of Parliament to form new states includes the power to form a new state or union territory by uniting a part of any state or union territory to any other state or union territory 3 . The President (or Parliament) is not bound by the views of the state legislature and may either accept or reject them, even if the views are received in time.
Answer
President


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
any state. However, Article 3 lays down two conditions in this regard: one, a bill contemplating the above changes can be introduced in the Parliament only with the prior recommendation of the <span>President; and two, before recommending the bill, the President has to refer the same to the state legistature concerned for expressing its views within a specified period. Further, the power of

Original toplevel document (pdf)

cannot see any pdfs







Indian territory can be ceded to a foreign state only by amending the Constitution under Article 368

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Consequently, the 9th Constitutional Amendment Act (1960) was enacted to transfer the said territory to Pakistan. On the other hand, the Supreme Court in 1969 ruled that, settlement of a boundary dispute between India and another country does not require a constitutional amendment. It can be done by executive action as it does not involve cession of Indian territory to a foreign country.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Fazl Ali Commission The creation of Andhra state intensified the demand from other regions for creation of states on linguistic basis. This forced the Government of India to appoint (in December 1953) a three-member States Reorganisation Commission under the chairmanship of Fazl Ali to re-examine the whole question. Its other two members were K M Panikkar and H N Kunzru. It submitted its report in September 1955 and broadly accepted language as the basis of reorganisation of states. But, it rejected the theory of ‘one language– one state’. Its view was that the unity of India should be regarded as the primary consideration in any redrawing of the country’s political units. It identified four major factors that can be taken into account in any scheme of reorganisation of states: (a) Preservation and strengthening of the unity and security of the country. (b) Linguistic and cultural homogeneity. (c) Financial, economic and administrative considerations. (d) Planning and promotion of the welfare of the people in each state as well as of the nation as a whole. The commission suggested the abolition of the four-fold classification of states under the original Constitution and creation of 16 states and 3 centrally administered territories.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The Constitution confers the following rights and privileges on the citizens of India (and denies the same to aliens): 1. Right against discrimination on grounds of religion, race, caste, sex or place of birth (Article 15). 2. Right to equality of opportunity in the matter of public employment (Article 16). 3. Right to freedom of speech and expression, assembly, association, movement, residence and profession (Article 19). 4. Cultural and educational rights (Articles 29 and 30). 5. Right to vote in elections to the Lok Sabha and state legislative assembly. 6. Right to contest for the membership of the Parliament and the state

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Accordingly, the Parliament has enacted the Citizenship Act, 1955, which has been amended in 1957, 1960, 1985, 1986, 1992, 2003, 2005 and 2015.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




T Fundamental Rights he Fundamental Rights are enshrined in Part III of the Constitution from Articles 12 to 35.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




justiciable’ Fundamental Rights.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Most of them are available against the arbitrary action of the State, with a few exceptions like those against the State’s action and against the action of private individuals. When the rights that are available against the State’s action only are violated by the private individuals, there are no constitutional remedies but only ordinary legal remedies

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




They are not sacrosanct or permanent. The Parliament can curtail or repeal them but only by a constitutional amendment act and not by an ordinary act. Moreover, this can be done without affecting the ‘basic structure’ of the Constitution. (The amendability of fundamental rights is explained in detail in Chapter 11)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




the six rights guaranteed by Article 19 can be suspended only when emergency is declared on the grounds of war or external aggression (i.e., external emergency) and not on the ground of armed rebellion

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Most of them are directly enforceable (self-executory) while a few of them can be enforced on the basis of a law made for giving effect to them. Such a law can be made only by the Parliament and not by state legislatures so that uniformity throughout the country is maintained (Article 35).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




According to the Supreme Court, even a private body or an agency working as an instrument of the State falls within the meaning of the ‘State’ under Article 12. LAWS INCONSISTENT WITH FUNDAMENTAL RIGHTS Article 13 declares that all laws that are inconsistent with or in derogation of any of the fundamental rights shall be void.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Right to freedom of religion (Article 25– 28) (a) Freedom of conscience and free profession, practice and propagation of religion (Article 25). (b) Freedom to manage religious affairs (Article 26). (c) Freedom from payment of taxes for promotion of any religion (Article 27). (d) Freedom from attending religious instruction or worship in certain educational institutions (Article 28). 5. Cultural and educational rights (Articles 29–30) (a) Protection of language, script and culture of minorities (Article 29). (b) Right of minorities to establish and administer educational institutions (Article 30). 6. Right to constitutional remedies (Article 32) Right to move the Supreme Court for the enforcement of fundamental rights including the writs of (i) habeas corpus, (ii) mandamus, (iii)prohibition, (iv) certiorari, and (v) quo war-rento (Article 32).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Right to elementary education (Article 21A). 5. Right of minorities to establish and administer educational institutions (Article 30).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The concept of ‘equality before law’ is of British origin while the concept of ‘equal protection of laws’ has been taken from the American Constitution.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




In the Indian System, the constitution is the source of the individual rights. The Supreme Court held that the ‘Rule of Law’ as embodied in Article 14 is a ‘basic feature’ of the constitution. Hence, it cannot be destroyed even by an amendment.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The President of India and the Governor of States enjoy the following immunities (Article 361): (i) The President or the Governor is not answerable to any court for the exercise and performance of the powers and duties of his office. (ii) No criminal proceedings shall be instituted or continued against the President or the Governor in any court during his term of office. (iii) No process for the arrest or imprisonment of the President or the Governor shall be issued from any court during his term of office. (iv) No civil proceedings against the President or the Governor shall be instituted during his term of office in any court in respect of any act done by him in his personal capacity, whether before or after he entered upon his office, until the expiration of two months next after notice has been delivered to him. 2. No person shall be liable to any civil or criminal proceedings in any court in respect of the publication in a newspaper (or by radio or television) of a substantially true report of any proceedings of either House of Parliament or either House of the Legislature of a State (Article 361-A). 3. No member of Parliament shall be liable to any proceedings in any court in respect of anything said or any vote given by him in Parliament or any committee thereof (Article 105).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Parliament can prescribe residence as a condition for certain employment or appointment in a state or union territory or local authority or other authority. As the Public Employment (Requirement as to Residence) Act of 1957 expired in 1974, there is no such provision for any state except Andhra Pradesh 5 and Telangana 5a .

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Mandal Commission and Aftermath In 1979, the Morarji Desai Government appointed the Second 6 Backward Classes Commission under the chairmanship of B P Mandal, a Member of Parliament, in terms of Article 340 of the Constitution to investigate the conditions of the socially and educationally backward classes and suggest measures for their advancement. The commission submitted its report in 1980 and identified as many as 3743 castes as socially and educationally backward classes. They constitute nearly 52% component of the population, excluding the scheduled castes (SCs) and the scheduled tribes (STs). The commission recommended for reservation of 27% government jobs for the Other Backward Classes (OBCs) so that the total reservation for all ((SCs, STs and OBCs) amounts to 50%

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Ram Nandan Committee was appointed to identify the creamy layer among the OBCs. It submitted its report in 1993, which was accepted. (b) National Commission for Backward Classes was established in 1993 by an act of Parliament.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Mysore High Court held that the subject matter of Article 17 is not untouchability in its literal or grammatical sense but the ‘practice as it had developed historically in the country’. It refers to the social disabilities imposed on certain classes of persons by reason of their birth in certain castes. Hence, it does not cover social boycott of a few individuals or their exclusion from religious services, etc.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




hereditary titles of nobility like Maharaja, Raj Bahadur, Rai Bahadur, Rai Saheb, Dewan Bahadur, etc, which were conferred by colonial States are banned by Article 18 as these are against the principle of equal status of all.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




he Supreme Court upheld the constitutional validity of the National Awards—Bharat Ratna, Padma Vibhushan, Padma Bhushan and Padma Sri. It ruled that these awards do not amount to ‘titles’ within the

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Freedom of Assembly

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




This freedom can be exercised only on public land and the assembly must be peaceful and unarmed.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




The State can impose reasonable restrictions on the exercise of right of assembly on two grounds, namely, sovereignty and integrity of India and public order including the maintenance of traffic in the area concerned. Under Section 144 of Criminal Procedure Code (1973), a magistrate can restrain an assembly, meeting or procession if there is a risk of obstruction, annoyance or danger to human life, health or safety or a disturbance of the public tranquillity or a riot or any affray. Under Section 141 of the Indian Penal Code, as assembly of five or more persons becomes unlawful if the object is (a) to resist the execution of any law or legal process; (b) to forcibly occupy the property of some person; (c) to commit any mischief or criminal trespass; (d) to force some person to do

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Reasonable restrictions can be imposed on the exercise of this right by the State on the grounds of sovereignty and integrity of India, public order and morality. Subject to these restrictions, the citizens have complete liberty to form associations or unions for pursuing lawful objectives and purposes. However, the right to obtain recognition of the association is not a fundamental right.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Freedom of Residence Every citizen has the right to reside and settle in any part of the territory of the country. This right has two parts: (a) the right to reside in any part of the country, which means to stay at any place temporarily, and (b) the right to settle in any part of the country, which means to set up a home or domicile at any place permanently.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




no objection can be made when the State carries on a trade, business, industry or service either as a monopoly (complete or partial) to the exclusion of citizens (all or some only) or in competition with any citizen. The State is not required to justify its monopoly. This right does not include the right to carry on a profession or business or trade or occupation that is immoral (trafficking in women or children) or dangerous

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4995822521612

Question
Improved yields: Farmers claim that the HtBt variety can withstand the spray of [...], a herbicide that is used to remove weeds, substantially improving the yield.
Answer
glyphosate


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Improved yields: Farmers claim that the HtBt variety can withstand the spray of glyphosate, a herbicide that is used to remove weeds, substantially improving the yield.

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995827764492

Question
Battle of [...] The decisive battle of the Third Carnatic War was won by the English on January 22, 1760 at Wandiwash (or Vandavasi) in Tamil Nadu. General Eyre Coote of the English totally routed the French army under Count Thomas Arthur de Lally and took Bussy as prisoner.
Answer
Wandiwash


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Battle of Wandiwash The decisive battle of the Third Carnatic War was won by the English on January 22, 1760 at Wandiwash (or Vandavasi) in Tamil Nadu. General Eyre Coote of the English totally routed the

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995829337356

Question
Battle of Wandiwash The decisive battle of the Third Carnatic War was won by the English on January 22, [...] at Wandiwash (or Vandavasi) in Tamil Nadu. General Eyre Coote of the English totally routed the French army under Count Thomas Arthur de Lally and took Bussy as prisoner.
Answer
1760


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Battle of Wandiwash The decisive battle of the Third Carnatic War was won by the English on January 22, 1760 at Wandiwash (or Vandavasi) in Tamil Nadu. General Eyre Coote of the English totally routed the French army under Count Thomas Arthur de Lally and took Bussy as prisoner.

Original toplevel document (pdf)

cannot see any pdfs







#121 #42 #Cours #Facultaires #Gynécologie #Incontinence #Médecine #Pelvienne #Tuméfaction

  • Dans la manœuvre de Bethoux, on refoule le col utérin à l’aide d’une pince et les fuites urinaires disparaissent.

  • Dans la manœuvre de Bonney, on remonte le col vésical dans l’enceinte abdominale en mettant deux doigts de part et d’autre du col vésical et ainsi, les fuites urinaires à l’effort disparaissent.
    Elle correspond à un bon pronostic chirurgical en cas d’IUE.

  • Le TVT test ou manœuvre d’Ulmsten consiste à réaliser un soutènement de l’urètre sans pression à l’aide d’une valve ou d’une pince longuette afin d’empêcher sa descente au cours d’un effort de poussée.
    Si les fuites urinaires n’apparaissent plus, une intervention type TVT devrait être efficace.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
bement du vagin correspond le plus souvent à une cystocèle (saillie vésicale) parfois à une urétrocèle (saillie antérieure de l’urètre). Peut apparaître également une fuite d’urines à l’effort. <span>Dans la manœuvre de Bethoux, on refoule le col utérin à l’aide d’une pince et les fuites urinaires disparaissent. Dans la manœuvre de Bonney, on remonte le col vésical dans l’enceinte abdominale en mettant deux doigts de part et d’autre du col vésical et ainsi, les fuites urinaires à l’effort disparaissent. Elle correspond à un bon pronostic chirurgical en cas d’IUE. Le TVT test ou manœuvre d’Ulmsten consiste à réaliser un soutènement de l’urètre sans pression à l’aide d’une valve ou d’une pince longuette afin d’empêcher sa descente au cours d’un effort de poussée. Si les fuites urinaires n’apparaissent plus, une intervention type TVT devrait être efficace. Temps postérieur : on refoule la paroi antérieure du vagin. A l’effort peut apparaître une colpocèle postérieure correspondant à une rectocèle (saillie du rectum dans le vagin) ou à une




Flashcard 4995841133836

Question
By which war French Political influence in India finished ??
Answer
the French political influence disappeared after the war of Wandiwash


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

pdf

cannot see any pdfs







Flashcard 4995858173196

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Audition

  • Il existe une orientation parfaite au bruit à l'âge de [...] mois.

Answer

6 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Audition L'enfant entend d'emblée ; le système auditif est fonctionnel dès la vie intra-utérine. Il existe une orientation parfaite au bruit à l'âge de 6 mois.

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995860794636

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Communication

  • Un sourire-réponse est présent dès [...] mois.

Answer

2 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Communication Un sourire-réponse est présent dès 2 mois. Les premières vocalises apparaissent vers 2 mois (gazouillis) ; le nourrisson rit aux éclats vers 4 mois. La qualité du contact et l'intérêt du regard sont les premiers indices de

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995862891788

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Communication

  • Les premières vocalises apparaissent vers [...] mois (gazouillis)

Answer

2 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Communication Un sourire-réponse est présent dès 2 mois. Les premières vocalises apparaissent vers 2 mois (gazouillis) ; le nourrisson rit aux éclats vers 4 mois. La qualité du contact et l'intérêt du regard sont les premiers indices de capacités de communication. La mise en place du c

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995864464652

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Communication

  • Le nourrisson rit aux éclats vers [...] mois.
Answer

4 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Communication Un sourire-réponse est présent dès 2 mois. Les premières vocalises apparaissent vers 2 mois (gazouillis) ; le nourrisson rit aux éclats vers 4 mois. La qualité du contact et l'intérêt du regard sont les premiers indices de capacités de communication. La mise en place du comportement d'attention conjointe est très importante à

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995866037516

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Communication

  • Le pointage du doigt pour montrer un objet ou pour le réclamer est présent dès [...] mois.

Answer

9 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
ntion visuelle conjointe, ou attraction du regard d'autrui vers un objet d'intérêt, doit être présente dès les premiers mois ; le pointage du doigt pour montrer un objet ou pour le réclamer dès <span>9 mois. À 9–10 mois, on note une capacité d'imitation, le nourrisson fait « au revoir », « bravo » <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995867610380

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Communication

  • À [...] mois, on note une capacité d'imitation, le nourrisson fait « au revoir », « bravo »

Answer

9 –10 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
elle conjointe, ou attraction du regard d'autrui vers un objet d'intérêt, doit être présente dès les premiers mois ; le pointage du doigt pour montrer un objet ou pour le réclamer dès 9 mois. À <span>9–10 mois, on note une capacité d'imitation, le nourrisson fait « au revoir », « bravo » <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995874163980

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Les parents peuvent surestimer le niveau de compréhension de leur enfant.

  • La compréhension des premiers mots survient entre [...] mois.
Answer

8 et 10 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Les parents peuvent surestimer le niveau de compréhension de leur enfant. La compréhension des premiers mots survient entre 8 et 10 mois. L'enfant comprend un ordre simple en contexte vers 15 mois et hors contexte vers 30 mois

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995875736844

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Les parents peuvent surestimer le niveau de compréhension de leur enfant.

  • L'enfant comprend un ordre simple en contexte vers [...] mois.

Answer

15 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
pan> Les parents peuvent surestimer le niveau de compréhension de leur enfant. La compréhension des premiers mots survient entre 8 et 10 mois. L'enfant comprend un ordre simple en contexte vers <span>15 mois et hors contexte vers 30 mois <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995877309708

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Les parents peuvent surestimer le niveau de compréhension de leur enfant.

  • L'enfant comprend un ordre simple hors contexte vers [...] mois

Answer

30 mois (= 2 ans et demi)


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
timer le niveau de compréhension de leur enfant. La compréhension des premiers mots survient entre 8 et 10 mois. L'enfant comprend un ordre simple en contexte vers 15 mois et hors contexte vers <span>30 mois <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995882552588

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • Sur le versant expressif, le babillage notamment canonique (redoublement des syllabes qui apparaît entre [...] mois) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois.

Answer

6 et 7 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Sur le versant expressif, le babillage notamment canonique (redoublement des syllabes qui apparaît entre 6 et 7 mois) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois. L'augmentation du nombre de mots est variable d'un enfant à l'autre. En moyenne, l'enfant à 15 m

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995884125452

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • Sur le versant expressif, le babillage notamment canonique (redoublement des syllabes qui apparaît entre 6 et 7 mois) a valeur de langage et précède l'apparition des premiers mots entre [...] mois.

Answer

10 et 12 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
> Sur le versant expressif, le babillage notamment canonique (redoublement des syllabes qui apparaît entre 6 et 7 mois) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois. L'augmentation du nombre de mots est variable d'un enfant à l'autre. En moyenne, l'enfant à 15 mois possède dix mots Entre 18 à 24 mois, l'enfant arrive à une masse critique de ci

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995885698316

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

L'augmentation du nombre de mots est variable d'un enfant à l'autre.

  • En moyenne, l'enfant à [...] mois possède dix mots

Answer

15 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
entre 6 et 7 mois) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois. L'augmentation du nombre de mots est variable d'un enfant à l'autre. En moyenne, l'enfant à <span>15 mois possède dix mots Entre 18 à 24 mois, l'enfant arrive à une masse critique de cinquante mots, il est alors capable d'apprendre entre quatre et dix mots nouveaux par jour. </s

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995887271180

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • En moyenne, l'enfant à 15 mois possède [...] mots

Answer

dix mots


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
s) a valeur de langage et précède l'apparition des premiers mots entre 10 et 12 mois. L'augmentation du nombre de mots est variable d'un enfant à l'autre. En moyenne, l'enfant à 15 mois possède <span>dix mots Entre 18 à 24 mois, l'enfant arrive à une masse critique de cinquante mots, il est alors capable d'apprendre entre quatre et dix mots nouveaux par jour. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995894873356

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • Entre 18 à 24 mois, l'enfant arrive à une masse critique de [...] mots.

Answer

cinquante mots


Entre 1 an et demi et 2 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
e 10 et 12 mois. L'augmentation du nombre de mots est variable d'un enfant à l'autre. En moyenne, l'enfant à 15 mois possède dix mots Entre 18 à 24 mois, l'enfant arrive à une masse critique de <span>cinquante mots, il est alors capable d'apprendre entre quatre et dix mots nouveaux par jour. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995896446220

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • Entre 18 à 24 mois, l'enfant est capable d'apprendre entre [...] mots nouveaux par jour.

Answer

quatre et dix nouveaux mots par jour


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
ariable d'un enfant à l'autre. En moyenne, l'enfant à 15 mois possède dix mots Entre 18 à 24 mois, l'enfant arrive à une masse critique de cinquante mots, il est alors capable d'apprendre entre <span>quatre et dix mots nouveaux par jour. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995900640524

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Tenue de tête

  • En décubitus ventral, l'enfant arrive à soulever sa tête du plan du lit très précocement, il la change de côté à [...] mois

Answer

1 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Tenue de tête En décubitus ventral, l'enfant arrive à soulever sa tête du plan du lit très précocement, il la change de côté à 1 mois À la naissance, elle est inexistante ; la manœuvre du tiré-assis permet de mesurer l'acquisition de celle-ci avec chute en arrière jusqu'à l'âge de 2 mois. À 2 mois, on note un con

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995902213388

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Tenue de tête

  • À la naissance, elle est inexistante ; la manœuvre du tiré-assis permet de mesurer l'acquisition de celle-ci avec chute en arrière jusqu'à l'âge de [...] mois.

Answer

2 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
ès précocement, il la change de côté à 1 mois À la naissance, elle est inexistante ; la manœuvre du tiré-assis permet de mesurer l'acquisition de celle-ci avec chute en arrière jusqu'à l'âge de <span>2 mois. À 2 mois, on note un contrôle de la tête en position verticale, à 3 mois un contrôle dans toutes les positions. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995903786252

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Tenue de tête

  • À 2 mois, on note un contrôle de la tête en position [...]

Answer

verticale


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
elle est inexistante ; la manœuvre du tiré-assis permet de mesurer l'acquisition de celle-ci avec chute en arrière jusqu'à l'âge de 2 mois. À 2 mois, on note un contrôle de la tête en position <span>verticale, à 3 mois un contrôle dans toutes les positions. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995905359116

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Tenue de tête

  • À [...] mois, on note un contrôle de la tête dans toutes les positions.

Answer

3 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
xistante ; la manœuvre du tiré-assis permet de mesurer l'acquisition de celle-ci avec chute en arrière jusqu'à l'âge de 2 mois. À 2 mois, on note un contrôle de la tête en position verticale, à <span>3 mois un contrôle dans toutes les positions. <span>

Original toplevel document (pdf)

cannot see any pdfs







According to the scientists, including those from NASA’s Jet Propulsion Laboratory in the US, a seawater current called the Beaufort Gyre keeps the polar environment in balance by storing fresh water near the surface of the Arctic ocean.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
NT A A A Heating up: A file photo of melt ponds on the Arctic sea ice. | Photo Credit: STEFAN HENDRICKS PTI Los Angeles, February 09, 2020 15:31 IST Updated: February 09, 2020 15:32 IST more-in <span>According to the scientists, including those from NASA’s Jet Propulsion Laboratory in the US, a seawater current called the Beaufort Gyre keeps the polar environment in balance by storing fresh water near the surface of the Arctic ocean. Researchers have unravelled how an ocean water current, which plays a key role in keeping Western Europe warm, could be altered by an influx of unprecedented amounts of cold, fresh wate




Flashcard 4995914009868

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station assise

  • On note un début de tenue assise vers [...] mois avec support

Answer

4 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Station assise L'acquisition de la station assise est progressive : À 1 mois, tenu, le nourrisson a le dos rond. On note un début de tenue assise vers 4 mois avec support À 5 mois, la station assise est présente avec appui des mains vers l'avant À 6–8 mois, il existe une réaction de parachute latéral (fig. 3.1). L'enfant est capable de

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995915582732

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station assise

  • L'enfant est capable de s'asseoir seul à partir de [...] mois

Answer

8 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 5 mois, la station assise est présente avec appui des mains vers l'avant À 6–8 mois, il existe une réaction de parachute latéral (fig. 3.1). L'enfant est capable de s'asseoir seul à partir de <span>8 mois À 8–9 mois, la station assise autonome, sans support, est parfaite. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995917155596

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station assise

  • À [...] mois, la station assise autonome, sans support, est parfaite.

Answer

8 – 9 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
la station assise est présente avec appui des mains vers l'avant À 6–8 mois, il existe une réaction de parachute latéral (fig. 3.1). L'enfant est capable de s'asseoir seul à partir de 8 mois À <span>8–9 mois, la station assise autonome, sans support, est parfaite. <span>

Original toplevel document (pdf)

cannot see any pdfs







The researchers said this fresh water is important in the Arctic since it floats above the warmer, salty water, and helps protect the sea ice from melting - in turn regulating the Earth’s climate.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
western Arctic Ocean, north of Canada, where it naturally collects fresh water from the melting of glaciers, and river runoff, the study, published in the journal Nature Communications, noted. <span>The researchers said this fresh water is important in the Arctic since it floats above the warmer, salty water, and helps protect the sea ice from melting - in turn regulating the Earth’s climate. As the fresh water is slowly released by the gyre into the Atlantic Ocean over a period of decades, it allows the Atlantic Ocean currents to carry it away in small amounts. However, sin




Due to this decades-long decline of the Arctic’s summertime ice cover, the Beaufort Gyre is more exposed to the wind, which has spun the gyre faster, trapping the fresh water in its current, the scientists noted.

The westerly winds have also persistently dragged the current in one direction for over 20 years, increasing its speed and size, as well as preventing the fresh water from leaving the Arctic Ocean, they said.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
c kilometres - or almost twice the volume of Lake Michigan in the US. According to the new study, the cause of this gain in freshwater concentration is the loss of sea ice in summer and autumn. <span>Due to this decades-long decline of the Arctic’s summertime ice cover, the Beaufort Gyre is more exposed to the wind, which has spun the gyre faster, trapping the fresh water in its current, the scientists noted. The westerly winds have also persistently dragged the current in one direction for over 20 years, increasing its speed and size, as well as preventing the fresh water from leaving the Arctic Ocean, they said. Where the winds used to change direction every five to seven years, this decades-long western wind is unusual for the region, the study noted. If the wind changes direction again, the s




Flashcard 4995924757772

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station debout du nourrisson

  • Il marche tenu vers [...] mois.

Answer

11 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
s, le nourrisson supporte le poids de son corps À partir de 9 mois sont présents les parachutes antérieurs À 10 mois, il se met debout en tirant avec les membres supérieurs. Il marche tenu vers <span>11 mois et seul entre 9 et 18 mois. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995926330636

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station debout

  • Il marche seul entre [...] mois.

Answer

9 et 18 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
rte le poids de son corps À partir de 9 mois sont présents les parachutes antérieurs À 10 mois, il se met debout en tirant avec les membres supérieurs. Il marche tenu vers 11 mois et seul entre <span>9 et 18 mois. <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995927903500

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Station debout

  • À [...] mois, le nourrisson supporte le poids de son corps

Answer

6 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Station debout Chez le nouveau-né, elle est réflexe. À 6 mois, le nourrisson supporte le poids de son corps À partir de 9 mois sont présents les parachutes antérieurs À 10 mois, il se met debout en tirant avec les membres supérieurs. Il march

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995932097804

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Préhension

  • Vers [...] mois, le nourrisson tend la main vers l'objet (préhension volontaire).

Answer

4 – 5 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Préhension Elle est réflexe à la naissance. Vers 4–5 mois, le nourrisson tend la main vers l'objet (préhension volontaire). Il existe un empaumement cubital vers l'objet. À 6 mois, il porte à la bouche, on note un empaumement médian. À 6

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995933670668

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Préhension

  • Vers 4–5 mois, il existe un empaumement [...] vers l'objet.

Answer

empaumement cubital


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Préhension Elle est réflexe à la naissance. Vers 4–5 mois, le nourrisson tend la main vers l'objet (préhension volontaire). Il existe un empaumement cubital vers l'objet. À 6 mois, il porte à la bouche, on note un empaumement médian. À 6 mois, il passe d'une main à l'autre et, à 9 mois, il manipule avec ses deux mains. Il existe une pince f

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995935243532

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Préhension

  • Il existe une pince fine avec opposition pouce-index à partir de [...] mois

Answer

9 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
la bouche, on note un empaumement médian. À 6 mois, il passe d'une main à l'autre et, à 9 mois, il manipule avec ses deux mains. Il existe une pince fine avec opposition pouce-index à partir de <span>9 mois <span>

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995940486412

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Vision

  • À [...] mois, il existe une poursuite horizontale parfaite

Answer

1 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Vision Le nouveau-né reconnaît le visage de sa mère et peut suivre horizontalement. À 1 mois, il existe une poursuite horizontale parfaite À 3 mois une poursuite horizontale et verticale. À 9 mois, le nourrisson cherche du regard un objet tombé et disparu. Au fil de la pre

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995942059276

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

Vision

  • À [...] mois une poursuite horizontale et verticale.

Answer

3 mois


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
Vision Le nouveau-né reconnaît le visage de sa mère et peut suivre horizontalement. À 1 mois, il existe une poursuite horizontale parfaite À 3 mois une poursuite horizontale et verticale. À 9 mois, le nourrisson cherche du regard un objet tombé et disparu. Au fil de la première année, l'acuité visuelle s'affine

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995945729292

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

À [...] ans

  • L'enfant est capable de :
    • Marcher à reculons
    • Il commence à courir
    • Lancer une balle
    • Donner un coup de pied dans un ballon.
    • Monter et descendre les escaliers marche par marche
    • Il ouvre une porte, grimpe sur des meubles
    • Il gribouille des figures circulaires, encastre des formes, fait des tours de six cubes, copie un trait vertical
    • Il peut laver et sécher ses mains, mettre ses chaussures, enlever ses vêtements, se servir d'une cuillère

Answer

2 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 2 ans L'enfant est capable de : Marcher à reculons Il commence à courir Lancer une balle Donner un coup de pied dans un ballon. ​​​​​​​ Monter et descendre les escaliers marche par marche

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995948350732

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

À [...] ans

  • Il est capable de tenir une attitude, de résister à une poussée douce.
  • Il saute à pieds joints vers l'avant, fait du tricycle.
  • Il copie un cercle et avec trois cubes reproduit le pont.
  • Il se lave les mains seul.

Answer

3 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 3 ans Il est capable de tenir une attitude, de résister à une poussée douce. Il saute à pieds joints vers l'avant, fait du tricycle. Il copie un cercle et avec trois cubes reproduit le po

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995950972172

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

À [...] ans

  • Il maintient un appui monopodal et peut commencer à sauter à cloche-pied, lance une balle en l'air.
  • Il copie un carré, dessine un bonhomme avec une tête et deux à quatre parties

Answer

4 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 4 ans Il maintient un appui monopodal et peut commencer à sauter à cloche-pied, lance une balle en l'air. Il copie un carré, dessine un bonhomme avec une tête et deux à quatre parties </s

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995953855756

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

À [...] ans

  • Il sait sauter à la corde, rattraper une balle qui rebondit.
  • Il sait faire du vélo sans les petites roues.
  • Il s'habille et se déshabille.

Answer

5 – 6 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 5–6 ans Il sait sauter à la corde, rattraper une balle qui rebondit. Il sait faire du vélo sans les petites roues. Il s'habille et se déshabille. À 5 ans, il copie le triangle et écrit son

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995955428620

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • À [...] ans, il copie le triangle et écrit son prénom en lettres bâton. Il reproduit une pyramide avec six cubes.

Answer

5 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
À 5–6 ans Il sait sauter à la corde, rattraper une balle qui rebondit. Il sait faire du vélo sans les petites roues. Il s'habille et se déshabille. À 5 ans, il copie le triangle et écrit son prénom en lettres bâton. Il reproduit une pyramide avec six cubes. À 6 ans, il copie le losange et écrit son prénom en lettres attachées </

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4995957001484

Tags
#53 #Cours #Développement #Facultaires #Médecine #Psychomoteur #Pédiatrie
Question

  • À [...] ans, il copie le losange et écrit son prénom en lettres attachées

Answer

6 ans


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
dit. Il sait faire du vélo sans les petites roues. Il s'habille et se déshabille. À 5 ans, il copie le triangle et écrit son prénom en lettres bâton. Il reproduit une pyramide avec six cubes. À <span>6 ans, il copie le losange et écrit son prénom en lettres attachées <span>

Original toplevel document (pdf)

cannot see any pdfs







Water from the Arctic loses heat and moisture to the atmosphere, and sinks to the bottom of the ocean, where it drives water from the north Atlantic Ocean down to the tropics in a conveyor-belt-like current called the Atlantic Meridional Overturning Circulation, the scientists explained.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
ead author of the study from NASA’s Jet Propulsion Laboratory. The release of fresh water from the Arctic Ocean to the North Atlantic can change the density of surface waters, the study warned. <span>Water from the Arctic loses heat and moisture to the atmosphere, and sinks to the bottom of the ocean, where it drives water from the north Atlantic Ocean down to the tropics in a conveyor-belt-like current called the Atlantic Meridional Overturning Circulation, the scientists explained. This current helps regulate the planet’s climate by carrying heat from the tropically-warmed water to northern latitudes like Europe and North America, and if it is slowed down, it coul




extinct ancient elephant called Deinotherium indicum.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
gh along with his team was out on their excavation work at Kutch. When he stumbled upon a premolar tooth of about 6 cm width and 7 cm length, little did he know that what he held belonged to an <span>extinct ancient elephant called Deinotherium indicum. First occurrence Interestingly, this turned out to be the region’s first occurrence of the mammal which weighed between eight and 10 tons in weight. Dr. Singh adds that this new find al




Novel selenium-graphene catalyst for fuel cells

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
ci-Tech Science Technology Health Agriculture Environment Gadgets Internet Data | Lowest GDP since 1976 to widening fiscal deficit: Capturing Indian economy in 9 charts Sci-Tech Science Science <span>Novel selenium-graphene catalyst for fuel cells Shubashree Desikan June 15, 2019 16:31 IST Updated: June 15, 2019 16:33 IST Share Article 2 PRINT A A A Right chemistry: A small amount of selenium and high amount of graphene, treated




India has developed a selenium-graphene–based catalyst which is more efficient, costs less and also remains stable for longer than the usual platinum based catalysts. The institutes involved in the work are: Tata Institute of Fundamental Research, Hyderabad (TIFR-H), University of Hyderabad and Indian Institute of Science Education and Research (IISER) Thiruvananthapuram.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
nology, for example fuel cells which are used commercially in hydrogen fuel–based cars, require good catalysts that are efficient as well as cost-effective. Now, a multi-institutional team from <span>India has developed a selenium-graphene–based catalyst which is more efficient, costs less and also remains stable for longer than the usual platinum based catalysts. The institutes involved in the work are: Tata Institute of Fundamental Research, Hyderabad (TIFR-H), University of Hyderabad and Indian Institute of Science Education and Research (IISER) Thiruvananthapuram. The research has been published in the journal ACS: Applied Energy Materials. Normally, fuel cells use expensive platinum-like elements. “These expensive metal-based technologies perfor




Normally, fuel cells use expensive platinum-like elements. “These expensive metal-based technologies perform excellently for initial few cycles, but then get degraded in performance due to many reasons

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
TIFR-H), University of Hyderabad and Indian Institute of Science Education and Research (IISER) Thiruvananthapuram. The research has been published in the journal ACS: Applied Energy Materials. <span>Normally, fuel cells use expensive platinum-like elements. “These expensive metal-based technologies perform excellently for initial few cycles, but then get degraded in performance due to many reasons,” explains T.N. Narayanan of TIFR-H, the corresponding author. As a result, there is a need to change this part of the fuel cell routinely. The oxygen reduction reaction is a key step i




The oxygen reduction reaction is a key step in the functioning of the fuel cell.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
then get degraded in performance due to many reasons,” explains T.N. Narayanan of TIFR-H, the corresponding author. As a result, there is a need to change this part of the fuel cell routinely. <span>The oxygen reduction reaction is a key step in the functioning of the fuel cell. Graphene by itself is a “poor” catalyst of this reaction. In the sense that it involves reduction of oxygen in two steps, each of which consume two electrons. This is not very useful ei




Platinum is often used to catalyse this reaction. As a substitute, the group developed the catalyst with selenium and graphene.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
lyst of this reaction. In the sense that it involves reduction of oxygen in two steps, each of which consume two electrons. This is not very useful either for fuel cells or metal-air batteries. <span>Platinum is often used to catalyse this reaction. As a substitute, the group developed the catalyst with selenium and graphene. “Graphene modified with selenium atoms in very low amounts can perform like platinum in a demonstrated reaction,” Dr. Narayanan clarifies. While neither selenium nor graphene can do the




Such direct water converting oxygen reduction reaction catalyst has enormous applications in other fields too, such as metal-air battery

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
that category into which this catalyst falls – is not new. But earlier concepts had used heavy metals such as platinum, palladium and gold. Using selenium is a novel idea mooted by this group. “<span>Such direct water converting oxygen reduction reaction catalyst has enormous applications in other fields too, such as metal-air battery. It is ongoing research for the development of high energy density devices in batteries. This will be far better than the existing lithium ion-based battery,” he says. Why you should pa




Johann Dobereiner of Germany in 1817 found that, if he took a triad of elements with similar properties, the atomic weight of the middle element is roughly midway between those of the other two [e.g., sodium with atomic weight 23 is midway between lithium (3) and potassium (39)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
or logic that one can derive by looking at the similarity in the properties of certain classes of atoms (say, lithium, sodium and potassium) on one hand, and their atomic weights on the other? <span>Johann Dobereiner of Germany in 1817 found that, if he took a triad of elements with similar properties, the atomic weight of the middle element is roughly midway between those of the other two [e.g., sodium with atomic weight 23 is midway between lithium (3) and potassium (39), or bromine (80) between chlorine (35) and iodine (127)]. And in 1865, the English chemist John Newlands stated his “law of octaves”: if elements are arranged in increasing atomic weigh




John Newlands stated his “law of octaves”: if elements are arranged in increasing atomic weight order, those with similar properties occur after each interval of seven elements (for example, lithium and sodium, or carbon and silicon)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
of the other two [e.g., sodium with atomic weight 23 is midway between lithium (3) and potassium (39), or bromine (80) between chlorine (35) and iodine (127)]. And in 1865, the English chemist <span>John Newlands stated his “law of octaves”: if elements are arranged in increasing atomic weight order, those with similar properties occur after each interval of seven elements (for example, lithium and sodium, or carbon and silicon), much as the notes in music. It was against this background that we meet Professor Dimitri Mendeleev at St. Petersburg, Russia, in 1865. Not satisfied with existing text books, he wrote




silicon and have an atomic weight of 72. Sure enough it was found in 1886, and was named germanium.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
th element in the table resembles the first), but could go further. Given this repetition rule, he could predict that an element (he named it eka-silicon) will be discovered which will resemble <span>silicon and have an atomic weight of 72. Sure enough it was found in 1886, and was named germanium. Likewise, his prediction of eka-aluminium too came true; gallium discovered in 1875 had all properties predicted by Mendeleev. Siegfried writes: “His [Mendeleev’s] table finished the tr




The new framework is aimed at facilitating further concrete action on marine waste, though on a voluntary basis, after the G20 Hamburg Summit in Germany adopted the “G20 action plan on marine litter” in 2017.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
ic bags outright. Japanese Prime Minister Shinzo Abe has said he wants his country to lead the world in reducing marine plastic trash, including developing biodegradables and other innovations. <span>The new framework is aimed at facilitating further concrete action on marine waste, though on a voluntary basis, after the G20 Hamburg Summit in Germany adopted the “G20 action plan on marine litter” in 2017. Under the new framework, G20 members will promote a comprehensive life-cycle approach to prevent and reduce plastic litter discharge to the oceans through various measures and internati




India has been an associate member of the IPTA since the last four years. But this is the first time that we will be hosting the annual meeting,” Dr. J.K.Solanki, head of administration, NCRA, said.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
all set to host the five-day annual International Pulsar Timing Array (IPTA) meet from June 17 to 21. The meet is a collaboration of radio astronomers from a dozen countries across the globe. “<span>India has been an associate member of the IPTA since the last four years. But this is the first time that we will be hosting the annual meeting,” Dr. J.K.Solanki, head of administration, NCRA, said. The IPTA is a collaboration of radio astronomers from a dozen countries across the globe. It uses more than 12 radio telescopes all over the world with an aim to detect ultra-low freque




The IPTA is a collaboration of radio astronomers from a dozen countries across the globe. It uses more than 12 radio telescopes all over the world with an aim to detect ultra-low frequency gravitational waves.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
has been an associate member of the IPTA since the last four years. But this is the first time that we will be hosting the annual meeting,” Dr. J.K.Solanki, head of administration, NCRA, said. <span>The IPTA is a collaboration of radio astronomers from a dozen countries across the globe. It uses more than 12 radio telescopes all over the world with an aim to detect ultra-low frequency gravitational waves. More than 40 expert international astronomers and 30 international students are expected to participate in the event, besides several Indian participants. “The upgrade of the Giant Metr




he current status of the quest for ultra-low frequency Gravitational Waves and the roadmap for future technical and scientific challenges is to be the main focus of the meeting.

“These waves are wrinkles in space-time produced by two massive black holes, each revolving around the other. Such black holes, which weigh billion times more than our Sun, are found in the centres of colliding galaxies. These waves affect radio pulses from 10km size stars called radio pulsars by changing ever so slightly the period of radio pulsation of these stars

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
this status by the conclusion of the upcoming meeting. We are expecting eighty international members apart from the twenty persons who will be representing our country,” informed Dr. Solanki. T<span>he current status of the quest for ultra-low frequency Gravitational Waves and the roadmap for future technical and scientific challenges is to be the main focus of the meeting. “These waves are wrinkles in space-time produced by two massive black holes, each revolving around the other. Such black holes, which weigh billion times more than our Sun, are found in the centres of colliding galaxies. These waves affect radio pulses from 10km size stars called radio pulsars by changing ever so slightly the period of radio pulsation of these stars,” said Prof. Yashwant Gupta, centre director, NCRA. He said that measuring these periods to a precision of 10 seconds of a nano-second may help the IPTA experiment to discover Gravitati




Bitcoin use causing huge CO2 emissions: Study

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
h Science Technology Health Agriculture Environment Gadgets Internet Data | Lowest GDP since 1976 to widening fiscal deficit: Capturing Indian economy in 9 charts Sci-Tech Technology Technology <span>Bitcoin use causing huge CO2 emissions: Study PTI Berlin, June 17, 2019 12:52 IST Updated: June 18, 2019 12:52 IST Share Article 7 PRINT A A A Representation of the Bitcoin virtual currency standing on a PC motherboard is seen in t




A team of scientists in Assam has developed a chemical process that turns ‘dirty’ coal into a biomedical ‘dot’ to help detect cancer cells.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
with coal and carbon quantum dots (inset). Rahul Karmakar GUWAHATI , June 19, 2019 22:09 IST Updated: June 19, 2019 22:09 IST more-in Costs one-twentieth of imported carbon quantum dots (CQDs). <span>A team of scientists in Assam has developed a chemical process that turns ‘dirty’ coal into a biomedical ‘dot’ to help detect cancer cells. The team, led by Binoy Kumar Saikia and Tonkeswar Das, has applied for a patent for their chemical method of producing carbon quantum dots (CQDs) from cheap, abundant, low-quality and h




chemical method of producing carbon quantum dots (CQDs) from cheap, abundant, low-quality and high-sulphur coals.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
veloped a chemical process that turns ‘dirty’ coal into a biomedical ‘dot’ to help detect cancer cells. The team, led by Binoy Kumar Saikia and Tonkeswar Das, has applied for a patent for their <span>chemical method of producing carbon quantum dots (CQDs) from cheap, abundant, low-quality and high-sulphur coals. CQDs are carbon-based nanomaterials whose size is less than 10 nm, or nanometre. “Carbon-based nanomaterials are used as diagnostic tools for bio-imaging, especially in detecting cancer




Carbon-based nanomaterials are used as diagnostic tools for bio-imaging, especially in detecting cancer cells, for chemical sensing and in opto-electronics.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
emical method of producing carbon quantum dots (CQDs) from cheap, abundant, low-quality and high-sulphur coals. CQDs are carbon-based nanomaterials whose size is less than 10 nm, or nanometre. “<span>Carbon-based nanomaterials are used as diagnostic tools for bio-imaging, especially in detecting cancer cells, for chemical sensing and in opto-electronics. A few chemical companies in the U.S. and Japan have been manufacturing CQDs. What we have done is develop fluorescent carbon nanomaterials at one-twentieth the cost of imported CQDs,” M




The CQDs that the CSIR-NEIST team developed emit a bluish colour with “high-stability, good-conductivity, low-toxicity, environmental friendliness, and good optical properties

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
nd Coal Chemistry Group of the Council of Scientific & Industrial Research-North East Institute of Science and Technology (CSIR-NEIST) in eastern Assam’s Jorhat, about 300 km from Guwahati. <span>The CQDs that the CSIR-NEIST team developed emit a bluish colour with “high-stability, good-conductivity, low-toxicity, environmental friendliness, and good optical properties”. The finer details have been published in their study published in the Journal of Photochemistry and Photobiology. “Our source material is abundant, low-quality Indian coal not directl




Our observed annual mass losses suggest that of the total ice mass present in 1975, about 87% remained in 2000 and 72% remained in 2016,” the study’s authors wrote.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
shed in the Science Advances journal on Wednesday, J.M. Maurer and co-authors analysed four decades of ice loss for 650 of the largest glaciers across a 2,000 km transect across the Himalayas. “<span>Our observed annual mass losses suggest that of the total ice mass present in 1975, about 87% remained in 2000 and 72% remained in 2016,” the study’s authors wrote. “We find similar mass loss rates across subregions and a doubling of the average rate of loss during 2000–2016 relative to the 1975–2000 interval,” they added. The study goes on to asse




Significantly, the document contains a modified version of the relativity theory and shows that Einstein was facing fierce resistance within the scientific community.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
andwritten editor’s annotations by German physicist Max von Laue who won the Nobel Prize in 1914. Von Laue owned the manuscript until 1948 before it passed into the hands of private collectors. <span>Significantly, the document contains a modified version of the relativity theory and shows that Einstein was facing fierce resistance within the scientific community. “This letter shows that even though Albert Einstein had received the Nobel prize, his physics was very much part of the debate among scientists at that time and Albert Einstein himself




Once an indispensable part of daily life in Japan, ultra-thin washi paper was used for everything from writing and painting to lampshades, umbrellas, and sliding doors, but demand has plunged as lifestyles have become more westernised.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
a. | Photo Credit: AFP AFP Hidaka, June 20, 2019 22:09 IST Updated: June 20, 2019 22:09 IST more-in Despite its UNESCO Intangible Cultural Heritage tag, the artefact’s market value is dwindling <span>Once an indispensable part of daily life in Japan, ultra-thin washi paper was used for everything from writing and painting to lampshades, umbrellas, and sliding doors, but demand has plunged as lifestyles have become more westernised. Despite its 1,300-year history and UNESCO Intangible Cultural Heritage status, washi paper is struggling to attract consumers and the market value has dropped by more than 50% in the pa




The traditional hand-made paper is manufactured from plants called kozo, or mulberry, which has fibres that are much longer than materials used for paper in the west such as wood and cotton.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
ess — from decay. “Washi paper is more flexible and durable” than what Japanese refer to as “western paper”, which disintegrates into tiny pieces when it becomes very old, said the 50-year-old. <span>The traditional hand-made paper is manufactured from plants called kozo, or mulberry, which has fibres that are much longer than materials used for paper in the west such as wood and cotton. “Old Japanese books from the seventh or eighth century remain in good condition... thanks to the fibres of the kozo plants,” said the washi maker at his small factory in Hidaka, a villa




The wild yak is an endangered species restricted to the higher Himalayas of Asia, the Tibetan plateau and parts of North Russia. It can tolerate temperatures as low as -40 degrees Celsius and is associated with the Himalayan tahr and White-bellied musk deer.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
researchers who spend days analysing yak dung to understand the vegetation and climate of the past and the connections they have to extinct mega herbivores such as the woolly rhino and mammoth. <span>The wild yak is an endangered species restricted to the higher Himalayas of Asia, the Tibetan plateau and parts of North Russia. It can tolerate temperatures as low as -40 degrees Celsius and is associated with the Himalayan tahr and White-bellied musk deer. The most non-invasive way to study its diet and the local vegetation is by examining its dung. During the summer of 2017, researchers from Birbal Sahni institute of Palaeosciences, Luck




This also indicated that the yak was able to modify its diet according to the climatic change of the past.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
is meant that the yak preferred a variety of food — simple grass to leaves and fruits of woody trees. This diversity was high during summer and the yak could walk up to 50 km in search of food. <span>This also indicated that the yak was able to modify its diet according to the climatic change of the past. “The end of the Pleistocene epoch (11,700 years ago) and the start of Holocene brought about a change in vegetation and also introduced humans,” explains Swati Tripathi, one of the auth




Giant mammoth and woolly rhino which used to live with the yak about 18,000-20,000 years ago were not able to adapt to these changes and thus went extinct. This is a classic example of ‘survival of the fittest’. Our humble yak proved to be the fittest one.”

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Unknown title
h (11,700 years ago) and the start of Holocene brought about a change in vegetation and also introduced humans,” explains Swati Tripathi, one of the authors of the paper published in PLOS ONE. “<span>Giant mammoth and woolly rhino which used to live with the yak about 18,000-20,000 years ago were not able to adapt to these changes and thus went extinct. This is a classic example of ‘survival of the fittest’. Our humble yak proved to be the fittest one.” The yak dung analysis also helped to map out the different plants and trees in that area, thus, generating modern botanical analogue for palaeo environmental studies in higher Himalayas




#machine-learning #software-engineering #unfinished
When machine learning packages are developed in an ivory-tower setting, the resulting packages may appear to be more like black boxes to the teams that actually employ them in practice.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on


Parent (intermediate) annotation

Open it
It’s worth noting that glue code and pipeline jungles are symptomatic of integration issues that may have a root cause in overly separated “research” and “engineering” roles. When machine learning packages are developed in an ivory-tower setting, the resulting packages may appear to be more like black boxes to the teams that actually employ them in practice.

Original toplevel document (pdf)

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie
Les voies aériennes supérieures doivent être libres, désobstruées si nécessaire et maintenues ouvertes. Chez un enfant inconscient, une canule oropharyngée de Guedel est mise en place

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

Ces différents éléments doivent être interprétés ; on distingue ainsi :

  • Un enfant eupnéique
  • Une détresse respiratoire aiguë (définie par l'augmentation du travail respiratoire)
  • Une insuffisance respiratoire (incapacité respiratoire à maintenir PO2 et PCO2 normales)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

« B » = ventilation

On évalue quatre paramètres :

  • FR : fréquence respiratoire
  • T : travail respiratoire
  • V : volumes pulmonaires
  • O : oxygénation

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

L'insuffisance respiratoire est dite décompensée si elle s'accompagne :

  • De troubles de la vigilance/conscience
  • D'une tachycardie supérieure aux limites supérieures de fréquence cardiaque selon l'âge
  • D'une bradycardie
  • De cyanose (hypoxie) ou de sueurs (hypercapnie)
  • De signes d'épuisement respiratoire (apnées, diminution du travail respiratoire et des volumes pulmonaires)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

« C » = circulation On évalue cinq paramètres :

  • FC : fréquence cardiaque
  • PAS : pression artérielle systolique
  • P : pouls
  • P : perfusion périphérique
  • P : précharge.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie
La PAS est maintenue normale plus longtemps que chez l'adulte en situation pathologique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie
Le pouls central est évalué au niveau huméral avant l'âge de 1 an, au niveau carotidien ensuite

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie
L'état de choc est dit décompensé s'il s'accompagne de troubles de la vigilance/conscience, ou d'une PAS inférieure aux limites inférieures de pression artérielle selon l'âge

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

La prise en charge d'un état de choc dépend de sa nature.

On prescrit :

  • Une expansion volémique (NaCl 0,9 % 20 mL/kg en bolus, sans dépasser 500 mL) en cas de choc hypovolémique, septique, distributif ou obstructif
  • Des catécholamines en cas de choc cardiogénique ou après trois remplissages en cas de choc septique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4996079422732

Tags
#knowledge-base-construction #machine-learning
Question
In contrast to KBC from text or tabular data, Fonduer aims to extract relations conveyed via textual, structural, tabular, and [...] expressions.
Answer
visual


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
In contrast to KBC from text or tabular data, KBC from richly formatted data aims to extract relations conveyed jointly via textual, structural, tabular, and visual expressions.

Original toplevel document (pdf)

cannot see any pdfs







Flashcard 4996083879180

Tags
#knowledge-base-construction #machine-learning
Question
In contrast to KBC from text or tabular data, Fonduer aims to extract relations conveyed via tabular, structural, [...] , and visual expressions
Answer
textual


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
In contrast to KBC from text or tabular data, KBC from richly formatted data aims to extract relations conveyed jointly via textual, structural, tabular, and visual expressions.

Original toplevel document (pdf)

cannot see any pdfs







#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

Les causes d'ACR ne sont pas les mêmes chez l'enfant que chez l'adulte.

  • L'ACR de l'adulte est en règle générale un ACR primaire, lié à une ischémie myocardique et un trouble du rythme ventriculaire (FV, TV sans pouls), dont la prise en charge précoce est la défibrillation.

  • L'ACR de l'enfant est le plus souvent un ACR secondaire, lié à une insuffisance respiratoire et/ ou circulatoire avec rythme préterminal non défibrillable (asystolie, activité électrique sans pouls).

  • Le pronostic de l'ACR est très sombre (< 5 % de survie à 1 an)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Flashcard 4996086762764

Tags
#knowledge-base-construction #machine-learning
Question
In contrast to KBC from text or tabular data, Fonduer aims to extract relations conveyed via tabular, textual, [...] , and visual expressions
Answer
structural


statusnot learnedmeasured difficulty37% [default]last interval [days]               
repetition number in this series0memorised on               scheduled repetition               
scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

Open it
In contrast to KBC from text or tabular data, KBC from richly formatted data aims to extract relations conveyed jointly via textual, structural, tabular, and visual expressions.

Original toplevel document (pdf)

cannot see any pdfs







#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

RCP de base

La prise en charge précoce suit la séquence « ABC » :

  • A : ouvrir, désobstruer, sécuriser (canule de Guedel) les voies aériennes
  • B : oxygéner, ventiler au masque et au ballon (5 insufflations initiales d'1 seconde chacune)
  • C : réaliser des compressions thoraciques, monitorer le rythme cardiaque

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

  • Chez le nourrisson d'âge < 1 an, un sauveteur seul utilise les extrémités de deux doigts ; si plusieurs sauveteurs sont présents, la technique à deux mains par encerclement du thorax est préférée.
  • À partir de 1 an, les compressions sont réalisées avec le talon d'une seule main.
  • Le rythme de RCP de base est : une série de 15 compressions thoraciques, suivie de 2 insufflations.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie
En cas d'apparition d'un rythme organisé sur le scope > 60/min, il faut chercher un pouls. La présence d'un pouls signifie le retour à une circulation spontanée

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

Garder également à l'esprit les huit causes réversibles d'ACR :

  • 4 « H » :
    • Hypoxie
    • Hypovolémie
    • Hypo-/hyperkaliémie
    • Hypothermie

  • 4 « T » :
    • Toxiques
    • pneumoThorax suffocant
    • Tamponnade
    • Thrombose (pulmonaire, coronaire).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

En cas de rythme non défibrillable :

  • Poser une voie intraosseuse (IO)
  • Adrénaline 10 gamma/kg (= 0,1 mL/kg de solution à 1/10 000) IV/IO
    + RCP 2 minutes

  • Réévaluer le rythme
    • S'il est inchangé : RCP 2 minutes

  • Réévaluer le rythme
    • S'il est inchangé : adrénaline + RCP 2 minutes

  • Réévaluer le rythme
    • S'il est inchangé RCP 2 minutes…

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#327 #ACR #Cours #Facultaires #Médecine #Pédiatrie

En cas de rythme débrillable :

  • 1 er choc électrique 4 J/kg + RCP 2 minutes + poser une voie intraosseuse
    • Réévaluer le rythme

  • S'il est inchangé : 2 e choc électrique 4 J/kg + RCP 2 minutes
    • Réévaluer le rythme

  • S'il est inchangé 3 e choc électrique 4 J/kg + RCP 2 minutes + adrénaline + amiodarone (ou lidocaïne bolus)
    • Réévaluer le rythme

  • S'il est inchangé : 4 e choc électrique 4 J/kg + RCP 2 minutes
    • Réévaluer le rythme

  • S'il est inchangé : 5 e choc électrique 4 J/kg + RCP 2 minutes + adrénaline + amiodarone (ou lidocaïne en IV continu)
    • Réévaluer le rythme

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Article 4996094889228

Devlin-presentation-BERT
#bert #unfinished

https://nlp.stanford.edu/seminar/details/jdevlin.pdf BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding (Bidirectional Encoder Representations from Transformers) Jacob Devlin Google AI Language Pre-training in NLP ● Word embeddings are the basis of deep learning for NLP ● Word embeddings (word2vec, GloVe) are often pre-trained on text corpus from co-occurrence statistics king [-0.5, -0.9, 1.4, …] queen [-0.6, -0.8, -0.2, …] the king wore a crown Inner Product the queen wore a crown Inner Product Contextual Representations ● Problem: Word embeddings are applied in a context free manner ● Solution: Train contextual representations on text corpus [0.3, 0.2, -0.8, …] open a bank account on the river bank open a bank account [0.9, -0.2, 1.6, …] on the river bank [-1.9, -0.4, 0.1, …] History of Contextual Representations ● Semi-Supervised Sequence Learning, Google, 2015 Train LSTM Language Model LSTM open LSTM open a LSTM a bank LSTM very LSTM funny LSTM movie POSITIVE ... Fine-tu



#bert #unfinished
Near-term improvements in NLP will be mostly about making clever use of “free” data. ○ Unsupervised vs. semi-supervised vs. synthetic supervised is somewhat arbitrary. ○ “Data I can get a lot of without paying anyone” vs. “Data I have to pay people to create” is more pragmatic distinction.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
present knowledge/context in latent space ○ Models that represent structured data (e.g., knowledge graph) ○ Models that jointly represent vision and language Common Questions ● Personal belief: <span>Near-term improvements in NLP will be mostly about making clever use of “free” data. ○ Unsupervised vs. semi-supervised vs. synthetic supervised is somewhat arbitrary. ○ “Data I can get a lot of without paying anyone” vs. “Data I have to pay people to create” is more pragmatic distinction. ● No less “prestigious” than modeling papers: ○ Phrase-Based & Neural Unsupervised Machine Translation, Facebook AI Research, EMNLP 2018 Best Paper Conclusions ● Empirical results f




#bert #unfinished
● Examples of NLP models that are not “solved”: ○ Models that minimize total training cost vs. accuracy on modern hardware ○ Models that are very parameter efficient (e.g., for mobile deployment) ○ Models that represent knowledge/context in latent space ○ Models that represent structured data (e.g., knowledge graph) ○ Models that jointly represent vision and language

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
with novel model architectures? ○ But that’s the most fun part of NLP research :( ● Maybe yes, for now, on some tasks, like SQuAD-style QA. ○ At least using the same deep learning “lego blocks” <span>● Examples of NLP models that are not “solved”: ○ Models that minimize total training cost vs. accuracy on modern hardware ○ Models that are very parameter efficient (e.g., for mobile deployment) ○ Models that represent knowledge/context in latent space ○ Models that represent structured data (e.g., knowledge graph) ○ Models that jointly represent vision and language Common Questions ● Personal belief: Near-term improvements in NLP will be mostly about making clever use of “free” data. ○ Unsupervised vs. semi-supervised vs. synthetic supervised is s




#bert #unfinished
interpretation: Predicting missing words (or next words) requires learning many types of language understanding features. ○ syntax, semantics, pragmatics, coreference, etc.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
week, get 80.5%. ○ Conference reviewers: “Who would do something so expensive for such a small gain?” Common Questions ● The model must be learning more than “contextual embeddings” ● Alternate <span>interpretation: Predicting missing words (or next words) requires learning many types of language understanding features. ○ syntax, semantics, pragmatics, coreference, etc. ● Implication: Pre-trained model is much bigger than it needs to be to solve specific task ● Task-specific model distillation words very well Common Questions ● Is modeling “solved” in




#bert #unfinished
Pre-trained model is much bigger than it needs to be to solve specific task ● Task-specific model distillation words very well

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
rnate interpretation: Predicting missing words (or next words) requires learning many types of language understanding features. ○ syntax, semantics, pragmatics, coreference, etc. ● Implication: <span>Pre-trained model is much bigger than it needs to be to solve specific task ● Task-specific model distillation words very well Common Questions ● Is modeling “solved” in NLP? I.e., is there a reason to come up with novel model architectures? ○ But that’s the most fun part of NLP research :( ● Maybe yes, for now




#bert #unfinished
Why wasn’t contextual pre-training popular before 2018 with ELMo? ● Good results on pre-training is >1,000x to 100,000 more expensive than supervised training. ○ E.g., 10x-100x bigger model trained for 100x-1,000x as many steps.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
ls ○ Off-by-one: LTR predicts next word, RTL predicts previous word ○ Not trivial to add arbitrary pre-training tasks. Common Questions ● Why did no one think of this before? ● Better question: <span>Why wasn’t contextual pre-training popular before 2018 with ELMo? ● Good results on pre-training is >1,000x to 100,000 more expensive than supervised training. ○ E.g., 10x-100x bigger model trained for 100x-1,000x as many steps. ○ Imagine it’s 2013: Well-tuned 2-layer, 512-dim LSTM sentiment analysis gets 80% accuracy, training for 8 hours. ○ Pre-train LM on same architecture for a week, get 80.5%. ○ Conference




#bert #unfinished
Imagine it’s 2013: Well-tuned 2-layer, 512-dim LSTM sentiment analysis gets 80% accuracy, training for 8 hours. ○ Pre-train LM on same architecture for a week, get 80.5%. ○ Conference reviewers: “Who would do something so expensive for such a small gain?”

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
ar before 2018 with ELMo? ● Good results on pre-training is >1,000x to 100,000 more expensive than supervised training. ○ E.g., 10x-100x bigger model trained for 100x-1,000x as many steps. ○ <span>Imagine it’s 2013: Well-tuned 2-layer, 512-dim LSTM sentiment analysis gets 80% accuracy, training for 8 hours. ○ Pre-train LM on same architecture for a week, get 80.5%. ○ Conference reviewers: “Who would do something so expensive for such a small gain?” Common Questions ● The model must be learning more than “contextual embeddings” ● Alternate interpretation: Predicting missing words (or next words) requires learning many types of lang




#bert #unfinished
Is deep bidirectionality really necessary? What about ELMo-style shallow bidirectionality on bigger model? ● Advantage: Slightly faster training time ● Disadvantages: ○ Will need to add non-pre-trained bidirectional model on top ○ Right-to-left SQuAD model doesn’t see question ○ Need to train two models ○ Off-by-one: LTR predicts next word, RTL predicts previous word ○ Not trivial to add arbitrary pre-training tasks.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

Devlin-presentation-BERT
gon in? What state is Roxy Ann Peak in? → What mountain is Roxy Ann Peak in? 8. Optionally: Two-pass training, where no-answer is modeled as regression second pass (~+0.5 F1) Common Questions ● <span>Is deep bidirectionality really necessary? What about ELMo-style shallow bidirectionality on bigger model? ● Advantage: Slightly faster training time ● Disadvantages: ○ Will need to add non-pre-trained bidirectional model on top ○ Right-to-left SQuAD model doesn’t see question ○ Need to train two models ○ Off-by-one: LTR predicts next word, RTL predicts previous word ○ Not trivial to add arbitrary pre-training tasks. Common Questions ● Why did no one think of this before? ● Better question: Why wasn’t contextual pre-training popular before 2018 with ELMo? ● Good results on pre-training is >1,000x




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

Le malaise du nourrisson constitue un motif fréquent de consultation aux urgences pédiatriques.

Il se définit par un accident inopiné et brutal entraînant des modifications du tonus et de la coloration des téguments, avec ou sans perte de connaissance.

Les nourrissons d'âge < 6 mois sont les plus concernés, avec une prédominance masculine.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

Le malaise se définit comme un accident inopiné et brutal associant à des degrés variables :

  • Des modifications du tonus : hypotonie, hypertonie
  • Des modifications de la coloration des téguments : pâleur, cyanose ; (parfois) érythrose
  • Avec ou sans modification du rythme respiratoire : bradypnées, tachypnées, apnées
  • Avec ou sans perte de connaissance

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

L'item de l'ECNi couple la thématique du malaise grave avec celle de mort inattendue du nourrisson (MIN), traitée au chapitre 9, la confusion ayant longtemps été entretenue du fait d'une étiologie commune alors très fréquente, l'asphyxie par enfouissement facial.

Les parents font cet amalgame ; ce qui contribue, en cas de malaise grave ou ressenti comme tel, à recommander une hospitalisation pour surveillance et réassurance parentale

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie
Malaise « grave » : détresse brutale hémodynamique, ventilatoire ou neurologique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

Critères cliniques de gravité d'un malaise du nourrisson.

  • Hémodynamiques
    • Teint gris
    • Bradycardie ou tachycardie, hypotension ou hypertension
    • Allongement du temps de recoloration cutanée, état de choc
    • Signes d'insuffisance cardiaque

  • Ventilatoires
    • Cyanose
    • Irrégularités du rythme respiratoire persistantes (bradypnées, apnées)
    • Signes de lutte respiratoire
    • Sat(O 2 ) < 90 % sous air

  • Neurologiques
    • Geignement, bombement de la fontanelle, augmentation du PC
    • Troubles de conscience (perte de contact prolongée ou répétée, somnolence, coma)
    • Déficit focalisé, hypotonie ou hypertonie axiale/périphérique
    • Mouvements anormaux (clonies, mâchonnements, pédalage)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

Examens complémentaires systématiques.

  • Bilan sanguin
    • Glycémie capillaire puis veineuse
    • NFS-plaquettes
    • CRP, PCT (si disponible)
    • Ionogramme sanguin (+ créatininémie, urée)
    • Calcémie
    • Transaminases
    • ± Lactates (si sévérité clinique)

  • Autres
    • BU
    • ECG avec mesure du QT corrigé
    • Radiographie de thorax (face)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie
Un QTc > 440 ms doit faire suspecter un syndrome du QT long

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie
Tout nourrisson ayant fait un malaise authentifié et récent (≤ 24 heures) doit être hospitalisé pour au moins 24–48 heures

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie
Sur un plan physiopathologique, une hypertonie vagale sous-tend fréquemment les malaises compliquant un RGO ou une douleur aiguë

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

En cas d'orientation vers une cause neurologique, il faut discuter :

  • Ammoniémie et gaz du sang + lactates (si possible dès l'admission)
  • EEG
  • Imagerie cérébrale : ETF, TDM/IRM
  • Fond d'œil

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#340 #Cours #Facultaires #Grave #Malaise #Médecine #Nourrisson #Pédiatrie

Un holter cardiaque est indiqué en cas de :

  • Existence d'anomalies à l'ECG (troubles du rythme, troubles de conduction)
  • Récidives de malaise sans étiologie retrouvée

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique

L'efficacité de ces premiers traitements doit être systématiquement réévaluée de manière fréquente durant la première heure.
À la phase initiale, l'examen clinique répété suffit à s'assurer de la réponse attendue aux traitements entrepris

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Syndrome de réponse inflammatoire systémique

Le SRIS est défini par la présence d'au moins deux des critères suivants, incluant au minimum température ou leucocytose :

  • Température > 38,5 °C ou < 36 °C
  • Fréquence cardiaque > 2 DS pour l'âge ou bradycardie (âge < 1 an)
  • Fréquence respiratoire > 2 DS pour l'âge ou nécessité de ventilation mécanique
  • Leucocytose > 12 000/mm3 ou < 4 000/mm3

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Le sepsis est défini par l'existence d'un SRIS associé à une infection, qu'elle soit prouvée ou uniquement suspectée

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Le sepsis grave est un sepsis avec une défaillance cardiovasculaire ne nécessitant pas plus de 40 mL/kg de remplissage vasculaire, ou un SDRA, ou au moins deux autres défaillances d'organe

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Le choc septique est un sepsis associé à une défaillance cardiovasculaire, avec persistance après 40 mL/kg de remplissage vasculaire réalisé sur 1 heure :

  • D'une hypotension
  • Ou du besoin de drogues vasoactives
  • Ou de deux signes d'hypoperfusion parmi les suivants
    • Acidose métabolique
    • Diurèse < 0,5 mL/kg/h
    • Différence température centrale/température cutanée > 3 °C

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
La mortalité du choc septique de l'enfant reste aujourd'hui encore comprise entre 10 et 20 % dans les pays à ressources économiques élevées

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Principaux sites d'infection

Par ordre de fréquence décroissante :

  1. L'arbre bronchopulmonaire (pneumopathie infectieuse)
  2. Le sang (bactériémie)
  3. L'arbre urinaire (pyélonéphrite aiguë)
  4. L'abdomen (péritonite)
  5. Les tissus mous (dermohypodermites et fasciites nécrosantes)
  6. Le système nerveux central (encéphalite, méningite)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

De la naissance à l'âge de 3 mois

Les principaux germes sont :

  • Streptocoque du groupe B
  • E. coli
  • Listeria monocytogenes

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
En pratique, tout nourrisson fébrile âgé de moins de 3 mois doit être considéré comme infecté jusqu'à preuve du contraire

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Entre les âges de 3 mois et 2 ans

Les principaux germes sont :

  • Streptococcus pneumoniae
  • Neisseiria meningitidis
  • Haemophilus influenzae b (qui a quasi disparu depuis la vaccination)

Les foyers infectieux sont essentiellement bronchopulmonaires et neuroméningés, parfois après un point de départ ORL.

Cette tranche d'âge est le premier pic épidémiologique du purpura fulminans (second vers l'âge de 15–20 ans).
Tout nourrisson fébrile doit être déshabillé entièrement lors de l'examen à la recherche d'une tâche purpurique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Après l'âge de 2 ans

Les principaux germes sont :

  • Streptococcus pneumoniae
  • Neisseiria meningitidis
  • Différentes entérobactéries
  • Staphylococcus aureus
  • Streptoccocus β-hémolytique du groupe A

Staphylococcus aureus et Streptoccocus β-hémolytique du groupe A sont fréquemment responsables de choc toxinique.

  • Souvent à point de départ pulmonaire (pleuropneumopathie) ou cutané (par exemple, dermohypodermite nécrosante surinfectant une varicelle)
  • Associant une érythrose diffuse à une très grande vasoplégie (pression artérielle diastolique effondrée, inférieure à la moitié de la pression artérielle systolique)
  • Aggravée par une importante hypovolémie par pertes liquidiennes abondantes (fièvre élevée, diarrhée et vomissements abondants)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Comme chez l'adulte, le risque de décès lors d'un choc septique est nettement augmenté au-delà de trois défaillances d'organe simultanées

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

On considère que la survenue d'un état de choc septique est liée à une réponse anti-inflammatoire trop importante au regard du foyer infectieux initial et de la stimulation inflammatoire localisée.

Cette réponse anti-inflammatoire devenue rapidement systémique et non plus localisée au seul foyer infectieux va stimuler la cascade de l'hémostase en entraînant une coagulation intravasculaire disséminée qui va modifier les qualités de la microcirculation, et donc de l'extraction d'oxygène

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Le choc septique est une étape d'un continuum physiopathologique allant de l'infection localisée à la défaillance multiviscérale et au décès. Rompre au plus vite cette cascade évolutive améliore la survie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Article 21 declares that no person shall be deprived of his life or personal liberty except according to procedure established by law.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




In effect, the protection under Article 21 should be available not only against arbitrary executive action but also against arbitrary legislative action.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
À noter que dans le choc toxinique, le TRC est immédiat en raison de la vasoplégie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




court held that the ‘right to life’ as embodied in Article 21 is not merely confined to animal existence or survival but it includes within its ambit the right to live with human dignity and all those aspects of life which go to make a man’s life meaningful, complete and worth living. It also ruled that the expression ‘Personal Liberty’ in Article 21 is of the widest amplitude

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Pouls périphériques mal perçus :

  • La palpation des pouls tibial postérieur ou pédieux, radial (brachial chez le nourrisson d'âge < 1 an) doit être systématique
    • Permettant de confirmer l'altération hémodynamique lors de la prise en charge mais aussi d'évaluer la réponse thérapeutique en surveillant leur réapparition
    • À noter que dans le choc toxinique, les pouls sont plutôt bondissants en raison de la différentielle systolodiastolique augmentée, avec résistances vasculaires systémiques basses et hyperdébit cardiaque

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Pâleur souvent importante, en rapport avec l'acidose métabolique liée à la dysoxie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Hypotension artérielle pour l'âge : non obligatoire pour définir un état de choc septique et pouvant être absente chez un nourrisson ou un enfant ayant déjà les autres signes hémodynamiques précités et une altération de la conscience

Sa survenue signe un « état de choc décompensé », c'est-à-dire plus avancé et donc plus sévère

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
L'examen répété permettra de juger de la réponse aux traitements entrepris : l'altération neurologique est l'un des premiers signes à disparaître en cas d'efficacité thérapeutique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




following rights as part of Article 21: (1) Right to live with human dignity. (2) Right to decent environment including pollution free water and air and protection against hazardous industries. (3) Right to livelihood. (4) Right to privacy. (5) Right to shelter. (6) Right to health. (7) Right to free education up to 14 years of age. (8) Right to free legal aid. (9) Right against solitary confinement. (10) Right to speedy trial. (11) Right against handcuffing. (12) Right against inhuman treatment. (13) Right against delayed execution. (14) Right to travel abroad. (15) Right against bonded labour. (16) Right against custodial harassment. (17) Right to emergency medical aid. (18) Right to timely medical treatment in government hospital. (19) Right not to be driven out of a state. (20) Right to fair trial. (21) Right of prisoner to have necessities of life. (22) Right of women to be treated with decency and dignity. (23) Right against public hanging. (24) Right to hearing. (25) Right to information. (26) Right to reputation. (27) Right of appeal from a judgement of conviction (28) Right to social security and protection of the family (29) Right to social and economic justice and empowerment (30) Right against bar fetters

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Right to Education Article 21 A declares that the State shall provide free and compulsory education to all children of the age of six to fourteen years in such a manner as the State may determine.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Glycémie capillaire puis plasmatique : recherche d'une hypoglycémie, facteur de très mauvais pronostic chez l'enfant, en particulier chez le nourrisson

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Examens bactériologiques systématiques et orientés selon la clinique :

  • Hémocultures (voir infra), PCR, antigénémie
  • ECBU dès la récupération d'une diurèse
  • Coprocultures
  • Examen du LCR : ponction lombaire formellement contre-indiquée chez un enfant en état de choc
    • L'antibiothérapie probabiliste sera initiée à doses méningées et la ponction lombaire différée

  • Selon le point d'appel : prélèvement intrapéritonéal lors du passage au bloc opératoire, lésion cutanée, écouvillonnage du point d'insertion d'un cathéter central…

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique - Hémocultures

  • En pratique on prélève de 1 mL (poids < 2,5 kg) à 10 mL (âge > 10 ans), si possible plusieurs fois à plusieurs heures d'intervalle, et si possible au minimum deux fois, sur un flacon aérobie (avant tout) et un flacon anaérobie, qu'on transporte au plus vite au laboratoire à température ambiante

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
En cas de suspicion de bactériémie ayant comme point de départ un cathéter central, on prélève au mieux quatre hémocultures (deux sur le cathéter et deux en périphérie, associant une hémoculture quantitative à une hémoculture qualitative) ou, si le poids de l'enfant ne le permet pas, seulement deux hémocultures (une sur le cathéter central et une en même temps en périphérie) afin d'identifier le cathéter central comme origine de la bactériémie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




In 1993 itself, the Supreme Court recognised a Fundamental Right to primary education in the right to life under Article 21. It held that every child or citizen of this country has a right to free education until he completes the age of 14 years. Thereafter, his right to education is subject to the limits of economic capacity and development of the state. In this judgement, the Court overruled its earlier judgement (1992) which declared that there was a fundamental right to education up to any level including professional education like medicine and engineering. In pursuance of Article 21A, the Parliament enacted the Right of Children to Free and Compulsory Education (RTE) Act, 2009.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




Preventive detention, on the other hand, means detention of a person without trial and conviction by a court. Its purpose is not to punish a person for a past offence but to prevent him from committing an offence in the near future.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique - PEC

Mesures thérapeutiques immédiates :

  • Monitorage non invasif : fréquence cardiaque, fréquence respiratoire, pression artérielle au brassard adapté à la taille de l'avant-bras, saturation transcutanée en oxygène
  • Oxygénothérapie systématique au masque à haute concentration quelle que soit la saturation transcutanée en oxygène
  • Mise en place de deux voies d'abord veineux de bon calibre ou d'une voie intraosseuse (à privilégier chez le nourrisson et le petit enfant en raison des difficultés de voies d'abord)
  • Remplissage vasculaire : NaCl 0,9 % 20 mL/kg (sans dépasser 500 mL) aussi rapidement que la voie d'abord le permet, à renouveler trois fois au maximum selon l'efficacité de la réponse thérapeutique (voir critères infra)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique - PEC

  • Antibiothérapie probabiliste intraveineuse synergique et bactéricide :
    • Céphalosporine de troisième génération ± aminoside

  • Surveillance : diurèse horaire, FC, FR, PA, score de Glasgow adapté à l'âge

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Un examen clinique identique à celui réalisé à l'admission et ayant permis de confirmer l'état de choc doit être réalisé à la fin de chaque remplissage vasculaire afin de :

  • Vérifier la correction des signes de choc, démasquer des signes d'insuffisance cardiaque.
    • On recherche systématiquement l'apparition d'un galop, de râles crépitants et d'une hépatomégalie avec reflux hépatojugulaire.
    • En l'absence de ces signes et devant l'inefficacité totale ou partielle du premier remplissage vasculaire, un deuxième sera entrepris, puis un troisième s'il y a lieu, pour trois au total, soit 60 mL/kg durant la première heure

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

En cas de réponse favorable, évolution des paramètres cliniques selon cet ordre :

  1. Amélioration de l'état de conscience
  2. Baisse de la fréquence cardiaque
  3. Récupération d'une pression artérielle moyenne (PAM) attendue pour l'âge
  4. Reprise d'une diurèse (valeur attendue supérieure à 1 mL/kg/h)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique - PEC

Examens biologiques aussi répétés toutes les 4 heures afin de s'assurer de leur amélioration concomitante :

  • Correction progressive de l'acidose métabolique
  • Disparition de l'hyperlactatémie
  • Disparition de l'insuffisance rénale fonctionnelle
  • Correction progressive de la CIVD avec persistance en général plusieurs jours de la thrombopénie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Choc septique - PEC (Après amines et admission en réa)

L'évaluation paraclinique, le plus souvent par échocardiographie-doppler à l'admission en réanimation est obligatoire

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Les deux pics d'incidence du purpura fulminans sont le nourrisson âgé de moins d'un an et le jeune adulte de 15 à 20 ans

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Essentiellement dû à Neisseria meningitidis dont les sérogroupes les plus fréquents sont A, B, C Y, W135, il peut aussi survenir suite à une infection à Streptococcus pneumoniae, et parfois même à Staphylococcus aureus.

En France, les sérogroupes les plus fréquemment responsables d'infections invasives à méningocoque, (essentiellement les méningites et le purpura fulminans) sont, par ordre décroissant les sérogroupes :

  1. B
  2. C
  3. W135

Les purpuras fulminans à méningocoque C seraient potentiellement plus sévères

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
La vaccination contre le sérogroupe B a été autorisée à la mise sur le marché en Europe en 2013. Elle devrait, dans les années à venir, faire nettement diminuer l'incidence des infections invasives à méningocoque dont le sérogroupe B est le plus fréquent en France

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Purpura fulminans

  • L'antibiothérapie recommandée, par voie intraveineuse ou intramusculaire, est une céphalosporine de troisième génération aux doses unitaires suivantes :
    • Ceftriaxone 50 à 100 mg/kg une fois par jour
      OU
    • Céfotaxime 50 mg/kg toutes les 6 à 8 heures.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Purpura fulminans

L'enquête des sujets contacts sera faite par l'Agence régionale de santé qui doit être prévenue au plus tôt par le médecin en charge de l'enfant, c'est-à-dire dès la suspicion de l'origine méningococcique du purpura fulminans, même si celle-ci n'est pas confirmée.

Seules les personnes en contact étroit avec les sécrétions oropharyngées du patient (bouche- à-bouche, intubation sans masque avant la première dose d'antibiotique) ou ayant demeuré longuement (plus de 2 heures) à moins de 1 mètre du patient sont à risque de contamination et doivent bénéficier d'une prophylaxie

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique
Le purpura fulminans, comme toutes les infections invasives à méningocoque, est une maladie à déclaration obligatoire

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Purpura fulminans

Urgence diagnostique et thérapeutique.

  • Antibiothérapie immédiate IV ou IM à la moindre suspicion clinique (1 seule tache purpurique et nécrotique en son centre d'au moins 3 mm de diamètre dans un contexte d'altération générale fébrile) avant toute confirmation bactériologique :
    • Ceftriaxone 50 à 100 mg/kg 1 fois par jour
      OU
    • Céfotaxime 50 mg/kg toutes les 6 à 8 heures.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#154 #328 #Choc #Cours #Facultaires #Médecine #Pédiatrie #Septique

Purpura fulminans

« Ce patient devra être pris en charge immédiatement avec un appel systématique au Samu – centre 15 pour être transféré vers un service d'urgence ou de réanimation prévenu de son arrivée et bénéficier de l'évaluation et d'un traitement précoce d'un état de choc avec mise en place d'une voie veineuse et remplissage vasculaire. »

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble
Le coma est une altération prolongée de la conscience avec disparition des activités de veille et incapacité de se réveiller (à la différence du sommeil)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble
Les causes de coma sont dominées par les infections neuroméningées, les intoxications et troubles métaboliques, et les atteintes du système nerveux central dont la fréquence augmente avec l'âge

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble
L'éveil est commandé par la formation réticulée du tronc cérébral, noradrénergique, qui, via l'hypothalamus, les thalamus et les structures hémisphériques sous-corticales, permet la restauration et le maintien de la vigilance

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble
Le coma est une altération aiguë ou subaiguë de la conscience, définie par l'absence d'éveil spontané ou provoqué, et prolongé pendant au moins une heure

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

Une réactivité stéréotypée en « décortication » (flexion bilatérale des membres supérieurs et extension bilatérale des membres inférieurs) signe une lésion extensive hémisphérique bilatérale.

Une réactivité stéréotypée en « décérébration » (extension des quatre membres) évoque une lésion extensive du mésencéphale

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

HTIC

À un stade décompensé : aggravation rapide des troubles de la vigilance, anomalies pupillaires, troubles respiratoires, troubles circulatoires (association très évocatrice de bradycardie et d'HTA).

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

HTIC :

À un stade plus ultime, signes d'engagement menaçant le pronostic vital immédiat et justifiant une prise en charge en extrême urgence :

  • Temporal (mydriase unilatérale aréactive)
  • Occipital avec signes dépendant du niveau de souffrance :
    • Diencéphalique :
      • Myosis
      • Réactivité motrice en décortication
      • Respiration de Cheynes-Stokes et mouvements pendulaires des yeux

    • Mésencéphalique :
      • Semi-mydriase aréactive
      • Réactivité motrice en décérébration
      • Hyperventilation centrale

    • Bulbaire :
      • Mydriase bilatérale aréactive
      • Absence de réactivité motrice
      • Apnée ou respiration apneustique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

La décision de mettre en place une ventilation invasive chez un enfant comateux repose sur :

  • La capacité à protéger ses voies aériennes supérieures
  • Le délai estimé de récupération
  • La profondeur du coma (Glasgow < 8)
  • L'HTIC
  • L'existence d'un état de choc

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

Bilan de première ligne :

  • Glycémie capillaire veineuse
  • BU
  • Ionogramme plasmatique
  • Fonction rénale, bilan phosphocalcique
  • NFS-plaquettes, bilan d'hémostase
  • Bilan infectieux avec hémocultures, CRP, procalcitonine
  • Gazométrie, dosage des toxiques urinaires et sanguins dont le CO

L'examen du LCR doit être systématique en cas de fièvre à la recherche d'une méningite ou d'une encéphalite, et doit être discuté devant un patient apyrétique sans diagnostic immédiat en absence de contre-indications (anomalies plaquettaires ou de l'hémostase, signes de localisation, troubles de la vigilance avec Glasgow < 11)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

Une seconde ligne d'investigations comprend :

  • Ammoniémie, lactacidémie
  • Enzymes pancréatiques, hépatiques, musculaires
  • Screening élargi à la recherche de toxiques exogènes
  • En cas de suspicion de maladie héréditaire du métabolisme :
    • Chromatographie des acides aminés plasmatiques
    • Profil plasmatique des acylcarnitines
    • Chromatographie des acides organiques urinaires

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

L'examen de choix est la TDM cérébrale, sans puis avec injection de produit de contraste en l'absence de contre-indications et toujours chez un patient stabilisé.

Chez le nourrisson, il peut parfois être remplacé par une échographie transfontanellaire

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

Bilan étiologique minimum chez un patient stabilisé :

  • Glycémie capillaire et BU
  • Bilan biologique de première ligne
  • Examen du LCR au moindre doute en l'absence de contre-indication
  • Tomodensitométrie cérébrale en cas de traumatisme crânien ou de signes de localisation persistants

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble
Les intoxications exogènes ont deux pics de fréquence, avant l'âge de 5 ans et à l'adolescence

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#338 #Confusionnel #Conscience #Cours #Facultaires #Médecine #Pédiatrie #Trouble

L'état de mal épileptique s'accompagne toujours de troubles de la conscience.

  • Le coma post-critique est classique, mais doit être rapidement résolutif.
  • Un état de mal convulsif infraclinique peut être responsable d'un coma prolongé.
  • Des crises convulsives focales peuvent avoir une expression confusionnelle ou psychiatrique

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
Les intoxications constituent la seconde cause d'accidents de la vie courante chez l'enfant après les traumatismes et devant les brûlures

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Le mode d'intoxication est accidentel entre les âges de 1 et 8 ans et plutôt intentionnel après l'âge de 10 ans.

Avant l'âge de 1 an, une erreur d'administration d'un médicament commise par un parent représente 25 % des cas d'intoxications (erreur de dose, médicament inapproprié)

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

La majorité des intoxications accidentelles sont bénignes et le plus souvent asymptomatiques.

Dans plus de 60 % des cas, les situations sont gérées au téléphone par les centres antipoison et les enfants ne requièrent pas de consultation médicale

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
L'intoxication n'est pas connue : garder à l'esprit la possibilité d'une intoxication aiguë devant des symptômes inexpliqués brutaux et les très rares intoxications cachées. Passer du temps à interroger la famille. Des prélèvements de sang et urines seront adressés au laboratoire de toxicologie, avec une fiche de renseignements.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Trois règles de base devant une intoxication chez l'enfant :

  • Ne rien faire boire, ne pas faire vomir avant l'avis du centre antipoison
  • Tenir compte de la dose la plus élevée possible qu'a pu prendre l'enfant
  • Toujours se méfier d'un autre produit non identifié

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
L'intoxication au CO (8 000 cas annuels, dont près de 20 % d'enfants) représente la première cause de décès par intoxication en France.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Intoxication au CO

Deux mécanismes contribuent à la toxicité :

  • L'hypoxie, secondaire à la formation de carboxyhémoglobine (HbCO)
  • Une réaction immunologique et inflammatoire par effet inhibiteur direct lié à la fixation du CO sur certaines hémoprotéines.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
Un malaise dans la salle de bains doit toujours faire évoquer une intoxication au CO.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

À l'arrivée des secours :

  • Approche « ABC » systématique
  • Mise en condition :
    • Scope, SaO2 (chiffre souvent faussement rassurant)
    • Pose d'une voie veineuse périphérique
    • Oxygénothérapie immédiate :
      • Masque à haute concentration (> 8 L/min) systématique
      • Ou intubation/ventilation si troubles de conscience
    • Examens complémentaires :
      • Prélèvement biologique pour HbCO le plus précoce possible
      • ECG

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Évaluation médicale :

  • Recherche des signes de gravité :
    • Troubles de conscience avec trismus, convulsions
    • HTA, hyperthermie, tachycardie
    • Détresse respiratoire
    • Signes ECG : trouble du rythme ou de la repolarisation

  • Identification de facteurs aggravants :
    • Intoxication aux fumées d'incendie
    • Lésions traumatiques associées
    • Perte de connaissance
    • HbCO > 15 %

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Prise en charge hospitalière :

  • Transport médicalisé
  • Poursuite de l'oxygénothérapie au masque pendant au moins 12 heures
  • ECG (si non fait)
  • Gaz du sang

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Indications d'une oxygénothérapie hyperbare (larges chez l'enfant) :

  • Perte de connaissance même brève
  • Troubles de la conscience, convulsions, signes neurologiques objectifs
  • Troubles du rythme cardiaque

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Suivi neurologique à 1 mois systématique :

  • Possibilité d'un syndrome post-intervallaire entre 2 et 40 jours :
    • Troubles de l'humeur et/ou du comportement, troubles du sommeil
    • Céphalées chroniques, crises convulsives

  • Séquelles possibles : troubles cognitifs, trouble de la mémoire, céphalées intermittentes.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Le paracétamol est métabolisé par le foie en métabolites conjugués non toxiques.

Environ 5 à 10 % du paracétamol sont oxydés par le cytochrome P450 en un métabolite appelé NAPQI, toxique mais inactivé en situation physiologique par le glutathion.
À doses toxiques, la fonction protectrice du glutathion est débordée et le NAPQI dénature les protéines de l'hépatocyte induisant une hépatite centrolobulaire

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

La dose toxique théorique est, pour une dose ingérée unique, supérieure à 100 mg/kg.

Un surdosage non pris en charge conduit à une évolution en deux phases :

  • Une phase initiale (jusqu'à H6) paucisymptomatique : signes digestifs non spécifiques (vomissements, hépatalgie)
  • Une phase secondaire (début après H12, maximale à H48) :
    • Majoration des signes digestifs
    • Neurologiques et désordres biologiques (transaminases, coagulation)
    • Moins de 1 % des enfants intoxiqués développent une hépatite fulminante

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
Le traitement spécifique repose sur la reconstitution des stocks hépatiques de glutathion par l'administration d'un précurseur : la N-acétylcystéine

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

Modalités de prescription de la N-acétylcystéine :

  • Administration précoce, dans les 15 à 24 heures maximum suivant l'ingestion
  • Voie per os ou IV selon l'état de conscience et l'existence de troubles digestifs
  • Dose de charge (140 mg/kg) puis bolus (70 mg/kg) toutes les 4 heures
  • Durée du traitement : 48 heures en IV, 72 heures en per os en cas d'intoxication avérée par les dosages sanguins, interprétés selon le nomogramme de Rumack-Matthew.

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie

En pratique, le traitement par N-acétylcystéine est indiqué :

  • À ll'arrivée de l'enfant :
    • Si l'ingestion est antérieure à 8 heures
    • Si la dose ingérée estimée est supérieure à 100 mg/kg
    • En cas d'intoxication polymédicamenteuse
    • En présence de signes cliniques et/ou biologiques de toxicité

  • En fonction de la paracétamolémie après la 4ème heure, en se référant au normogramme

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs




#332 #Cours #Facultaires #Intoxications #Médecine #Pédiatrie
Prise en charge urgente : N-acétylcystéine, réévaluation en fonction de la paracétamolémie à H4 selon le nomogramme de Rumack-Matthew

statusnot read reprioritisations
last reprioritisation on reading queue position [%]
started reading on finished reading on

pdf

cannot see any pdfs