La grossesse chez les hémodialysées chroniques

La survenue d'une grossesse en hémodialyse chronique (HDC) est rare, mais depuis la description du premier cas par Confortini en 1971, plusieursobservations ont été rapportées. L'hémodialyse a considérablement  amélioré la fertilité de ces patientes. Nous rapportons l'expérience de  douze grossesses survenues entre 1999 et 2014, chez douze patientes d'âge médian 34 ans (22-44), en hémodialyse (HD) depuis 40 mois  (3-72), l'âge gestationnel moyen de diagnostic est de 16 semaines  d'aménorrhée, la grossesse était compliquée dans 50% des cas par un hydramnios. Le terme moyen est de 35 semaine d'aménorrhée (SA) et l'accouchement a été réalisé dans 90% des grossesses par voie basse. Le poids moyen des nouveau-nés est de 1800g. De telles grossesses sont à haut risque du fait de la fréquence des complications. Elles devraient être contrôlées par les équipes multidisciplinaires, et la consultation prénatal ne devrait pas être négligée. L'objectif de ce travail est de rapporter notre expérience concernant la survenue d'une grossesse chez les patientes dialysées et de la confronter aux données de la littérature

Profil des insuffisants rénaux chroniques diabétiques à l’initiation de l’hémodialyse au service de néphrologie et dialyse de l’hôpital militaire de Rabat, Maroc

Le diabète constitue une cause fréquente d'insuffisance rénale chronique terminale (IRCT) dans le monde. Ce travail présente une étude clinique rétrospective dont le but est de décrire le profil clinico-biologique des patients diabétiques en IRCT, de le comparer aux patients non-diabétiques au stade d'IRCT, et de suivre l'évolution de leurs abords vasculaires, afin d'en déduire des conclusions sur une prise en charge particulière des patients diabétiques. Les paramètres cliniques et biologiques concernant les patients mis en hémodialyse dans notre formation entre le 01 janvier 2006 et le 31 décembre 2011, ont été recueilli et analysés. Nous avons procédé à l'étude comparative des patients en fonction de l'existence ou non d'une néphropathie diabétique, et nous nous sommes intéressés à l'évolution de leurs abords vasculaires. Il s'agit de 207 patients insuffisants rénaux chroniques, dont 86 diabétiques. Le groupe des patients diabétiques était moins suivi avant la mise en hémodialyse (3,66 mois vs. 6,32 mois), avec une prise beaucoup plus importante d'antihypertenseurs (1,87 vs. 1,14, p<0,001). L'échec des abords vasculaires était plus important chez les patients diabétiques (45% vs. 27%, p=0,006), avec une survie moyenne plus faible de leurs abords vasculaires (509 vs 753 jours, p=0,003). L'étude comparative des taux d'hémoglobine, de parathormone intacte, d'albuminémie et de C-réactive protéine, entre le groupe de patients diabétiques et non diabétiques était non significative. Notre étude soulève le problème du suivi néphrologique chez les diabétiques, pourtant censés être mieux suivis, et son retentissement sur l'avenir de leurs abords vasculaires.Key words: Diabète, insuffisance rénale chronique, hémodialys

Diminishing Water-Intake may have Pragmatic Aspects in Lambs Fed on Pelleted Complete Diet and Reared under Thermo-Neutral Condition

Some basic questions regarding sheep’s ability to tolerate different levels of water intake (WI), especially when fed on a pelleted-complete diet (PCD) and reared under comfortable climatic conditions, are still open. To investigate the direct influence of different levels of WI in sheep fed PCD and reared under such conditions on the lambs' physiological (performance, thermal, blood and urine) status, 24 healthy male growing Najdi lambs were exposed under thermo-neutral conditions to three levels of WI (100%, 67%, and 33% of their ad libitum WI or water requirement) for 6 weeks. Meteorological, production performance, thermo-physiological, as well as blood and urine biochemical measurements, were all determined. The obtained findings clearly substantiate that reducing the level of water intake (p<0.05) produced tangible effects in both 67-WI and 33-WI lamb groups. However, 67-WI lambs showed resilience to limited water availability by inducing proportional physiological responses in their production performances, body temperatures, blood metabolites, and renal function but within the homeostatic ranges similar (p>0.05) to 100-WI lambs. Results collectively signify that diminishing WI up to 33% in lambs (fed on PCD and reared under comfortable conditions) would ensure that water is adequately conserved under prevailing water scarcity and can be implemented without compromising their homeostatic functions. Such applied approaches can consequently have a pragmatic aspect through improving water management approaches required for PCD-based sheep production under water scarcity conditions, which is crucial to economical animal production and responsible animal stewardship. Feasibility studies are thereby highly recommended

Enlarged Asymptotic Compensation in Discrete Distributed Systems

This work concerns an enlarged analysis of the problem of asymptotic compensation for a class of discrete linear distributed systems. We study the possibility of asymptotic compensation of a disturbance by bringing asymptotically the observation in a given tolerance zone . Under convenient hypothesis, we show the existence and the unicity of the optimal control ensuring this compensation and we give its characterizatio

Bisalbuminemia during remission of nephrotic syndrome

The bisalbuminemia acquired outside of the long-term antibiotic treatment is an exceptional event. It is a rare condition characterised by the presence of two distinct fractions of serum albumin on electrophoresis. This anomaly reflects the presence, at the same time, of a normal albumin and a modified albumin. These changes of albumin may be related to various causes. Their association with nephrotic syndrome is exceptional. We report a case of bisalbuminemia during a period of remission of nephrotic syndrome

A comparative thermophysiological study between two purebred Saudi sheep under biometeorologically-simulated environment

Due to global warming, animal’s heat tolerance and adaptability characteristics to hot environmental conditions are attracting more research interest. The current experimental study was actually designed to evaluate and compare the heat tolerance efficiency of two purebred Saudi sheep when exposed to heat stress conditions under a biometeorologically-simulated environment similar to Kingdom of Saudi Arabia (KSA) semi-arid environment. A total of 20 healthy male growing lambs of Najdi and Naimi breed with an initial body weight of 24.71 ± 4.65 Kg and 4 month-old were used in a 2-phases experiment. During the preliminary phase (lasted for 3 weeks), lambs were placed under a stable thermoneutral condition. Meanwhile, simulation of the external environment was performed using climatic-controlled chambers during the experimental phase (lasted for 8 weeks). Several meteorological [ambient temperature (Ta), relative humidity (RH) and temperature humidity index (THI)] and thermophysiological [rectal temperature (Tr), skin temperature (Tsk), respiratory rate (RR), heat tolerance coefficient (HTC), adaptability coefficient (AC), internal (BTGin), external (BTGex) and total (BTGto) body thermal gradients] measurements were recorded at weeks 0, 4 and 8. The obtained meteorological data showed that the prevailed conditions in the climatic chamber exhibited (P < 0.05) elevated values compared to the chambers with control or thermoneutral conditions, which indicated that all lambs had undergone a different level of surrounding conditions, which was our goal in the first place. Notably, the obtained findings of all variables showed irrespective to the breed the same trend as they all were affected (P < 0.05) at the 4th weeks and slowly returned to their steady values by the 8th weeks, especially body temperatures. Under such hot climatic condition, lambs showed as well some breed difference, where Naimi lambs kept in eliciting (P < 0.05) higher values of RR, AC, and BTGto as well as lower values of HTC compared to their Najdi associates. In conclusion, the outcomes might collectively enable us to initially recommend selecting Najdi breed over Naimi breed for herding under the hot environmental conditions of KSA. However, identification of genes responsible for acquiring heat tolerance ability of Najdi compared to Naimi is highly recommended in future studies