Un syndrome malin des neuroleptiques compliqué d’hémorragie méningée et révélant une vascularite cérébrale

Le syndrome malin des neuroleptiques est une complication du traitement par les neuroleptiques. Son incidence est estimée à 0,02% dans la population générale. Le traitement reste symptomatique et repose essentiellement sur l'arrêt immédiat du traitement antérieur. Nous rapportons l'observation clinique d'une patiente de 26 ans, schizophrénique sous Chlorpromazine, se présentant aux urgences pour la prise en charge d'un syndrome malin des neuroleptiques compliqué d'une hémorragie méningée et révélant une vascularite cérébrale

Les pneumopathies nosocomiales en réanimation de CHU Hassan II de Fès

L'objectif principal de notre étude était d'identifier les bactéries incriminées dans la pneumopathie nosocomiale (PN) au service de réanimation A1 du CHU Hassan II de Fès, en vue d'en améliorer la prise en charge et de diminuer la morbi-mortalité associée. Il s'agit d'une étude rétrospective et descriptive, menée du 1er janvier 2012 au 31 décembre 2013. Seules les infections pulmonaires survenant au-delà de 48 heures de l'admission du patient au service de réanimation ont été incluses. L'incidence de la PN était de 11,2%. Les Bacilles à Gram négatif (BGN) étaient retrouvés dans 48,5% des cas, le Staphylocoque Aureus dans 21,21% des cas et le Klebsiella Pneumoniae était dans 10,7% des cas. Le taux de mortalité était de 48,33%. L'âge, la gravité de la pathologie sous jacente et le retard de l'instauration d'une antibiothérapie adaptée étaient considérées comme facteurs de mauvais pronostic. L'étude de la résistance aux antibiotiques, montre une multirésistance surtout pour les BGN, dont il faut tenir compte en mettant en place une stratégie de prévention active.Pan African Medical Journal 2015; 2

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality