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

Actinobacillose (Shigellose) équine: à propos des premiers cas observés au Maroc

La septicémie néonatale due àActinobacillus equ uli (Actinobacillose, Shigellose) a été diagnostiquée chez deux poulains. Cliniquement, les animaux étaient faibles et refusaient de téter. Histo-pathlogiquement, de multiples micro-abcès ont été observés au niveau des reins, du foie, des glandes surrénales et du poumon. Actinobacillus equuli a été isolé à partir de certains organes.Equine actinobaciIIosis (Shigellosis): report of first cases in MoroccoN eonatal septicemia caused by Actinobacillus equuli (Actinobacillosis, Shigellosis) was diagnosed in two foals. Clinically the animaIs were weak, depressed and refused to nurse. Pathologically, multiple microabceses were observed in kidneys, adrenals, liver and lungs. Actinobacillus equuli was isolated from several organs

Lupus Nephritis Emerging During Remission of Minimal Change Disease

No Abstract

Optimization of cadmium ions biosorption by fish scale from aqueous solutions using factorial design analysis and Monte Carlo simulation studies

International audienceThis work investigated cadmium ions biosorption on Fish scales (FS) of Sardina pilchardus. Different relevant parameters such as initial pH in the range 2.14-7.76, initial cadmium concentration from 35 to 150 mg L-1, and biosorbent dose in the range 50-300 mg L-1, were examined. The effect of these parameters on the cadmium removal was analyzed and optimized using full factorial design methodology and the analysis of variance. The kinetics were modelized for pseudo-second order and pseudo-first order models. Results showed that the pseudo-second order kinetic gave the best fit for equilibrium data. The biosorption isotherms were investigated for Freundlich and Langmuir models. Langmuir isotherm model gave the best fit and led to a maximum biosorption capacity of Cd(II) on FS of 52.08 mg g-1. The results indicated that FS of was effective in the removal of cadmium ions. Optimum Cd(II) removal of 88.2 % was calculated for pH 3, 75 mg L-1 of Cd(II) and 250 mg L-1 of FS. Monte Carlo simulation was used as relatively greener pathway to study the biosorption behavior of Cd(II) ions onto FS. It showed that the interaction Cd(II) - hydroxyapatite was more favored than Cd(II) - collagen

Major depressive disorders in chronic hemodialysis patients in Nazareth: identification and assessment

Zaher Armaly, Joseph Farah, Adel Jabbour, Bishara Bisharat, Amir Abd-El Qader, Shahira Saba, Maha Zaher, Elia El Haj, Munir Hamzi, Abdalla BowirratThe Nazareth Hospital, Hospital Affiliated with Galilee Medical School-Bar Ilan University, Zefat, IsraelObjective: Depression illnesses are commonly observed in hemodialysis (HD) patients, which can influence the quality of life of end-stage renal disease patients. We evaluate the prevalence and predictive risk factors of depression in the Arab population undergoing HD in Nazareth, Israel.Methods: We conducted a prospective study that included 71 patients in the HD unit with a mean age of 61.9 ± 14.13 years who had undergone HD and 26 healthy control subjects with a mean age of 59.3 ± 7.3. Beck's Depression Inventory and Hamilton Depression Scale assessments were administered. Blood analysis for hematological and biochemical parameters was obtained. Diagnosis was made using the Diagnostic and Statistical Manual of Mental Disorders scale to correlate psychological variables with clinical, hematological, and biochemical parameters. Statistical analysis was carried out using analysis of variance followed by Tukey post-hoc multiple comparison tests.Results: The prevalence of depression was 43.7% in HD patients. Between HD patients and controls, cortisol values were 16.96 ± 0.5476 and 11.96 ± 1.116, respectively (P < 0.0001; 95% confidence intervals [CI]: 2.416–6.825). Between depressed HD patients versus control subjects, cortisol values were 16.48 ± 0.72 and 11.96 ± 1.116, respectively (P = 0.0013; 95% CI: 1.878–7.184). Hematological and biochemical parameters were compared between depressed HD and nondepressed patients, but differences between the two groups were found to be insignificant (P > 0.05).Conclusion: Our HD patients were severely depressed. Studies of glucocorticoid turnover activity such as cortisol, a potent chemical stress hormone, may be used as a model and marker for early diagnosis of depression among HD patients. The strong familial support system in Arabic traditions has failed to decrease depression among these patients.Keywords: Beck Depression Inventory, cortisol, depression, hemodialysi

Test-based De-isolation in COVID-19 Immunocompromised patients: Ct value versus SARS-CoV-2 viral cultures

Background Immunocompromised patients with coronavirus disease 2019 (COVID-19) have prolonged infectious viral shedding for more than 20 days. A test-based approach is suggested for de-isolation of these patients. Methods The strategy was evaluated by comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (cycle threshold (Ct) values) and viral culture at the time of hospital discharge in a series of 13 COVID-19 patients: six immunocompetent and seven immunocompromised (five solid organ transplant patients, one lymphoma patient, and one hepatocellular carcinoma patient). Results Three of the 13 (23%) patients had positive viral cultures: one patient with lymphoma (on day 16) and two immunocompetent patients (on day 7 and day 11). Eighty percent of the patients had negative viral cultures and had a mean Ct value of 20.5. None of the solid organ transplant recipients had positive viral cultures. Conclusions The mean Ct value for negative viral cultures was 20.5 in this case series of immunocompromised patients. Unlike those with hematological malignancies, none of the solid organ transplant patients had positive viral cultures. Adopting the test-based approach for all immunocompromised patients may lead to prolonged quarantine. Large-scale studies in disease-specific populations are needed to determine whether a test-based approach versus a symptom-based approach or a combination is applicable for the de-isolation of various immunocompromised patients