Le syndrome des jambes sans repos : fréquence et facteurs de risque chez l’hémodialysé

Le syndrome des jambes sans repos (SJSR) ou syndrome d'impatience musculaire est un trouble moteur caractérisé par des sensations désagréables dans les jambes. Les causes sont mal connues et sa fréquence est estimée entre 25% et 75% chez les hémodialysés. Il s'agit d'une étude transversale monocentrique menée au centre d'hémodialyse du CHU Hassan II de Fès (hôpital Al Ghassani) entre décembre 2012 et janvier 2013. Nous avons défini le syndrome de jambes sans repos selon la définition de l'international restless legs study group de 2003 reposant sur 4 critères essentiels au diagnostic. L'international restless legs  syndrome scale (IRLES) a été coté par un même néphrologue pour  mesurer la sévérité du syndrome des jambes sans repos. 84 hémodialysés ont répondu au questionnaire avec 41,7% de cas de SJSR dont 6,6% de formes graves. Nous avons retrouvé une association entre le SJSR et la carence martiale p(0,018), la néphropathie initiale p(0,041), l'HTA  p(0,026) et le sexe féminin p(0,024). Dans notre série, il ressort que la carence martiale et l'HTA sont les principaux facteurs de risque modifiables de ce syndrome chez nos patients. Les facteurs traditionnels comme le tabagisme, l'âge supérieur à 50 ans et la dialyse inadéquate ne sont pas associés à ce trouble dans notre série

The outcome of Pleurodesis in Malignant Pleural Effusion

Background: Accumulation of fluid in pleural space, which is malignant in nature, is secondary to lung, breast or ovarian tumors. Metastatic Adeno Ca is most commonly seen in male and breast Ca is most commonly seen in female. It indicates advanced disease and reduced survival. Aim: Is to study prospectively thirty patients with malignant pleural effusion according to their clinical presentation, ways of diagnosis, and methods of chemical pleurodesis. Patient and methods: Data of thirty patients with malignant pleural effusion collected and analyzed using a form to categorize them according to their age, gender, presenting features, imaging studies and procedure performed to drain the fluid and to arrange chemical pleurodesis. Results: Eighteen patients were male; twelve patients were female in a ratio of 1.5:1. The youngest was 52 years old while the oldest was 81 years old. The mean age was 65.8 ±7.34. The most frequent presenting features were cough and dyspnea. Imaging studies showed that eleven patients had left sided effusion with underlying mass. Eight patients had right sided effusion with underlying mass while the remaining eleven patients had only effusion. Twenty patients received (Talc) and ten patients received (Bleomycin) with comparable recurrence rate of the  effusion, in seven patients out of 20 in Talc (35%) and in three out of 10 patients received Bleomycin (30%). Conclusion: Malignant pleural effusion should be drained nearly complete evacuation; regardless the primary cause, prior to installation of agent for pleurodesis and both (Talc & Bleomycin) can be used with comparable results and recurrenc

Difficult intubation in a parturient with syringomyelia and Arnold–Chiari malformation: Use of Airtraq™ laryngoscope

Anesthetic technique in parturient with syringomyelia and Arnold–Chiari malformation is variable depending on the teams. Difficult intubation is one of the risks when general anesthesia is opted. Different devices have been used to manage the difficult intubation in pregnant women. We report the use of Airtraq™ laryngoscope after failed standard laryngoscopy in a parturient with syringomyelia and Arnold–Chiari type I malformation

A Survey of Gopherus polyphemus Intestinal Parasites in South Florida

Gopherus polyphemus populations are diminishing throughout their range due to urbanization, fragmentation, and poor habitat management. Increased population densities, poor habitat quality, and lack of fire may influence disease transmission. Parasite roles within wild tortoise populations are largely unknown; despite evidence these pathogens may pose significant health risks. This study provides a baseline of gopher tortoise intestinal parasites across South Florida and reports on how varying environmental and tortoise characteristics may affect intestinal parasite species prevalence and approximate loads. Tortoise fecal samples were taken from six tortoise populations across five South Florida sites. Seven species of intestinal parasites were discovered from 123 tortoises. Identified parasites include endohelminths such as cyathostomes, pinworms, ascarids, flukes, and protozoans including Eimeria, Cryptosporidium, and Amoeba species. Significant differences in parasite prevalence and loads were seen between sites, while parasitism among sex, size class, and habitat type remained relatively ubiquitous