Lymphangiome kystique de l’arrière-cavité des épiploons

Le lymphangiome kystique de l'arrière-cavité des épiploons est une localisation exceptionnelle dont le  diagnostic est suspecté par la radiologie et confirmé par l'examen anatomo-pathologique. L'exérèse  chirurgicale constitue le traitement de choix. Key words: Lymphangiome kystique, arrière-cavité des épiploons, chirurgi

Thrombose veineuse mésentérique supérieure compliquant une appendicite méconnue

La thrombose veineuse mésentérique supérieure (TVMS) peut se présenter selon un mode aigu, subaigu ou chronique. Réputée rare, elle peut être primitive ou secondaire. Les étiologies chirurgicales les plus fréquemment identifiées de TVMS sont la diverticulite colique et l'appendicite aiguë. Les auteurs ont jugé utile de rapporter une observation de TVMS compliquant une appendicite refroidie par les antibiotiques, tout en insistant sur la latence clinique de telle pathologie rendant son diagnostic et son traitement plus difficile.Pan African Medical Journal 2013; 14:1

Predictive factors of thrombosis during autologous stem cell transplantation in multiple myeloma: Experience from EHU Oran (Algeria)

Introduction-The objectives of our work are to measure the incidence of thrombosisand identify predictive factors during the procedure of autologous hematopoieticstem cells, during real life, in the University Hospital of Oran (Algeria).Methods-This is a retrospective study covering a period from 2009 to 2019. The diagnosisof thrombosis is made on the basis of clinical signs and symptoms of thrombosisand confirmed by a Doppler ultrasound of the site of location concerned oran angio-scanner, in the case of suspicion of arterial embolism, as well as D-Dimerelevation. The study focused on the overall incidence of thrombosis and the identificationof predictive factors during the autograft procedure. Thepredictive factorsstudied are: age, co-morbidities, use of IMiDs, use of Granocyte colony stimualingfactor in mobilization, the central venous catheter insertion site, cytapheresiscount, CD34+ perfused, and finally deep venous thrombosis prophylaxis by a lowmolecular weight heparin .The statistical analysis focused on a univariate study,followed by a multivariate analysis using binary logistic regression.Results-Among 411 patients with MM underwent autologous transplantation ofwhich 249 were male with a sex ratio of 1,53. The overall incidence of thrombosiswas estimated at 18,49% (76 patients). The associative factors found in univariateanalysis in our study are the use of IMiDs (p = 0,0006), the femoral KTC insertion site(p = 0,021) and its duration (p = 0,018), the level of G-CSG≥ 15μg/kg (0,014) duringHSC mobilization and aplastic phase, the number of perfused CD34 +> 5x106/kg (p= 0,035) and prophylaxis with low molecular weight heparin (LMWH)(p = 0,029).Inmultivariate analysis, only the absence of LMWH prophylaxis was an independentpredictor of thrombosis (p=0.001).Conclusion-Despite the similarity of the overall incidence of thrombosis with the literature,its prophylaxis with LMWHs was the only independent factor of its risk inAlgeria, which would have restricted it in daily practice of autografts in multiplemyeloma

Permissive underfeeding, cytokine profiles and outcomes in critically ill patients.

BackgroundDuring critical illness in humans, the effects of caloric restriction on the inflammatory response are not well understood. The aim of this study is to examine the associations of caloric restriction, inflammatory response profiles and outcomes in critically ill patients.MethodsThis is a sub-study of the PermiT trial (Permissive Underfeeding or Standard Enteral Feeding in Critically Ill Adults Trial- ISRCTN68144998). Serum samples were collected on study days 1, 3, 5, 7 and 14 and analyzed for a panel of 29 cytokines. We used principal component analysis to convert possibly correlated variables (cytokine levels) into a limited number of linearly uncorrelated variables (principal components). We constructed repeated measures mixed linear models to assess whether permissive underfeeding compared to standard feeding was associated with difference cytokine levels over time.ResultsA total of 72 critically ill patients were enrolled in this study (permissive underfeeding n = 36 and standard feeding n = 36). Principal component analysis identified 6 components that were responsible for 78% of the total variance. When adjusted to principal components, permissive underfeeding was not associated with 90-day mortality (adjusted odds ratio 1.75, 95% confidence interval 0.44, 6.95, p = 0.43) or with incident renal replacement therapy. The cytokines did not differ with time between permissive underfeeding and standard feeding groups.ConclusionsThe association of permissive underfeeding compared to standard feeding with mortality was not influenced by the inflammatory profile. Permissive underfeeding compared to standard feeding was not associated with differences in the serum levels of cytokines in critically ill patients