Profil de l’infection urinaire nosocomiale dans un service de nephrology

L'infection urinaire est l'infection nosocomiale la plus fréquente. Elle constitue un véritable problème de santé publique par la surmortalité et le surcoût qu'elle entraîne. L'objectif de notre étude est de  déterminer l'incidence et le profil des IU nosocomiales dans un service de Néphrologie. Etude  rétrospective sur dossier de tous les patients hospitalisés dans notre service durant l'année 2011, ayant bénéficié d'un examen cytobactériologique des urines. Ont été exclus, tous les patients admis avec une IU connue ou active. 325 dossiers ont été retenus. L'incidence de l'IU nosocomiale était de l'ordre de 16,9%. La durée moyenne d'hospitalisation était de 14,1±10,15 jours. 30% de nos patients ont été  transférés du service des urgences. 80% des IU nosocomiales étaient compliquées. Le germe  responsable était E.Coli dans 2/3 des cas dont 14,5% était à E.Coli sécrétrice de bétalactamases à  spectre étendu. L'évolution après traitement était favorable chez 90,7%. En analyse multivariée, les  facteurs de risque pour contracter une IU nosocomiale étaient le sexe féminin; le sondage urinaire et  l'antécédent d'IU à répétition. Nos résultats rejoignent ceux de la littérature concernant les facteurs de risque liés à la survenue de l'IU nosocomiale, la fréquence des infections à entérobactéries, et l'émergence de souches résistantes. Une Surveillance microbiologique et une évaluation de la résistance aux antibiotiques constituent une ligne de défense pour faire face à l'accentuation de nouvelles souches bactériennes de plus en plus résistantes aux antibiotiques rendant les options thérapeutiques très limitées.Key words: Infection urinaire, nosocomiale, facteurs de risque, néphrologi

Diabetic Patients and Peritoneal Dialysis

The prevalence of diabetes mellitus (DM) among patients requiring renal replacement therapy (RRT) has been on the rise worldwide, with DM now being the primary cause of end-stage renal disease (ESRD) in roughly one-third of RRT initiations. Although renal transplantation is the optimal treatment for ESRD, its limited availability has led to in-center hemodialysis (HD) being widely used as the default RRT modality in many countries. However, peritoneal dialysis (PD) may offer a superior option for diabetic patients due to its slower ultrafiltration rate, which can help mitigate the dialysis-induced hypotension and coronary ischemia that are associated with extracorporeal circulation during HD. Despite these advantages, unfounded concerns about technique failure and increased complication rates have discouraged some clinicians from recommending PD as a first-line RRT for diabetic patients. We conducted a retrospective study comparing the incidence of complications and technique survival rates between diabetic and non-diabetic patients undergoing PD at a dialysis unit in Morocco. Our findings reveal that, diabetic patients undergoing PD experienced no significant difference in technique survival or incidence of complications compared to their non-diabetics. Nevertheless, only a small proportion (17.5%) of patients in our PD unit was diabetic, suggesting a need to improve access to PD for diabetic patients with ESRD

Arthropathie destructrice des épaules au cours d'une acromégalie

L'acromégalie est une maladie endocrinienne rare, en rapport avec une hypersécrétion d'hormone de croissance. Elle a des conséquences rhumatologiques: l'arthropathie périphérique, l'atteinte rachidienne et les syndromes canalaires. L'atteinte articulaire accompagne une acromégalie active, sa survenue après un traitement radical et une rémission complète est rare. Nous présentons le cas d'une patiente de 70 ans ayant un antécédent d'acromégalie sur adénome hypophysaire il y a 25 ans, traitée chirurgicalement et déclarée en rémission complète, a développé une arthropathie destructrice des deux épaules. Le but de notre observation est de mettre le point sur la possibilité d'une atteinte articulaire au cours de l'acromégalie et de son retentissement fonctionnelle

Chemical Composition and Anti-Urolithiatic Activity of Extracts from Argania spinosa (L.) Skeels Press-Cake and Acacia senegal (L.) Willd

Ethnobotanical studies have reported the traditional medicinal uses of Acacia senegal (L.) Willd. and Argania spinosa (L.) Skeels against kidney stone formation and other chronic kidney diseases. The present work is undertaken to study the litholytic activity and the inhibiting activity of calcium oxalate crystallization by bioactive compounds identified in Argania spinosa (L.) Skeels press-cake (residue of Argan oil) and in Acacia senegal (L.) Willd. The litholytic activity was studied in vitro on cystine and uric acid stones using a porous bag and an Erlenmeyer glass. The study of the inhibiting activity of calcium oxalate crystallization, was based on temporal measurements of the optical density, registered at a 620 nm wavelength for 30 min using an ultraviolet–visible spectrophotometer. The silylation method was performed to identify phytochemicals, followed by gas chromatography coupled with mass spectrophotometry (GC/MS) analysis. The results show significant litholytic activity of Argania Spinosa press-cake hydro-ethanolic extract on uric acid and cystine stones, respectively, with dissolution rates (DR) of 86.38% and 60.42% versus 3.23% and 9.48% for the hydro-ethanolic extract of Acacia senegal exudate. Furthermore, the percentages of nucleation inhibition are 83.78% and 43.77% (p ˂ 0.05) for Argania spinosa and Acacia senegal, respectively. The results point to the detection of 17 phytochemicals in Argania spinosa press-cake extract, the majority of which are phenolic acids and have potent anti-urolithiatic action

Chemical Composition and Anti-Urolithiatic Activity of Extracts from Argania spinosa (L.) Skeels Press-Cake and Acacia senegal (L.) Willd

Ethnobotanical studies have reported the traditional medicinal uses of Acacia senegal (L.) Willd. and Argania spinosa (L.) Skeels against kidney stone formation and other chronic kidney diseases. The present work is undertaken to study the litholytic activity and the inhibiting activity of calcium oxalate crystallization by bioactive compounds identified in Argania spinosa (L.) Skeels press-cake (residue of Argan oil) and in Acacia senegal (L.) Willd. The litholytic activity was studied in vitro on cystine and uric acid stones using a porous bag and an Erlenmeyer glass. The study of the inhibiting activity of calcium oxalate crystallization, was based on temporal measurements of the optical density, registered at a 620 nm wavelength for 30 min using an ultraviolet–visible spectrophotometer. The silylation method was performed to identify phytochemicals, followed by gas chromatography coupled with mass spectrophotometry (GC/MS) analysis. The results show significant litholytic activity of Argania Spinosa press-cake hydro-ethanolic extract on uric acid and cystine stones, respectively, with dissolution rates (DR) of 86.38% and 60.42% versus 3.23% and 9.48% for the hydro-ethanolic extract of Acacia senegal exudate. Furthermore, the percentages of nucleation inhibition are 83.78% and 43.77% (p ˂ 0.05) for Argania spinosa and Acacia senegal, respectively. The results point to the detection of 17 phytochemicals in Argania spinosa press-cake extract, the majority of which are phenolic acids and have potent anti-urolithiatic action

Chemical Composition and Anti-Urolithiatic Activity of Extracts from Argania spinosa (L.) Skeels Press-Cake and Acacia senegal (L.) Willd

Ethnobotanical studies have reported the traditional medicinal uses of Acacia senegal (L.) Willd. and Argania spinosa (L.) Skeels against kidney stone formation and other chronic kidney diseases. The present work is undertaken to study the litholytic activity and the inhibiting activity of calcium oxalate crystallization by bioactive compounds identified in Argania spinosa (L.) Skeels press-cake (residue of Argan oil) and in Acacia senegal (L.) Willd. The litholytic activity was studied in vitro on cystine and uric acid stones using a porous bag and an Erlenmeyer glass. The study of the inhibiting activity of calcium oxalate crystallization, was based on temporal measurements of the optical density, registered at a 620 nm wavelength for 30 min using an ultraviolet-visible spectrophotometer. The silylation method was performed to identify phytochemicals, followed by gas chromatography coupled with mass spectrophotometry (GC/MS) analysis. The results show significant litholytic activity of Argania Spinosa press-cake hydro-ethanolic extract on uric acid and cystine stones, respectively, with dissolution rates (DR) of 86.38% and 60.42% versus 3.23% and 9.48% for the hydro-ethanolic extract of Acacia senegal exudate. Furthermore, the percentages of nucleation inhibition are 83.78% and 43.77% (p < 0.05) for Argania spinosa and Acacia senegal, respectively. The results point to the detection of 17 phytochemicals in Argania spinosa press-cake extract, the majority of which are phenolic acids and have potent anti-urolithiatic action.Peer reviewe

Chemical Composition, Antioxidant Potentials, and Calcium Oxalate Anticrystallization Activity of Polyphenol and Saponin Fractions from Argania spinosa L. Press Cake

A wide range of biological properties and a potent therapeutic and prophylactic effect on chronic diseases are all present in Argania spinosa L. press cake. The aim of this research is to valorize the anticrystallization properties against calcium oxalate crystals of Argania spinosa L. press cake fractions and identify its bioactive components. Chemical species identification was performed using GC–MS analysis. The turbidimetric model was used to investigate crystallization inhibition in vitro. Infrared spectroscopy technique was used to characterize the synthesized crystals. Furthermore, both DPPH and FRAP methods were used to assess antioxidant activity. The results show that the fractions are equally important in crystallization inhibition percentages of calcium oxalate crystals. For saponin and polyphenol fractions, the inhibition percentages are in the orders of 83.49% and 82.83%, respectively. The results of the antioxidant activity by DPPH method show that the two fractions are equally important in the elimination of free radicals; the inhibition percentages were 77.87 ± 4.21 and 89.92 ± 1.39 for both polyphenols and saponins, respectively. FRAP method showed that the absorbance increases proportionally with concentration, and the absorbance are almost similar for both fractions and reach maximum values in the orders of 0.52 ± 0.07 and 0.42 ± 0.03, respectively, for saponins and polyphenols. These findings demonstrate that both fractions are rich in bioactive chemicals and have an anticrystallization capacity, allowing them to be employed for the curative and prophylactic effects against urolithiasis

Chemical Composition, Antioxidant Potentials, and Calcium Oxalate Anticrystallization Activity of Polyphenol and Saponin Fractions from Argania spinosa L. Press Cake

A wide range of biological properties and a potent therapeutic and prophylactic effect on chronic diseases are all present in Argania spinosa L. press cake. The aim of this research is to valorize the anticrystallization properties against calcium oxalate crystals of Argania spinosa L. press cake fractions and identify its bioactive components. Chemical species identification was performed using GC-MS analysis. The turbidimetric model was used to investigate crystallization inhibition in vitro. Infrared spectroscopy technique was used to characterize the synthesized crystals. Furthermore, both DPPH and FRAP methods were used to assess antioxidant activity. The results show that the fractions are equally important in crystallization inhibition percentages of calcium oxalate crystals. For saponin and polyphenol fractions, the inhibition percentages are in the orders of 83.49% and 82.83%, respectively. The results of the antioxidant activity by DPPH method show that the two fractions are equally important in the elimination of free radicals; the inhibition percentages were 77.87 +/- 4.21 and 89.92 +/- 1.39 for both polyphenols and saponins, respectively. FRAP method showed that the absorbance increases proportionally with concentration, and the absorbance are almost similar for both fractions and reach maximum values in the orders of 0.52 +/- 0.07 and 0.42 +/- 0.03, respectively, for saponins and polyphenols. These findings demonstrate that both fractions are rich in bioactive chemicals and have an anticrystallization capacity, allowing them to be employed for the curative and prophylactic effects against urolithiasis.Peer reviewe

Chemical Composition, Antioxidant Potentials, and Calcium Oxalate Anticrystallization Activity of Polyphenol and Saponin Fractions from Argania spinosa L. Press Cake

A wide range of biological properties and a potent therapeutic and prophylactic effect on chronic diseases are all present in Argania spinosa L. press cake. The aim of this research is to valorize the anticrystallization properties against calcium oxalate crystals of Argania spinosa L. press cake fractions and identify its bioactive components. Chemical species identification was performed using GC–MS analysis. The turbidimetric model was used to investigate crystallization inhibition in vitro. Infrared spectroscopy technique was used to characterize the synthesized crystals. Furthermore, both DPPH and FRAP methods were used to assess antioxidant activity. The results show that the fractions are equally important in crystallization inhibition percentages of calcium oxalate crystals. For saponin and polyphenol fractions, the inhibition percentages are in the orders of 83.49% and 82.83%, respectively. The results of the antioxidant activity by DPPH method show that the two fractions are equally important in the elimination of free radicals; the inhibition percentages were 77.87 ± 4.21 and 89.92 ± 1.39 for both polyphenols and saponins, respectively. FRAP method showed that the absorbance increases proportionally with concentration, and the absorbance are almost similar for both fractions and reach maximum values in the orders of 0.52 ± 0.07 and 0.42 ± 0.03, respectively, for saponins and polyphenols. These findings demonstrate that both fractions are rich in bioactive chemicals and have an anticrystallization capacity, allowing them to be employed for the curative and prophylactic effects against urolithiasis

Patients diabétiques en dialyse péritonéale

The prevalence of diabetes mellitus (DM) among patients requiring renal replacement therapy (RRT) has been on the rise worldwide, with DM now being the primary cause of end-stage renal disease (ESRD) in roughly one-third of RRT initiations. Although renal transplantation is the optimal treatment for ESRD, its limited availability has led to in-center hemodialysis (HD) being widely used as the default RRT modality in many countries. However, peritoneal dialysis (PD) may offer a superior option for diabetic patients due to its slower ultrafiltration rate, which can help mitigate the dialysis-induced hypotension and coronary ischemia that are associated with extracorporeal circulation during HD. Despite these advantages, unfounded concerns about technique failure and increased complication rates have discouraged some clinicians from recommending PD as a first-line RRT for diabetic patients. We conducted a retrospective study comparing the incidence of complications and technique survival rates between diabetic and non-diabetic patients undergoing PD at a dialysis unit in Morocco. Our findings reveal that, diabetic patients undergoing PD experienced no significant difference in technique survival or incidence of complications compared to their non-diabetics. Nevertheless, only a small proportion (17.5%) of patients in our PD unit was diabetic, suggesting a need to improve access to PD for diabetic patients with ESRD.La prévalence du diabète sucré chez les patients nécessitant une thérapie de remplacement rénal est en hausse dans le monde entier, et le diabète est désormais la principale cause d'insuffisance rénale chronique terminale (IRCT) chez environ un tiers de ces patients. Bien que la transplantation rénale soit le traitement optimal pour l'IRCT, sa disponibilité limitée a conduit à l'utilisation généralisée de l'hémodialyse en centre (HD) comme modalité de remplacement rénal par défaut dans de nombreux pays. Cependant, pour les patients diabétiques, la dialyse péritonéale (DP) peut offrir une option supérieure en raison de son taux d'ultrafiltration plus lent, qui peut aider à diminuer les complications associées à la circulation extracorporelle pendant l'HD. Malheureusement, des préoccupations infondées concernant l'échec technique et l'augmentation des taux de complications ont dissuadé certains cliniciens de recommander la DP comme traitement de première intention pour les patients diabétiques en IRCT. Nous avons mené une étude rétrospective comparant l'incidence des complications et les taux de survie technique entre les patients diabétiques et non diabétiques bénéficiant de la DP dans une unité de dialyse au Maroc. Nos résultats révèlent que les patients diabétiques en DP n'ont pas connu de différence significative en termes de survie de la technique ou d'incidence de complications par rapport aux non diabétiques. Cependant, nous avons constaté que seule une petite proportion (17,5 %) des patients de notre unité de DP était diabétique, ce qui suggère que l'accès à la DP pour les patients diabétiques atteints d'ESRD doit être amélioré