Phéochromocytome et grossesse - Gestion péri opératoire et conduite à tenir obstétricale: a propos d’un cas clinique et revue de littérature

L’association phéochromocytome et grossesse est rare pouvant mettre en jeu le pronostic vital maternel et fœtal. Le diagnostic est aisé à condition d’y penser systématiquement face à une hypertension artérielle gravidique atypique, accompagnée de signes cliniques évocateurs, ou résistante au traitement. La certitude diagnostique est donnée par des tests biologiques simples et fiables. Nous rapportons le cas d’un phéochromocytome survenu au 1er trimestre, révélé par des épisodes d’hypertension artérielle. Le traitement avait consisté en une préparation médicale préopératoire suivie d’une surrénalectomie. L’évolution materno-fœtale était favorable. La survenue d’un phéochromocytome au cours de la grossesse pose un problème de diagnostic et de contrôle tensionnel. La stratégie thérapeutique dépend du terme, du retentissement materno-fœtal et de la réponse au traitement médical

Significations plurielles des urgences médicales et chirurgicales. Étude sociologique au service des UMC au CHU d’Oran

Les urgences hospitalières sont caractérisées par une ambigüité dans leur statut et mission, un flou organisationnel dans leur fonctionnement et un niveau d’incertitudes médicales.Conçues pour l’accueil des seuls malades dans un état grave, pouvant entrainer la mort ou des lésions irréversibles s’ils ne sont pas pris en charge rapidement, les urgences se retrouvent submergées par des malades pour toutes sortes de pathologies médicales et de détresses psycho-sociales. Il s’agit, dans cet article, de restituer quelques idées fortes qui se dégagent d’une étude ethnographique réalisée au sein du service des urgences médico-chirurgicales (UMC) du Centre hospitalier universitaire d’Oran (CHUO) pour comprendre comment les médecins, au sein des structures des urgences hospitalières, vivent au quotidien cette dualité et quelles sont les répercussions de cette situation sur leur identité professionnelle et sur leurs rapports avec les malades.Medical emergencies are being imbued with an ambiguity in status and profession, a structural gap in their functionning, and a medical and organizational « bankruptcy ».The emergencies, which primary mission is only to providing care for the sick persons in critical situations, who may die or endure irreversible lesions if not rapidly secured, emergencies happen to be overcrowded by patients of all sorts of diseases and other cases of psycho-social distress. The aim of the present article, is to restore some sound beliefs issued from an ethnographic study accomplished in the medico-surgery Department (UMC) of the University Hospital Centre of Oran (CHUO), to shed light on this duality which emergency practitioners experience daily, and what « side-effects », in this case, forge their professional identity and their relationships with the sick.يسود الغموض الاستعجالات الاستشفائية ، فثمة تذبذب من الناحية التنظيمية والطبية. لقد أنشئت الاستعجالات الاستشفائية لاستقبال المرضى في حالات حرجة فقط، والتي قد تؤدي إلى الموت أو الإصابة بعاهات مستديمة لو لم يتم التكفل بالمريض بشكل سريع، إلا أن المرضى – الذين يعانون أمراضا صحية مختلفة أو أزمات نفسية اجتماعية- “يغزون” الاستعجالات الطبية.يهدف هذا المقال إلى تقديم مجموعة من الأفكار الرئيسية بناء على الدراسة الإثنوغرافية –المنجزة بمصلحة الاستعجالات الطبية والجراحية بالمركز الاستشفائي الجامعي بوهران- وذلك بغية فهم كيفية تَعايُش الطبيب مع ثنائية “الطبيب-المريض” يوميا. وما هي انعكاسات ذلك على هويتهم المهنية وعلاقاتهم بالمرضى

Opening of the Algerian Basin: Petrological, geochemical and geochronological constraints from the Yaddene Complex (Lesser Kabylia, Northeastern Algeria)

International audienceThe Yaddene complex, located in Lesser Kabylia (northeastern Algeria), is composed of Tertiary mafic and ultramafic rocks that outcrop within syn-rift sedimentary rocks of the Algerian marginal basin, in the Maghrebide belt of North Africa. Petrographic observations show that the Yaddene complex is composed mainly of two distinct lithologies: (1) a layered quartz-bearing gabbro at the bottom, which consists mainly of plagioclase (An93), clinopyroxene (altered to actinolite) and rare interstitial quartz; and (2) layered plagioclase-bearing lherzolites composed of olivine (Fo86-88) orthopyroxene (En86–87), clinopyroxene (diopside and augite), rare plagioclase (anorthite) and amphibole of pargasitic composition.The trace element concentrations in pyroxenes and olivine of the Yadenne complex show a depletion in light rare earth elements (LREE) similar to basalts of the Mid-Ocean Ridge (N-MORB), which reflects the depletion of the mantle source. In addition, high #Cr in spinel reflects a high degree of partial melting of the mantle source. On the other hand, slight enrichment in Large Ion Lithophile Elements (Cs, Rb, Ba), weak but significant negative Nb, Ta, Zr, Hf and Ti anomalies, and positive Pb spikes are observed in both whole-rocks and minerals. These patterns are best explained by interaction between parental mantle and fluids and/or siliceous melts derived from a subducting oceanic slab. The tectonic discrimination diagrams of minerals and whole rocks indicate that the most likely geodynamic setting for emplacement of the Yaddene Complex is a back arc basin environment.In situ U-Pb dating of euhedral zircons and titanite from a quartz-bearing gabbro yields an age of 18.97 ± 0.12 Ma (2σ), which is interpreted as the crystallization age of magmatic zircons and the gabbroic magma. Zircons from a plagioclase-bearing lherzolite gave a consistent age of 19.05 ± 0.39 Ma (2σ), which is attributed to zircon growth during metamorphic/metasomatic processes coeval to gabbroic magma emplacement. The mafic/ultramafic rocks of the Yaddene complex are intercalated within fine-grained sediments of the syn-rift “Oligo-Miocene Kabyle” and the obtained early Burdigalian ages are interpreted as the early stages of an extensional regime that ultimately led to the opening of the oceanic Algerian Basin

Estimation of canine Leishmania infection prevalence in six cities of the Algerian littoral zone using a Bayesian approach

A large-scale study on canine Leishmania infection (CanL) was conducted in six localities along a west-east transect in the Algerian littoral zone (Tlemcen, Mostaganem, Tipaza, Boumerdes, Bejaia, Jijel) and covering two sampling periods. In total 2,184 dogs were tested with an indirect fluorescent antibody test (IFAT) and a direct agglutination test (DAT). Combined multiple-testing and several statistical methods were compared to estimate the CanL true prevalence and tests characteristics (sensitivity and specificity). The Bayesian full model showed the best fit and yielded prevalence estimates between 11% (Mostaganem, first period) and 38% (Bejaia, second period). Sensitivity of IFAT varied (in function of locality) between 86% and 88% while its specificity varied between 65% and 87%. DAT was less sensitive than IFAT but showed a higher specificity (between 80% and 95% in function of locality or/and season). A general increasing trend of the CanL prevalence was noted from west to east. A concordance between the present results and the incidence of human cases of visceral leishmaniasis was observed, where also a maximum was recorded for Bejaia. The results of the present study highlight the dangers when using IFAT as a gold standard

Desert Endemic Plants in Algeria: A Review on Traditional Uses, Phytochemistry, Polyphenolic Compounds and Pharmacological Activities

Due to their robust antioxidant capabilities, potential health benefits, wide variety of biological activities, and strong antioxidant qualities, phenolic compounds are substances that have drawn considerable attention in recent years. The main goal of the review is to draw attention to saharian Algerian medicinal plants and the determination of their bioactivity (antioxidant, anti-cancer, and anti-inflammatory importance), and to present their chemical composition as well as in vivo and in vitro studies, clinical studies, and other studies confirming their real impact on human health. Research results have revealed a rich variety of medicinal plants used to treat various disease states in this region. Based on in vivo and in vitro studies, biological activity, and clinical studies, a list of 34 species of desert plants, belonging to 20 botanical families, useful both in preventive actions and in the treatment of neoplastic diseases has been established, and polyphenolic compounds have been identified as key to the health potential of endemic diseases and desert plants. It has been shown that people who follow a diet rich in polyphenols are less prone to the risk of many cancers and chronic diseases, such as obesity and diabetes. In view of the increasing antioxidant potential of these plant species, as well as the increasing trade in herbal products from the Sahara region, phytosanitary and pharmaceutical regulations must change in this respect and should be in line with Trade Related Aspects of Intellectual Property Rights (TRIPS), and the sustainable use and development of plant products must be addressed at the same time

Estimates from the Hui-Walter model.

<p>Pr₁ = prevalence first period; Pr₂ = prevalence second period; Se_IFAT = sensitivity IFAT; Sp_IFAT = specificity IFAT; Se_DAT = sensitivity DAT; Sp_DAT = specificity DAT; <i>p_D</i>, <i>DIC</i> top line = values calculated from posterior values of variable nodes resp. for first period and second period, (bottom line) = values calculated from posterior probabilities</p><p>Estimates from the Hui-Walter model.</p

Apparent prevalence per locality.

<p>From top to bottom: only IFAT, only DAT, serial interpretation of the two test results and parallel interpretation of the two test results.</p

Canine <i>Leishmania</i> infection prevalence estimates according to the Hui-Walter model.

<p>Top prevalence is for first sampling period, bottom for second.</p

Canine <i>Leishmania</i> infection prevalence estimates according to full conditional test dependence model.

<p>Top prevalence is for first sampling period, bottom for second.</p

Apparent prevalence per test per sampling period per locality.

<p>From top to bottom: IFAT first period; IFAT second period; DAT first period; DAT second period.</p