La prise en charge d’un goitre compressif chez une femme enceinte

Introduction: Les médecins d'urgence reçoivent fréquemment des patients atteints d'une pathologie de la thyroïde. Cependant, il est rare que ces troubles mettent la vie du patient en danger. La compression des voies aériennes supérieures due à une augmentation du volume d'une tumeur bénigne de la thyroïde et peut nécessiter un traitement chirurgical urgent.But: rappeler les modalités de prise en charge d'un goitre chez une femme enceinte.Observation: nous rapportons un cas d'une femme enceinte qui a été admise pour un goitre compressif avec dyspnée laryngée, qui exigeait une thyroïdectomie totale en urgence.Conclusion: La thyroïdectomie urgente chez la femme enceinte peut être réalisée si on respecte les précautions nécessaires.Mots clés: goitre, grossesse, thyroïdectomie.Introduction: emergency physicians frequently encounter patients with thyroid disease. However, it is unusual for these thyroid disorders to create acute, life-threatening situations. Critical airway compression attributable to benign thyroid enlargement may occur suddenly and require urgent treatement.Aim: we recall making procedures in charge of a goiter in pregnant women.Case -report : We report a case of pregnant women who was admitted for compressive goiter with laryngeal dyspnea, which required emergency total thyroidectomy.Conclusion: Urgent thyroidectomy in pregnant women can be performed if we respect the precautions.Keywords: goiter, pregnancy, thyroidectomy

A new prescription model for regional citrate anticoagulation in therapeutic plasma exchanges.

Regional citrate anticoagulation (RCA) is proposed for various extracorporeal purification techniques to overcome the risk of bleeding that might result from systemic anticoagulation. Yet, no individualized treatment protocol has been proposed for therapeutic plasma exchange (TPE) so far. The objective of this study was to assess the determinants of blood citrate concentration needed and to develop an individualized RCA protocol useful for clinical practice. The study population included 14 patients who underwent a total of 47 TPE sessions. Citrate was infused pre-plasmafilter. Post-plasmafilter and systemic plasma ionized calcium concentrations were measured at standardized time intervals. An algorithm was proposed for the supplementation of calcium. During the discovery phase, citrate was infused at a fixed starting rate, and adapted accordingly to obtained post-plasmafilter ionized calcium levels. Using a mathematical approach, an algorithm was thereafter developed for individualized prescriptions of citrate. Pre-treatment values of hematocrit and plasma ionized calcium were the main determinants of the required rate of citrate infusion. These can be integrated into a final equation enabling to individualize the prescription. A prefilter ionized calcium concentration between 0.24 and 0.33 mmol/l prevented coagulation of the extracorporeal circuit. Significant hypocalcemia occurred in 8.5% of treatments. There were no significant acid-base disturbances. We propose a new protocol, which enables for the first time to individualize the prescription of regional citrate anticoagulation during TPE, in an efficient manner. The immediately obtained regional anticoagulation protects against both the risk of coagulation of the membrane and the exposure to an excess of citrate

Erratum to: A new prescription model for regional citrate anticoagulation in therapeutic plasma exchanges.

BACKGROUND: Regional citrate anticoagulation (RCA) is proposed for various extracorporeal purification techniques to overcome the risk of bleeding that might result from systemic anticoagulation. Yet, no individualized treatment protocol has been proposed for therapeutic plasma exchange (TPE) so far. The objective of this study was to assess the determinants of blood citrate concentration needed and to develop an individualized RCA protocol useful for clinical practice. METHODS: The study population included 14 patients who underwent a total of 47 TPE sessions. Citrate was infused pre-plasmafilter. Post-plasmafilter and systemic plasma ionized calcium concentrations were measured at standardized time intervals. An algorithm was proposed for the supplementation of calcium. During the discovery phase, citrate was infused at a fixed starting rate, and adapted accordingly to obtained post-plasmafilter ionized calcium levels. Using a mathematical approach, an algorithm was thereafter developed for individualized prescriptions of citrate. RESULTS: Pre-treatment values of hematocrit and plasma ionized calcium were the main determinants of the required rate of citrate infusion. These can be integrated into a final equation enabling to individualize the prescription. A prefilter ionized calcium concentration between 0.24 and 0.33 mmol/l prevented coagulation of the extracorporeal circuit. Significant hypocalcemia occurred in 8.5% of treatments. There were no significant acid–base disturbances. CONCLUSION: We propose a new protocol, which enables for the first time to individualize the prescription of regional citrate anticoagulation during TPE, in an efficient manner. The immediately obtained regional anticoagulation protects against both the risk of coagulation of the membrane and the exposure to an excess of citrate. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0494-9) contains supplementary material, which is available to authorized users

Studi In Silico Senyawa Aktif Daun Tagalolo (Ficus septica Burm F) sebagai Ligan Uji pada Enzim L-Histidin Decarboxylase

Histamine is one of the parameters in the tuna export trade that needs to be considered so that the product can be well received in the United States (USA), European Union (EU), and Japan. Histamine is used as a quality indicator for food safety of tuna products, because high histamine can cause toxic effects in humans. The leaves of the tagalolo/awar-awar plant (Ficus septica Burm. F) contain active compounds that function to cure several types of diseases such as ulcers, itching, wounds, diarrhea, dysentery and drugs to reduce fever and are used as inflammatory drugs. This study aims to determine the types of active compounds in tagalolo/awar-awar leaves from the literature search and their potential to react with the enzyme L-histidine decarboxylase through non-empirical research in silico. The compounds obtained from the literature search are Genistin, ß-amyrin, Pyrrolidine and Phenanthroindollizidine. These compounds were then tested In Silico with molecular docking. The results of the in silico study showed that the compounds Genistin, ß-amyrin, Pyrrolidine and Phenanthroindollizidine could not react with the L-histidine decarboxylase enzyme because all the tested ligands did not react or bind to the receptor.Keyword:     Tagalolo plant, Histamine, In Silico, Molecular Docking. Histamin merupakan salah satu parameter dalam perdagangan ekspor tuna yang perlu diperhatikan agar produk dapat diterima dengan baik di Amerika Serikat (USA), Uni Eropa (UE), maupun Jepang. Histamin dijadikan indikator mutu untuk keamanan pangan produk tuna, karena histamin yang tinggi dapat menyebabkan efek keracunan pada manusia. Daun tanaman tagalolo/awar-awar (Ficus septica Burm. F) mengandung senyawa aktif yang berfungsi menyembuhkan beberapa jenis penyakit seperti obat bisul, gatal-gatal, luka, diare, disentri dan obat untuk menurunkan demam serta digunakan sebagai obat radang atau inflamasi. Penelitian ini bertujuan untuk mengetahui jenis-jenis senyawa aktif daun tagalolo/awar-awar hasil penelusuran pustaka dan potensinya untuk bereaksinya dengan enzim L-histidin dekarboksilase melalui riset non-empirik secara in silico. Senyawa yang didapatkan dari penelusuran pustaka yaitu Genistin, β- amyrin, Pyrrolidine dan Phenanthroindollizidine. Senyawa-senyawa tersebut kemudian diuji secara In Silico dengan penambatan molekul (molecular docking). Hasil studi secara in silico menunjukkan bahwa senyawa Genistin, β- amyrin, Pyrrolidine dan Phenanthroindollizidine tidak dapat bereaksi dengan enzim L-histidin dekarbokasilase karena semua ligan uji tidak bereaksi atau terikat dengan reseptor.Kata kunci:  Tanaman Tagalolo, Histamin, In Silico, Molecular Docking

Search for R-parity Violating Supersymmetry in Dimuon and Four-Jets Channel

We present results of a search for R-parity-violating decay of the neutralino chi_1^0, taken to be the Lightest Supersymmetric Particle. It is assumed that this decay proceeds through one of the lepton-number violating couplings lambda-prime_2jk (j=1,2; k=1,2,3). This search is based on 77.5 pb-1 of data, collected by the D0 experiment at the Fermilab Tevatron in ppbar collisions at a center of mass energy of 1.8 TeV in 1992-1995.Comment: 10 pages, 3 figure

A Quasi-Model-Independent Search for New Physics at Large Transverse Momentum

We apply a quasi-model-independent strategy ("Sleuth") to search for new high p_T physics in approximately 100 pb^-1 of ppbar collisions at sqrt(s) = 1.8 TeV collected by the DZero experiment during 1992-1996 at the Fermilab Tevatron. Over thirty-two e mu X, W+jets-like, Z+jets-like, and 3(lepton/photon)X exclusive final states are systematically analyzed for hints of physics beyond the standard model. Simultaneous sensitivity to a variety of models predicting new phenomena at the electroweak scale is demonstrated by testing the method on a particular signature in each set of final states. No evidence of new high p_T physics is observed in the course of this search, and we find that 89% of an ensemble of hypothetical similar experimental runs would have produced a final state with a candidate signal more interesting than the most interesting observed in these data.Comment: 28 pages, 17 figures. Submitted to Physical Review

Direct Search for Charged Higgs Bosons in Decays of Top Quarks

We present a search for charged Higgs bosons in decays of pair-produced top quarks in pbar p collisions at sqrt(s) = 1.8 TeV using 62.2 pb^-1 of data recorded by the D0 detector at the Fermilab Tevatron collider. No evidence is found for signal, and we exclude at 95% confidence most regions of the (M higgs, tan beta) parameter space where the decay t->H b has a branching fraction greater than 0.36 and B(H -> tau nu) is large.Comment: 11 pages, 4 figures, submitted to Phys. Rev. Let

Search for New Physics Using Quaero: A General Interface to D0 Event Data

We describe Quaero, a method that i) enables the automatic optimization of searches for physics beyond the standard model, and ii) provides a mechanism for making high energy collider data generally available. We apply Quaero to searches for standard model WW, ZZ, and ttbar production, and to searches for these objects produced through a new heavy resonance. Through this interface, we make three data sets collected by the D0 experiment at sqrt(s)=1.8 TeV publicly available.Comment: 7 pages, submitted to Physical Review Letter