Search

Le syndrome de Lyell est une maladie rare de survenue imprévisible, grave et

We report the case of a patient admitted for management of posttraumatic status epilepticus, associated with shock and respiratory failure. After conditioning and initial management, transthoracic echocardiography showed a tamponnade effect with compression of the right cavities. The thoracic CT scan revealed an emphysematous right lung, with a large basithoracic bulla on the right completely crushing the cardiac chambers. Thoracic drainage improved the patient both clinically and radiologically. [ABSTRACT FROM AUTHOR]

We conducted a study of 46 patients admitted to the Intensive Care Unit with postoperative peritonitis. The incidence of postoperative peritonitis in this setting was 2.7%. The average age of patients was 53.3 years, with a sex ratio of 1.2. Submesocolic surgery was the most common cause of postoperative peritonitis (65.2%), mainly occurring in the colorectal region (48%). Clinical signs were dominated by fever (78%), abdominal pain (57%) and extra-abdominal signs. The mean time between symptom onset and diagnosis was 7.3 days. Reoperation was performed on the basis of clinical and biological criteria in 56.5% of cases. Therapeutic management was based on perioperative reanimation, treatment of organ dysfunctions, probabilistic antibiotic therapy and middle laparotomy. The bacteriological profile was dominated by BGN (79%). The loosening of the anastomotic sutures was the direct cause of PPO in 57% of patients. Mortality rate was 60%. The main prognostic factors were: renal failure, the number of patients with organ failure, PT<50%, the need for ventilation and the use of catecholamines. [ABSTRACT FROM AUTHOR]

Résumé: Le syndrome malin des neuroleptiques (SMN) est une urgence neuropsychiatrique diagnostique et thérapeutique rare et potentiellement mortelle en l'absence de prise en charge adaptée et précoce, reposant essentiellement sur un traitement symptomatique et spécifique. Exigeant une forte suspicion clinique pour le diagnostic et le traitement, le SMN est à juste titre un syndrome plus souvent considéré que véritablement diagnostiqué, et, du fait de sa faible incidence, les données factuelles le concernant, dans la littérature, sont limitées. Cette mise au point physiopathologique et thérapeutique a pour objectifs d'améliorer le raisonnement clinique et de réduire la marge d'incertitude du praticien en proposant un protocole actualisé, contextualisé et personnalisable. [ABSTRACT FROM AUTHOR]

Introduction et objectifs : le syndrome de résorption est un syndrome rare mais grave, pouvant compliquer certaines chirurgies utilisant des liquides d'irrigation vésicale. Des moyens prophylactiques ont été proposés, mais leur efficacité n'a pas été vérifiée par des études prospectives. Le but de notre étude est d'évaluer l'impact des mesures préventives sur l'incidence du syndrome de résorption, en quantifiant les variations de la natrémie chez les patients opérés pour résection transuréthrale de la prostate (RTUP) pour déterminer l'incidence des hyponatrémies postopératoires, leurs signes cliniques et leurs facteurs favorisants. Matériel et méthodes : étude prospective observationnelle incluant tous les patients opérés pour RTUP au bloc opératoire d'urologie au CHU Hassan II, de Fès, sur une période de neuf mois. Les critères évalués étaient le profil épidémiologique de la population étudiée, le poids de la prostate, le type d'anesthésie, sa durée, le volume prostatique réséqué et la survenue de signes prémonitoires d'un syndrome de résorption, la natrémie préopératoire (H-24) et postopératoire (H6 et H24). Les données de l'examen clinique et de l'ionogramme ont été comparées en postopératoire. Résultats : 134 patients ont été inclus, avec un âge moyen de 67 ans. Une comorbidité a été notée chez 46 % des malades. Le poids moyen de la prostate était de 50 g, avec une durée d'intervention moyenne de 45 min. Une rachianesthésie a été réalisée chez 88 % des patients. Douze pour cent des malades ont présenté des troubles du rythme cardiaque peropératoire, alors que 8 % ont présenté des bradycardies sévères. Deux patients ont développé des troubles neurologiques peropératoires ayant imposé l'arrêt de l'intervention. Des hyponatrémies < 135 mmol/L ont été objectivées chez 12,7 % des malades. Les principaux facteurs de risque de ces hyponatrémies sont l'apparition de troubles visuels, d'une bradycardie peropératoire inférieure à 45 battements/min, d'une agitation, une taille de prostate réséquée > 45 g et une natrémie préopératoire < 138 mmol/L. Conclusion : le respect des mesures prophylactiques semble prévenir de manière efficace la survenue du « TURP syndrome ». Néanmoins, des hyponatrémies mineures sont survenues chez 15 % des malades, dont 8 % étaient symptomatiques, mais d'évolution favorable en quelques heures chez tous les patients. [ABSTRACT FROM AUTHOR]

Le foudroiement est rare mais grevé d'une lourde morbimortalité associée notamment aux lésions cardiovasculaires secondaires, de mécanismes multifactoriels et complexes. Des cas d'infarctus du myocarde, de myocardite, d'arythmies, de contusion cardiaque ou encore de lésions aortiques ou péricardiques sont répertoriés dans la littérature. La prise en charge rejoint celle du traumatisé grave et l'évaluation cardiovasculaire nécessite au moins un monitorage électro- et échocardiographique, ainsi qu'une cinétique de troponine. Nous rapportons le cas d'une myocardite chez un jeune foudroyé admis aux urgences dans un tableau d'état de choc cardiogénique avec défaillance ventriculaire gauche et dont l'évolution était favorable sous assistance ventilatoire et support inotrope. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les complications thromboemboliques associées à l´infection par Mycobacterium tuberculosis ont été rapportées dans la littérature et ont eu lieu dans 1,5 à 3,4% de l´infection tuberculeuse. Nous rapportons le cas d'une fillette âgée de 4ans suivie pour spondylodiscite tuberculeuse, admise dans notre formation pour prise en charge d'une ischémie aigue des deux membres inférieurs consommée, ayant nécessité une amputation trans- tibiale d'un côté et trans-fémorale du coté contro-latéral. Nous discutons les aspects cliniques, physiopathologiques et le lien de causalité. [ABSTRACT FROM AUTHOR]

Résumé: Les chambres implantables à cathéters veineux centraux font partie intégrante de la prise en charge des patients atteints de cancer. L'approche fémorale est une alternative sûre et incontournable en cas d'obstruction cave supérieure. Nous rapportons le cas d'implantation d'une chambre pour chimiothérapie en fémoral chez un jeune patient de 32 ans porteur d'un lymphome médiastinal compliqué de syndrome cave supérieur. Implantable venous access port systems are one of the imperatives of modern medical therapy in oncology. Femoral insertion is considered an effective and reliable option in cases of superior cava system occlusion. We report our step-by step implantation technique in a case of a 32-year-old lymphoma patient presenting with a superior vena cava syndrome. [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary resuscitation (CPR) training is crucial for nursing students as future nurses are the first responders in the ambulatory and hospital care chain. Simulation-based learning has been shown to be more effective in acquiring the knowledge and technical and non-technical skills required for CPR. The present study aims to evaluate the impact of high-fidelity simulation-based adult CPR training on the acquisition and retention of knowledge and the development of technical and non-technical skills of nursing students at the Higher Institute of Nursing Professions and Health Techniques in Fez, Morocco., Methods: We conducted an interventional study with 49 nursing students. Twenty-five students (51.02%) in the simulation group received both traditional CPR training (theoretical lecture and demonstration of procedures) and simulation CPR training, while 24 students (48.97%) in the control group received only traditional training. Data were obtained using a questionnaire on theoretical knowledge of CPR, a technical skills assessment grid, and the Team Emergency Assessment Measure (TEAM) for non-technical skills., Results: The post-test scores for theoretical knowledge immediately after simulation were significantly higher for the simulation group (16.41±1.73 out of 20) than for the control group (13.15±1.96 out of 20). Mean CPR knowledge retention scores 30 days after training were significantly higher in the simulation group (15.60±1.71) compared with the control group (11.38±1.93). Assessment of technical skills on a high-fidelity mannequin showed a considerable advantage for the simulation group (30.88±1.64 out of 34) over the control group (18.00±0.78 out of 34). In addition, the results demonstrated a significant difference between the TEAM score of the simulation group (37.84±2.67 out of 44) and the control group (22.33±0.96 out of 44) and a significant difference between the Global Team Performance of the simulation group (8.16±0.68) out of 10 and the control group (4.83±0.38)., Conclusion: The findings demonstrated that adult CPR training using high-fidelity simulation was superior to the traditional method with regard to knowledge acquisition and retention and the development of technical and non-technical skills in undergraduate nursing students., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Hospital-University Ethics Committee of Fez, Laboratory of Anatomy, Surgery and Anesthesiology, Faculty of Medicine, Pharmacy and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, and the Regional Directorate of Health and Social Protection of Fez Meknes issued approval N°32/22 and N°5997. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, El Ougli et al.)

We report the case of a 78-year old patient, with no particular past medical history, who underwent transurethral resection of the prostate (50 g) under spinal anesthesia for benign hypertrophy. 90 minutes after the beginning of the procedure, the patient had nausea, vomiting, visual fog and bradycardia, suggesting TURP syndrome. Ionogramme objectified a serum sodium level of 118meq/L, hence the patient was treated with 3% hypertonic saline solution, with good evolution. This study describes a common but moderate occurrence of TURP syndrome whose management was facilitated by patient's alertness during spinal anesthesia.

Introduction: Simulation is an innovative educational tool based on learning experience in a secure environment without fear of repercussions especially in critical situations such as in emergencies. It offers great prospects in the development of dialysis training., Methods: We report the results of an observational study comparing medical simulation to conventional training methods in the management of hemodialysis in emergency situations. We discuss afterwards the possibilities currently allowed by medical simulation in dialysis training., Results: The training was beneficial (significant difference between initial and final level of knowledge) for all participants. There was no significant difference between the conventional approach, simulation training and the two combined tools. However, satisfaction rate was higher in simulation training. We observed a tendency to have better results in "active players" of the simulation compared to observers., Conclusion: We emphasize the importance of integrating medical simulation training in our dialysis training strategies as a complementary tool to classical teaching/learning methods., (Copyright © 2016 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)