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La crise financière internationale de 2008 a remis en selle les politiques monétaires non conventionnelles. L’Algérie n’a pas été en reste, suite à l’effondrement des cours du pétrole en 2014, qui avait eu un impact négatif sur l’ensemble de l’activité économique, ce qui avait nécessité de profondes restructurations dans la conduite de la politique économique. A cet effet, les autorités monétaires ont fait recours au financement non conventionnel dit (FNC), à travers l’amendement de la loi sur la monnaie et le crédit (loi n°17-10 du 11/10/2017). Cet article a pour objet d’analyser l’impact du FNC sur les agrégats macroéconomiques du modèle de Kaldor (1971) et quelques agrégats financiers, à l’aide de la méthode d’analyse en composantes principales. Les résultats obtenus montrent que le financement non conventionnel n’a fait que combler d’une manière partielle le déficit budgétaire. En effet, il ne peut pas être à lui seul une source de relance économique sans qu’il soit accompagné d’un certain nombre de mesures qui lui permettront d’être efficace et de réaliser ses objectifs.

We describe the emergence of plasmid-mediated colistin resistance mcr-1 in a clinical isolate of Escherichia coli ST19. The strain was isolated from a urine sample of a 75-year-old male patient. The identification was carried out by an automated system. The antibiogram was performed according to CLSI recommendations. The colistin MIC was determined by broth micro-dilution according to CA-SFM/EUCAST criteria. The detection of mcr-1 was carried out by immunochromatographic test and PCR mcr-1. Genetic transfers and determination of the plasmid incompatibility group were made. The ST was carried out by MLST using the Pasteur scheme. The strain has a high-level penicillinase resistance phenotype. It was susceptible to amikacin and resistant to gentamicin, tobramycin, fluoroquinolones, tetracycline, chloramphenicol, and cotrimoxazole. The strain was resistant to colistin (MIC ꞊ 4 μg/ml). The genetic transfer is given a colistin-resistant transconjugant. The plasmid carrying mcr-1 gene belongs to the incompatibility group IncHI2.The strain belongs to ST19. J Microbiol Infect Dis 2019; 10(4):222-224.

Introduction et contexte : L’obésité représente actuellement un problème majeur de santé publique dans le monde et le recours à la chirurgie bariatrique est dans ce contexte de plus en plus fréquent. Or, cette méthode est grevée de nombreuses complications notamment neurologiques. Cette étude se concentre plus précisément sur les atteintes du système nerveux périphérique. Plusieurs tableaux sont décrits dans la littérature : polyneuropathie aiguë, polyneuropathie chronique, mononeuropathie et neuropathie des petites fibres. Des mécanismes nutritionnels, mécaniques et inflammatoires sont mis en cause dans ces atteintes suite à une chirurgie bariatrique. L’objectif principal de cette étude était de décrire sur les plans clinique, électroneurophysiologique et thérapeutique une cohorte normande de patients atteints de neuropathies suite à une chirurgie bariatrique, de les comparer à ceux retrouvés dans la littérature et de proposer une éventuelle prise en charge. Méthode : Nous avons mené une étude de cohorte, descriptive, rétrospective, multicentrique en Haute-Normandie. Les patients inclus étaient issus des services de neurologie et neurophysiologie du CHU de Rouen, de neurologie du CHI d’Elbeuf et de la consultation des neurologues libéraux de Haute-Normandie. Ils devaient avoir plus de 18 ans, bénéficié d’une chirurgie bariatrique entre 2009 et 2019, présenté des symptômes en lien avec une neuropathie et ne pas avoir d’antécédent de neuropathie.Résultats : Dix-neuf patients ont été inclus dans notre étude. Cinq phénotypes électrocliniques ont pu être identifiés : polyneuropathie aiguë, polyneuropathie axonale chronique, neuronopathie sensitive, mononeuropathie et neuropathie des petites fibres. Un suivi postopératoire inadéquat était retrouvé chez treize patients, une carence en vitamine B1 était présenté chez cinq patients et une carence en vitamine B12 chez quatre patients. Le handicap initial était sévère avec un Rankin moyen initial à 2,65 mais une évolution clinique favorable était observée après une prise en charge pluridisciplinaire par un neurologue et un nutritionniste. Discussion - Conclusion : Les éléments qui semblent favoriser les neuropathies périphériques suite à une chirurgie bariatrique sont une perte de poids importante, un suivi post-opératoire insuffisant et la survenue de vomissements dans la période post-opératoire. Une prise en charge comprenant un suivi régulier dans la période post-opératoire avec une évaluation nutritionnelle complète, et un dépistage précoce (interrogatoire et examen clinique neurologique) pourrait permettre d’éviter la survenue de ces neuropathies ou au moins d’éviter une atteinte sévère.

Résumé L’un des dix-sept objectifs du développement durable tracés par les Nations Unis à l’horizon 2030 est. le tourisme. Ce dernier est considéré comme un bon indicateur multidimensionnel sur le plan économique, social et politique. En Algérie, le tourisme saharien présente un potentiel très important en raison des différents gisements matériels et immatériels qui existent. Cet article essaie de mettre en valeur l’importance du tourisme saharien en Algérie d’un coté; et essaie de chercher des éléments de réponses aux véritables contraintes qui freinent l’essor de se secteur et enregistre de ce fait une perte d’opportunité de développement certaines de l’autre coté, dans un contexte d’un environnement socioéconomique en pleine mutation. Mots clés: Tourisme Saharien, types de tourisme saharien, objectifs de développement durable, opportunités et contraintes, développement socioéconomiques, Summary One of the seventeen goals of sustainable development identified by the United Nations by 2030 is tourism. The latter is considered a good multidimensional indicator on the economic, social and political levels. In Algeria, Saharan tourism has a very important potential because of the various material and immaterial deposits that exist. This article tries to highlight the importance of Saharan tourism in Algeria on one side; and tries to find elements of answers to the real constraints that slow down the development of the sector and thus saves a loss of development opportunity, some on the other side, in the context of a socioeconomic environment in full change. Keywords: Saharan tourism, types of Saharan tourism, sustainable development objectives, opportunities and constraints, socio-economic development.

Purpose: To report unusual presentations of type 2A idiopathic macular telangiectasia (IMT). Methods: A retrospective analysis of disease presentation was conducted in 32 patients with type 2A IMT. All patients underwent a complete ophthalmological examination, including spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA). Results: Three out of 32 study patients showed the simultaneous presentation of type 2 IMT and other retinal diseases. In the first patient, the ophthalmological examination revealed a proliferative IMT associated with late-onset Stargardt disease. The second patient presented bilateral nonproliferative IMT and chronic serous chorioretinopathy in the left eye. The examination of the third patient revealed basal laminar drusen and soft drusen associated with IMT in both eyes. Conclusions: Type 2 IMT may represent an unusual presentation of Stargardt disease, chronic serous chorioretinopathy and basal laminar drusen. These presentations are most likely coincidental and highlight the importance of FA, ICGA and SD-OCT in the diagnosis and treatment of such cases.

PURPOSE To evaluate the dynamic remodeling of drusen in subjects with unilateral neovascular age-related macular degeneration (AMD) receiving a three-year course of oral docosahexaenoic acid (DHA) or placebo. SETTING Institutional setting. METHODS Three hundred subjects with age-related maculopathy and neovascular AMD in the fellow eye were randomly assigned to receive either 840 mg/day DHA or placebo for 3 years. Main outcome measures of this post-hoc sub-group analysis were progression of drusen number, total diameter, and total area on fundus photography, and their association with DHA supplementation, socio-demographic and genetic characteristics. RESULTS Drusen progression was analyzed in 167 subjects that did not develop CNV (87 that received DHA and 80 that received placebo). None of the drusen remodeling outcomes were significantly associated with DHA supplementation. Total drusen diameter reduction in the inner subfield was significantly associated with age (older patients: r = -0.17; p = 0.003). Women showed a tendency to decreased total drusen diameter in the inner subfield with CFH polymorphism (p = 0.03), where women with TT genotype tended to have a greater reduction in drusen diameter than other genotypes (CC and CT). Drusen area in the inner subfield was more reduced in older patients (r = -0.17) and in women (p = 0.01). Drusen number showed no significant trends. CONCLUSIONS Dynamic drusen remodeling with net reduction in drusen load over three years was found in patients with exudative AMD in one eye and drusen in the other eye (study-eye). This reduction was correlated with increased age and female gender, and showed a tendency to be influenced by CFH genotype, but did not appear to be affected by DHA supplementation. TRIAL REGISTRATION Controlled-Trials.com ISRCTN98246501.

Purpose The possibility of applying long-lasting steroids, such as triamcinolone and subsequently dexamethasone implant, directly in the eye, without the systemic side effects observed after their oral or intravenous administration, aroused great enthusiasm among ophthalmologists. Methods and results The SCORE study, a multicenter clinical trial, compared the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with observation in central retinal vein occlusion (CRVO) participants with macular edema secondary to perfused CRVO. This study marked a turning point in the management of retinal vein occlusion (RVO), since it was the first report on an effective treatment of macular edema due to CRVO. But in branch retinal vein occlusion (BRVO), the SCORE study showed no difference in visual acuity for the standard care group compared with the triamcinolone groups; however, the rates of adverse events (particularly elevated intraocular pressure and cataract) were highest in the 4-mg group. The authors concluded that laser grid photocoagulation should remain the benchmark against which other treatments should be compared. The Geneva Study, a randomized, controlled, clinical trial, conducted to evaluate the safety and efficacy of an intravitreal implant that delivers sustained levels of dexamethasone (Ozurdex™), studied the largest group of RVO patients with macular edema (1267 patients), including 35% CRVO and 65% BRVO. The study demonstrated that this slow-release device could both reduce the risk of vision loss and improve the speed and incidence of visual improvement in eyes with macular edema secondary to CRVO and BRVO, with fewer side effects, such as elevation of intraocular pressure or cataract. Other ongoing studies evaluate the safety and efficacy of anti-vascular endothelial growth factor injection; preliminary results showed that these therapies are effective in decreasing macular edema and improving visual acuity, with fewer ocular adverse effects, but their duration of action seems limited. Conclusions These recent studies result in a great change in the management of macular edema from RVO. Unfortunately, long-term studies on safety and efficacy are not yet available, and further studies will have to show whether the short-term benefits are only transient or may finally lead to a long-lasting improvement in vision.

Objective To observe the tolerance of repeated intravitreous injections over the short and long term and to analyze their complications. Patients and methods The clinical records of consecutive patients having one or several intravitreous injections between 2002 and 2007 were evaluated, for all indications except the treatment of endophthalmitis. Results 2028 intravitreous injections were performed, mainly for age-related macular degeneration (n=1 192) or macular edema secondary to diabetes mellitus or retinal vein occlusion (n=41). The injected drug was triamcinolone acetonide 4 mg (339 injections), pegaptanib sodium 0.3 mg (1179 injections), and ranibizumab 0.3 (497 injections). The patients received 1-27 intravitreous injections per eye. The main complications were endophthalmitis (two after triamcinolone, 0.1% of the total group), pseudoendophthalmitis (two after triamcinolone, 0.1% of the total group), hypertony (7.69% of the total group, 13.78% after triamcinolone, 3.56% after pegaptanib, 1.21% after ranibizumab), including five cases of acute hypertony with transient light perception loss after ranibizumab, cataract (0.44% of total group), and macular hole (one patient after triamcinolone). No case of retinal detachment nor systemic complication was observed. Discussion Most of the complications were observed with the use of nonfiltered triamcinolone. The incidence of endophtalmitis was considerably lower with increased experience and the use of a dedicated room for the injections. Repeated injections were locally well tolerated. Conclusion With the strict respect of asepsis rules, intravitreous injection seems well tolerated over the short and long term.

Introduction Afin d’etablir une classification fiable sur laquelle pourront se baser des etudes cliniques ou genetiques, il est necessaire de pouvoir determiner des sous-groupes homogenes de degenerescence maculaire liee a l’âge (DMLA) a partir de l’examen clinique, angiographique et OCT. La premiere partie de notre etude (SPA-1) porte sur le phenotypage des precurseurs de la maculopathie liee a l’âge base sur l’angiographie a la fluoresceine. Patients et methodes Trente items portant sur la classification des stades precoces de DMLA, de la neovascularisation choroidienne et de l’atrophie ont ete selectionnes a partir de la litterature. Vingt yeux de vingt patients consecutifs ont ete choisis a partir d’une etude prospective NAT-2, incluant des formes variees de precurseurs. La cotation a ete basee sur les photographies couleur du fond d’œil, les cliches anerythres et l’angiographie a la fluoresceine. Pour chaque cas, la grille a ete remplie par quatre observateurs independants et un expert. La variance intra-patient a ete etudiee pour chaque item. Resultats L’accord le plus pertinent entre observateurs est retrouve pour l’item « decollement drusenoide de l’epithelium pigmentaire » (variance intra-patient = 0,000). La plus mauvaise valeur pour la variance intra-patient concerne l’item « drusen intermediaire entre 5 et 20 » (variance intra-patient = 0,255). Conclusion Cette evaluation de la premiere partie de notre grille demontre un accord satisfaisant entre observateurs pour la plupart des items. Concernant l’item avec le plus faible accord, il sera amene a etre modifie apres concertation des differents medecins. A terme, elle pourrait etre utilisee dans des etudes futures cliniques ou genetiques.

INTRODUCTION Persistent macular edema (ME) is the main cause of poor visual outcome in nonischemic retinal vein occlusion (RVO). The aim of this study was to evaluate the results of surgery in this disorder. PATIENTS AND METHODS Retrospective nonrandomized comparative pilot study. Visual acuity measurement, fluorescein angiography, and optical coherence tomography were performed before and after treatment, at 3 months, 6 months, and 1 year. RESULTS The study included 42 eyes: 15 eyes underwent vitrectomy with peeling of the posterior hyaloid and/or the internal limiting membrane, 19 received intravitreous injection of triamcinolone (IVT), and four had a combination of both treatments. In the vitrectomy group, 63% of the eyes showed a progressive decrease of ME throughout the year of follow-up (p

Objective: To evaluate the efficacy of docosahexaenoic acid (DHA)-enriched oral supplementation in preventing exudative age-related macular degeneration (AMD). Design: The Nutritional AMD Treatment 2 study was a randomized, placebo-controlled, double-blind, parallel, comparative study. Participants: Two hundred sixty-three patients 55 years of age or older and younger than 85 years with early lesions of age-related maculopathy and visual acuity better than 0.4 logarithm of minimum angle of resolution units in the study eye and neovascular AMD in the fellow eye. Methods: Patients were assigned randomly to receive either 840 mg/day DHA and 270 mg/day eicosapentaenoic acid (EPA) from fish oil capsules or the placebo (olive oil capsules) for 3 years. Main Outcome Measures: The primary outcome measure was time to occurrence of choroidal neovascularization (CNV) in the study eye. Secondary outcome measures in the study eye were: incidence of CNV developing in patients, changes in visual acuity, occurrence and progression of drusen, and changes in EPA plus DHA level in red blood cell membrane (RBCM). Results: Time to occurrence and incidence of CNV in the study eye were not significantly different between the DHA group (19.5 +/- 10.9 months and 28.4%, respectively) and the placebo group (18.7 +/- 10.6 months and 25.6%, respectively). In the DHA group, EPA plus DHA levels increased significantly in RBCM (+70%; P < 0.001), suggesting that DHA easily penetrated cells, but this occurred unexpectedly also in the placebo group (+9%; P = 0.007). In the DHA-allocated group, patients steadily achieving the highest tertile of EPA plus DHA levels in RBCM had significantly lower risk (-68%; P = 0.047; hazard ratio, 0.32; 95% confidence interval, 0.10-0.99) of CNV developing over 3 years. No marked changes from baseline in best-corrected visual acuity, drusen progression, or geographic atrophy in the study eye were observed throughout the study in either group. Conclusions: In patients with unilateral exudative AMD, 3 years of oral DHA-enriched supplementation had the same effect on CNV incidence in the second eye as did the placebo. However, RBCM fatty acid measurements revealed that CNV incidence was significantly reduced in DHA-supplemented patients showing a steadily high EPA plus DHA index over 3 years. (C) 2013 by the American Academy of Ophthalmology.

Journal of Neuroradiology - In Press.Proof corrected by the author Available online since jeudi 21 fevrier 2013

Purpose:To evaluate lipid, lipoprotein and fatty acid profile in patients with advanced exudative Age-related Macular Degeneration (AMD) participant to the NAT2 study compared to normal sighted non-AMD individuals (CON). The NAT2 study (ARVO2011 #6642) showed overall reduced 3-year incidence (27% vs 33% expected) of choroidal neovessels (CNV), similarly in patients randomly allocated oral Docosa-Hexaenoic Acid (DHA 840mg/d) or Olive Oil (OLO 602mg/d). Since cohort studies suggested that daily OLO or DHA intake could prevent exudative AMD, here we explored if changes in circulating and cellular FA could account for main findings of the NAT2 study. Methods:Exudative AMD patients (N=289, 188F/101M, Age=74.2 ±6.6y) had legal blindness (LogMar 1.044) and CNV in one eye at study entry. Age and sex matched normal sighted controls (n=102, 60F/42M, Age=73.0 ±6.0y) were recruited in parallel with NAT2 participants after ophthalmologic and fundus examination. Fasting plasma lipoproteins were measured enzymatically. Plasma and erythrocyte membrane fatty acid (FA) profile was assessed by Gas Chromatography. Results:Except for lower plasma TG (1.12 vs 1.33 mmol/L, p=0.002) plasma lipoprotein profile was similar in AMD and CON groups. In both groups HDL cholesterol was higher in women than in men (AMD: 1.89F vs 1.56M, CON: 1.89F vs 1.70M mmol/L, p

Purpose:The NAT-2 (Nutritional AMD treatment-2) study was a randomized, placebo-controlled, double-blind, parallel, comparative study. The purpose of NAT-2 was to evaluate the efficacy of oral docosahexaenoic acid (DHA) supplementation for preventing exudative age-related macular degeneration (AMD). The purpose of this ancillary study was to correlate the effects of DHA supplementation with genetic background. Methods:263 patients (Full Analysis Set) aged ≥55 and

L’examen par tomographie en coherence optique (ou OCT) est un nouveau procede d’imagerie diagnostique, analogue a l’ultrasonographie et capable de produire des images en coupe anteroposterieure des tissus du fond d’œil et d’apporter des elements nouveaux et utiles en pratique clinique pour la DMLA. C’est la confrontation des images obtenues par les angiographies en fluoresceine et en ICG et celles de l’OCT qui fournit les informations les plus utiles pour chacune des formes cliniques de la DMLA. Certains symptomes sont faciles a reconnaitre tels qu’un soulevement sereux retinien, un œdeme intraretinien diffus ou cystoide, un decollement de l’epithelium pigmentaire sereux ou fibrovasculaire et une eventuelle dechirure, ou encore une hyper-reflectivite liee a une fibrose cicatricielle. D’autres symptomes sont plus delicats a reconnaitre tels que la presence des neovaisseaux choroidiens, leur localisation par rapport a la fovea et par rapport a l’epithelium pigmentaire, les associations de lesions (decollement de l’epithelium pigmentaire, decollement sereux retinien, hemorragies, exsudats, fibrose, anastomoses et autres), et meme les lesions les plus rares telles que les vasculopathies polypoidales choroidiennes, neovaisseaux intra retiniens, surcharge de materiel. En clinique, au cours de l’evolution, les neovaisseaux choroidiens peuvent apparaitre le plus souvent sous forme de neovaisseaux choroidiens mixtes et intriques, et selon des modalites variables. L’OCT peut permettre de confirmer leur presence, de les localiser et de porter les indications therapeutiques avec precision. Dans le cas du suivi post-therapeutique, l’OCT est particulierement precieux pour affirmer la persistance d’une reaction exsudative, ou au contraire pour affirmer sa disparition.