Sexes de femmes sexe homo
Summary The lymphocytic meningitis is a diagnostic and therapeutic emergency. The aim of this work is to study the epidemiology, clinic, biology, etiology, treatment and outcome of lymphocytic meningitis in children. We retrospectively reviewed the records of 53 patients hospitalized with lymphocytic meningitis in the pediatric department, university hospital Hassan II Fez, for 3 years from January to December We included 34 boys and 19 girls, there mean age was 6.
One patient had a history of tuberculosis. The average time between the clinical sign and consultation of was 3 days. An external ventricular diversion is performed in 2 patients. The average hospital stay was 10 days 2- 30days. The outcome was propitious in We deplore one death 1 month old infant with miliary tuberculosis associated with meningitis. Our study highlights the frequency of lymphocytic meningitis in children, as well as the severity of the tuberculosis and herpes, hence the need for a diagnosis and early management.
Les anti aromatases sont des traitements efficaces des cancers du sein chez la femme ménopausée. Dans notre travail nous nous sommes intéressés à la prévalence des arthralgies et aux facteurs de risque de fractures chez les patientes traitées pour cancer du sein. La vitamine D a un rôle indéniable dans le métabolisme osseux et musculaire. However, they expose to rheumatic manifestations wich may lead to therapeutic stop, they also expose to an increased risk of osteoporosis and fractures in the longer term.
In our work, we studied the prevalence of arthralgia and fracture risk in patients treated for breast cancer. Vitamin D had an undeniable role in bone metabolism and muscle. Because of the high prevalence of vitamin D deficiency and frequency of musculoskeletel complications, we should seek a bilogical assessment for all women initiating treatment with an aromatase inhibitors to search and treat a hypovitaminosis. Hence the value of a good assessment of fracture risk clinical risk factors and BMD in all women receiving aromatase inhibitors to detect and treat pre existing osteoporosis.
Au cours des dernières décennies, l'incidence de ce cancer a progressivement augmenté principalement en raison des progrès de l'imagerie et de son utilisation plus précoce dans les investigations. In recent decades, due to the use of imaging in the investigation of those cancers,its incidence has progressively increased. The classic support of kidney cancer is mainly based on the radical nephrectomy, and for decades, interferon-a and interleukin-2 were the only medication available, with modest efficacy.
The evolution of surgery for kidney cancer is marked by the advent of laparoscopic surgery and conservative surgery, and the development of minimally invasive techniques, especially the radio frequency therapy by heat, the thermal rise , and cryotherapy cold therapy.
The process involves implanting one or more electrodes under radiological ultrasound and MRI to the tumor. Currently, the understanding of tumor microenvironment and in particular the process of tumor neovascularization opens new therapeutic perspectives based primarily on the inhibition of different pathways of angiogenesis. A number of molecules have been developed including monoclonal antibodies such as; Bevacizumab, or molecules that inhibit the functional activity of tyrosine kinases sorafenib, sunitinib or mTOR inhibitors, acting directly on angiogenesis.
Ces 98 cas se répartissent en 72 garçons, et 26 filles. Les patients ayant bénéficié de cette exploration présentaient soit une constipation 57cas , une encoprésie 12 cas , une association des deux 24 cas , et une malformation anorectale 5cas.
Le reflexe recto anal inhibiteur. La manométrie anorectale était normale chez 4 patients. Pour les Autres cas on a trouvé: Elle permet également une orientation thérapeutique plus adaptée fondée sur des paramètres objectifs et surtout quantifiables. SUMMARY Anorectale manometry is a test base for exploitation of functional anorectal disorders, but also to optimize the therapeutic management. The purpose of our study was to evaluate the diagnostic yield and basically any therapeutic exploration in our series, and compare it with literature data.
These 98 cases were distributed in 72 boys and 26 girls the age of our patients ranged from 1 year to 13 years with an average of 6 years. The patients who underwent this exploration had either a constipation 57 cases , an encopresis 12 cases an association of the two cases 24 cases , and an anorectale malformation 5 cases.
Anorectale manometry allows to study the resistive and capacitive device of the functional anorectal unit by measuring: The anorectal manometry was normal in 4 patients , in the other cases we found: Anorectal manometry is a powerful technique in the diagnosis, it allows a more suitable therapeutic orientation based on objective parameters and especially quantifiable.
Facteurs de mortalité des malades de neurochirurgie admis en réanimation polyvalente a1 A propos de cas. Différents paramètres ont été recueillis et comparés entre le groupe des survivants et celui des décédés. La mortalité chez les malades de neurochirurgie admis en réanimation reste relativement élevée, les causes du décès sont surtout dominées par les causes infectieuses suivies des causes neurologiques.
La prévention repose essentiellement sur: The search of the factors of mortality is a key element in an intensive care unit and their evaluation and analysis are needed to improve the quality of care in an ICU. The aim of our work is to study the factors of mortality of patients admitted to intensive care unit A1 because this department preferentially recruit patients under neurosurgery and require resuscitation. This is a retrospective study performed in the intensive care unit A1 CHU Hassan II of Fez, over a period of six months from 1 March to August 31, , including all neurosurgical patients admitted to intensive care and died at Beyond 48 hours of admission.
Various parameters were collected and compared between the group of survivors and that of the deceased. The age, medical history, the initial diagnosis, duration of ICU stay, duration of mechanical ventilation, the type of surgery, complications, general severity scores and organ dysfunction were significantly elevated in the group of patients who died.
Mortality in patients admitted to the neurosurgical intensive care remains relatively high, the cause of death are mainly dominated by infectious causes followed by neurological causes. Prevention is based primarily on: Analyse critique de l'apport de la ponction lombaire dans les infections néonatales A propos de cas.
La PL a été réalisée chez presque un tiers des cas. Les tumeurs malignes de paupières représentent une pathologie relativement fréquente. Ce travail est une étude rétrospective portant sur une série de 51 malades présentant tous une tumeur palpébrale maligne sur une période de 66 mois comprise entre janvier et juin Les résultats postopératoires sont satisfaisants pour la majorité de nos malades, hormis quelques complications.
Cependant, on ne pouvait pas conclure sur le suivi à long terme puisque la plupart de nos patients sont perdus de vues précocement. Les tumeurs palpébrales malignes, dont le carcinome basocellulaire est le plus fréquent, posent essentiellement un problème thérapeutique où la chirurgie reste le moyen le plus utilisé. Malignant tumors of the eyelids are a relatively frequent pathology. Before any therapeutic coverage, a clinical examination must be made, to guide the assessment, followed by a biopsy confirming malignancy.
The TDM and the MRI allow best to specify the extension and so to direct the therapeutic choice which is often surgical. A histological examination of the piece will then ensure margins of resection. The objective of our thesis is to identify the epidemiological aspects and diagnosis of these tumors and to evaluate their therapeutic decision. This work is a retrospective study of a series of 51 patients presenting all a malignant eyelid tumor, over a period of 66 months between January and June A detailed medical record allowed us this study.
These are 31 men and 20 women; the average age is The Advanced age and the chronic sun exposure are the most important risk factors. The seat of predilection is the lower eyelid; otherwise the left eye is most frequently affected. Radiological examination has allowed us to detect a case of basal cell carcinoma with liver metastases. The frozen section was used in 8 cases. He helped change excision in 4 cases and found false negative in one case. The postoperative results were satisfactory for the majority of our patients, except for some complications.
However, we could not conclude on the long-term follow-up because the most of our patients are early lost sight.
The malignant eyelid tumors, including basal cell carcinoma is the most frequent, pose a therapeutic problem mainly where surgery remains the most used. The best treatment is prevention that begins with public education and use of current means of photoprotection which are of big efficiency.
Nos patients ont été diagnostiqués par TDM et ont été suivis après traitement avec un recul moyen de 18 mois et 10 jours. Les résultats sont moins bons chez le 3ème patient ayant une AJI et diagnostiqué tardivement. Summary The atlonto-axoidial rotator dislocation is a rare condition of the child for which a consensus diagnosis and treatment are still missing and whose complications can be serious.
Our work consisted of a retrospective study over a period of 03 years performed in the Trauma- Orthopedic Pediatrics department in University Hospital Center Hassan II of Fez and about 03 cases of C1C2 rotational dislocation in children.
The aim of our study was to analyze our results based on several epidemiological and clinical settings, choose the best diagnostic strategy and good driving practice to this pathology. Our patients were diagnosed by CT and were followed after treatment with a mean of 18 months and 10 days. The average age in our study was 6. The etiologies were various with a case of traumatic origin, a case due to juvenile rheumatoid arthritis and one case of undetermined cause.
One of our patients was treated conservatively with cervical traction followed by immobilization successfully. The other two patients, after failure of traction, have benefited from a fusion C0C2 by screwing guying and implementation of a bone graft. Evolution was satisfactory in 2 patients 1 case who received orthopedic treatment and one case treated surgically with a good functional result.
The results are worse in the third patient with JRA who were diagnosed late. Morover, we have shed light on the contribution of the pH-metry esophageal in diagnosting gastro esophageal reflux in children who have atypical extradigestive symptomology , which is source of difficulties for diagnostics, especially when they take the from of faulse respiratory or ENT Ere Nose and Throat symptomology.
Sa prise en charge est multidisciplinaire. La thyroïdectomie est un des principaux traitements de cette pathologie. La clinique a été dominée par les signes de thyrotoxicoses qui ont été retrouvées chez tous les patients.
En post-opératoire, des complications ont été colligés: Abstract Hyperthyroidism is a serious condition by its systemic impact. Its management is multidisciplinary. Thyroidectomy is a major treatment of this disease.
The aim of our study is to evaluate, trough a retrospective study, the epidemiological, clinical, therapeutic, and outcome of patients undergoing thyroidectomy as part of a surgical treatment of hyperthyroidism in the ORL department of the CHU Hassan II of Fez between and The clinic has been dominated by the signs of thyrotoxicosis which were found in all patients. Exploration has identified 60 cases of toxic multinodular goitre or prétoxique A medical preparation was put in 69patients.
A total thyroidectomy was performed in 70 patients The toxic goiter was in most cases Benin Postoperatively, complications were recorded for.
The surgical risks of toxic goiters deemed saingnards and members, must be performed by an experience surgeon who must double their vigilance to minimize morbidity represented mainly by laryngeal paralysis and hypoparathyroidism.
Notre étude est une étude rétrospective a porté sur 45 cas de tumeurs de la main et du poignet, opérés dans le service de chirurgie ostéo articulaire B4 au CHU Hassan II de Fès entre et a permis de conclure que: Our work is a retrospective study of 45 cases of tumors of the hand and wrist, in the department of surgery osteoarticular B4, CHU Hassan II of Fez between and concluded that: Squamous cell carcinoma 8.
La prise en charge multidisciplinaire des métastases hépatiques est devenue indispensable. La résection chirurgicale est le seul traitement des métastases hépatiques pouvant permettre une survie à long terme acceptable. Abstract The multidisciplinary therapeutic approach of hepatic metastases is necessary. Surgical resection remains the only treatment that can ensure long-term survival and cure in some patients.
However, only a minority of patients can benefit from a curative surgery. The challenge now, is to develop innovative strategies combining resection to other treatments such as radiofrequency, portal vein embolization and the use of new chemotherapy protocols in order to treat, with curative intent, the liver tumors initially considered as non-resectable.
La gynécologie obstétrique est une spécialité souvent confrontée à l'urgence, mettant parfois en danger la vie de deux personnes. Ce travail a pour objectif d'exposer les principaux cas d'urgence réelle, de manière synthétique et didactique. Scindé en deux grandes parties, ce travail aborde vingt six situations urgentes: It is essential that clinician have the knowledge and skills to achieve a rapid and an effective response, especially in the context of a national commitment to reduce maternal mortality.
In this context, developing a practical guide for gynecological and obstetrical emergencies could be an essential tool for young practitioners in obstetrics and gynecology. This work aims to highlight the main real emergency, in a synthetic and didactic way.
Split into two main parts, the book tackles twenty six clinical situations: The various emergency situations and appropriate conduct are clearly exposed many efforts were made to provide consistent information with current medical knowledge, based on research in the database PubMed, the Cochrane Database, in Encyclopedia of medical and surgical gynecology Obstetrics taking into account the recommendations issued by WHO and the French and American learned societies It has also inspired several rigorous protocols in emergency departments of waiver.
En effet, Plus de 10 millions de nouveaux cas et plus de 6 millions de décès sont recensés chaque année dans le monde, dont plus de la moitié surviennent dans les pays en développement. Au Maroc, le cancer constitue un des problèmes majeurs de santé publique, car le diagnostic est souvent tardif et la prise en charge est difficile et coûteuse. Objectifs de notre travail: Les objectifs de ce travail sont déclinés en objectifs principaux et objectifs secondaires: Nous avons noté la fréquence des sujets jeunes dans notre série avec un âge moyen de 53,5 ans et un âge médian de 55 ans.
Des corrélations ont été effectuées entre les différents types histologiques et les données cliniques concernant les différentes localisations. Cancer is now one of the most common causes of morbidity and mortality worldwide.
Indeed, more than 10 million new cases and over 6 million deaths occur each year worldwide, which more than half diagnosed in developing countries. In Morocco, cancer is a major public health problem, because its diagnosis is often delayed and the care is difficult and costly.
Several records have already been established, including the register of the city of Rabat RECRAB , the cancer registry of the Greater Casablanca and soon, the cancer registry of Marrakech. They can give an idea on the epidemiology of cancer in these regions. Besides, in Fes and its regions, there is currently no reliable regional data base, that allow us to assess the frequency and distribution of cancers diagnosed in this region and from which a cancer control could be developed.
Aims of our work: The objectives of this work are available in main objectives and secondary objectives: During our study, we have collected cancer cases, including We noted the frequency of young patients in our series with a mean age of The digestive system cancers represented the most common location of all cancers, and were dominated by colorectal cancers which accounted for Breast and gynecological cancers represented the first woman cancers and accounted for Moreover, our study is characterized by the frequency of the bladder and urinary excretory cancers which represented the first male cancer counting for 9.
However, by analyzing data recorded during the two years and , following the inauguration of the CHU Hassan II of Fez, we observed that our results match those of the literature, and the lung cancer was the second most common cancer in men, followed by colorectal cancer and prostate cancer, who was in turn, the leading cancer of the urogenital tract among males. Correlations were made between the different histological types and clinical data on the different locations Conclusion: Our work is a represents a first step for establishment of a hospital cancer registry in the University Hospital Canter of Fes and gives an idea of the epidemiological cancer in our hospital, which drains the majority of patients with cancer, in the region of Fez-Boulemane.
Cinq formes ont été individualisées: Le syndrome inflammatoire était présent chez tous les malades de notre série. Les AAN étaient positifs dans 2 cas ayant une oligoarthrite, et les facteurs rhumatoïdes étaient positifs chez un cas de polyarthrite, et chez un autre ayant une arthrite qui ne répond à aucune des autres formes.
Huit patients avaient des radiographies des articulations atteintes qui sont normales. Une prise en charge thérapeutique précoce conduit souvent à une bonne évolution ultérieure.
Le retard statural 3 cas , les séquelles articulaires 2 cas , et le kyste synovial 1 cas. Summary The juvenile idiopathic arthritis is a disease that is rare and difficult to diagnosis, since the latter is worn only after eliminating other diseases with articular term.
In order to better know the epidemiological profile of children with JIA, and for better policy for diagnosis and treatment, we conducted this study. The diagnosis is guided by the anamnesis, clinical examination and tests paraclinical, which can also classify patients based on the criteria of Edmonton.
Five types were distinguished: The inflammatory syndrome was present in all patients in our series. Eight patients had a normal X-rays of affected joints.
An early therapeutic management often leads to a good future development. Short stature 3 cases , sequelae joints 2 cases , and synovial cyst 1 case. It appears from this work, the importance of good knowledge of the different clinical forms of this disease whose diagnosis is not always easy.
This is the guarantor of an early care and adapted to improve the prognosis for systemic form and functional outcome joint and eye for other forms. Ainsi dans notre série la tétralogie de Fallot est la plus fréquente des cardiopathies congénitales suivies en consultation. À noter 2 cas de décès peropératoire.
Les suites lointaines après intervention curative ont été appréciées après un recul moyen de 3 ans et 3 mois chez nos malades. SUMMARY By analyzing the medical records of 55 children, with the Tetralogy of Fallot followed in the pediatric cardiology departement at the University Hospital of Fez on a four-year period between January and December , we try to approach the epidemiological, clinical, paraclinical, therapeutic and evolutive disease.
In our series tetralogy of Fallot is the most common congenital heart disease followed at consultation. The mean age of discovery is 2 years and 7 months. There is a male predominance among our patients sex ratio 1. The diagnosis is confirmed by echocardiography in all the cases and the lesional examination has been completed by an angioscan in 7 patients. The spontaneous evolution of our patients was marked by deaths of two patients, and neurological complications in a case.
The surgey is performed in 16 cases, 3 patient who underwent "modified Blalock shunt ", 2 patients are waiting for a complete cure, after Blalock operation. The immediate evolution after curative surgery is satisfactory, one patient developed congestive heart failure, and 2 patients developed pericardial effusion, whose evolution has been good.
Noted 2 cases of death during surgery. The remote continuations after curative intervention were appreciated after a median follow-up of 3 years and 3 months of our patients. Finally, we insisted on the role of the improvement of the precocious screening in our country as well as the necessity to create a system of social security in order to pay the costs of expensive surgical treatment.
Le retard de croissance constitue un motif fréquent de consultation en pédiatrie. Les étiologies du retard statural étaient dominées par 5 pathologies principales: The aim of the study is to describe the epidemiological, clinical and paraclinical aspects and therapeutics of growth delay, to deduce the main etiologies and to suggest an adapted approach in our context.
The etiologies were dominated by 5 main pathologies: The delayed growth has a multiple causes, which impose an adapted diagnosis based on the epidemiological, anamnesis and clinical inputs that permit to guide the diagnosis towards a known etiology and complementary exams targeted. Manifestations hématologiques au cours du lupus: Les manifestations hématologiques observées au cours du LES sont nombreuses, variées et bien établies dans la littérature. En effet, La participation hématologique fait partie intégrante des critères diagnostiques du lupus et se définit par une: Sur une période de deux ans allant de Janvier à Décembre , 39 cas ont été identifiés et colligés.
Les principales doléances de nos patients consistaient en un syndrome anémique mal toléré, un syndrome hémorragique, des adénopathies périphériques et une pancytopénie fébrile. Les données de littérature corroborent les résultats de notre étude et confirment le polymorphisme et la sévérité des événements hématologiques survenant au cours du lupus.
The haematological abnormalities observed in SLE are commun, varied and well established in the literature. Nearly all SLE patients develop some haematological manifestation during the course of the disease.
Haematologic involvement is a part of the revised criteria of the American Rheumatism Association ARA and is defined by: La plupart des anomalies cliniques évocatrices d'une glomérulopathie sont des indications à la biopsie rénale. The glomerular renal disease may be primary or secondary diagnosis based on renal biopsy because there is no clinicopathological correlation.
Our work, which is a retrospective study of type descriptive and analytical studies in patients supported for glomerular renal disease collected at the service of nephrology, dialysis, kidney transplantation at the university hospital Hassan II of Fez during a period from January to December , aims to describe the epidemiological characteristics of patients with glomerular nephropathy CHU Hassan II of Fez and assess the frequency of different histological types.
The incidence of glomerular renal disease in our study and The indication for renal biopsy in our study in dominated by the nephrotic syndrome which is Most clinical evidence suggestive of glomerulopathy are indications to renal biopsy.
The diagnosis of most glomerular nephropathy is the fruit of reflection carried out jointly by the pathologist and the nephrologist. Dans notre série la fracture était: La durée moyenne de consolidation de nos malades était 15 semaines. En accord avec la majorité des auteurs nous concluons à de très bons résultats pour le traitement chirurgical des fractures de la clavicule par plaque vissée.
A retrospective study was performed for surgery osteoarticular B4 CHU Hassan II of Fez, to analyze the clinical and radiological results of surgical treatment of clavicle fractures and to evaluate our functional results, for 23 patients hospitalized, between and , the slice Age ranged from 19 to 72 years, the average age is The average duration of consolidation of our patients was 15 weeks.
In agreement with most authors we find that very good results for the surgical treatment of clavicle fractures by bone plate. Il est considérablement amélioré par une attitude thérapeutique précoce et bien réfléchie. The analyse of our serie and literature data allowed us to deduce the following: The echoendoscopy has, in addition to its diagnosis interest, a major interest in the assessment of local and regional extension, it was realized at 2 patients of our series, and made possible to pose the diagnosis of the ampulla of Vater at a patient.
The scan is essential for the assessement of extension. Reflected Attitude and early treatment improves it significantly.
Notre travail consistait en une étude rétrospective de 84 cas de cancer du col utérin, diagnostiqués au service d'anatomie-pathologique du CHU HASSAN II de Fès, parmi eux 38 cas étaient pris en charge aux services de gynécologie obstétrique, durant une période de 3 ans entre Janvier et Décembre Ces résultats étaient dû au faite que la plupart des facteurs de risques du développement du cancer du col utérin étaient retrouvés chez nos patientes.
La classification utilisée était celle de la FIGO, ainsi on a eu les résultats suivants: La colpohystérectomie élargie par voie abdominale avec lymphadénectomie représentait le type de chirurgie le plus utilisé. Il est au deuxième rang des cancers féminins dans le monde, principalement dans les pays en voie de développement.
Summary The cervical cancer is an unusual cancer, for over a century, we know that this is a sexually transmitted disease caused by human papillomavirus. Its detection is ideal, since it is realized by a simple and approved technical: The objective of this work is to describe the epidemiological and pathological aspects in all our patients, and study the risk factors, clinical, paraclinical and therapeutic aspects of cervical cancer patients in services Obstetrics Gynecology of the CHU Hassan II of Fez.
The average age of the disease in our series was early, compared to developed countries These results are due to the presence of most risk factors for the development of cervical cancer in our patients because, in fact: In contrast, only 2. Squamous cell carcinoma was found predominantly in Adenocarcinoma, malignant mixed Mullerian tumor and verrucous carcinoma have accounted for Metrorragy revealed the diagnosis in With a delay of care: The used classification is the FIGO, it gives us the follow results: The association radio-surgicale is the most used protocol of treatment.
It was appliedfor The colpohysterectomy enlarged through the abdomen with lymphadenectomy represented the most often used type of surgery. The cervical cancer is an infectious disease.
It is the second most common cancer in women worldwide, mainly in developing countries. Improved living conditions and the organization of screening by cervico-vaginal smear, could help to bring down the impact and mortality of this cancer. The temporary pacing permits the replacement of ventricular electrical activity spontaneously deficient in the heart by imposing a variable frequency electrical stimulation.
Temporary transvenous pacing makes this training through the establishment, intravenously, a probe at the right ventricle that is connected to an external stimulator. The main indications in emergency are represented by symptomatic conduction disturbances during the acute phase of myocardial infarction. We report the experience of the Cardiology Service of the University Hospital Hassan II of Fez in the field of temporary transvenous pacing, analyzing the technical aspects, indications and complications of this emergency procedure.
Les 5 nouveau-nés ont présenté une détresse respiratoire néonatale, avec des accès de cyanose au moment de fermeture de la bouche, et parmi les 5 nouveau-nés 2 présentaient un syndrome CHARGE. Abstract choanal atresia is a rare congenital malformation, which is characterized by the persistence of a septum membranous or bony or mixed separating the nasal cavity and the pharynx, it may be complete or incomplete, unilateral or bilateral.
We present this study pro-and retrospective over a period of one year and three months, from 1 January to 31 March on five cases of choanal atresia admitted to the neonatal intensive care CHU Hassan II - Fez. The admission rate of newborn was 0. The 5 newborns presented neonatal respiratory distress, with attacks of cyanosis at the time of closing of the mouth, and among the five newborns two had a CHARGE syndrome.
The diagnosis of choanal atresia was made at the time of nasal aspiration and confirmed by CT and intraoperative endoscopy for 5 cases. We conclude through this study that nasal endoscopy and Computed Tomography have revolutionized the diagnostic and therapeutic approaches to choanal atresia, the frequent association with other abnormalities requires the practice of clinical assessment and paraclinical and a long-term monitoring by the pediatrician.
Le traumatisme est suggéré comme un facteur plutôt péjoratif. Following a review of the literature about three cases of osteosarcoma of the proximal humerus in the orthopedic - trauma service at University Hospital Hassan II in Fez in It is important to stress the following points: The trauma is suggested as a factor rather derogatory.
MRI is a fundamental review to visualize the limits of the extension intraosseous and soft tissue. The existence of pulmonary metastases at diagnosis is a significant poor prognostic factor. At the shoulder it will most often by deltopectoral chest. It must take the future incision and requires precise anatomical landmarks.
The development of immunohistochemistry confirmed the existence of multiple forms specific and avoids misdiagnosis in some limiting forms.
Deux grands facteurs étiologiques se dégagent de notre travail: Après un intervalle libre de quelques heures à plusieurs jours, apparait un tableau de détresse neurologique. Il est globalement favorable pour les hématomes sous duraux. They are divided into six subarachnoid hemorrhage Two major etiological factors emerge: The existence of a subarachnoid hemorrhage in lumbar puncture is an additional argument for the diagnosis to be quickly confirmed by ultrasound and CT transfontanellar.
The Cerebral CT is essential to confirm diagnosis and determine the characteristics of the hematoma: These vary according to the authors. The surgical abstention is the rule for deep hematomas, or rather multiple, small little symptomatic. Many authors recommend the evacuation of the hematoma where there is a translation of midline structures, an effect on the ventricular system or brainstem compression.
The waning of our work, this attitude seems to be qualified since we observe many similar situations with a favorable outcome in the absence of any direct action on the hematoma. The prognosis of these hematomas varies according to their topography and can be apprehended by CT data and the initial electroencephalogram. It is generally favorable for subdural hematomas in. But in meningeal and intraventricular hemorrhage, it appears related to the extent of bleeding and the degree of cerebral anoxia associated.
Finally we encourage the interest on the monitoring of pregnancies to avoid certain forms of intracranial hemorrhage. Evaluation psycho-comportementale dans la lombalgie chronique A propos de cas.
La lombalgie commune chronique, bien que bénigne, entraîne des retentissements socio-économiques et psychologiques importantes.
La dépression constitue le facteur psychologique le plus fréquemment associé aux plaintes douloureuses chroniques. Abstract Low back pain, although mild, cause a socio-economic repercussions and psychological changes. Among the psychological factors, mood disorders, anxiety and depression in particular, are important.
Depression is the psychological factor most frequently associated with chronic pain complaints. The principal objective of our study was to evaluate the prevalence of depression and anxiety in chronic low back pain population and factors associated with depression and anxiety.
This is a cross study in patients with chronic low back pain followed in rheumatology consultation through a questionnaire evaluating depression and anxiety Beck scale, HAD anxiety and depression and FABQ scales fears and beliefs about professional and physical activity ;demographic and clinical data age, sex, educational level, profession, BMI, duration of back pain, VAS for pain, kinesitherapy, harbor the lumbar support belt.
The results of our study confirm an important psychological impact with a high prevalence of depression and anxiety in chronic low back pain. Sex, age, educational level and VAS pain are the most factors associated with depression and anxiety.
La défense et le signe de Blomberg, bien que moins fréquent chez la femme enceinte, sont souvent présent, ceci malgré les modifications anatomopathologiques. Les tableaux cliniques les moins évocateurs sont souvent associés à une pathologie et un âge gestationnel avancé.
The diagnosis of acute appendicitis is modified little by the pregnancy, as well with the first as with the second quarters, with some significant differences in the clinical presentation between these two quarters. Our work aims to describe the characteristic of acute appendicitis in the expectant mother in term of diagnosis clinical, biological, radiological, therapeutic, and evolutionary as well as the risks incurred for the mother and the fetus by acute appendicitis.
This study was based on the consultation of the files of the services as well as an electronic library search. It is about a retrospective study of the cases of acute appendicitis in the course of the pregnancy in the departments of gynecology and obstetrics 1 in CHU Hassan II Fes during Our series comprises 3 cases of acute appendicitis during pregnancy. In term of epidemiology the majority of the studies find a prevalence of the primiparous patients presenting an acute appendicitis.
The middle age of occurred of acute appendicitis ranges between 24 and 30 years thus one notes a more important proportion of which has occurred during the second quarters of pregnancy. In spite of the multiple possible tables the sign of the most constant examination some is the stage of pregnancy remains, as apart from the pregnancy, the pain caused on the level of the F. D and this in spite of the migration of the appendix. The defense and the sign of Blumberg, although less frequent in the expectant mother, are often present, this in spite of the anatomopathologic modifications.
The clinical pictures least evocative are often associated with a pathology and an advanced age gestational. As apart from the pregnancy biology is only one diagnostic tool additional not making it possible him neither to only affirm nor to cancel the diagnosis. Echography can specify, rectify or support a suspected diagnosis.
The scanner in not stripped of danger, but its high efficiency can, in the event of clinical picture doubtful being of an invaluable help. In the course of intervention any hypoxia, hypotension, hypertension, acidosis, hypo or hyperventilation must be avoided. The laparoscopy adds other risks related to the pneumoperitoneum.
The laparoscopic surgery during the pregnancy and in particular the appendicectomy present of multiple advantages compared to the laparotomy and seems to be able to be realized in full safety for increasingly advanced stages of pregnancy although it is not there to date of consensus on the limiting stage. In our context, there is no place with the laparoscopic surgery for appendicectomy during the pregnancy and the laparotomy takes its entire place.
Appendicitis during pregnancy is a combination high-risk maternal fetal whose prognosis depends on early diagnosis and therapeutic management. Le sexe masculin était le plus touché avec un sex-ratio de 1,42 en faveur des garçons. Mais selon l'âge, les étiologies varient et sont différentes de celles retrouvées dans la population adulte.
Plus de la moitié de nos malades ont reçu une antibiothérapie. The objective of this study was to present to every practitioner confronted with a disorder of consciousness the epidemiological characteristics, the clinical evaluation, the parameters biological and radiological and the various etiologies allowing him, so, to estimate the prognosis and to specify an appropriate treatment for each case.
The children of urban origin were the most affected. The male was the most affected with a sex-ratio of 1,42 in favor of the boys. But according to the age, etiologies vary and are different from those found in the adult population. More than half our patients received an antibiotic treatment. The antiviral, the anticonvulsive and the insulinothérapy are alternative therapeutic the most used.
In noted that the majority of our patients had woken up in the first ones 24 hours and duration mean hospitalization is of 9 days. Although the prognosis at the child is better than at the adult, the gravity of the disorders of consciousness at the child is conversely proportional at its age.
Il est définit comme un syndrome à double composante: Plusieurs progrès ont été effectués concernant les méthodes de diagnostic et de traitement. La chirurgie est binoculaire chez 66 patients.
La chirurgie des muscles horizontaux est celle pratiquée chez tous nos patients. Le recul musculaire est la technique utilisée chez 97 patients, associé ou non à la résection musculaire. Le résultat postopératoire est globalement satisfaisant, avec un angle résiduel. La croissance staturo-ponderale des enfants diabétiques de type 1 A propos de 86 cas. C'est une étude rétrospective qui a été menée durant 3ans Les critères d'inclusion étaient tous les enfants suivis pour diabète de type1 dont le diagnostic a été fait au service ou suivi en consultation de diabétologie pédiatrique.
Ceci est possible chez tous les jeunes diabétiques avec une prise en charge minutieuse et une éducation adéquate à l'autogestion de la maladie. ABSTRACT Type1 diabetes is an autoimmune disease with serious complications in the medium and long term whereas the interest of good care and proper monitoring.
The objective of this study is to evaluate the growth in height and weight in the diabetic children in the pediatric department at University Hospital Hassan II of Fes and their follow up during consulting pediatric diabetologist and to raise the problems encountered. This is a retrospective study which was conducted during 3 years The inclusion criteria were all children followed for type 1 diabetes whose diagnosis was made in the department or follow up in consultation with pediatric diabetologist.
They received a lestradet protocol with transition to insulin in skin. This is possible for all young diabetics provided to receive a proper education to self disease. Les pneumopathies nosocomiales constituent un problème de santé publique. Elles figurent au second rang des infections acquises en milieu hospitalier après les infections urinaires.
Ces germes isolés étaient multirésistants. The diagnosis of the pneumopathy nosocomial is based on a beam of arguments clinical, biological, radiological and bacteriological.
This work consisted of an epidemiologic analysis of the PN in medium of reanimation, and aimed at evaluating of it the frequency, the risk factors, the antibioresistance of the isolated bacteria and the mortality factors. The isolated germs was multiresistants. In this study, we find a very high mortality and a major additional morbidity of the pneumopathy nosocomial by prolongation of duration of hospitalization, of mechanical ventilation and a major additional cost. It appears in the light of this work that a strategy of prevention based on the strict application of measurements of hygiene and a sepsis and resting on an elaborate maintenance of the materiel of ventilation as on the respect of the procedure of care prove to be urgent in our context.
Les données ont été analysées par le logiciel SPSS. Les variables quantitatives ont été exprimées en moyenne et écart type et les variables qualitatives en nombre et pourcentage. Parmi les diabétiques de type 2; 32 patientes étaient sous antidiabétique oraux ADO , 7 patientes sous insulinothérapie, et 13 patientes sous insulinothérapie plus ADO. Concernant les modalités contraceptives, la moitié de nos patientes utilisaient une contraception hormonale, le quart utilisait un moyen mécanique DIU , alors que le reste usait soit des méthodes locales ou naturelles.
SUMMARY The question of contraception must be systematically approached in diabetic women during consultation, to allow the choice of an efficacious and tolerable method, and the programming of pregnancies, which is necessary for their smooth progress.
This is a descriptive retro-prospective study involving diabetic patients which are followed by consultation in the university hospital centre of Fez over a period of one year from March to March The collection of information was done through a questionnaire, having information related to the patient age, social security , illness duration of diabetes, the treatment used, the presence or absence of complications , and the and the parameters in relation to contraception modality, duration, efficiency.
The average age is The duration of diabetes is averaging 6. Among type 2 diabetics. Regarding the contraceptive terms, half of our patients used hormonal contraception, one quarter used a mechanical method IUD , while the rest used either local or natural methods.
Among patients under hormonal contraception, the indication of the estroprogestatif pill was inappropriate in 17 patients with type 2 diabetes mellitus.
This underscores the lack of information and support for these women to particular medical condition. Information about contraception must be a part of the essential points of the education of all diabetic in childbearing age, in the same way as treatment monitoring.
Awareness cannot achieve its objectives, without the close collaboration between dialectologists, gynecologists and general practitioner doctors, to ensure to the diabetic women the equilibrium of his diabetes and to plan her pregnancies. Les atrésies duodénales sont des embryopathies digestives peu fréquentes réalisant la forme typique des occlusions intestinales hautes.
Le pronostic a été conditionné par les malformations associées qui ont représenté: Le traitement a été chirurgical qui a comporté une duodéno-duodénostomie latéro-latérale chez tout les patients complétée par une duodénoplastie de modulation chez un cas. The purpose of this study is to present their clinic and radiological aspects and to rate the therapeutic results through a series of 12 cases collected since to at the department of pediatric surgery in the CHU Hassan II of Fez.
The diagnosis has been ,the most often, easy in front of bilious vomiting with flat belty and data of abdomen radiography without preparation. The higher digestive opacification has been practiced in 3 cases. The antenatal diagnosis has been based on the antenatal echography in only 3 cases. The prognosis has depended on the associated malformations that represented: The evolution was marked by a good outcome in 9 cases with an average postoperative stay of 5 days.
Le traitement chirurgical des osteonecroses aseptiques non traumatique de la tête fémorale A propos de 14 cas. ONATF idiopathique a été retrouvé dans 6 cas. Sur les 14 hanches opérées, le forage a été réalisé pour 3 hanches et la PTH pour 11 hanches dont 7 cimentées et 4 non cimentées. Tous les malades étaient suivis en consultation avec un examen clinique et radiologique. Abstract We retrospectively analyzed 14 cases of non traumatic osteonecrosis of the femoral head in 14 patients followed and treated at the Trauma Orthopedic B4 of the University Hospital Hassan II of Fez.
This study was conducted over a period of four years from the beginning of January until the end of December Our objective through this series was to show the benefit of surgical treatment in this type of pathology, on improving the quality of life of these young patients. These are 9 men and 5 women. The average age was The side was reached in 12 cases with unilateral predominance of the right side 8 cases and bilateral in 2 case.
Idiopathic osteonecrosis was found in 6 cases. Of the 14 hips operated, drilling was carried out for 3 hips and total hip prosthesis in 11 hips, 7 cemented and uncemented 4. All patients were followed for consultation with a clinical examination and radiological. Trading in Postel and Merle d'Aubigne was used to assess the state of the hip before and after surgery.
Le tableau clinique était polymorphe selon la localisation de la masse. Les suites opératoires immédiates et long terme ont été sans complications. Excluding the hydatid cysts and ovarian cysts functional abdominal cystic masses include digestive duplications, cystic lymphangioma, cystic nephroblastoma, cystic tumors of the ovary, the congenital biliary dilatation, splenic cysts, pseudocysts of the pancreas, etc. This is a retrospective study of ten cases of children with cystic abdominal mass, collated in child surgery department at CHU Hassan II of Fez, over a period of 7 years The clinical picture was polymorphic depending on the location of the mass.
Thus, three of our patients had chronic abdominal pain, the chance discovery of an abdominal mass was reported in two case, an array of acute abdomen was noted in two patients, chronic perineal pain were noted in one patient, against the 3rd trimester ultrasound revealed an abdominal cystic mass in the fetus in a case , and one patient revealed her illness to jaundice.
Paraclinical investigations were requested to guide the diagnosis. The abdomen without preparation was performed in all patients and showed fluid levels in one case. Our patients benefit from surgical treatment, and surgical approach was different depending on the pathology. The two patients with cystic dilatation of the bile duct underwent a bilio-digestive anastomosis end-to-side Y, tumor ablation and adnexectomy were performed in both the girls with ovarian teratoma, the total resection of the malformation was performed in patients with gastrointestinal duplication or cystic lymphangioma and cystic nephroblastoma patient received a total nephroureterectomy expanded.
Pathology The study was performed in all cases. The immediate postoperative and long term were uncomplicated. Ainsi nous avons recueilli les données cliniques, échographiques, thérapeutiques et évolutives pour chaque patient.
SUMMARY Corrected transposition of great arteries disease remains the rarest of congenital heart disease, its evolution is dominated by left ventricular dysfunction morphologically right. Through a retrospective study about five cases of corrected transposition of great arteries conducted at the pediatric department CHU Hassan II of Fez, all patients are hospitalized or seen in consultation.
The aim is to study the clinical, paraclinical aspect, emphasize the importance of echocardiography, and show the therapeutic aspects. In 2 cases the cyanosis was the revealing clinical symptoms, in one case a VSD was associated, respiratory distress is found in 3 cases luked to pulmonary arterial hypertension, whereas foluretly murmur is discovered in one case.
Diuretic treatment is indicated for four patients, one patient underwent a surgery for aortic coarctation, and one patient is scheduled for pulmonary artery banding. The evolution is especially marked by heart failure which were found in two cases. Le kyste hydatique rétrovésical est une localisation exceptionnelle, et constitue 0. La tomodensitométrie abdominale pratiquée chez 2 patients avait permis de confirmer le diagnostic.
La prise en charge thérapeutique avait consistée initialement au traitement spécifique des complications. Le traitement du Kyste hydatique rétrovésical était chirurgical dans tous les cas. La technique utilisée était une kysto-périkystéctomie partielle par voie sous péritonéale chez deux patients, et par voie trans-péritonéale chez le troisième patient.
Le traitement médical a été utilisé chez 1 patient en association au traitement chirurgical. Le kyste hydatique rétro vésical est une localisation rare de la maladie hydatique.
Le traitement est essentiellement chirurgical et consiste souvent en une kysto-périkystéctomie partielle. The objective of this study is the analysis of the epidemiological, clinical, biological, radiological, etiopathogenic characteristics, and therapeutic of the retrovesical localization of the hydatidosis.
The hydatic disease rages in the endemic state in our country where it raises a real problem of public health. It spares no organ. The retrovesical hydatid cyst is an exceptional and rare localisation, it constitutes only 0. We present a retrospective study about 3 cases of retrovesical Hydatid cyst brought together in the urological department at Hassan II CHU of fez during a period of 10 years. The study has been done on 3 men ages range between between 45 and 74 years average is The ultrasound is the main paraclinic examination which allows the diagnosis.
It realized to all patients and showed: The abdominal scanning is practised at 2 patients allowed to confirm the diagnosis. The therapeutic coverage contains first of all the specific treatment of the complications.
The treatment of retrovesical Hydatid cyst is surgical. The used technique is the partial perikystectomie by under peritoneal way at two patients, and intraperitoneal way at the third patient.
The medical treatment was used at one patient in combination with the surgical treatment. The results were satisfactory in all cases, and no recurrence was reported in our series. Ils partent vers le désert de sel où de nouvelles aventures les attendent. Les Marseillais South America: Replay du 7 mars, Paga en pleurs Par Pauline Landais. Ajouter aux favoris épisode du jour. Je certifie ne pas envoyer d'e-mail indésirable. Replay du 14 mars, Liam déclare la guerre. Plus de Les Marseillais.
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