ABSTRACT
There are chronic malignant haemopathy resulting from the attack of a hematopoietic original cell and resulting in monoclonal proliferation, without blocking of cellular maturation, concerning at least one of the three lineages myeloid [granulous, erythroblastic, thrombocytic]. These syndromes gather four affections: chronic myeloid leukaemia, the polycythemia vera, the essential thrombocytaemia and the primitive myelofibrosis. It is about a retrospective study carried out over 6 years period from 2002 to 2007. The data were collected from the registers of the laboratory. The diagnosis of these various myeloproliferative syndromes is based on the data of the complete blood count, the blood smear, and is supplemented when it is necessary by the study of the myelogram and the cytogenetic study of the myeloid cells as it is the case for the Chronic myeloid leukaemia. This work interested 50 cases of myeloproliferative syndromes, distributed as: 44 cases of chronic myeloid leukemia, four cases of polycythemia vera and two cases of primitive myelofibrosis. The means of age were respectively of 42 +/- 15 years, 56 +/- 14 years and of 43 +/- 5 years. There was a clear male prevalence. It was not noted a case of essential thrombocytaemy. The epidemiologic aspect and the clinical signs and biological parameters in the diagnosis of these various myeloprliferative syndromes were evoked and discussed during this work. There are rare chronic malignant haemopathy. There is few data on epidemiology of these affections; their incidence is estimated in the Western counties at 5 to 10 new cases per million inhabitants, each year, according to the type. The diagnosis rests on the clinical and hematological data. There are rare affections, requiring the multidisciplinary collaboration [clinician and hematologist], for best dealt with diagnostic and therapeutic. Their evolution, often pejorative is revealed by clinical signs and above all by disturbances with the complete blood count different from those noted at the time of the initial presentation
ABSTRACT
The roponine Ic is a good tool diagnosis and forecast in the assumption of responsibility of cardiac ischemic pathologies. Its requirement in the mergency department often exceeds the framework of the international recommendations. Our objective of this work is to evaluate the practices concerning the regulation of the proportioning of TnIc. This is a study that was conducted over a period of one month from 01/04/ 2009 to 30/04/2009. Sixty-six patient who benificie of a regulation of the proportioning of the TnIc. On the whole, 130 proportionings were carried out, with the method of the first proportioning to the admission, then a second 6 to 9 hours after, in the event of negativity of the first. The reasons for admission having led to the regulation of proportioning are: thoracic pain [63%], dyspnea [18,4%], disorders of conscience [7.8%], epigastric pains [6.8%], dysarythmy [4%]. The number of pathological results of TnIc according to the symptoms of calls is of 20 cases for the thoracic pains, 3 for dyspnea, 4 for the disorders of conscience. The number of pathologicalresults of TnIc according to diagnosed pathology is of 17 per 27 cases of SCA,6 per 15 case of cardiac failure, 2 per 7 cases of ischemic heart disease, 1 per 18 cases of atypical thoracic pains and 1 per 9 cases of acute edema of the lungs. This study confirms that the proportioning of TnIc is required ill-advisedly in a large number of cases considering the percentage of pathological results [20,8%]. This proportioning as that of any biological marker is only one help with the diagnosis. These results suggests that a better control of the use of TnIc, is essential on the part of the prescribers