Pathologie fracturaire post-traumatique et embolie graissuse [a propos de 40 cas]

Our study is concerned with 40 cases of fat embolism syndrome. [From January 1990 to July 1994]. The diagnosis was based on the osseous notion, a free interval and at least two major criteria: All the patients were males, aged from 5 to 75 [the age average was 34]. The most frequent fractures concerned the femur and the tibia. Neurologic disorders were constant. 60% of the patients presented the respiratory and cutaneo-mucous signs. In the first 24 hours, 60% of our patients benefited from an orthopedic treatment. The treatments was symptomatic and essentially based on the respiratory take-up Eleven patients died. The recurrence has been noticed in one case 48 hours after a surgical treatment. Diagnostically, speaking, the fat embolism syndrome has lately benefited from the imaging by magnetic resonance. However, as concerns therapy, and because of the still unknown physiopathology of the fat embolism syndrome, the take-up of the long osseous fractures is based on three parameters: - The prevention by early surgical treatment, - The clinical, radiologie and gazometrie supervision, and. - The respiratory take-up, essentially after the appearance of the fat embolism syndrome signs

[Inquest over fungic plant-life's floor of a swimming pool in Casablanca]

179 samples have been realized on the grounds of an olympic swimming-pool in Casablanca in order to find the fungus responsible of superficial mycosa, the candida albicans and the dermatophytes. The samples have been realized before and after cleaning and they concerned the ground of the circumference of the pool, the diving boards, the showers, the cloak-rooms, the corridors, and the pediluve waters. The mycologic examination showed 22,3% of the positive samples. With isolation and identification of 16 stumps of candida albicans and 68 colonies of dermatophytes [57 of trichophyton interdigitales, 10 of trichophyton rubrum and 1 epidermophyton flocosun]. These pathogen fungus have been found at all the level of samples with a greater tensity at the level of the circumferences of the pools, the pediluve water and the showers. The frequency of isolation in the showers, the cloak-rooms, the corridors and the pediluve waters has been noticeably the same whatever was the sex of the users, the isolation of the candida albicans has been more frequent when it is about women. Finally, the fungus have been isolated even after the cleaning of the ground of the pools but with a density less high than before the cleaning. Measurements of hygiene of the bathers and the ground of the swimming-pools are necessary to reduce the risks of contamination of the users

[Evaluation of the systematic per-operative complete physical examination]

The authors report on a retrospective study about 1000 cases of patients hospitalized in a department of adult visceral surgery in order to evaluate the importance of the systematic preoperative complete physical examination and laboratory testing. The blood grouping has been realized for all the patients where as only 37 patients have been transfused. The rate of prothrombine [TP] is abnormal in 2 cases [0,2%]. The creatinine and the blood urea have been abnormal, respectively in 9,25% and 8,9% of the cases, but without any influence on the decision of the intervention. The fasting blood glucose showed 0,2% of asymptomatic diabetus. The thoracic radiography has been abnormal in 17,3% of the cases, but it has differed the intervention only in 0,7% of the cases. The electrocardiogram influenced the decision to operate only in 1,16% of the cases. We conclude from this study that we must abandon the pre-operative systematic complete physical examination. The interogatory and the clinic examination realized during a per-anesthesic consultation permit a judicious joice of complementary examinations