[Descriptive study of the oral and dental health state in patients with chronic renal insufficiency under hemodialysis]

In order to evaluate the state of health and needs in oral and dental treatments among the patients affected by chronic renal insufficiency under Hemodialisis, a descriptive transverse investigation bas beeb led in the service of nephrology of CHU lbn Rochd of Casablanca, that concerned a population of 161 patients patient adults IRC [middle age: 44,9 years]. The main results of this survey showed that: "A weak oro-dental hygiene level with an indication of plate means of 2,5% and 52,59% of the patients present the plate and tartar respectively. "The CAO indication is lower to the one of the general population and he is on average of 10, with a rate of dental attack of 3 5,80%. "97,03" to present a periodontal attacks with a middle ICPBT of 2,9 the rate of bleeding is of 97,04%. "31,68" of the patients endure xerostomia. This situation of the bucco-dental health state lets foresee the particularity of the needs in bucco-dental treatments among the renal chronicle insufficient patients and the needs of the physician dentist to professional formation

Demons-meigs syndrome

Demons Meigs is a rare, anatomo-clinical syndrome associated, with a benign ovarian tumor, ascitis and hydrothorax. The interest assigned to this triad reside in its similarity to the malignant ovarian tumor in its advanced stage and in its perfect and definitive surgical curability. The authors report here a case of 65 years old female patient, who were consulted for hypogastric pains and signs of vesical compression. Clinical examination showed a well defined hypogastic mass, rounded in shape measured 15cm diameter in a moderately abundant ascitis. The abdomino-pelvic echographic examination, showed a left heterogenic ovarian mass associated with intra peritoneal effusion. Chest X-Ray showed right hydrothorax. As the general condition was conserved, diagnosis of Demons-Meigs syndrome was evoked. This diagnostic was confirmed in the preaperative period by the presence of an ovarian mass without macroscopic malignants signs of malignancy, also histological examination showed benign fibroma. A simple excision was sufficient to have a definite recovery without recurrence six years after the operation. The association of pleural effusion and an ovarian tumour is not synonymous of metastasic invasion. Demon Meigs syndrome must be evoked because the surgical excision of the ovarian tumour permits the definitive recovery without complementary treatment

[Breast carcinoma associated to cancer of the vulva]

The synchronous association of breast infiltrating ductal carcinoma and moderately-differentiated squamous cell carcinoma of the vulva is extremely rare. The interest assigned to this association is not only resides in its rarity, but also in the therapeutic problems that it can raise. A 50 year woman, presented with a lesion of the left labia major of the vulva, its diameter measured 2cm, The tumour was mobile, painful, and bleeds at the least contact. The biopsy concluded to a moderately-differentiated squamous cell-carcinoma. Systematic genital examination revealed the presence of a nodule the right upper quadrant of breast. It was hard, painless and without axillary's nodes. The surgical intervention consisted at a radical mastectomy, with axillary's lymphonodectomy; in followed by a radical vulvectomy and bilateral inguinal lymphatic nodes dissection. The pathological examination concluded to a breast infiltrating ductal carcinoma II rank of SBR, confirmed the histological type of the vulvar tumour, and showed an inguinal involvement node. A postoperative radiotherapy and chemotherapy has been done. The patient was well with a postoperative follow up period of 18 months. The coexistence of a breast infiltrating ductal carcinoma and squamous cell carcinoma of the vulva is an extremely rare occurrence. Two cases have been previously reported in the literature. A congenital origin is possible; adenocarcinoma can be developed from ectopic, mammary gland tissue in the vulva. The acquired origin is also possible; the vulvar localization can be secondary to a metastatic breast cancer. Nevertheless, these two etiological approaches suppose that in the two localizations, the cancers are of the same histological type. The association of distinct types is uncommon. The double localization poses a problem of operative time chronology, and of the necessity of adjustment of doses of radiotherapy or chemotherapy. It must be discussed case by case; indeed the reduced number published case doesn't permit to establish a standard protocol. The logical therapeutic attitude seems to be, the surgical excision in the same time; every localization being considered as isolated. Otherwise all complementary pen-operative treatment [radiotherapy, chemotherapy] should include an adjustment of doses

tumeurs villeuses recto-sigmoidiennes [a'propos de 15 cas]

The authors report here a series of 15 cases of rectosigmoid villous tumors seen from 1980 to 1996. They conclude that: Their frequency is 3 4% with regard to the whole colorectal tumors They occur more particularly in the old subject - Malignancy is correlated with the tumoral size. The mucoglairy emissions which are characterized for such a condition are found to be present in only 60% of cases. The preoperative biopsy is not sufficient to estimate malignancy The tumorectomy performed in 66% of the patients mainly by transanal duct has the advantage of its benignancy and proved to be sufficient to manage the tumors either benignant or with non invasive malignancy The recurrent risk depends on the evolution of the disease