Water quality in turkey farms in Khemisset (Morocco) and potential risk factors. / Qualité des eaux en élevage de dinde à Khémisset (Maroc) et hypothèses sur les facteurs de risques.

The objectives of this study were to assess the microbiological and physical/chemical quality of water in broiler turkey farms in the province of Khemisset (north-western Morocco) and, based on a questionnaire, to ascertain potential risk factors for contamination of drinking water with faecal coliforms. A total of 80 samples were collected and analysed in 20 farms (four from each farm). At the main inlet to the water line at the entrance to each turkey house, 100% of the samples were of unacceptable quality in terms of faecal coliforms, Escherichia coli, faecal streptococci, sulphitereducing anaerobes and enterococci. A significant reduction in microbiological contamination of the water line (p < 0.05) was observed on Day 60. While more than 90% of the samples were of satisfactory quality in terms of pH, nitrites, conductivity, nitrates and iron, only 35% were satisfactory in terms of total hardness and only 20% met quality standards for ammonium content. The factors affecting levels of contamination with faecal coliforms were water chlorination (p = 0.065; odds ratio = 14; 90% confidence interval [CI] = 1.14-71), cleaning and disinfection (p = 0.028; odds ratio = 14; 95% CI = 1.25-156.6) and antibiotic treatment (p = 0.001; odds ratio = 6; 95% CI = 2.1-35.2). To improve water quality in poultry farms, farmers are advised to protect wells from contamination and to install water purification units (pre-oxidation, coagulation, flocculation, disinfection). In addition, turkey houses and rearing equipment should be rigorously cleaned and disinfected between each batch of birds.

Cette étude a pour objectifs d'évaluer la qualité microbiologique et physico-chimique de l'eau des élevages de dinde de chair dans la province de Khémisset (nord-ouest du Maroc) et de formuler, au moyen d'un questionnaire, certaines hypothèses sur les facteurs de risque potentiels associés à la contamination de l'eau d'abreuvement par les coliformes fécaux. Au total, 80 échantillons ont été prélevés et analysés dans 20 élevages (quatre de chaque élevage). Au sas de la ligne d'abreuvement, 100 % des échantillons étaient de qualité inacceptable en ce qui concerne les coliformes fécaux, Escherichia coli, les streptocoques fécaux, les anaérobies sulfito-réducteurs et les entérocoques. Une réduction significative de la contamination microbiologique a été observée en bout de la ligne d'abreuvement (p < 0,05) au jour 60. Plus de 90 % des échantillons étaient de qualité satisfaisante pour ce qui concerne le pH, les nitrites, la conductivité, les nitrates et le fer ; en revanche, seulement 35 % et 20 % d'échantillons étaient conformes pour ce qui concerne la dureté totale et la présence d'ammonium, respectivement. Les facteurs associés à la contamination par les coliformes fécaux étaient la chloration de l'eau (p = 0,065 ; rapport des cotes = 14 ; intervalle de confiance [IC] à 90 % = 1,14-71), le nettoyage et la désinfection (p = 0,028 ; rapport des cotes = 14 ; IC à 95 % = 1,25-156,6) et le traitement par antibiotiques (p = 0,001 ; rapport des cotes = 6 ; IC à 95 % = 2,1-35,2). Afin d'améliorer la qualité de l'eau dans les élevages avicoles, il est recommandé aux éleveurs de protéger les puits contre la contamination et d'installer des stations de potabilisation de l'eau (pré-oxydation, coagulation, floculation, désinfection). Il convient également de procéder à un nettoyage et une désinfection rigoureux des bâtiments et du matériel d'élevage à la fin de chaque bande.

Los autores describen un estudio destinado a evaluar la calidad microbiológica y fisicoquímica del agua de explotaciones productoras de pavos de engorde de la provincia de Khemisset (noroeste de Marruecos) y a formular, mediante un cuestionario, ciertas hipótesis sobre los posibles factores de riesgo asociados a la contaminación del agua de bebida por coliformes fecales. En total se tomaron y analizaron 80 muestras de 20 explotaciones. En la esclusa de entrada del agua en la línea de bebederos, el 100% de las muestras era de calidad inaceptable por lo que respecta a la presencia de coliformes fecales, Escherichia coli, estreptococos fecales, bacterias anaerobias sulfitorreductoras y enterococos. A la salida de la línea de bebederos se observaba una reducción significativa de la contaminación microbiológica (p < 0,05) en el día 60. Más del 90% de las muestras eran de calidad satisfactoria por lo que respecta a pH, nitritos, conductividad, nitratos y hierro. En cambio, solo un 35% y un 20% de las muestras satisfacían los criterios relativos a la dureza total y la presencia de amonio, respectivamente. Los factores asociados a la contaminación por coliformes fecales eran la cloración del agua (p = 0,065; razón de probabilidades = 14; intervalo de confianza [IC] al 90% = 1,14-71), la limpieza y desinfección (p = 0,028; razón de probabilidades = 14; IC al 95% = 1,25-156,6) y el tratamiento con antibióticos (p = 0,001; razón de probabilidades = 6; IC al 95% = 2,1-35,2). Con el fin de mejorar la calidad del agua en las explotaciones avícolas se recomienda a los productores que protejan los pozos de la contaminación e instalen potabilizadoras de agua (preoxidación, coagulación, floculación y desinfección). Asimismo, conviene proceder a una limpieza y una desinfección rigurosas de los locales y el material de cría al final de cada banda.

[Ileocolic intussusception from metastatic renal cell carcinoma]. / Localisation iléale d'un carcinome à cellules rénales révélée par une invagination iléo-cæcale.

The lung, the liver, the bone tissue and the brain are the most frequent sites for renal cell carcinoma metastasis. Small bowel metastasis from renal cell carcinoma is rare, with only few cases published. We report the case of ileal metastasis from operated kidney cancer revealed by ileocolic intussusception and causing intestinal obstruction in a 32-year-old woman.

Malformative uropathies and kidney transplantation.

INTRODUCTION: Malformative uropathies are a frequent cause of end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Medical management of urinary tract infections and advances in surgical reconstruction procedures resulted in good outcomes of kidney transplantation among these patients. The aim of this article was to describe the epidemiological profiles and outcomes of patients who underwent transplantation for ESRD related to malformative uropathies. PATIENTS AND METHODS: Among 493 kidney recipients at our center from 1986 to 2009, 47 had malformative uropathies as the cause of ESRD. We retrospectively studied the incidence of acute rejection episodes, acute tubular necrosis, as well as patient and graft survivals, comparing these results to those observed in patients without malformative uropathies using chi-square tests for qualitative parameters and nonpaired Student t tests for continuous variables. Log-rank tests were used for comparisons of survival curves. RESULTS: The 47 patients, representing 9.53% of our kidney transplant recipients, included 27 men and 20 women (sex ratio=1.35) with an overall mean age of 27.6±9.1 years (range, 10-49). The common etiology was vesico-ureteral reflux (78.7%). Hemodialysis was the main RRT modality (68%) with a median duration of 41 months. Also, 82.9% of patients received transplants from living donors. Acute tubular necrosis occurred in 4 of these (8.5%) versus 22.06% of the other patients (P=.03). Acute rejection episodes were observed in 13 of these patients (27.6%) versus 23.1% of the other patients (P=not significant [NS]). After a cumulative follow-up period of 3744 months (median, 41.8 months), 5 patients had died (1.6 death/y/100 patients) and 5 had lost their allografts and returned to dialysis (1.6 case/y/100 patients). Graft survival rates at 1, 5, and 10 years were 97.8%, 93.2%, and 79.9%, which were comparable with 95.9%, 87.6%, and 78.9% among the other patients, respectively (P=NS). Patient survival rates at 1, 5, and 10 years were 100%, 88.5%, and 82.6% versus 96%, 87.6%, and 79.6%, respectively (P=NS). CONCLUSION: Kidney transplantation in patients with malformative uropathies is increasingly frequent. The incidence of acute rejection episodes as well as patient and graft survivals were comparable with those of subjects without malformative uropathies.

Short- and long-term outcomes of living donors in Tunisia: a retrospective study.

Despite initiatives to increase cadaveric donation, there is still a shortfall in donor organs. Kidneys from living donors now makes a significant contribution to increasing the number of organs available for transplantation in Tunisia. We performed a retrospective study of 405 kidney transplantations, including 321 (79.3%) from living donors performed from June 1986 to December 2007. We obtained information on only 162 (50.4%), namely, 64 men (39.5%) and 98 women (60.5%), whose mean age at the time of donation was 42.3 ± 12.2 years. Twelve (8.22%) perioperative complications occurred: wound infections (n = 4), pneumothorax (n = 4), phlebitis (n = 1), hematomas (n = 2), and urinary infection (n = 1). The mean follow-up period was 117.4 ± 74.4 months. Hypertension occurred in 42 donors (25.9%) with mean values of 134 ± 20 for systolic and 79 ± 10 for diastolic blood pressure. Twelve donors (7.4%) developed proteinuria (mean proteinuria, 0.08 ± 1.25 g/d). Renal insufficiency was found in 28 donors (19.44%), 2 of whom developed chronic renal failure requiring dialysis at intervals of 36 and 84 months. In both cases, we diagnosed a familial form of focal segmental glomerulosclerosis. Two donors (1.2%) died within 10 years after kidney donation due to senility. The relatively favorable outcomes suggest that living-donor kidney transplantation is an acceptable approach, in view of the superior results it yields in recipients. However, efforts to increase the number of cadaveric donors in Tunisia should be made. It is also important to develop a registry of long-term kidney function after kidney donation.

[Xanthogranulomatous orchitis. Report of 7 cases]. / Orchites xanthogranulomateuses. A propos de sept cas.

The xanthogranulomatosis orchiepididymititis is a benign and a rare disease. Its etiology is unknown. It creates diagnosis, therapeutic and etiological problems. The diagnosis is hardly made because of the variability of the clinical findings. The confusion is mainly made with a malignant tumor, and sometimes with a simple orchiepididymitis. Orchidectomy is usually performed. We report seven cases of orchiepididymitis characterized by their antibiotherapeutic resistance, the destruction of the testis which needed a surgical removal. The diagnosis is established after the histological study of the testis. The etiology is not yet known. The authors study the clinical evolution and therapeutic characteristics of our serial comparing with the literature data.

[Xanthogranulomatous pyelonephritis in pelvic kidney. A case report]. / La pyelonephrite xanthogranulomateuse sur un rein pelvien. A propos d'un cas.

We report the case of a xanthogranulomatous pyelonephretis in a pelvic ectopic kidney that is revealed by a buttockal abscess.