Antibiotic therapy for infectious hemodialysed patients in Bamako: Pharmacokinetic analyses and first improvement suggestions.

Infection which occurs in renal kidney failure patient have to be therapeutically managed immediately and the treatment must be aggressive to be quickly efficient. In Bamako (Mali). Posology adaptation cause a problem in nephrology, especially for the most common used antibiotics to care these infections. Drug dosage is not routinely performed in Bamako. The main objective of this work is to compare anthropometric, clinical and pharmacokinetic profiles and the clinical future between infected hemodialysis patients following an antibiotic therapy in Bamako and Lyon (hospital used as a reference). To reach these objectives, a preliminary punctual study of clinical pharmacokinetic of vancomycin were set up at Bamako, following the personalization therapeutics model from Lyon. Bamako patients' samples were imported to France and dosage analysis were performed at Lyon. BestDose software was used to view and compare complete pharmacokinetic profile. It includes for the first time, in routine, the 50 ml/mn of the renal function during dialyses for 58 patients: 31 for Bamako and 21 for Lyon. The residual concentration at the beginning of the dialysis session was compared. In Bamako, patients are younger, the renal failure is more severe and arteriovenous fistula are never set up, treatments are limited in dose and in duration; the residual concentration before the dialyses are too low; as a consequence, infections are rarely quickly reduced and more especially the death linked to these infections are more important (9 in Bamako versus 1 in Lyon). Urgent corrective measures have to be proposed: propose a conciliation between therapeutic requirements formulated within Lyon protocols and the financial ability of the patient, to promote arteriovenous fistula creation as soon as possible, and develop first dose strategy (unfortunately there is often only one dose): a more aggressive dose estimated from simulation profile performed in this study.

[Prevalent Of Echocardiography Anomaly In Chronic Hemodialysis Patients At The Point G Hospital]. / Prevalence Des Anomalies Echocardiographiques Chez Les Hemodialyses Au Chu Point G.

INTRODUCTION: Cardiovascular abnormalities are frequent and often early, severe and masked in patients with renal impairment. These cardiovascular complications are the main causes of death in hemodialysis patients. The diagnosis of these cardiovascular anomalies by cardiac ultrasound allows the individualization of patients at high cardiovascular risk. We conducted this study to evaluate the echo-cardiographic aspects of chronic hemodialysis in the nephrology and hemodialysis department of the G-Point CHU. METHODS: This is a retrospective study of chronic renal failure patients who have undergone extra-renal treatment for 6 months or more from January 1, 2011 to December 31, 2012. Results: During this study, 83 files were retained The sex ratio was 1.51 in favor of men. The average age of patients was 48 years old. HTA (59%) and tobacco (43.3%) remain the dominant risk factors. Vascular nephropathy was the leading cause of CKD, 44.6%. Echo-cardiac abnormalities are dominated by cavitary dilatation (78.3%), LVH (41%), cardiac dysfunction (83.2%), valvular lesion (30.1%), and pericarditis (22,9%). The cardiovascular complications were LVH (41%), hypertension (25.3%) and dilated cardiomyopathy (9.7%). The evolution was favorable for 73.5% of the patients, the mortality represented 8.4% with various complication (18.1%).

INTRODUCTION: les anomalies cardiovasculairessont fréquentes et souvent précoces, sévères et masquées chez les patients insuffisants rénaux. Ces complications cardiovasculaires sont les principales causes de mortalités et de morbidité chez les hémodialysés. Le diagnostic de ces anomalies cardiovasculaires par l'échographie cardiaque permet l'individualisationdes patients à haut risque cardio vasculaire. L'objectif de cette étude était d'évaluer les aspects échocardiographiques chez les hémodialyses chroniques dans le service de néphrologie et d'hémodialyse du CHU du point G. MÉTHODES: Il s'agit d'une étude rétrospective du 1er janvier 2011 au 31 décembre 2012 et a concerné les insuffisances rénales chroniques ayant bénéficié d'une épuration extra-rénale depuis6mois. RÉSULTATS: Au cours de cette étude 83 dossiers étaient retenus. Le sex ratio était de 1,5 en faveur des hommes. L'âge moyen des patients était de 48 ans. L'HTA (59%), le tabac (43,3%) restent les facteurs de risque dominant. La néphropathie vasculaire a été la principale cause d'IRC soit 44,6%.Les anomalies échocardiographiques sont dominées par la dysfonction cardiaque (83,2%), ladilatation cavitaire (78,3%), l'HVG (41%), la lésion valvulaire (30,1%), et l'épanchement péricardique (22,9%). Les complications cardiovasculaires étaient l'HTA (67.%), lacardiomyopathie dilatée (49,7%) et l'HVG (41%). L'évolution était favorable chez 73,5% des patients, la mortalité représentait 8,4% avec complication diverse (18,1%).

Effects of in ovo feeding of carbohydrates and arginine on hatchability, body weight, energy metabolism and perinatal growth in duck embryos and neonates.

1. The objective of this study was to test the hypothesis that in ovo feeding of carbohydrates and arginine into the duck amnion may improve the glycogen store and perinatal growth. At 23 d of incubation, fertile eggs were injected with 1·2 ml of sodium chloride (NaCl), sucrose + maltose (CHO), arginine (Arg) or sucrose + maltose + arginine (CHO + Arg), with controls not injected. Body weight, liver and muscle glycogen levels, and hepatic glucose-6-phosphatase activity were determined at 25 d of incubation, at hatch, and at 3 and 7 d posthatch. 2. At hatch and 7 d of age, the body weights were greater in the in ovo-feeding treatments than the controls. Arg and CHO + Arg significantly enhanced liver glycogen level at hatch compared with controls. CHO and CHO + Arg significantly increased muscle glycogen level at 25 d of incubation over controls. CHO and Arg decreased glucose-6-phosphatase at 25 d of incubation, whereas NaCl and CHO + Arg increased glucose-6-phosphatase at hatch relative to controls. 3. In ovo feeding of carbohydrates and arginine at 23 d of incubation may improve glycogen reserves, which may, in turn, provide the energy needed for perinatal growth.

Effects of early feeding and exogenous putrescine on growth and small intestinal development in posthatch ducks.

1. Effects of early feeding with a diet containing added putrescine on duck intestinal development and growth performance were examined by a 2 x 2 factorial arrangement with two different feeding times (6 and 48 h) and two levels of putrescine (0 and 025%). 2. A significant main effect of early feeding on increasing body weight (BW) was observed from hatch to 35 d, whereas dietary putrescine had no significant effect on BW. 3. In the first week posthatch, enhanced small intestinal weight and intestinal density (weight of intestinal tissue/unit length of intestine), increased villus length and reduced crypt depth were observed in the early feeding group, while no effect was observed when putrescine was added to the diet. 4. Maltase and sucrase activity and protein/DNA ratio in jejunum were increased by early feeding in the first week, while decreased by putrescine supplementation. 5. In conclusion, early feeding methods have great potential for small intestine development and thereafter enhanced the growth performance of ducks, but dietary putrescine used during this period should be used cautiously to avoid toxicity.

Prévalence des anomalies échocardiographiques chez les hémodialyses au chu Point G

Introduction : les anomalies cardiovasculaires sont fréquentes et souvent précoces, sévères et masquées chez les patients insuffisants rénaux. Ces complications cardiovasculaires sont le principales causes de mortalités et de morbidité chez les hémodialysés. Le diagnostic de ces anomalies cardiovasculaires par l'échographie cardiaque permet l'individualisation des patients à haut risque cardiovasculaire. L'objectif de cette étude était d'évaluer les aspects échocardiographiques chez les hémodialyses chroniques dans le service de néphrologie et d'hémodialyse du CHU du point.Méthodes :Il s'agit d'une étude rétrospective du 1er janvier 2011 au 31 décembre 2012 et a concerné les insuffisances rénales chroniques ayant bénéficié d'une épuration extra-rénale depuis 6 mois. Résultats : Au cours de cette étude 83 dossiers étaient retenus. Le sex ratio était de 1,5 en faveur des hommes. L'âge moyen des patients était de 48 ans. L'HTA (59%), le tabac (43,3%) restent les facteurs de risque dominant. La néphropathie vasculaire a été la principale cause d'IRC soit 44,6%.Les anomalies échocardiographiques sont dominées par dysfonction cardiaque(83,2%),la dilatation cavitaire (78,3%), l'HVG (41%), la lésion valvulaire (30,1%), et l'épanchement péricardique (22,9%). Les complications cardiovasculaires étaient (67.%),la cardiomyopathie dilatée (49,7%) et l'HVG(41%). L'évolution était favorable chez 73,5% des patients, la mortalité représentait 8,4% avec complication diverse (18,1%)