Fonctionnalité, finalité et fiabilité des tests médicaux

The choice of medical tests, their purposes, and their results are often at the centre of controversy. This article provides an additional perspective based on a number of recent reports published in the international scientific literature.     

Une méthode simple de prévision des tendances appliquée aux séries temporelles de qualité des eaux courantes

Missing values, non-regular sampling, censored data and departure from normality are common problems in the analysis of ecological or environmental time series. For over 20 years, in the scope of the National Basin Network in France, numerous water quality time series have been collected. A method is proposed for the regularization of the series, the detection of trend changes and short-term forecasting, on the basis of the last detected trend, using a non-parametric regression. The method is applied to phosphates and nitrogen concentrations measured on the Sambre river (northern France).     

Hydrolyse enzymatique des protéines par les bactéries du rumen

The hydrolysis of proteins in the rumen is a process brought about mainly by bacteria, of which many species produce proteases. The majority of endopeptidases are cysteine proteases, whereas exopeptidases are mainly aminopeptidases. Prevotella ruminicola is distinguished from other bacterial species by its capacity to produce dipeptidases such as type I dipeptidyl aminopeptidase. The mechanisms controlling the synthesis of endo- and exopeptidases have been little studied. Enzyme production seems to depend on the concentrations of peptides, amino acids and carbohydrates. Proteolytic activity varies in relation to pH, and the concentrations of ions and phenolic compounds. Various works have shown that hydrolysis of a protein by enzymes depends on its three-dimensional structure and possible bonding to non-protein structures. These properties determine the peptide and amino acid concentrations that occur in the rumen. The molecular weight, hydrophobic property and primary structure of the peptides are the main factors that affect the hydrolysis and/or uptake of these compounds by rumen bacteria. The methodological problems inherent to assaying these compounds do however lead to current divergences of opinion concerning the physico-chemical characteristics of the peptides that escape rumen fermentation.     

Traitement des menaces d'avortement et des avortements habituels par la médroxyprogestérone

A clinical study was made of an oral form of medroxyprogesterone in a group of pregnant patients with signs of a threatened abortion or with a history of habitual abortions, under conditions very similar to those obtaining in general practice. The aim was to assess the agent''s effectiveness, its harmlessness, and its effect on the pregnancy in respect of both the mother and the infant.During a 31-month period, 43 pregnant women were administered this drug. The overall result in terms of live and healthy babies was 70%. This result was somewhat lower than that expected on the basis of previous studies; both public and private patients were included and no selection of patients was attempted. There were no apparent harmful side effects to mother or infant or evidence of virilization of female infants; postmaturity was not a problem.     

La fertilité chez le blessé médullaire. Effet du niveau de la lésion médullaire

The majority of spinal cord injured males cannot procreate naturally due to anejaculation as well as abnormal sperm characteristics. Treatment of this impaired fertility must be associated with treatment of neurogenic urinary tract disorders, bowel dysfunction and spasticity. The level of the spinal lesion and the spinal cord injury syndrome influence the possibility of inducing reflex ejaculation by penile vibratory stimulation and sperm quality.     

Assurance qualité du circuit des médicaments radiopharmaceutiques du service de médecine nucléaire de l’hôpital Ibn Sina de Rabat

Since Law n^o 17-04 of the national code of medicine and pharmacy, published in the official newspaper of November 22, 2006, radiotracers used in nuclear medicine in Morocco have become drugs or diagnostic radiopharmaceuticals. As such, radiopharamaceuticals must meet the requirements of pharmaceutical quality and control that apply to any drug (Payoux and Prigent, 2009 [5]). This task must be undertaken under the pharmacist's responsibility with a specific skill known as “radiopharmacist” (Morera et al., 1993 [6]). In the situation of Moroccan hospital, like Ibn Sina hospital for which the only law of the national code is partially applied, nevertheless the pharmacy department cannot ignore this issue. As part of this work, we present the proposed new quality installation service for 24 months. It aims to improve the proper use of radiopharmaceuticals, to contribute to the quality of diagnostic and therapeutic procedures and especially to ensure the optimal conditions of safety for staff and patients. This activity closely affects the pharmaceutical supply, preparation, dispensing and management of radioactive waste resulting from handling radiopharmaceutical drugs. Radiopharmaceutical quality control of was also integrated into the global quality control program, despite the technical constraints encountered during their day-to-day practice. Our basic documentation referred to European directives (Pharmacopée européenne, 2010 [8]), French Pharmacopoeia (Bonnot-Lours, 2000 [2]) and good preparation practise rules (Afssaps, 2006 [3]). The reflection was undertaken within a multidisciplinary framework: nuclear physician, physicists, a pharmacist working in hospitalpharmacy, chemists of the drug control department, computer and paramedical staff (technicians, nurses, and cleaners).