Aim of the study:To study clinical, laboratory and imaging features correlated with complete response (CR) to transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC) through 162 patients collected in Hassan II University Hospital of Fez. Material and methods: From January 2015 to December 2019, 162 patients diagnosed with 225 HCC were treated by TACE. Among them, 14 showed CR during the follow-up. Imaging response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). A multivariate analysis was performed including demographic parameters, etiology, α-fetoprotein (AFP) rates, hepatic function scores, imaging and TACE features. In cases with complete response and remission, follow-up duration was considered from the first to the last imaging control showing no viable tumor and eventually nodule retraction. Results: Among the 162 patients with 225 nodules, 14 (9%) of them showed remission and 148 (91%) did not. There was no significant difference between the two groups in age, performance status (PS), AFP, nodularity, size nodule or number of TACE cures. Sex, etiology, Child-Pugh and MELD scores, location, BCLC stage and blush extinction were all found to have a significant impact on therapeutic response. Conclusions: This study demonstrates that CR of HCC treated by TACE is strongly correlated with male sex, etiology (viral hepatitis C), location (segments VI and VII) and complete blush extinction on digital subtraction angiography (DSA). No significant correlation was found, particularly that of tumor size and segment IV (as a pejorative location).

Les endoscopes sont des dispositifs médicaux qui ne peuvent faire l'objet de mesures de stérilisation en raison de leur caractère complexe et notamment de la sensibilité à la chaleur de certains de leurs constituants. La complexité de leur structure rend possible une accumulation de souillures organiques ou minérales qui peuvent elles-mêmes renfermer des agents infectieux. Une fré-quence ou une qualité insuffisante de la procédure de désinfection peut aboutir à la formation d'un biofilm.L'objectif de notre travail est de faire une évaluation de la contamination microbiologique des endoscopes après désinfection dans une unité d'endoscopie du service d'hé-pato-gastro-entérologie du CHU Hassan II de Fès, Maroc.Les prélèvements ont concerné 13 endoscopes. Ils ont été réalisés en deux phases : l'injection d'une solution de décrochage dans les canaux de l'endoscope, et l'écou-villonnage de l'embout distal, puis insufflation et aspiration. L'eau du rinçage terminal ainsi que la solution de désinfection ont également été contrôlées.Les résultats obtenus ont montré une contamination résiduelle de la flore mésophile aérobie totale (FMAT) de l'ordre de 3,6.10 3 UFC/endoscope. Nous avons identifié 60 micro-organismes. Pseudomonas sp. est la bactérie la plus fréquemment rencontrée dans nos prélèvements (35 %), Acinetobacter sp. (13 %), Micrococcus sp. (17,5 %), Escherichia sp. (15 %), Staphylococcus sp.et Streptococcus sp. (11 %), Bacillus sp. (6 %), et Candida sp. (3 %).La modification dans la procédure de désinfection adoptée dans le service a permis de ramener la contamination à un niveau cible (FMAT < 10 UFC/endoscope).Le respect des principes de bases de l'hygiène hospitalière et l'application de procédures de nettoyage et de désinfection rigoureuses sont des éléments majeurs dans la prévention et la lutte contre les infections nosocomiales.Abstract: Due to the nature of the materials, which they are made of, flexible endoscopes require disinfection at a cool temperature after their use. A poorly-executed disinfection procedure can lead to cases of infection of varying degrees of severity, from simple cases of fever to fatal septicemia.The objective of our study is to test the effectiveness of the disinfection procedure for digestive endoscopes. This will be done by evaluating the residual microbiological contamination after disinfection of digestive endoscopes in the gastroenterological unit of the Hassan II Teaching Hospital in Fez (Morocco).The sample included 13 digestive endoscopes. It was undertaken in two phases: the injection of an uncoupling solution in the endoscope channels, and the swabbing of different points of the endoscope structure, particularly its extremity, and its air inlet and outlet. The water used in the final rinsing and the disinfecting solution were also tested.The results obtained indicate a residual contamination of approximately 3,6 × 103 UFC/endoscope. We identified 60 micro-organisms. The most prevailing bacteria encountered in our samples are Pseudomonas sp. (35%), Acinetobacter sp. (13%)...

Delusional parasitosis (DP) is a disorder in which the patient believes that he is infested by a parasite.Although this is a psychiatric disorder, patients usually seek care from dermatologists. A dermatology-psychiatry liaison is advocated for establishing a viable differential diagnosis and selecting appropriate therapy. Objectives: To review the literature through a case report. Aims: To highlight the incidence, the causes, the typical characteristics of patients with DP, the best approach when dealing with a patient with DP Methods: Case report. Results: A 75 year-old widow was referred to the outpatient psychiatric department of Razi Hospital by a dermatologist because of hyperchromic pruritic skin lesions in arms. The illness began 2 years ago, after the death of her husband, with itching sensations on her arms that the patient attributed to "bugs" under her skin. She used to put the 'animals" in a piece of paper to prove their existence. She tried various strategies for eradicating the alleged parasites, such as using pesticides on herself and her possessions.Risperidone was started up to 3mg per day. She had a progressive clinical improvement. Conclusions Ekbom's syndrome is a delusion of hallucinatory mechanism that might have different cultural presentations and could be favored by social vulnerability. The typical patient is an elderly woman who is unmarried or living along. Rather than a unique illness, DP is a neuropsychiatric syndrome that can follow primary psychotic and depressive disorders, dementia or other organic diseases.Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.

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