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Prise en charge de l’insuffisance rénale chronique avant le stade d’épuration extra-rénale : étude monocentrique tunisienne. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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2
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Intérêt du suivi néphrologique dans les suites de la prééclampsie. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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AB1268 CLINICAL ASPECT AND THERAPEUTIC MANAGEMENT OF SUBACUTE OSTEOMYELITIS IN CHILDREN. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSubacute osteomyelitis in children is a distinct entity encompassing primary localizedosteomyelitis. It poses a diagnostic problem related to its few or no constitutionalsymptoms, misleading radiological manifestations and often a negative bacteriologicalinvestigations. The treatment remains very controversial.ObjectivesThe aim of this study was to identify the main epidemiological, clinical, histological and evolutionary characteristics of this affection and to propose an adequate therapeutic attitude.MethodsIt was a retrospective longitudinal study, carried out over a period of 25 years from January 1995 to December 2019 in the orthopedic department of Taher Sfar Hospital,Mahdia, that included 37 cases of subacute osteomyelitis in children.ResultsThe mean age of the patients was seven years nine months with a male predominance (sex ratio: 2.27). The average time to hospitalization was 41 days. A diagnostic delay was very likely because of delay in consultation which was related to clinical latency, reported in all cases. The imaging showed osteolysis in all cases, setting in long bones in 54% of cases and in 46% other cases in short and flat ones. The lesion was multiple in two different bones only in one case and was found in pure epiphyseal location in seven cases. The bacteriological investigation allowed the isolation of a germ only in eight cases. In all cases, it was a Staphylococcus aureus. Surgical treatment was performed in 21 cases (60% of patients). The outcome was favorable in 35 cases (95% of cases). An infectious awakening was noted in 2 cases.ConclusionSubacute osteomyelitis poses a diagnosis and therapeutic problem. Magnetic resonance imaging is a valuable examination. Surgical treatment combined with appropriate antibiotic therapy is indicated for any suspicious lesion. It can be useful in taking samples for diagnosis, improve distribution of the antibiotic in injury and accelerate healing radiation.Disclosure of InterestsNone declared
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Prévalence de la microangiopathie au cours de la néphropathie à IgA primitive. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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SUN-365 LUPUS NEPHRITIS: EPIDEMIOLOGICAL, CLINICAL, BIOLOGICAL, PATHOLOGICAL FINDINGS, OUTCOMES AND PROGNOSTIC FACTORS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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SUN-177 HYPERTENSION AND RENAL DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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SUN-132 PERCEPTION OF INDICATIONS FOR NEPHROLOGY REFERRAL IN A MULTIDISCIPLINARY HOSPITAL. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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SUN-410 RENAL INVOLVEMENT IN RHEUMATOID ARTHRITIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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SUN-431 TUBERCULOSIS IN PATIENTS WITH LUPUS NEPHRITIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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SUN-430 GLOMERULAR DISEASES ASSOCIATED WITH HEPATITIS C VIRUS INFECTION. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Néphropathie lupique : aspect épidémiologique, clinico-biologique, histologique, évolutif et facteurs pronostiques. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Les microangiopathies thrombotiques rénales : profil étiologique et facteurs pronostiques. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Profil métabolique des patients hémodialysés selon le statut vitaminique. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hépatite virale C et néphropathie glomérulaire : Données de biopsies rénales. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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La glomérulonéphrite membranoproliférative type 1 : à partir de 563 biopsies rénales : étude épidémiologique, clinicobiologique et étiologique. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Microangiopathie thrombotique et glomérulonéphrite à anticorps anti-membrane basale glomérulaire : à partir de 3 biopsies rénales. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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Néphropathie lupique séronégative. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Le traitement chirurgical de l’hyperparathyroïdie secondaire à l’insuffisance rénale chronique. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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La sclérose tubéreuse de Bourneville : l’évaluation rénale s’impose. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Profil histologique et évolutif de l’hypertension artérielle chez les patients atteints d’une néphropathie lupique. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 2017; 37:580-586. [DOI: 10.1177/0960327117722822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.
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[Exhaustion of vascular capital in patients on hemodialysis: what will be the outcome?]. Pan Afr Med J 2017; 25:237. [PMID: 28293353 PMCID: PMC5337301 DOI: 10.11604/pamj.2016.25.237.10665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/02/2016] [Indexed: 11/11/2022] Open
Abstract
Despite advances in the treatment of chronic renal failure, vascular access remains the weakest link in renal replacement therapy (RRT) and the leading cause of morbidity in patients on hemodialysis We report the case of a young female patient with chronic renal insufficiency secondary to vascular nephropathy on periodic hemodialysis and whose vascular capital was early exhausted due to iterative thromboses in arteriovenous fistulas and failure in peritoneal dialysis. Protein C deficiency was objectified. The patient underwent tunneled hemodialysis catheter insertion at the level of the right atrium via a right anterolateral thoracotomy with cannulation of the inferior vena cava, with poor functional outcome after three months of use. Since then she has been dialyzed using puncture of the external jugular veins.
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Micro-angiopathie thrombotique rénale au cours du lupus érythémateux systémique : à partir de 38 biopsies rénales. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Profils cliniques et génétiques de patients atteints de xeroderma pigmentosum forme-C : à propos de 64 patients tunisiens. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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26
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Clinical, genealogical and molecular investigation of the xeroderma pigmentosum type C complementation group in Tunisia. Br J Dermatol 2015. [PMID: 26211814 DOI: 10.1111/bjd.14046] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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27
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Association xéroderma pigmentosum et anomalies thyroïdiennes : étude préliminaire. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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[BCG multifocal osteomyelitis. A case report]. Arch Pediatr 2014; 21:761-4. [PMID: 24935450 DOI: 10.1016/j.arcped.2014.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 12/22/2013] [Accepted: 04/23/2014] [Indexed: 11/16/2022]
Abstract
Multifocal osteomyelitis is a rare complication of the Bacille Calmette-Guerin (BCG) vaccine. It particularly affects immunocompromised children and poses a difficult diagnostic problem. A 6-month-old boy had BCG vaccination postnatally and developed extensive disseminated skeletal osteomyelitis. He was found to have severe combined immunodeficiency. Despite antibiotic therapy and bone marrow grafting, the disease was fatal.
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Le mélanome cutané en Tunisie : un cancer sous-estimé. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.04.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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The experience of a Tunisian referral centre in prenatal diagnosis of Xeroderma pigmentosum. Public Health Genomics 2013; 16:251-4. [PMID: 24021614 DOI: 10.1159/000354584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/24/2013] [Indexed: 11/19/2022] Open
Abstract
AIMS Xeroderma pigmentosum (XP, OMIM 278700-278780) is one of the most severe genodermatoses and is relatively frequent in Tunisia. In the absence of any therapy and to better manage the disease, we aimed to develop a molecular tool for DNA-based prenatal diagnosis. METHODS Six consanguineous Tunisian XP families (4 XP-A and 2 XP-C) have benefited from a prenatal diagnosis. Screening for mutations was performed by direct sequencing, while maternal-foetal contamination was checked by genotyping. RESULTS Among the 7 prenatal diagnoses, 4 foetuses were heterozygous for the screened mutation. Exclusion of contamination by maternal cells was checked. Mutations were detected at a homozygous state in the remaining cases, and the parents decided to terminate pregnancy. CONCLUSION Our study illustrates the implementation of prenatal diagnosis for better health support of XP in Tunisia.
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Renal histopathology. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Atteinte rénale au cours de la sarcoïdose. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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33
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Endocardite infectieuse chez l’hémodialysé chronique : à propos de dix cas. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Syndrome d’activation macrophagique compliquant une maladie de Castleman multicentrique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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35
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[Maternal mortality into question]. J Gynecol Obstet Hum Reprod 2010; 39:173-174. [PMID: 20116935 DOI: 10.1016/j.jgyn.2009.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
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36
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[Radiation induced breast sarcoma: a case report]. ACTA ACUST UNITED AC 2007; 35:997-1000. [PMID: 17920327 DOI: 10.1016/j.gyobfe.2007.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 05/16/2007] [Indexed: 11/19/2022]
Abstract
Radiation-induced breast sarcoma is a late complication of radiation treatment. We report a case of an undifferentiated sarcoma occurring 8 years after breast conserving treatment, which required mastectomy taking pectoralis major.
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Facteurs de risque du portage du streptocoque du groupe B chez la femme enceinte à terme: étude prospective à propos de 294 cas. ACTA ACUST UNITED AC 2007; 35:312-6. [PMID: 17344086 DOI: 10.1016/j.gyobfe.2007.01.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Accepted: 01/08/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the rate and risk factors for group B streptococcus (GBS) colonization in term pregnancies. PATIENTS AND METHODS Vaginal and anal cultures were prospectively conducted in 294 parturient on admission for term vaginal delivery. RESULTS Thirty-eight (12.92%) parturient had positive GBS cultures. None of the studied risk factors (age, education status, nulliparity, previous obstetric problem, twin pregnancy and diabetes) was statistically predictive of maternal colonization. All the isolated GBS were sensitive to the penicillin G. DISCUSSION AND CONCLUSION Systematic screening strategy of GBS close to the delivery on all pregnant women is desirable.
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[Tuberculous axillary lymphadenitis: an unusual presentation]. REVUE MEDICALE DE LIEGE 2007; 62:188-9. [PMID: 17566386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Axillary lymph node tuberculosis is rare and often poses problems of differential, diagnosis, especially with breast carcinoma. We report the case of a tuberculous axillary lymphadenitis discovered at the time of the exploration of a supposedly metastatic liver and, initially, taken for metastases of an occult breast carcinoma. Tuberculous axillary lymphadenitis remains a rare condition which must be considered in patients living in country with endemic tuberculosis.
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[The effect of uterine incision expansion at caesarean delivery on perioperative haemorrhage: a prospective randomised clinical trial]. REVUE MEDICALE DE LIEGE 2007; 62:235-8. [PMID: 17566395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
To determine if blunt or sharp expansion of the uterus at caesarean delivery is associated with increased maternal peripartum haemorrhage as estimated by the drop in hematocrit. Prospective randomised intention to treat clinical trial of women undergoing elective or urgent caesarean delivery at at least 36 weeks gestation. Two study groups were formed; after an initial hysterotomy which consisted in a transverse uterine incision of the lower segment, in the blunt group, the surgeon's indexes expanded the initial incision bilaterally and cephalad; in the sharp group, expansion of the initial incision was made using scissors. The primary outcome measure was the mean drop in hematocrit and p < 0.05 was considered significant. Three hundred women were randomised: 153 to the sharp group and 147 to the blunt group. The demographic and clinical characteristics of the two populations were similar. There were no statistically significant differences between the groups in estimated blood loss as assessed by the mean drop in hematocrit (%) (respectively 1.71 +/- 3.18 versus blunt group 1.91 +/- 3.28 p = 0.58 non significant). Our findings support that sharp or blunt expansion of hysterotomy during caesarean section equally affect blood loss as estimated by drop in hematocrit.
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Oxytocin in the third stage of labor. Int J Gynaecol Obstet 2007; 96:198-9. [PMID: 17289048 DOI: 10.1016/j.ijgo.2006.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Revised: 11/08/2006] [Accepted: 11/15/2006] [Indexed: 10/23/2022]
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[Clinical case of the month. Peritoneal tuberculosis mimicking ovarian carcinoma]. REVUE MEDICALE DE LIEGE 2007; 62:77-80. [PMID: 17461295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Peritoneal tuberculosis can mimic advanced stage ovarian cancer and can lead to the performance of an unnecessary extended surgery. Clinical discrimination between peritoneal tuberculosis and ovarian carcinoma may sometimes be extremely difficult. We report 2 cases of peritoneal tuberculosis mimicking ovarian carcinoma. Diagnosis was made on perioneal biopsy.
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Abstract
CONTEXT/OBJECTIVE Not much is known about the implication of adipokines and different cytokines in gestational diabetes mellitus (GDM) and macrosomia. The purpose of this study was to assess the profile of these hormones and cytokines in macrosomic babies, born to gestational diabetic women. DESIGN/SUBJECTS A total of 59 women (age, 19-42 yr) suffering from GDM with their macrosomic babies (4.35 +/- 0.06 kg) and 60 healthy age-matched pregnant women and their newborns (3.22 +/- 0.08 kg) were selected. METHODS Serum adipokines (adiponectin and leptin) were quantified using an obesity-related multiple ELISA microarray kit. The concentrations of serum cytokines were determined by ELISA. RESULTS Serum adiponectin levels were decreased, whereas the concentrations of leptin, inflammatory cytokines, such as IL-6 and TNF-alpha, were significantly increased in gestational diabetic mothers compared with control women. The levels of these adipocytokines were diminished in macrosomic babies in comparison with their age-matched control newborns. Serum concentrations of T helper type 1 (Th1) cytokines (IL-2 and interferon-gamma) were decreased, whereas IL-10 levels were significantly enhanced in gestational diabetic mothers compared with control women. Macrosomic children exhibited high levels of Th1 cytokines and low levels of IL-10 compared with control infants. Serum IL-4 levels were not altered between gestational diabetic mothers and control mothers or the macrosomic babies and newborn control babies. CONCLUSIONS GDM is linked to the down-regulation of adiponectin along with Th1 cytokines and up-regulation of leptin and inflammatory cytokines. Macrosomia was associated with the up-regulation of Th1 cytokines and the down-regulation of the obesity-related agents (IL-6 and TNF-alpha, leptin, and adiponectin).
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Diagnostic clinico-échographique et devenir des variétés postérieures dans la présentation du sommet : étude prospective longitudinale de 350 parturientes. ACTA ACUST UNITED AC 2006; 34:484-8. [PMID: 16713321 DOI: 10.1016/j.gyobfe.2005.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2005] [Accepted: 11/26/2005] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate clinical reliability compared to intrapartum ultrasound as a tool to diagnose occiput posterior position and to investigate the proportion of rotations occurring during labour. PATIENTS AND METHODS 350 women in labor with a singleton fetus in a vertex position were prospectively studied using ultrasound and obstetrical examination. Outcome of labor was also monitored. RESULTS Reliability of clinical examination is 85,7%, initial occiput posterior position represented 40,2% and most rotated in an anterior position (84, 8%) while only 0,6% of initial anterior positions delivered in occiput posterior position. Logistic regression did not allow to find significant predictor of occiput posterior position rotation. DISCUSSION AND CONCLUSION Clinical examination is relatively reliable for posterior position diagnosis and in most cases, initially occipitoposterior positions rotate anteriorly.
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Predictive factors of vaginal birth after cesarean delivery. Int J Gynaecol Obstet 2006; 94:43-4. [PMID: 16730010 DOI: 10.1016/j.ijgo.2006.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2006] [Revised: 03/23/2006] [Accepted: 03/29/2006] [Indexed: 11/24/2022]
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Benign multicystic peritoneal mesothelioma. Int J Gynaecol Obstet 2006; 93:267-8. [PMID: 16687143 DOI: 10.1016/j.ijgo.2006.03.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2006] [Revised: 03/08/2006] [Accepted: 03/08/2006] [Indexed: 10/24/2022]
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Previous cesarean scar exploration following vaginal delivery and hemorrhagic morbidity. Int J Gynaecol Obstet 2005; 92:135-6. [PMID: 16378610 DOI: 10.1016/j.ijgo.2005.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2005] [Revised: 10/10/2005] [Accepted: 10/24/2005] [Indexed: 11/28/2022]
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[Cavernous hemangioma of the breast: a case report]. ACTA ACUST UNITED AC 2005; 33:884-6. [PMID: 16243569 DOI: 10.1016/j.gyobfe.2005.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 05/16/2005] [Indexed: 11/23/2022]
Abstract
Cavernous hemangiomas of the breast are uncommon. Clinical diagnosis is rather difficult. Generally there are coincidental microscopic findings. We present a case of a 67-year-old woman which commenced as a 6 cm palpable mass of the right breast. The use of mammography, ultrasound and MRI facilitate diagnosis. Large surgical excision of the lesion was performed and histology allowed to find a cavernous hemangioma without cellular atypia.
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[Operative termination of pregnancy between 12 and 14 weeks' gestation: influence of the operator's experience]. ACTA ACUST UNITED AC 2005; 34:334-8. [PMID: 16136659 DOI: 10.1016/s0368-2315(05)82838-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the feasibility of operative termination of pregnancy between 12 and 14 weeks of gestation and the role of the operator's experience in physicians previously unfamiliar to this technique. MATERIALS AND METHODS A prospective study of 251 operative terminations of pregnancy, from July 1st, 2001 to January 31st, 2002, and from May 1st, 2002 to October 31st, 2002, in order to assess the role of operator's experience. 104 terminations between 12 and 14 weeks were compared to 147 terminations at earlier gestational ages. All patients received cervical ripening with 400 mcg oral misoprostol 3-4 hours before operation performed under general anesthesia. Evaluation criteria were: duration of operation, need for use of forceps, and complications: uterine perforation, cervical laceration, bleeding > 500 ml and need for blood transfusion. RESULTS There was no difference in the rate of operative complications between terminations before and after 12 weeks. The duration of operation was slightly longer after 12 weeks than before (12.9 +/- 6.7 min versus 11.1 +/- 2.8 min.; p < 0.05). Forceps use was 0.7% before 12 weeks, 20% between 12 and 13 weeks, and 59% between 13 and 14 weeks (p < 0.01). There was no difference in the complication rate or in the need for forceps according to the operator's experience. The perceived difficulty in cervical dilatation was higher in early experience than in experimented operators (19.6% versus 5.2%; p < 0.05). CONCLUSION Operative termination of pregnancy is technically feasible beyond 12 weeks without dramatic increase in operative complications. Technical skill can be acquired in a short time interval.
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[Rupture of rudimentary horn pregnancy at the 18th week of gestation: a case report]. ACTA ACUST UNITED AC 2005; 33:505-7. [PMID: 16005657 DOI: 10.1016/j.gyobfe.2005.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Accepted: 05/06/2005] [Indexed: 11/20/2022]
Abstract
We report a case of pregnancy in a rudimentary horn that ruptured at 18 weeks. An emergency laparotomy was taken for acute abdomen and ruptured right rudimentary horn pregnancy was diagnosed. Excision of the rudimentary horn and ipsilateral salpingectomy were carried out. The patient's postoperative course was uneventful, and she left the hospital 6 days later.
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Abstract
OBJECTIVES To assess the clinical efficacy of mifepristone 100 mg followed two days later by misoprostol 400 microg orally in women undergoing medical termination of pregnancy up to 56 days gestational age. MATERIALS AND METHODS Retrospective study over 8.5 months of 762 cases early medical abortion. 100 mg mifepristone was used on day 1 after clinic visit and vaginal ultrasonography. Misoprostol 400 microg was administered orally on day 3. Following administration of prostaglandin, women were observed in the ward for 4 hours. A control visit on day 15 was systematic. Success was defined as a complete uterine evacuation without the need for surgical intervention. RESULTS Medical terminations accounted for 42% of all abortions. 16% of women were pregnant for < 42 days, 76% for 43 to 49 days and 8% for 50 to 56 days. Termination occurred within 4 hours after administration of misoprostol in 80.2% of the women. Only one woman aborted within 48 hours of mifepristone administration only. The success rate in this study was 94.4% and the failure rate increased with the gestational age. Pain was the predominant side effect. Six cases of bleeding required a surgical intervention. No patient required transfusion. 96% of patients attended a control visit on day 15. The acceptability rate of the method has been 94%. CONCLUSION Mifepristone 100 mg followed two days later by misoprostol 400 microg orally is safe and effective for early termination of pregnancy.
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