11 research outputs found
Profil Ă©pidĂ©miologique de lâinsuffisance rĂ©nale chronique terminale dans la rĂ©gion de Sfax
Introduction: L'insuffisance rénale chronique terminaleest un véritable problÚme mondial de Santé publique. En Tunisie, le coût de la prise en charge des patients dialysés pour l'année 2011 a dépassé les 90 millions de dinars (37000 Euro), soit prÚs de 5% des dépenses globales de santé. Une meilleure connaissance du profil épidémiologique de l'insuffisance rénale chronique terminale va contribuer à l'élaboration et à l'évaluation des stratégies sanitaires visant à améliorer la prévention et la prise en charge de cette maladie. L'objectif de notre travail est de décrire le profil épidémiologique des cas incidents dans le gouvernorat de Sfax sur une période de 10 ans. Méthodes: Il s'agit d'une étude descriptive rétrospective allant de Janvier 2003 à Décembre 2012. Nous avons inclus les cas incidents d'insuffisance rénale chronique terminale dans le gouvernorat de Sfax. Résultats: Le diagnostic d'insuffisance rénale chronique terminale a été porté à 1708 cas. Il s'agit de 957 hommes et 751 femmes (sex-ratio = 1,27). L'ùge moyen était de 58,4ans [10-100ans]. L'étude de l'évolution de l'ùge moyen durant la période étudiée a montré une tendance vers la hausse avec un indice de corrélation positive (0,749) et p = 0,006. La principale néphropathie causale était la néphropathie diabétique (21,5%), avec une augmentation significative de sa fréquence d'une année à l'autre (un coefficient de corrélation positive (0,770) avec p = 0,009). L'hémodialyse était la technique de dialyse de choix, entreprise chez 96% des patients. Conclusion: Un registre national reste indispensable afin de mieux comprendre le profil épidémiologique de l'insuffisance rénale chronique terminale en Tunisie et de pouvoir améliorer sa prise en charge
Profiling beneficial phytochemicals in a potato somatic hybrid for tuber peels processing: phenolic acids and anthocyanins composition
The purpose of this study was to characterize the peels of a CN1 somatic hybrid obtained from two dihaploid potato lines (Cardinal H14 and Nicola H1) in terms of the healthâpromoting phenolic compounds (phenolic acids and anthocyanins). The CN1 hybrid is defined by a pink tuber skin color making it different from the lightâyellowâskinned âSpunta,â which is the most commonly grown potato cultivar in Tunisia. Ovenâdried peel samples derived from CN1 hybrid and cv. Spunta were ground, and phenolic compounds were extracted with water or methanol for quantification. Lyophilized peels were used for the phenolic acid and anthocyanin analyses. Higher total quantities of phenolic compounds were recovered in methanol extracts compared with water extracts. A slightly higher concentration of phenolic acids (100 mg/100 g DW) was obtained in the lyophilized peels extract of CN1 hybrid than in the cv. Spunta corresponding sample (83 mg/100 g DW). The profiles of the chlorogenic acid isomers were almost identical in both of CN1 hybrid and cv. Spunta. Caffeic acid (CA) and three caffeoylquinic acids (CQAs): 3âCQA, 4âCQA, and 5âCQA, were identified from both genotypes, 5âCQA being the dominant form in both potatoes. Since the CN1 hybrid has a pink skin color, its anthocyanin profile was also determined. The anthocyanin quantity in the CN1 peels was 5.07 mg/100 g DW, involving six different anthocyanins that were identified within the extract, namely, Pelargonidinâ3ârutinosideâ5âglucoside, peonidinâ3ârutinosideâ5âglucoside, coumaroyl ester of pelargonidinâ3ârutinosideâ5âglucoside, coumaroyl ester of peonidinâ3ârutinosideâ5âglucoside, feruloyl ester of pelargonidinâ3ârutinosideâ5âglucoside, and feruloyl ester of peonidinâ3ârutinosideâ5âglucoside. These results suggest that the peel waste of CN1 somatic hybrid can be considered as a promising source of highâvalue compounds for food industry
Profiling beneficial phytochemicals in a potato somatic hybrid for tuber peels processing: phenolic acids and anthocyanins composition
The purpose of this study was to characterize the peels of a CN1 somatic hybrid obtained from two dihaploid potato lines (Cardinal H14 and Nicola H1) in terms of the health-promoting phenolic compounds (phenolic acids and anthocyanins). The CN1 hybrid is defined by a pink tuber skin color making it different from the light-yellow-skinned "Spunta," which is the most commonly grown potato cultivar in Tunisia. Oven-dried peel samples derived from CN1 hybrid and cv. Spunta were ground, and phenolic compounds were extracted with water or methanol for quantification. Lyophilized peels were used for the phenolic acid and anthocyanin analyses. Higher total quantities of phenolic compounds were recovered in methanol extracts compared with water extracts. A slightly higher concentration of phenolic acids (100 mg/100 g DW) was obtained in the lyophilized peels extract of CN1 hybrid than in the cv. Spunta corresponding sample (83 mg/100 g DW). The profiles of the chlorogenic acid isomers were almost identical in both of CN1 hybrid and cv. Spunta. Caffeic acid (CA) and three caffeoylquinic acids (CQAs): 3-CQA, 4-CQA, and 5-CQA, were identified from both genotypes, 5-CQA being the dominant form in both potatoes. Since the CN1 hybrid has a pink skin color, its anthocyanin profile was also determined. The anthocyanin quantity in the CN1 peels was 5.07 mg/100 g DW, involving six different anthocyanins that were identified within the extract, namely, Pelargonidin-3-rutinoside-5-glucoside, peonidin-3-rutinoside-5-glucoside, coumaroyl ester of pelargonidin-3-rutinoside-5-glucoside, coumaroyl ester of peonidin-3-rutinoside-5-glucoside, feruloyl ester of pelargonidin-3-rutinoside-5-glucoside, and feruloyl ester of peonidin-3-rutinoside-5-glucoside. These results suggest that the peel waste of CN1 somatic hybrid can be considered as a promising source of high-value compounds for food industry
La grossesse en hémodialyse chronique: à propos de 25 cas survenus dans le Sud Tunisien
Introduction: la survenue de grossesse au cours de lŽhémodialyse chronique est rare. Néanmoins, avec lŽévolution des techniques de dialyse, une amélioration de la fertilité est possible. Le but de notre travail est de rapporter notre expérience concernant la survenue d'une grossesse chez les patientes dialysées et de dégager les facteurs impliqués dans sa réussite.
Méthodes: notre étude rétrospective a porté sur 25 grossesses spontanées survenues chez 19 patientes traitées par hémodialyse périodique dans différents centres dŽhémodialyse du sud tunisien sur une période de 34 ans.
RĂ©sultats: lÂŽĂąge maternel de survenue de grossesse Ă©tait en moyenne Ă©gal Ă 35,6 ans [23-44ans] avec une anciennetĂ© moyenne en hĂ©modialyse de 4,22 ans [1-17 ans]. Sept patientes (37%) avaient une diurĂšse rĂ©siduelle (>500 ml/24h). Le volume horaire hebdomadaire de dialyse Ă©tait â„16 heures par semaine dans 7 cas et â„20 heures dans 4 cas. Le succĂšs de la grossesse (nouveau-nĂ© survivant au moins 28 jours) Ă©tait estimĂ© Ă 56%. LÂŽĂąge gestationnel mĂ©dian Ă©tait de 34 semaines dÂŽamĂ©norrhĂ©e [28-38 SA]. Le poids nĂ©onatal moyen est Ă©gal Ă 1970g [1500g-2300g]. LÂŽĂ©tude analytique a montrĂ© une corrĂ©lation significative entre lÂŽaugmentation des heures de dialyse par semaine et la rĂ©ussite de la grossesse (R= 0,59; p= 0,002).
Conclusion: on souligne quÂŽavec une prise en charge adĂ©quate et notamment la majoration du nombre de sĂ©ances de dialyse, les complications materno-fĆtales peuvent ĂȘtre minimisĂ©es et la balance risque-bĂ©nĂ©fice vire vers donner la chance Ă une femme dialysĂ©e de devenir maman
Service de Cardiologie, Faculté de Médecine, Université Mohammed Premier, Oujda, Maroc
Lâamylose rĂ©nale est une complication rare au cours de la maladie de Still de lâadulte. Nous rapportons 3 observations dâamylose rĂ©nale parmi une sĂ©rie de 33 cas de maladie de Still de lâadulte. Il sâagit de 3 patientes dâĂąge moyen de 43 ans (extrĂȘme: 33 et 58 ans). Le diagnostic de maladie de Still a Ă©tĂ© retenu devant une polyarthrite fĂ©brile (3 cas) associĂ©e Ă une Ă©ruption cutanĂ©e fugace (1 cas), un syndrome inflammatoire biologique en lâabsence de toute cause infectieuse, inflammatoire ou nĂ©oplasique. Toutes ont Ă©tĂ© traitĂ©es par une corticothĂ©rapie associĂ©e secondairement au mĂ©thotrexate devant une polyarthrite destructrice (2 cas) et devant une rĂ©cidive (1 cas). Une amylose rĂ©nale Ă©tait survenue 4,9 ans aprĂšs la maladie de Still (extrĂȘme: 33 mois et 7ans). Lâamylose Ă©tait rĂ©vĂ©lĂ©e par un syndrome nĂ©phrotique (3 cas), associĂ© Ă une insuffisance rĂ©nale (1 cas). Le diagnostic a Ă©tĂ© posĂ© par une ponction biopsie rĂ©nale (3 cas) concluant Ă une amylose AA (2 cas) et non typĂ©e (1 cas). Tous les malades ont reçu la colchicine. LâĂ©volution Ă©tait favorable chez une patiente alors que les deux autres ont Ă©voluĂ© vers lâinsuffisance rĂ©nale chronique. Lâamylose rĂ©nale est une atteinte inhabituelle de la maladie de Still de lâadulte. Une fois installĂ©e, elle peut engager le pronostic vital
The inflammatory profile of chronic kidney disease patients
Background: Chronic kidney disease is a worldwide public health issue which is associated with an increased risk of end-stage renal failure and cardiovascular disease. Systemic inflammation exists during chronic renal failure. Recent researches have highlighted the pivotal role of inflammation between renal and cardiovascular disease. The aim of our study is to determine the inflammatory profile of the patient suffering from chronic kidney disease and the influence of hemodialysis on this profile.Methods: We carried out a cross sectional study on 93 patients in the Nephrology Department at Hedi Chaker University Hospital, Sfax, South of Tunisia. Among those patients, 72 patients underwent hemodialysis and 21 patients had chronic kidney disease at stage 3. Clinical data and antecedents were collected. Biological samples were taken after informing the patients and taking their consent. Biological data consisted in lipid profile, albumin rate, hemoglobin rate, uric acid concentration and the usual markers of inflammation noting sedimentation rate, C - reactive protein and orosomucoid.Results: Hemodialysis group of the 72 patients had mean hemodialysis vintage of 54.6 ± 43 months. The inflammatory profile was worse in hemodialysis patients compared to chronic kidney disease patients. Both sedimentation rate, C - reactive protein and orosomucoid were higher in hemodialysis group than in chronic kidney disease group with 71 ± 35.3 mm vs. 42.1 ± 15.5 mm (p < 0.05); 14.6 ± 28.7 mg/l vs. 6.7 ± 8 mg/l (p = 0.02); 1.3 ± 0.7g/l vs. 0.9 ± 0.4 g/l (p = 0.01), respectively.Conclusion: Inflammation increases in dialysis patient. It deserves the nephrologist’s consideration in order to minimize its harmful effects. The monitoring of inflammation markers must be integrated into the nephrologist’s medical practice
Tumoral calcinosis, calciphylaxis, hyperparathyroidism and tuberculosis in a dialysis patient
Tumoral calcinosis and calciphylaxis are uncommon but severe complications in ure-mic patients. They occur generally after long-term hemodialysis (HD) treatment explained by ad-vanced secondary hyperparathyroidism and longstanding high calcium phosphorus product (Ca Ă P). Other factors such granulomatous diseases may worsen the calcium phosphate homeostasis alterations. We report a young male patient treated by HD for 6 years who developed tuberculosis in addition to tumoral calcinosis and calciphylaxis
La péritonite chyleuse en dialyse péritonéale
Chylous peritonitis (CP) is a rare complication in patients on peritoneal dialysis. There are many reasons for this. It can occur as a result of a traumatic insertion of the peritoneal dialysis catheter or secondary to infectious or drug causes. The evolution is favorable at the elimination of the causative agent.
We report 3 cases of PC occurring in 3 patients on peritoneal dialysis. In 2 patients, CP was secondary to calcium channel blockers and in 1 case associated with lymph node tuberculosis. The cessation of the causative agent allowed a clarification of the effluent dialysate. CP is a mild form of non-infectious peritonitis that is often confused with infectious peritonitis. In this article we discuss the etiologies of CPs, the pathophysiology and the conduct to be held in front of a CP.La pĂ©ritonite chyleuse (PC) est une complication rare chez les patients en dialyse pĂ©ritonĂ©ale. Les causes sont multiples. Elle peut survenir suite Ă une insertion traumatique du cathĂ©ter de dialyse pĂ©ritonĂ©ale ou secondaire Ă des causes infectieuses ou mĂ©dicamenteuses. LâĂ©volution est favorable Ă lâĂ©limination de lâagent causal.
Nous rapportons 3 cas de PC survenant chez 3 patients en dialyse pĂ©ritonĂ©ale. Chez 2 patients, la PC Ă©tait secondaire Ă la prise dâinhibiteurs calciques et dans 1 cas associĂ© Ă une tuberculose ganglionnaire. LâarrĂȘt de lâagent causal a permis un Ă©claircissement du dialysat effluent. La PC est une forme bĂ©nigne de pĂ©ritonite non infectieuse qui prĂȘte souvent Ă confusion avec les pĂ©ritonites infectieuses. Dans cet article nous discutons les Ă©tiologies des PC, la physiopathologie et la conduite Ă tenir devant une PC
Poor prognostic factors of lupus nephritis
The occurrence of renal involvement during the clinical course of systemic lupus erythematous (SLE) is generally considered to be the most important factor influencing the prognosis in terms of morbidity and mortality. The factors influencing prognosis in lupus nephritis (LN) are variable in literature. Our aim was to determine predictive factors of poor prognosis in LN among our population. In this retrospective study, 82 cases of LN observed over 18 years were studied. There were 12 males and 70 females with a mean age of 26.9 ± 11 years. At presentation, the mean proteinuria was 3.9 ± 4 g/day; the nephrotic syndrome, hematuria, leukocyturia and renal failure were observed in 67.1%, 63.4%, 56.1% and 37.8% of cases, respectively. LN was of class I, II, III, IV and V in 4.9%, 13.4%, 23.2%, 50% and 8.5% of the cases, respectively. Fifteen patients developed end-stage renal failure and/or died. The presence of hypertension, renal failure, massive proteinuria and high activity index score of LN was associated with poor renal prognosis
Differential Expression of Anti-Inflammatory RNA Binding Proteins in Lupus Nephritis
Lupus nephritis (LN) is a type of immunological complex glomerulonephritis characterized by chronic renal inflammation which is exacerbated by infiltrating leukocytes and fueled by a variety of pro-inflammatory cytokines. A profound understanding of the pathogenesis of LN is necessary to identify the optimal molecular targets. The role of RNA-binding proteins (RBPs) in post-transcriptional gene regulation in the immune system is being explored in greater depth to better understand how this regulation is implicated in inflammatory and autoimmune diseases. Tristetraprolin (TTP), Roquin-1/2, and Regnase-1 are 3 RBPs that play a critical role in the regulation of pro-inflammatory mediators by gating the degradation and/or translational silencing of target mRNAs. In this study, we proposed to focus on the differential expression of these RBPs in immune cells and renal biopsies from LN patients, as well as their regulatory impact on a specific target. Herein, we highlight a novel target of anti-inflammatory treatment by revealing the mechanisms underlying RBP expression and the interaction between RBPs and their target RNAs