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Biomedical subjects

F Ben Hamida

Publications and source records attributed to F Ben Hamida.

At least 19 recordsLinked to original sources
PubMed2006

[Renal manifestations in tuberous sclerosis].

BACKGROUND: Tuberous sclerosis is a rare inherited disease which can involve several organs. Renal involvement is one of the most severe manifestations of the disease. We analysed in this study renal involvement of tuberous sclerosis. METHODS: We studied retrospectively nine cases of tuberous sclerosis with renal involvement diagnosed between 1994 and 2005. The diagnosis was based on the presence of typical extra-renal manifestations and familial history of tuberous sclerosis. RESULTS: There were eight females and one male. Their mean age was 40.8+/-16.4 years (range: 15-62). At first presentation, we noted hypertension in three cases, proteinuria in seven cases, hematuria in eight cases and renal failure in five cases (end stage renal failure in four cases). By ultrasonography, we found angiomyolipoma in one case, cysts in four cases and angiomyolipoma associated to cysts in four cases. Nephrectomy was performed in two patients, in one case for hydronephrosis secondary to urolithiasis and in the other for hemorrhagic complication. In the later, pathological examination revealed renal carcinoma. At last evaluation, two patients were lost to follow-up, one had normal serum creatinine, five were on renal replacement therapy and the latter died from sepsis following kidney removal. CONCLUSIONS: In our patients, renal disease was diagnosed late at chronic renal failure stage. Patients with end-stage renal failure require dialysis and renal transplantation, but we recommend binephrectomy after starting dialysis and before transplantation due to the risk of cancer and bleeding related to angiomyolipomas.

Adolescent↗
PubMed2005

[Retroperitoneal fibrosis].

OBJECTIVE: We studied the clinical, therapeutic and progressive characteristics of retroperitoneal fibrosis. METHODS: We analysed the observations of retroperitoneal fibrosis diagnosed between 1980 and 2002 in our hospital, from the summaries of 15 patients exhibiting retroperitoneal fibrosis (RPF). Therapeutical supervision was based on biology and radiology. RESULTS: There were 11 men and 4 women with a mean age of 44.5 years ranging from 28-64 years. Pain was predominantly lumbar or abdominal in all patients. An inflammatory syndrome was observed in all patients and renal failure in 11. Radiological examinations revealed single or bilateral in 14 cases and the fibrosis plaque in 13 cases. Treatment consisted in corticosteroids alone in 9 patients, surgery alone in 3 cases and surgery with corticosteroids in 3 patients. Ten relapses (range: 1-5) occurred in 4 patients when corticosteroids were stopped. After a mean follow-up of 36 months (range:18 days-11 years), one death was observed, 12 patients had normal renal function and 2 patients had persistent moderate renal failure. CONCLUSION: This study confirms the rarity of retroperitoneal fibrosis, the difficulty in its diagnosis, the frequency of pain, inflammatory syndrome and renal failure. Corticosteroids are efficient and regular follow-up is required.

Abdominal Pain↗
PubMed2005

[Lupus nephritis: 211 cases].

PURPOSE: Renal involvement is one of the most severe and frequent manifestations of systemic lupus erythematosus. Prognosis factors are variable in the different studies. We analyze in 211 patients clinical, biological and histologic characteristics of lupus nephritis and the different prognosis factors. METHODS: It's a retrospective study in 211 with lupus nephritis followed-up between 1975 and 2003. RESULTS: There were 195 women and 16 men aged meanly of 28,8 years. At first presentation, we noted hypertension in 32,3% of cases, nephrotic syndrome in 47,7% of cases and renal failure in 51,6% of cases. histologic examination of kidney revealed class III in 59 cases, class IV in 97 cases and class V in 33 cases. Two hundred and five patients were treated by corticosteriods associated with immunosupressive agents in 95 cases. After a mean follow-up of 103 months (2-289 months), we obtained remission in 55,3% deterioration of renal function in 34,8% with end stage renal failure in 14,7% and relapses occurred in 51% of cases. Thirty-three patients died. Age <24 years, hypertension, nephrotic syndrome and initial renal failure were statistically associated with deterioration of renal function. CONCLUSION: Lupus nephritis is severe in our patients with predominance of proliferative forms. Age <24 years, hypertension, nephrotic syndrome and initial renal failure were statistically associated with deterioration of renal function.

Adrenal Cortex Hormones↗
PubMed2005

[Indications, complications and cost of internal jugular catheters in hemodialysed patients: study of 533 cases].

INTRODUCTION: Central venous catheters for hemodialysis are very useful as blood accesses when arteriovenous fistulas (AVF) are not available. The aim of this study is to analyse the clinical impact of internal jugular catheters (IJC) in hemodialysed patients and to assess their economic consequences. PATIENTS AND METHODS: It is a prospective study realised from July 1998 to March 2002 including 533 hemodialysed patients without functional AVF: 280 males and 253 females aged between 17 and 87 years (mean age: 54.1 +/- 15 years). Single lumen polyurethane Vygon were used. All catheters were placed using Seldinger procedure and the posterior route of Jernigan which is more comfortable for patient. RESULTS: Indications of IJC placement were new hemodialysed patients without AVF in 73.5% cases and no functional AVF in 26.5% cases. During the period of the study. IJC was placed in 533 patients. We failed to place the IJC at the first attempt in 42 patients but we succeed in placing it on the controlateral side. During IJC placement, we observed 50 (9.4%) cases of accidental puncture of carotid artery. The median duration use of IJC was 41 days (extreme: 1 to 413 days). IJC were removed mainly because of the use of AVF in 469 (88%) cases and the catheter infection in 41 (77%) cases. Bacteriological analysis were made only for 25 patients: staphylococci were identified in 16 cases and catheter cultures were negative in the 9 other cases. All patients were treated with antibiotics. Outcome was favourable for 39 of them and we had 2 deaths by septicemia. The IJC cost was 44,287 Tunisian Dinars (DT) coresponding to 31.633 Euro including 10125 DT (7,232 Euro) for infectious treatment. CONCLUSION: The use of IJC is frequent in our center with a high rate of infectious complications which increased the hemodialysis cost. The realisation of AVF, in patients with chronic renal failure before the beginning of hemodialysis, is the best way to limit the use of catheters.

Adolescent↗
PubMed2004

[Induction and reversibility of thyroid proliferative changes in suckling rats given thiocyanate].

Potassium thiocyanate given in the drinking water of pregnant rats led to decreased body weight in their 14-day-old offspring (27%) without altering thyroid weight. Reduction of the suckling rat's body weight could be explained be defective thyroxinemia (38). Plasma FT3 and TSH were unchanged after thiocyanate treatment. The biochemical changes were in agreement with the histological aspects of the hypothyroid animals. The typical pattern was hyperplastic goiter. Colloid volume was reduced compared with controls. Presence of resorbed peripheral vacuoles, a sign of thyroid hyperactivity, was disclosed by a three-fold increase in radioiodide (131I) uptake compared with controls. When the antithyroid drug was removed from the mother's milk, the pups'weight increased but did not reach control values. Plasma thyroid hormone levels returned to normal and even exceeded control values in spite of partial recovery of thyroid iodine content when thiocyanate treatment was stopped for ten days.

Animals↗
PubMed2003

[Thiocyanate and central nervous system maturation of young mice].

Potassium thiocyanate, given to the drink of pregnant mothers provoked a body weight decrease of 14 day-old mice (-18%), without perturbations of cerebrum and cerebellum weights. The reduction of pups' body weight could be explained by a decrease of plasmatic thyroid hormone levels: FT3 and FT4, (-54; -57%) in youngs and (-66; -49%) in their mothers. A defect of thyroid hormone levels, observed in young mice, provoked a decrease of cerebrum and cerebellum protein concentrations (-15 and -13%) respectively. Modifications of biochemical parameters confirmed the histological aspects of hypothyroid mice cerebellum with purkinje cells incompletely differentiated. When thiocyanate ion was removed from mothers' drink, we have noted in pups a partial return of some biochemical parameters (iodine thyroid contents, protein concentrations of cerebrum and cerebellum) and of cerebellum histological aspects. While thyroxinemia (FT4) and plasmatic FT3 levels were completely restored and even exceeded control values, which were necessary for central nervous system maturity of young.

Animals↗
PubMed2001

Renal replacement therapy for diabetic end-stage renal disease. Experience of a Tunisian hospital centre.

OBJECTIVE: To determine the epidemiological and clinical characteristics of 299 uremic diabetics at the initiation of renal replacement therapy (RRT) and to evaluate their morbidity and the factors influencing their mortality during the dialysis period. PATIENTS AND METHODS: All patients starting RRT for diabetic end-stage renal disease (ESRD) at Charles Nicolle Hospital of Tunis during a period of seven years (1990-1996) constituted the study population. During the follow-up period ended on December 31, 2000, all morbid events, hospitalizations and deaths were recorded. Multivariate analysis according to the Cox proportional hazards model was performed to identify the predictors of mortality. RESULTS: There were 238 type 2 (79.6%) and 61 type 1 diabetics (20.4%) representing 20.3% of all patients accepted for RRT. The mean age at the onset of RRT was 53.16 +/- 12.43 years (range: 23 to 80 years). A poor glycemic control was observed in 46.7% of type 2 diabetics and in 67.3% of type 1 diabetics (p=0.0055). A third of patients started RRT in emergency conditions and 91% required a temporary vascular access. At the time of onset of RRT, 86.7% of patients were hypertensive and 52.1% had a nephrotic syndrome. Blindness was observed in 22.9% of type 1 diabetics and in 7.5% of type 2 diabetics (p=0.0014). During the follow-up period, 217 patients died representing a rate of 22% patient-years, 26.7% of these deaths occurred during the first 3 months of RRT and 53% were attributed to infectious or cardiovascular complications. Actuarial survival rates were 68.4%, 59.6% and 45.3% at 1, 2 and 4 years, respectively. Age, co-morbidities and conditions of onset of RRT were independently correlated with survival time. CONCLUSION: Diabetes is a frequent cause of ESRD in Tunisia, the delayed referral to a nephrologist and coexistence of serious co-morbidities at the initiation of RRT resulted in a high rate of early death. Greater efforts should be made in our country in view of improving the quality of medical care of uremic diabetics before and during RRT.

Adolescent↗
PubMed2001

[Propythiouracil and perchlorate effects on thyroid function in young and lactating mice].

We have studied the effects of propythiouracil (PTU) or perchlorate (CIO(4)(-)), given to the mothers' drink from the 15(th) day of pregnancy until the day of sacrifice, on thyroid function of suckling mice. Antihyroid drugs (PTU or CIO(4)(-)) provoked growth perturbations of young mice during studied ages from 6 to 18 days. A decrease of body weight was respectively as follows: 14 and 22% in 6 day-old mice; 16 and 23% in 10 day-old mice; 18 and 18% in 14 day-old mice; 19 and 11% in 18 day-old mice. We have noticed an hypertrophy of thyroid glands of pups and their mothers caused by an increase of pituitary TSH. Thyroid follicles presented the aspect of hypothyroid animals with an increase of follicular number and vascularisation. Structural modifications confirmed biochemical results. In fact thyroid iodine contents decreased strongly in young as follow: 40 and 43% in 6 day-old mice; 51 and 50% in 10 day-old mice; 66 and 84% in 14 day-old mice; 54 and 89% at 18 day-old mice and in their mothers (50, 37%; 59, 54%; 75, 65% and 85, 72%) respectively after PTU or CIO(4)(-) treatment. A decrease of iodine thyroid gland was accompanied by an important fall of free thyroid hormones levels (FT3 and FT4) in young and adult mice. A decrease of thyroid hormonemia could explain the pups' growth perturbations.

Aging↗
PubMed1995

[Adult uveitis: apropos of 1 case with acute idiopathic interstitial nephritis].

The association of acute interstitial nephritis and uveitis is rare. In 1975, Dobrin reported a new syndrome in two children presenting acute interstitial nephritis, anterior uveitis and marrow-lymph node granulomas. We report one case of this association in the adult. A 35-year-old man was admitted to the hospital for acute renal failure, arthralgia and anterior uveitis. The infectious and the immunological investigations were negative. The ocular examination shows bilateral anterior uveitis. The renal biopsy revealed acute tubulo-interstitial nephritis. He was treated by prednisone (0.5 mg/Kg/day). His clinical course was favorable. Seven years later, the renal function is normal and we not observed a relapse of his uveitis.

Acute Disease↗
PubMed1994

[Hyperparathyroidism secondary to renal insufficiency. Physiopathology, clinicoradiological aspects and treatment].

Stimulation of PTH secretion and synthesis in chronic renal failure involves direct and indirect factors. The indirect ones are those contributing to a decrease of plasma ionized calcium concentration which stimulates the release of PTH (1) primarily the negative calcium balance due to the iatrogenic reduction of dietary calcium intake associated with an inadequate synthesis of calcitriol, this latter being explained by a reduction in the nephronic mass, the phosphate retention, the acidosis and the retention of uremic toxins (2) more accessorily, the physicochemical dysequilibrium induced by the late occurring hyperphosphatemia. The factors acting directly on the parathyroid gland stimulating synthesis of prepro PTH at its transcription level: not only hypocalcitriolemia but also hypocalcemia and hyperphosphatemia. The clinicoradiological manifestations appear late, mostly only after the patient has been put on dialysis. The most precocious sign is the subperiosteal resorption assessed on the hand X-rays. Therefore diagnosis of hyperparathyroidism relies mainly on the measurement of plasma concentration of intact PTH. In dialysis patients the optimal range corresponding to the best bone histology is between 1 an 3 times the upper limit of normal. No such data exist for predialysis patients. Medical treatment of hyperparathyroidism should primarily be preventive, probably in predialysis lipin patient as soon as plasma intact PTH is greater than the normal upper limit. This treatment is based primarily on the prevention of phosphate retention, of negative calcium balance and acidosis by the use of oral alkaline salts of calcium given with the meals in association with appropriate dietary protein and phosphate restriction. Native vitamin D depletion should also be prevented but use of 1 alpha OH vitamin D3 metabolites in controversial: it is reasonable to administer them only when plasma intent PTH is above 3-7 the normal upper limit and when plasma phosphate is below 1.2 in predialysis patients below 1.5 mmol/l in dialysis patients and plasma calcium remains below 2.3 mmol/l in spite of CaCO3 administration. This situation is encountered in less than 50% of the dialysis patients and rarely in predialysis patients. In dialysis patients the calcium concentration in the dialysate should be chosen in relation to the dose of oral calcium and the use of 1 alpha OH vitamin D3. The superiority of the intermittent (oral or intravenous) over the daily oral administration is not yet clinically proven. The surgical parathyroidectomy is indicated when hypercalcemia and/or hyperphosphatemia occur under medical treatment, whereas the intact PTH levels remain very high (> 500 pg/ml).(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1994

[Late renal and hypertensive complications of extracorporeal lithotripsy. Myth or reality?].

Extracorporeal shock wave lithotripsy (ESWL) has produced dramatic advances in the surgical management of urinary calculi. However this new procedure could induce deleterious effects as loss of renal function and hypertension. Animal studies show that ESWL induces focal areas of necrosis and subsequent fibrosis in renal tissue. In humans, imaging technics demonstrate renal alterations in 80% of the patients. Acute renal hemodynamic and functional changes is frequent but transient in most of the cases. Some studies have shown a tendancy to an increase in blood pressure related to a decrease in renal plasma flow in one study. However most of these results are based on retrospective surveys of blood pressure and renal function. Therefore prospective clinical trials are needed to investigate the important questions of ESWL-induced hypertension and decrease renal function.

Animals↗