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Biomedical subjects

N Ben Dhia

Publications and source records attributed to N Ben Dhia.

At least 19 recordsLinked to original sources

[Desmoid cervical tumour following the placing of an internal jugular catheter].

INTRODUCTION: A desmoid tumour is a rare fibroblastic tumour and generally located in the abdomen. However, it can also develop on surgical scars. OBSERVATION: A 36 year-old woman on chronic dialysis consulted for a cervical mass on the left side that was progressively increasing in volume, on the site of a scar of an internal jugular catheter placed 7 months earlier. Histological analysis of a sample of this mass concluded in a benign fibroblastic proliferation and led to the diagnosis of a desmoid tumour. Study of the patient's history revealed that a left jugular catheter had been placed on two occasions to be used for the hemodialysis approach, the lesion provoked by the latter would explain the development of the desmoid tumour. COMMENTS: The potential severity of this tumour is related to its proximity with the carotid, trachea and base of the skull. In general, desmoid tumours, rare benign tumours of the connective tissue, exhibit a complex multifactor etiopathogenesis. A surgical trauma can often trigger-off such tumours.

Adult↗

[Acute renal insufficiency in Boutonneuse Mediterranean fever: description of three cases].

Boutonneuse fever is a bacterial infection caused by Rickettsia conorii. It occurs mainly in countries around the Mediterranean basin. Most cases are benign. However severe forms with major morbidity and a high mortality risk have been described. Severe forms often involve altered mental status, hepatic cytolysis, hemostatic disturbances, pneumopathy, and kidney failure. The causes of renal complications are unclear. The purpose of this report is to describe three cases of boutonneuse fever associated with acute kidney failure due to different underlying mechanisms, i.e., acute renal function failure, acute tubular necrosis, and extracapillary glomerulonephritis. While the first two mechanisms of kidney failure have been reported frequently in association with Boutonneuse fever, extracapillary glomerulonephritis has, to our knowledge, been mentioned only once. This case supports speculation that Rickettsia conorii has a toxic effect on glomeruli.

Acute Kidney Injury↗

[Adrenocortical insufficiency in renal amyloidosis].

Renal involvement in amyloidosis leads to chronic renal failure. Prognosis is poor. Although amyloid deposits are frequent in adrenal glands, symptomatic adrenal dysfunction is uncommon. We report the case of a 63-year-old man with chronic renal failure (serum creatinine: 202 micromol/L) subsequent to amyloidosis who was referred to our unit for vomiting, dehydration despite a persistent nephrotic syndrome, acidosis, hyponatremia (121 mmol/l) and hyperkaliemia (7.1 mmol/l). A synacthen test was performed and disclosed adrenal insufficiency. Despite the initiation of substitution therapy, the patient died one month later from Addisonian crisis. Features of adrenal insufficiency may be masked by those of chronic renal failure, emphasizing the importance of adrenal explorations in patients with chronic renal failure due to amyloidosis.

Adrenal Insufficiency↗

[Anxiety and depression in the hemodialysis patient].

Terminal renal failure and haemodialysis are precarious statute which put to the test capacities of adaptation of all patients. In this context, authors tempted to evaluate, using several instruments of measure, the importance and features of minor psychiatric disorders among 109 patients on chronic haemodialysis. Results of Goldberg test (GHQ) confronted to those of the medical interview reveal that anxio-depressive morbidity is frequent. According to results of the adaptation test to stress, our patients preserve a good mood but are often invaded by black ideas. In the field of the personal life, dissatisfaction concerns by decreasing order the lodging and the environment of the patient, the relation with parents, friends, the conjoined and medical care. This work, if it raises problems relatively unknown as much by the psychiatrist that by nephrology specialist, insist on the importance of multidisciplinary in order to assure holistic care and to improve the quality of life of patients on dialysis.

Adaptation, Psychological↗

[Pregnancy with delivery at term in hemodialyzed women].

Genital disturbances are frequent in chronic renal failure with amenorrhea anovulatory cycles, elsewhere a good hemodialysis improve these disturbances pathogenesis of there; derived from central gonado stimuline dysfunction. We stated 13 pregnancies in our hemodialysed population. Only one successful delivery of a (baby alive and in due time) is registered. Residual diuresis and blood pressure are the most important predictor pregnancy factors in spite of a good dialysance the fetal prognosis in still unclear. Complications were observed in the mother as well as new babies.

Adult↗

[Primary hypothyroidism and glomerular involvement].

Association between auto-immune dysthyroidism and glomerulonephritis is quite rare. The authors report 3 cases with proteinuria varying from 2.72 to 6.06 g/day and hypothyroidism. Nephrotic syndrome was found in 2 cases and thyroid auto-antibodies (microsomal and thyroglobulin) and circulating immun complexes (C.I.C.) in 1 case, complement fractions C3 and C4 were normal in all cases. Renal biopsy showed membranous glomerulonephritis in 2 cases and minimal lesions in the third case. Proteinuria disappeared with glucocorticoids and thyroxine in 1 case, with thyroxine alone in an other case and persisted in the third case with normal thyroid function.

Adult↗

[Familial distal tubular acidosis].

This study concerned a Tunisian family of 52 members. We have looked for distal tubular acidosis (D.T.A.) after we had discovered that 2 members of this family suffered from nephrocalcinosis with D.T.A. Twenty six of our patients (group I) suffered from D.T.A., 17 from confirmed metabolic acidosis with low urinary pH (5.22 +/- 0.25). Patients of latest groups may present a D.T.A. with intact capacity to lower urinary pH. Our literature review revealed 27 families composed of 228 patients.

Acidosis, Renal Tubular↗

[Psychological aspects and details of care of patients on hemodialysis].

Chronic renal failure and periodic hemodialysis, by the physical reach and the therapeutic imperatives that they mislead disrupt by several ways the universe of the patient. This one is confronted to changes, or even to aggressions that undergo his body, his domestic and socio-professional life, which is accepted in general with difficulty. Indeed, our survey that concerned 109 patients on chronic hemodialysis shows that the minor psychiatric pathology is frequent and can represent a source of problems as well for the patients that for the medical and nursing staff. Besides the analysis of minor psychiatric specificities revealed by a known measure instrument (the GHQ), this work insists on the importance to take account of this aspects with the aim to enhance management and holistic care of these patients.

Adult↗