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Clinical Characteristics and Follow-Up Data in a Series of Twenty Infective Endocarditis Complicated of Rheumatic Manifestations

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Open Journal of Clinical Diagnostics 2015年第2期5卷 58-62页

作者： Madiha Mahfoudhi Imen Gorsane Hedia Bellali amel Gaieb Battikh Sami Turki Fathi ben Hamida Taieb ben Abdallah Internal Medicine A Department Charles Nicolle HospitalTunisTunisia Research Unit of Kidney Diseases(LR00SP01) Charles Nicolle HospitalTunisTunisia Epidemiology and Statistics Department A Mami HospitalArianaTunisia

The infective endocarditis is a septicemia complicated of many systemic manifestations. Rheumatic manifestations can be revelatory, leading sometimes to a lateness diagnosis. The aim of this study is to determine the epidemiological, clinical, bacteriological profile and the follow up in patients affected of an infective endocarditis complicated of rheumatic manifestations. It’s a retrospective study concerning the period from January 1990 to December 2015. The analysis had implicated epidemiological, clinical, biological data, in association to immunological, bacteriological and radiological examinations. All the patients fulfilled the revised Duke’s criteria for the infective endocarditis. Articular and osseous radiographs, blood culture, transthoracic and/or transoesophageal echocardiography were performed in all patients. Twenty patients had rheumatic manifestations. The mean age was 37 years. There were arthralgia in 15 cases, myalgia in 5 cases and arthritis in 8 cases: 6 cases of mono-arthritis and 2 cases of oligo-arthritis. All patients had an inflammatory biological syndrome. The blood culture was positive in all the cases. Echocardiography revealed vegetations in all the patients: mitral in 10 cases, aortic in 4 cases, mitral and aortic in 4 cases, aortic and tricuspid in 1 case, tricuspid in 1 case. The radiological examination found 2 cases of spondylodiscitis and a case of saco-iliitis. The articular outcome was favorable in 17 cases. Three patients had died. The infective endocarditis should be considered in case of febrile arthritis. An early diagnosis and adapted treatment are guarantors of better prognosis.

关键词： Infective Endocarditis Blood Culture Vegetation Myalgia Arthritis

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Splenic Infarction Associated with Acute Brucellosis: A Case Report

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Advances in Infectious Diseases 2012年第4期2卷 89-91页

作者： Wissem Hachfi Foued Bellazreg Amira Atig Nadia ben Lasfar Naoufel Kaabia amel Letaief Department of Internal Medicine and Infectious Diseases Farhat Hached Hospital Sousse Tunisia

We report a case of a 21-year-old shepherd who presented with fever, left hypochondrium pain and splenomegaly. Blood tests showed thrombocytopenia and high liver enzymes. Computed tomography scan revealed the presence of hypodense lesions suggestive of splenic infarction. Echocardiography was without abnormalities. Laboratory evaluation for thrombophilia was negative. A bone marrow aspiration and a bone marrow biopsy were normal. Brucella serology was positive. The patient was treated with doxycycline, rifampicin and streptomycin for 12 weeks. Fever, abdominal pain and thrombocytopenia resolved promptly. At one year of follow-up, he remained well and no splenic infarction could be detected on ultrasonography.

关键词： Brucellosis Splenic Infarction Thrombocytopenia

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Epidemiological, Clinical and Follow-Up Data in a Series of Thirteen Renal Insufficiencies Complicating Sarcoidosis

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Open Journal of Clinical Diagnostics 2015年第2期5卷 50-53页

作者： Madiha Mahfoudhi Imen Gorsane amel Gaieb Battikh Sami Turki Hayet Kaaroud Rym Goucha Fathi ben Hamida Taieb ben Abdallah Internal Medicine A Department Charles Nicolle HospitalTunisTunisia Research Unit of Kidney Diseases(LR00SP01) Charles Nicolle HospitalTunisTunisia

The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and the interest of considering sarcoidosis diagnosis in case of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 13 women with an average age of 41 years. Biological investigations showed an abnormal normocalcemia in 8 cases, a hypercalcemia in 5 cases, a hypercalciuria in 11 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 540 umol/L. The renal echography was normal in all patients. The kidney biopsy performed in all patients showed tubulo-interstitial nephritis. The extra-renal signs were: pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymphadenopathy in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 3 cases and a polyarthritis in 6 cases. Six patients benefited from hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis should be made rapidly in order to avoid end stage renal failure.

关键词： Sarcoidosis Acute Renal Failure Interstitial Nephritis Granuloma

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Geochemical characterization of the salinity of irrigated soils in arid regions(Biskra, SE Algeria)

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Acta Geochimica 2021年第2期40卷 234-250页

作者： Mohamed Amine Abdennour Abdelkader Douaoui Jesus Barrena Manuel Pulido Abdelhamid Bradai amel bennacer Chiara Piccini Alberto Alfonso-Torreno Laboratory of Ecosystem Diversity and Agricultural Production System Dynamics in Arid Zones(DEDSPAZA) Mohamed Khider University07000 BiskraAlgeria Laboratory of Crop Production and Sustainable Valorization of Natural Resources Djilali Bounaama University44225 Khemis MilianaAlgeria GeoEnvironmental Research Group University of Extremadura10071 CaceresSpain Laboratory of Water and Environment Hassiba Ben Bouali University02180 ChiefAlgeria Laboratory of Valorization and Conservation of Biological Resources Faculty of SciencesMohamed Bougara University35000 BoumerdesAlgeria Research Centre for Agriculture and Environment Council for Agricultural Research and EconomicsVia della Navicella 2-400184 RomeItaly

The agriculture in Biskra,southeastern Algeria,is based on traditional practices and characterized by small irrigated *** the last decades,the increasing demand in water as well as the scarcity of rainfall has forced many farmers to use groundwater of low quality to maintain the profitability of their ***,this practice seems to be the main harmful factor for soil quality in the region since it is responsible for the salinization of the irrigated *** to assess the impact of this phenomenon,the soils of the irrigated perimeter of El Ghrous-a representative rural community located in the west of Biskra-have been analyzed.A set of 82 soil samples was collected from top and subsoil(0-15 and15-35 cm respectively),on which the following physicochemical analyzes were performed:Ca^(2+),Mg^(2+),K^(+),Na^(+),Cl^(-),SO_(4)^(2-),HCO_(3)^(-),NO_(3)^(-),pH,electrical conductivity(EC)and sodium adsorption ratio.A Principal Component Analysis was performed to individuate the geochemical processes that influenced significantly the evolution of soil salinity and its *** results showed a calcium sulfate(CaSO_(4))facies with a high risk of salinity and a low to medium risk of *** calcite residual alkalinity and generalized residual alkalinity decreased as the solutions became more *** of the samples were oversaturated in carbonate minerals(aragonite,calcite,and dolomite)and under saturated in evaporitic minerals(anhydrite,gypsum,and halite).Finally,two multiple linear regressions(using cations and anions as independent variables)have been proposed to quantify soil *** equations,with an accuracy of 85%,can represent a time and money-saving tool for managers and farmers to estimate the EC,in comparison to the traditional estimation methods.

关键词： Electrical conductivity Cations Anions Soil quality Saturation index PHREEQC

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Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism

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International Journal of Clinical Medicine 2015年第4期6卷 252-256页

作者： Madiha Mahfoudhi Khaled Khamassi amel Gaieb Battikh Rym Lahiani Turki Sami Mamia ben Salah Department of Internal Medicine A Charles Nicolle Hospital Tunis Tunisia Department of Oto-Rhino-Laryngology Charles Nicolle Hospital Tunis Tunisia

Brown tumor or localized form of osteitis fibrosa cystic is a focal lesion complicating hyperpara-thyroidism. It’s rarely revelatory of the clinical feature and corresponds to a mass with partly cystic and partly solid areas. A 65-year-old man, followed up for hypertension, complained of a progressive swelling in the left paranasal part of the face lasting for 3 months. Physical examination revealed a left paranasal swelling of 4 cm diameter, with a healthy looking skin. CT facial bones found a round formation of 2 cm involving the left maxilla. He received tumor resection by vestibular pathway. Histological examination showed many giant cells. We then discussed the brown tumor diagnosis. The PTH dosage was high: 645 pg/mL (normal: 15 - 68 pg/mL). The serum calcium was in the superior normal limit (100 mg/dL). Cervical ultrasound revealed a bottom left parathyroid nodule. A lower left parathyroidectomy was performed. Histological results confirmed parathyroid adenoma. Monitoring was marked by a marked decrease of the PTH serum level then a return to normal values, a normocalcemia and no recurrence of the maxillary tumor with Recoil of 14 months. Brown tumor of the maxilla is rare and should be considered even in absence of hypercalcemia.

关键词： Hyperparathyroidism Brown Tumor Maxilla

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Asthma-Like Tracheo-Bronchial Amyloidosis

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Open Journal of Respiratory Diseases 2012年第2期2卷 57-59页

作者： Fatma Chermiti ben Abdallah Hanene Smadhi Ridha Mahouachi amel Chtourou Sofia Taktak Ayda Ayadi Faouzi El Mezni Ali ben Kheder Anatomy-Pathology Department Abderrahmen Mami Hospital Ariana Tunisia Pneumology IV Department Abderrahmen Mami Hospital Ariana Tunisia

Localized bronchial Amyloidosis is an uncommon disease of unknown origin. Clinical signs are not specific. Tracheobronchial symptoms are the most frequent. We report a case of a 31 year-old man complaining of asthma-like dyspnea. Bronchoscopy was performed because of ineffectiveness of antiasthmatic treatment, showed a submucosal infiltration with stenosis of both right and left upper bronchi and a complete stenosis of intermediate troncus. Multiple biopsies were performed and concluded to Amyloidosis of AL type. Oral corticosteroids were indicated with clinical improvement.

关键词： Amyloidosis Biopsy Histology Corticosteroids

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A Mass Shadow on Chest X-Ray in a 40-Year-Old Man: What’s Your Diagnosis?

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Advances in Infectious Diseases 2012年第4期2卷 148-150页

作者： Foued Bellazreg Wissem Hachfi Atef ben Abdelkader Zouhour Hattab Naoufel Kaabia Fathi Bahri amel Letaief Department of Internal Medicine and Infectious Diseases Farhat Hached Hospital Sousse Tunisia Department of Pathology Farhat Hached Hospital Sousse Tunisia

A 40-year-old man presented recurrent cough and bloody sputum for 4 months. Chest X-ray showed a large mass in the right upper lobe. Histopathologic examination of tissue from percutaneous biopsy of the lesion revealed actinomycotic granules and branching filamentous bacteria, and therefore pulmonary actinomycosis was diagnosed. These findings suggest that pulmonary actinomycosis should be included in the differential diagnosis of a mass on a chest X-ray film.

关键词： Actinomycosis Lung Infections Thoracic Neoplasms

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Amyloïdosis Complicating Behcet’s Disease

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Open Journal of Clinical Diagnostics 2016年第3期6卷 42-46页

作者： amel Harzallah Hayet Kaaroud El Jery Mariem Hajji Ikram Mami Rim Goucha Sami Turki Fethi ben Hamida Madiha Mahfoudhi Taieb ben Abdallah Department of Medicine A Charles Nicolle Hospital Tunis Tunisia Faculty of Medicine University of Tunis El Manar Tunis Tunisia Laboratory of Renal Pathology LR00SP01 Charles Nicolle Hospital Tunis Tunisia

Background: Behcet’s disease is a vasculitis affecting several organs. A renal involvement is rarely described. It is most of the time about a renal amyloidosis. Patients and methods: It is a descriptive retrospective study concerning the patients followed in our department for a Behcet’s disease having presented a renal amyloidosis. Results: It is about 4 men with average age of 38.25 years old. The renal involvement was revealed after an average delay of 5.7 years by a nephrotic syndrome in all cases. A renal insufficiency was noted in 3 cases with an average serum creatinine of 587 μmol/l (127 - 1490). The type of the amyloidosis was AA in 2 cases. The treatment contained colchicines in every case. The evolution was marked by the worsening of the renal function leading to end stage renal disease in 3 cases. Death occurred in 1 case and one patient lost to follow up. Discussion: Renal amyloidosis can complicate the evolution of a Behcet’s disease. It occurs generally 1 to 10 years after the beginning of the disease. Once installed, it evolves generally towards the chronic renal insufficiency and can condition the forecast of this affection. Conclusion: Amyloidosis is a rare complication of the Behcet’s disease. Its screening is so desirable to improve the renal prognosis of these patients.

关键词： Amyloidosis Prognosis Behcet’s Disease

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Mortality in Kidney Transplantation

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Open Journal of Nephrology 2015年第2期5卷 25-28页

作者： Karima Boubaker Madiha Mahfoudhi amel Gaieb Battikh Hayet Kaaroud Ezzeddine Abderrahim Taieb ben Abdallah Adel Kheder Department of Internal Medicine A Charles Nicolle Hospital Tunis Tunisia

It’s a retrospective study whose aim was to evaluate the incidence and the mortality in a popula-tion including 329 patients who received first kidney transplants from a living donor in 269 cases and cadaveric donor in 60 cases at Internal Medicine A department between June 1986 and December 2003. Aetiologies of mortality in our kidney transplant recipients were determined. There were 157 males and 75 females having an average age of 30.8 years. After a period of follow-up of 5.64 years, 51 patients (21.98%) died. Aetiologies of mortality were multiple and were known in approximately 98% of cases. Infections were observed in 25 cases. Cancer was observed in 7 cases (13.72%). Patient survival was not affected by gender, donor age or cause of donor death. Infections represent the major cause of mortality in our patients even many years after kidney transplantation. The maximum of death occurred in the 8th year after kidney transplantation.

关键词： Kidney Transplantation Aetiology Mortality

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Left intracardiac thrombosis: An exceptional complication revealing BehCet’s disease

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Open Journal of Internal Medicine 2013年第1期3卷 15-18页

作者： Mounira El Euch ben Fredj Ismail Fatma Rezgui amel Karmani Monia Derbali Fatma Amri Raja Laouani Kechrid Chedia Department of Internal Medicine Sahloul University Hospital Sousa Tunisia

Although cardiac involvement during Behcet syndrome is uncommon and intracardiac thrombosis is exceptional, it concerns the right ventricle much more than the left one. We report an illustrative case of left intracard... 详细信息

关键词： Behcet’s Disease Cardiac Involvement Thrombosis

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