Bøger af Meriam Khadhar

Vwedenie: Tuberkulez qwlqetsq odnoj iz osnownyh problem obschestwennogo zdrawoohraneniq w razwiwaüschihsq stranah. Ego rasprostranennost' w 12-26 raz wyshe u pacientow na dialize, chem w obschej populqcii. Diagnostika chasto zatrudnena iz-za otsutstwiq specificheskih simptomow i powyshennoj chastoty wnelegochnyh form, chto priwodit k zaderzhke w postanowke diagnoza i osobenno w lechenii. Cel'ü nashej raboty bylo wyqwlenie klinicheskih i terapewticheskih osobennostej tuberkuleza u bol'nyh hronicheskim dializom za dewqtiletnij period. V nashe issledowanie byl wklüchen 41 pacient. Diagnoz byl postawlen na osnowanii klinicheskih, bakteriologicheskih i gistologicheskih dannyh. Otmechalas' äwolüciq zabolewaniq w processe lecheniq, a takzhe pobochnye äffekty protiwotuberkuleznoj terapii. Proqwleniq tuberkuleza u pacientow na dialize nespecifichny. Jeti atipichnye osobennosti zaderzhiwaüt klinicheskij diagnoz, a takzhe nachalo lecheniq, wliqq na razwitie i prognoz.

Polyomavirus nephritis (PVAN) is one of the most common viral complications in renal transplantation. It is in more than 97% of cases caused by BK virus in the context of BK virus nephritis and in less than 2% caused by JC virus. PVAN leads to graft loss in 30 to 80% of cases. Early diagnosis is therefore necessary to modify the immunosuppressive treatment and avoid graft loss. The diagnosis of PVAN is histological and combines tubulo-interstitial inflammation and a viral cytopathic effect in the form of nuclear inclusions of tubular cells. Tubular cell infection can be highlighted by immunohistochemical evidence of Sv-40 viral antigen expression. PVAN has histologic similarities to acute cellular rejection, but the resulting treatments are diametrically opposed. One requires a decrease in immunosuppression, while the other requires an increase in immunosuppression, so accurate and early diagnosis is a major challenge.

Peritoneal dialysis is one of the methods of extrarenal purification in patients with end-stage renal disease and receiving replacement therapy.In 2015, estimates suggest that 272,000 people are on peritoneal dialysis worldwide about 11% of the dialysis population. Infectious complications are the most feared complications of this technique. There are two main types of infections: infections of the catheter outlet and infections of the dialysis fluid. These peritonitises occur essentially as a result of contamination during handling, or either by continuity following an outlet infection or in relation to a bacterial translocation through the digestive wall.The objective of this work is to evaluate the theoretical knowledge and practical conduct of young Tunisian nephrologists in terms of prevention of infectious complications in order to detect the difficulties encountered and remedy them.

Introduction: Tuberculosis is a major public health problem in developing countries. Its incidence is 12 to 26 times higher in dialysis patients than in the general population. Diagnosis is often difficult because of a non-specific symptomatology and the increased frequency of extra-pulmonary forms leading to a delay in diagnosis and especially in therapeutic management. The aim of our work was to highlight the clinical and therapeutic particularities of tuberculosis in chronic dialysis patients over a nine-year period. Forty-one patients were included in our study. The diagnosis was based on clinical, bacteriological and histological evidence. The evolution of the disease under treatment as well as the adverse effects of the anti-tuberculosis treatment were noted. The manifestations of tuberculosis in dialysis patients are not specific. These atypicalities delay the clinical diagnosis as well as the start of treatment, influencing the evolution and the prognosis.