Serum uric acid level and cardiovascular risks in hemodialysis patients: an Algerian cohort study.

BACKGROUND: Elevated serum uric acid (SUA) was usually associated with an increased risk of cardiovascular events and mortality in the general population. However, there are few reports concerning the clinical impact and the pathogenic role of uric acid (UA) in hemodialysis (HD) patients. The aim of the study was to investigate the relationship between SUA and various cardiovascular (CV) risk factors in HD patients. METHODS: This retrospective, observational cohort study includes 45 HD patients with a mean age of 51.26 +/- 15.21 years. The differences of the CV risk factors between the patients according to their SUA levels were investigated. RESULTS: Age, cardiovascular diseases (CVD), increased creatinine, fasting blood glucose (FBG), corrected calcium (cCa), phosphate (P), cCa x P product, and LDL cholesterol levels were associated with lower SUA levels, whereas a higher SUA level was associated with diabetes mellitus (DM), hypertension, and increased triglycerides level (p < 0.01). In multiple regression analysis, history of diabetes (beta = 0.360, p < 0.05), reduced corrected serum calcium (cCa) (beta = -1.456, p < 0.01), and phosphate (P) levels (beta = -1.752, p < 0.01) were predictive of an increased SUA concentration. CONCLUSIONS: Despite what has been demonstrated in the general population and DM patients, a lower SUA level in HD patients was associated with higher cardiovascular risk factors and high co-morbidity burden. Moreover, higher SUA concentrations may be cardioprotective in dialysis patients.

Knee brown tumor revealing a primary hyperparathyroidism: a case report.

Primary hyperparathyroidism is a common endocrine disorder, asymptomatic and diagnosed through a fortuitous hypercalcemia. Brown tumors are exceptional but severe hyperparathyroidism bone complications. We report in this paper an original observation of hyperparathyroidism due to a parathyroid adenoma presenting as a brown tumor. A 28 year-old girl admitted for a bone tumor of the knee, the blood test shows hypercalcemia with hyperparathyroidism, bone biopsy revealed giant cell lesions characteristic of brown tumors.

[Propionibacterium avidum cutaneous abscess in a young immunocompetent]. / Abcès cutané à Propionibacterium avidum chez un jeune immunocompétent.

Severe infections by Propionibacterium avidum are rare, we report a case of abscess of the root of the thigh in a young immunocompetent adult with no risk factor for infection with Propionibacterium sp. The liquid of abscess pus was inoculated immediately on culture media enriched and incubated under an atmosphere 5 to 10% CO2. The isolated strain was identified by API Coryne gallery (bioMérieux, Marcy l'étoile, France). An MIC of ciprofloxacin was performed by E-test (bioMérieux Marcy l'étoile). Cultivation led to the isolation after 3 days of incubation of pure and abundant culture of Propionibacterium avidum. To our knowledge, this is only the third documented case of infection by this organism in immunocompetent patient without iatrogenic risk. Thus, further studies on the pathogenicity of P. avidum are more than necessary.

[Campylobacter fetus bacteremia complicating a dysenteric syndrome in a young epileptic]. / Bactériémie à Campylobacter fetus compliquant un syndrome dysentérique chez un jeune épileptique.

Campylobacter fetus bacteremia is rare and occurs mainly in elderly and immunosuppressed patients. We report an original observation of C. fetus bacteremia complicating acute mucoid diarrhea in a young epileptic with no known risk factors. Our observation suggests that antiepileptic treatment could increase the risk of blood-borne of C. fetus infection.

[Antibiotic resistance of strains isolated from community acquired urinary tract infections between 2007 and 2011 in Guelma (Algeria)]. / Résistance aux antibiotiques de souches isolées d'infections urinaires communautaires entre 2007 et 2011 à Guelma (Algérie).

Urinary tract infections are a real public health problem. They are a frequent reason for consultation as they entail a significant and sometimes inappropriate prescription of antibiotics. This is a retrospective study which involved 1,334 patients between October 2007 and February 2011. Enterobacteriaceae accounted for 85% of isolated bacteria, predominantly Escherichia coli (60%). Gram-positive bacteria account for only 11%. The highest rate of acquired resistance of Escherichia coli was observed with ampicillin (70%). This study give an idea on the rates of antibiotic resistance of the main bacteria involved in urinary tract infections and illustrate the importance of the proper use of antibiotics coupled to surveillance in order to control the spread of these resistances.

Acute myocardial infarction revealing a polycythemia vera.

The occurrence of myocardial infarction in myeloproliferative disease is mostly attributed to coronary thrombosis due to hyperviscosity and thrombocytosis. We report a 55-year-old man case with polycythemia vera none diagnosed before and revealing with ST-segment elevation myocardial infarction; this is a relative rare association. The clinical status, comorbidities and patient outcome were studied. This case illustrates the importance of early diagnosis of polycythemia vera and research almost systemic thrombotic complications.