[Dyslipidemia and suicidal risk in patients with psychiatric disorders]. / Dyslipidémie et risque suicidaire chez des patients avec maladies psychiatriques.

The aim of this work is to study the association between dyslipidemia and suicidal risk in patients with psychiatric pathology. Our study has involved 155 patients suffering from major depressive disorder and 124 schizophrenic patients aged 40.58±12.16 and 43.43±10.60 years, respectively. Total cholesterol (TC), triglycerides (TG) and HDL-c were determined by enzymatic methods, LDL-c was calculated by the Friedewald formula. Plasma cholesterol level was significantly lower among suicidal schizophrenic or depressive patients. There were no significant differences in the others lipid levels. The results of our study suggest that total cholesterol values less than 3.59mmol/L could be an indicator of suicide vulnerability in patients with schizophrenia or major depressive disorder.

Is low total cholesterol levels associated with suicide attempt in depressive patients?

BACKGROUND: Patients with major depressive disorder (MDD) have a high risk of suicide. Many pathophysiological factors involved in MDD and suicide such us a low cholesterol levels have been associated with MDD and increased vulnerability to suicide. In this study, we investigate the relation between lipid parameters and suicide risk in patients with MDD. METHODS: Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were determined in 160 patients meeting the DSM-IV-TR criteria for MDD (110 patients without suicidal behavior and 52 suicidal attempters) and 151 healthy controls. RESULTS: A significant decrease in plasma cholesterol levels was observed in the group of suicidal depressive patients compared to those without suicidal behavior (p < 0.001). For the other lipid levels (triglycerides, HDL cholesterol, and LDL cholesterol), there were no significant differences between suicidal and non-suicidal patients. CONCLUSIONS: Our study showed a significant decrease in plasma cholesterol levels in suicidal patients. This result support the hypothesis of the association of low plasma cholesterol level and suicidal behavior in patients with major depressive disorder.

Effect of cigarette smoking on insulin resistance risk.

OBJECTIVES: Smoking is one of the main risk factors for cardiovascular disease (CVD). The mechanism(s) of the effects of smoking on CVD are not clearly understood; however, a number of atherogenic characteristics, such as insulin resistance have been reported. We aim to investigate the effects of cigarette smoking on insulin resistance and to determine the correlation between this parameter with smoking status characteristics. STUDY DESIGN: This study was conducted on 138 non-smokers and 162 smokers aged respectively 35.6±16.0 and 38.5±21.9 years. All subjects are not diabetic. METHODS: Fasting glucose was determined by enzymatic methods and insulin by chemiluminescence method. Insulin resistance (IR) was estimated using the Homeostasis Model of Assessment equation: HOMA-IR=[fasting insulin (mU/L)×fasting glucose (mmol/L)]/22.5. IR was defined as the upper quartile of HOMA-IR. Values above 2.5 were taken as abnormal and reflect insulin resistance. RESULTS: Compared to non-smokers, smokers had significantly higher levels of fasting glucose, fasting insulin and HOMA-IR index. These associations remained significant after adjustment for confounding factors (age, gender, BMI and alcohol consumption). A statistically significant association was noted between the smoking status parameters, including both the number of cigarettes smoked/day and the duration of smoking, and fasting insulin levels as well for HOMA-IR index. Among smokers, we noted a positive correlation between HOMA-IR index and both plasma thiocyanates and urinary cotinine. CONCLUSION: Our results show that smokers have a high risk to developing an insulin resistance and hyperinsulinemia, compared with a matched group of non-smokers, and may help to explain the high risk of cardiovascular diseases in smokers.

[Is PON1 a factor of cardiovascular risk in type 2 diabetes?]. / La PON1 est-elle un facteur du risque cardiovasculaire chez les diabétiques de type 2 ?

OBJECTIVE: We evaluate the association between the decrease of serum paraxonase 1 activity and the risk of cardiovascular disease in type 2 diabetes. METHODS: One hundred and fourteen patients with type 2 diabetes were included in the present study. Seventy-one of them have significant coronary disease. The control group consisted of 53 healthy adults. RESULTS: PON1 activity was significantly reduced in diabetic patients compared to controls (P=0.021), especially in those with significant coronary disease (P=0.013). No significant variation in PON1 activity according to age was observed both in controls and in patients. When HDLc≥1.03mmol/L, the PON1 activity was significantly higher in patients without significant coronary disease compared to those with significant coronary disease (0.030). In case of significant coronary disease, a decrease of 12.23% in PON1 activity was observed in smokers compared with non-smokers, but without statistical significance. The PON1 activity did not very significantly according to the presence or absence of hypertension in patients with significant coronary disease. CONCLUSION: The implication of diabetes in the decrease of PON1 activity seems highly probable but PON1 activity seems not to be in itself a marker of cardiovascular disease.

Zearalenone-induced changes in biochemical parameters, oxidative stress and apoptosis in cardiac tissue: Protective role of crocin.

Zearalenone (ZEN) is a mycotoxin from Fusarium species commonly found in food commodities and is known to cause reproductive disorders. Several in vivo studies have shown that ZEN is haematotoxic and hepatotoxic and causes several alterations of immunological parameters. Meantime, the available information on the cardiotoxic effects of ZEN is very much limited. In the present study, we investigated the toxic effects of ZEN in heart tissues of Balb/c mice. We demonstrated that ZEN (40 mg kg(-1) body weight (b.w.)) increased creatine phosphokinase, lactate dehydrogenase, aspartate transaminase, alanine transaminase, total cholesterol and triglyceride levels and induced oxidative stress as monitored by measuring the malondialdehyde level, the generation of protein carbonyls, the catalase and superoxide dismutase activity and the expression of the heat shock proteins (Hsp 70). We also demonstrated that acute administration of ZEN triggers apoptosis in cardiac tissue. Furthermore, we aimed to evaluate the safety and efficacy of crocin (CRO), a natural carotenoid, to prevent ZEN-induced cardiotoxicity in mice. In fact, combined treatment of ZEN with different doses of CRO (50, 100, and 250 mg kg(-1) b.w.) showed a significant reduction of ZEN-induced toxicity for all tested markers in a dose-dependent manner. It could be concluded that CRO was effective in the protection against ZEN-induced toxicity in cardiac tissue.

Idiopathic urolithiasis in Tunisian children: a report of 134 cases.

We evaluated the metabolic and the nutritional aspects of 134 urolithiasis children in order to outline the characteristics of idiopathic urolithiasis in children. This prospective study group of 134 children (56 females, 78 males) with renal calculi was evaluated. The age range of the patients was six months to 16 years. A dietary survey was performed on every child. All patients were investigated with respect to stone localization and serum and urine risk factors. Statistical analysis of data was carried out using software SPSS 11.0 for Windows. Hypercalciuria was the most common risk factor detected in this group (28.3%). A decrease of water intake was noted in all age groups, especially in the rural area (549.6 mL/day vs. 1150.6 mL/day), and there was an increase in animal protein intake in 17 cases (mean: 1.9 g/kg). In addition, increased intake of starchy foods and food with high oxalate content (sorgum) were detected in the ten to 16 years age group (51%) of our study. Calcium oxalate monohydrate represents the principal component of idiopathic stone (58.2%), which is more frequent in children (68%) than in infants (51.7%) (P <0.02). The major etiology of idiopathic urolithiasis highlights the influence of dietary habit in stone formers in our country. The increased occurrence of calcium oxalate stones in school age children confirms the change in the etiology of urolithiasis according to age.

[Stone composition in the central coast Tunisian population]. / Étude de la composition des calculs urinaires en fonction de l'âge dans la population du centre tunisien.

BACKGROUND: Studies that evaluated the effect of age and gender on the stone composition were scarce. The aim of this study was to identify the stone composition in Tunisian patients and to highlight their modification according to patients' sex and age. PATIENTS AND METHODS: We studied 1200 urolithiasic patients, from the urologic and the pediatric surgery departments, ranging from six months to 92years old and known as having urinary stones (729 males and 471 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and the molecular composition of each. RESULTS: Kidney stones were encountered in 48.6% of calculi. Children and old men were more affected by bladder stone. Whewellite was the main component in 51.8% of the stones and 39.6% of the stone core, its frequency fell according to age from 61.4% in young adults to 47.7% in elderly in favor of the increase of uric acid stones, from 16.4% in young adults to 35.6% in elderly (P<0,02). Struvite stones were rare (3.2%) and more frequent in boys. CONCLUSION: The analysis of these data shows that urinary stones in Tunisia were tending to evolve in the same direction as in industrialized countries.

Cambios en el tipo de cálculos renales según sexo y edad en pacientes tunecinos / Changes in Kidney Stones Type According to Sex and Age in Tunisian Patients

Objetivos: Los estudios que evalúan el efecto de la edad y el género sobre la composición de las piedras renales son escasos. El objetivo de este estudio es subrayar la modificación de las características epidemiológicas de esta patología de acuerdo con el sexo y la edad de los pacientes. Material y métodos: Estudiamos a 1.269 pacientes con urolitiasis de edades comprendidas entre 6 meses y 92 años y que se conocía que tenían cálculos urinarios (752 varones y 517 mujeres). Se realizó un análisis de las piedras usando un microscopio estereoscópico y espectroscopía infrarroja para determinar respectivamente el tipo morfológico y la composición molecular de cada una. Resultados: La incidencia anual promedio de formación de nuevas piedras fue de 30,25 por cada 100.000 personas. En 1.041 pacientes (el 81%) los cálculos estuvieron localizados en el tracto urinario superior. Los niños y ancianos fueron más afectados por piedras en la vejiga. El monohidrato de oxalato de calcio sigue siendo el componente más frecuente de los cálculos, a pesar de que su frecuencia caía en relación con la edad (63,2% en adolescentes y 40,6% en ancianos [p<0,05]). Las piedras de estruvita fueron raras (3,5%) y más frecuentes en niños. Conclusión: El análisis de estos datos muestra que los cálculos urinarios en Túnez tienden a evolucionar en la misma dirección que en países indrustrializados (AU)

Background: Studies that evaluate the effect of age and gender on the stone composition are scarce. The aim of this study is to highlight the modification of epidemiological characteristics of this pathology according to patients’ sex and age. Patients and methods: We studied 1269 urolithiasic patients ranging from 6 months to 92 years old and known as having urinary stones (752 males and 517 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and molecular composition of each. Results: The annual average incidence of new stone formation was 30.25 per 100000 inhabitants. In 1041 patients (81%), calculi were located in the upper urinary tract. Children and old man were more affected by bladder stone. Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell according to age (63.2% in teenagers and 40.6% in elderly [p<0.05]) in favour of the increase of uric acid stones (3,5% in teenagers and 41.5% in elderly [p<0.05]). Struvite stones were rare (3.5%) and more frequent in children. Conclusion: The analysis of these data shows that urinary stones in Tunisia are tending to evolve in the same direction as in industrialized countries (AU)

[Changes in kidney stones type according to sex and age in Tunisian patients]. / Cambios en el tipo de cálculos renales según sexo y edad en pacientes tunecinos.

BACKGROUND: Studies that evaluate the effect of age and gender on the stone composition are scarce. The aim of this study is to highlight the modification of epidemiological characteristics of this pathology according to patients' sex and age. PATIENTS AND METHODS: We studied 1269 urolithiasic patients ranging from 6 months to 92 years old and known as having urinary stones (752 males and 517 females). Stone analysis was performed respectively using a stereomicroscope and infrared spectroscopy to determine, respectively, the morphological type and molecular composition of each. RESULTS: The annual average incidence of new stone formation was 30.25 per 100,000 inhabitants. In 1041 patients (81%), calculi were located in the upper urinary tract. Children and old man were more affected by bladder stone. Calcium oxalate monohydrate remains the most frequent stone component even if its frequency fell according to age (63.2% in teenagers and 40.6% in elderly [p<0.05]) in favour of the increase of uric acid stones (3,5% in teenagers and 41.5% in elderly [p<0.05]). Struvite stones were rare (3.5%) and more frequent in children. CONCLUSION: The analysis of these data shows that urinary stones in Tunisia are tending to evolve in the same direction as in industrialized countries.

[Hyperhomocysteinemia and schizophrenia: case control study]. / Hyperhomocystéinémie et schizophrénie : étude cas-témoin.

OBJECTIVES: Homocysteine (Hcys) is a sulphur-containing amino acid that has been widely investigated for its putative role in neuropsychiatric disorders. Elevated plasma homocysteine levels have been associated with schizophrenia. Among other factors, low folate and vitamin B12 levels have been implicated in the increase in homocysteine. The aim of the study was to determine plasma Hcys, folate and vitamin B12, and the frequency and severity of hyperhomocysteinemia in patients with schizophrenia, and to investigate the association between Hcys and clinical features and its relationship with folate and vitamin B12 levels. METHODS: This was a case-control study carried out on 61 (54 males and seven females, mean age=33.3 ± 9.2) inpatients with chronic schizophrenia according to DSM-IV criteria and 46 (25 males and 21 females, mean age=45.9 ± 14.2) healthy controls. Most of patients (90.2%) were treated by first generation antipsychotics with a mean daily dosage of 401.6 mg chlorpromazine equivalents. Total homocysteine serum levels were determined quantitatively by fluorescence-polarization immunoassay (FPIA) with an AxSYM analyzer™ (Abbott). Quantitative vitamin B12 and folate serum levels were measured with an Elecsys 2010 analyzer™ (Roche Diagnostics). Differences between patients and controls were examined using a two-way Ancova with gender and diagnosis as independent variables, adjusting for age. RESULTS: Patients with schizophrenia showed higher plasma Hycs and lower plasma folate than controls (mean=16.1 µmol/L in patients versus 10.9 µmol/L in controls; P=0.028 for Hycs and 4.2 µg/L in patients versus 8.2 µg/L in controls; P<0.001 for folate). Patients and controls did not differ in vitamin B12 levels. Both male and female patients had increased plasma Hcys compared to controls. Hyperhomocysteinemia (Hcys levels>15 µmol/L) was present in 34.4% of the patients versus 15.2% in controls. The prevalence of moderate hyperhomocysteinemia (Hcys levels: 15-29 µmo/L) was 26.2% and that of intermediate hyperhomocysteinemia (Hcys levels: 30-100 µmol/L) was 8.2%. In patients with schizophrenia, plasma Hcys was not correlated with age (r=0.07; P=0.56), duration of illness (r=-0.04; P=0.78) and did not differ with gender and clinical sub-types. Moreover, plasma Hcys was higher in patients without family history of psychiatric disorders (19.2 µmol/L) versus 12.7 µmol/L in patients with family history of psychiatric disorders (P=0.032). Concerning therapeutic features, plasma Hcys did not differ with type of antipsychotic and was not related to daily dosage of antipsychotics. A negative correlation was found between plasma Hcys and vitamin B12 levels (r=-0.26; P=0.04). CONCLUSION: These results confirm an increase of Hcys levels in schizophrenic patients and suggest that it is associated with absence of family history of psychiatric disorders and with low vitamin B12 levels. Hyperhomocyteinemia could be related to the pathophysiology of aspects of this illness. Homocysteine should be considered as a factor to consider in monitoring and management of patients with schizophrenia.

[Ochronosis: report of two familial cases]. / L'ochronose: a propos de deux cas familiaux.

BACKGROUND: Ochronosis of alkaptonuria is a rare hereditary autosomal recessive disease in which there is an absence of homogentisic acid oxidase resulting in accumulation of homogentisic acid in tissues. AIM: To report a new case of alkaptonuria CASE REPORT: A 49-year-old man had been followed for 4 years for chronic lombalgia and arthropaty of two knees. He is married to his cousin and father of 4 girls. His parents are also cousins. The clinical examination has found a cutaneuous pigmentation and a lumbar stiffness. At biological checking, creatininemia was at 190 µmol/L and there are not inflammatory indicators. The radiography have shown a discal dorsolumbar calcifications, anterior inter somatic bridges and bilateral arthritis of knees without articular chondrocalcinosis. The diagnosis of ochronosis have been suspected and confirmed by the blackness of urine and the dosage of alkaptonuria. The patient has been treated symptomatiquely. Familial investigation have revealed that his daughter suffered from the same disease with the notion of blackness of urine. She is 12 year old and she's asymptomatic on the osteoarticular level. CONCLUSION: Alkaptonuria causes a degenerative arthropaty which can endanger functional prognosis. Early diagnosis and scanning of this innate error of metabolism by genetic study play a fundamental interest, especially for molecular and genetic advisement.

Accumulation of mercury and its effects on testicular functions in rats intoxicated orally by methylmercury.

All forms of mercury are considered poisonous. Methylmercury, one organic form, is highly toxic to many organs. The aim of the present study was to assess the effects of this form on the reproductive system in the rat. For this, 20 male rats were divided into two groups. One, which is considered as reference, received tap water. The second group received tap water containing methylmercury at the rate of 20 mg l⁻¹ for 8 weeks. At the end of the experiment, blood samples were collected for the determination of total mercury and plasma testosterone. The left testes were used for the determination of total mercury and histological examination. Appropriate centrifugation was applied on right testes to extract interstitial and seminiferous tubular fluids. The epididymides were homogenised for the sperm count. Our results showed a dramatic fall in the plasma testosterone in the contaminated animals. The fall in plasmatic testosterone seems to be in relation with the decrease in the secretion of testosterone. In association with this, the concentration of testosterone in seminiferous tubules fluid dropped about 55% in the poisoned animals in comparison with the controls. Despite this, no decrease in the epididymal sperm count in contaminated rats was observed.

Metabolic syndrome in Tunisian bipolar I patients.

BACKGROUND: The metabolic syndrome is a growing global public health problem which is frequently associated with psychiatric illness. OBJECTIVES: To evaluate the prevalence of metabolic syndrome and to study its profile in Tunisian bipolar I patients. METHODS: Our study included 130 patients with bipolar I disorder diagnosed according to the DSM-IV and assessed for metabolic syndrome according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III modified criteria. The mean age was 37.9 ± 12.1 years, 45 were women (mean age 37.5 ± 13.4 years) and 85 were men (mean age 38.1 ± 11.4 years). RESULTS: The prevalence of metabolic syndrome was 26.1%.The highest prevalence of this syndrome was obtained by association between obesity, low c-HDL and hypertriglyceridemia (44.1%). In the total sample, 59.2% met the criteria for low c-HDL, 53.1% for hypertriglyceridemia, 33.8% for obesity, 16.1% for high fasting glucose and 5.4% for hypertension. Gender, age, illness episode and treatment were not significantly associated with metabolic syndrome, while patients under lithium had higher prevalence of metabolic syndrome than those under valproic acid, carbamazepine or antipsychotics. Patients with metabolic syndrome had significant higher levels of HOMA-IR and uric acid than metabolic syndrome free patients (p< 0.001). CONCLUSIONS: Bipolar patients have high prevalence of metabolic syndrome which is associated with insulin resistance and an increase of uric acid values that raise the risk of cardiovascular disease.

False bisalbuminemia and hyperalphafetoproteinemia.

The capillary electrophoresis is a very powerful separation method offering a high degree of resolution. However, certain interferences can be detected giving transitory shoulders or peaks. We report the case of a serum protein electrophoresis performed with Capillarys (Sebia) in a 68-year-old patient, hospitalized for cancer of the head of the pancreas, which showed an important shoulder in the migratory range of albumin, simulating bisalbuminemia. An interference with alphafetoprotein was proven explaining this electrophoretic aspect.

Pediatric urolithiasis in the central coast of Tunisia: Epidemiologic changes over the past twenty-five years.

The incidence of pediatric urolithiasis has been constantly decreasing during the past twenty-four years (1982-2007) in Tunisia as well as in other Mediterranean countries. This study was undertaken to observe the incidence of stone disease and its composition in children. Our study shows a downward trend of incidence of urolithiasis in pediatric patients over the last 25 years. The prevalence of calcium oxalate stones has constantly increased with decrease in the stones related to infections Whewellite (calcium oxalate) was more frequent in children of school age. In conclusion, the decrease in struvite frequency in children patients during the past twenty-five years and the stabilization of calcium phosphate stones are the result of a significant improvement of diagnostics and the treatment of urinary tract infections in the young children in our country.

Changes in stone composition according to age and gender in Tunisian children.

OBJECTIVE: Studies evaluating the influence of age and gender on the distribution of the various types of pediatric urinary calculi are scarce. The aim of this study was to highlight the modification of epidemiological characteristics of this pathology according to patients' sex and age. PATIENTS AND METHODS: A total of 205 calculi (from 122 boys and 83 girls) were analyzed by infrared spectroscopy between 1993 and 2007; 54.6% of the patients were under 5 years. RESULTS: Calcium oxalate was the predominant constituent in 54.7% of stones, followed by calcium phosphate and purines (14.6% each). We found a predominance of calcium oxalate in females (59.1% vs 50.8%), and a male preponderance for struvite stones (12.3% vs 1.2%). There was an increasing prevalence of calcium oxalate stones with age in both genders (42.9% in infants vs 59.3% in older children). Purine stones were predominant in 20% of cases, but prevalence decreased with age (28.6% in infants vs 18.5% in older children). CONCLUSION: The increase in calcium oxalate stones in school-age children and the decrease in stones containing purines confirm a change in the etiology of urolithiasis according to age.

[Complex metabolic disorders revealing a gastric ulcer of the bulb. A case report]. / Troubles métaboliques complexes révélateurs d'un ulcère gastrique sténosant du bulbe. A propos d'un cas.

We report the case of a 54-year-old man, without particular pathological antecedents admitted to the emergency of the university hospital of Monastir, for right renal colic. Radiography of the urinary tract without preparation and renal echography showed bilateral renal lithiasis and a right ureteral lithiasis. The interrogation revealed concept of vomiting after which the patient felt relieved. The biological assessment objectified an hypochloremic metabolic alcalosis, an increase in the anion gap, a severe impaired renal function of obstructive origin and an hypokaliemia. The presence of the lithiasis did not explain on its own the metabolic disorders of this patient. The other investigations showed that initial pathology was an evolutionary bulb ulcer into pre-stenosis justifying treatment by omeprazole and explaining the biological disorders.

[Prevalence and composition of urolithiasis in a pediatric Tunisian population]. / Prévalence et composition de la lithiase urinaire dans une population pédiatrique tunisienne.

OBJECTIVES: The epidemiologic characteristics are significant to take into account in order to determine the etiology of the paediatric urinary calculi. In this study we studied the composition of stones according to the sex and the age. PATIENTS AND METHODS: Our study focuses on 205 tunisian children aged between three months and 16 years, admitted in our service between 1993-2007. A first urinary metabolic balance was conducted among 126 patients. The physical and chemical stones analysis was performed respectively by a stereomicroscope and infrared spectroscopy. Statistical analysis of the results was made using the software SPSS11.0. RESULTS: Bladder stone was present in 30.7%. It was more frequent in infants than children over 10 years (p<0.02). The Whewellite was present in 72.7% and predominant in older children stones (59.3% vs 42.9% in infants) (p<0.05). Purines stones were more common among infants. Struvite has been the major compound in only 7.8% of cases where it was more common in infants (p<0.05) male (p<0001). CONCLUSION: The higher prevalence of calcium oxalate stones and weaker purin ones in old children suggested the presence of different lithogenous factors of risk according to the age. A modification of the food practices is probably in question.

[Primary distal renal tubular acidosis]. / Acidose tubulaire rénale distale primitive.

Renal tubular acidosis are forms of metabolic acidosis characterized by an impairment of urinary acidification due to a lack of urine excretion of protons or loss of bicarbonates. Primary distal renal acidosis (dRTA) is characterized by hyperchloremic metabolic acidosis due to failure in proton excretion, variably severe nephrocalcinosis and/or nephrolithiasis associated with hypercalciuria and hypocitraturia. When the metabolic acidosis is compensated, dRTA can be diagnosed by the failure of urinary acidification after oral ammonium chloride or furosemide administration. dRTA is inherited as either an autosomal dominant or autosomal recessive trait. An autosomal dominant form results from a SLC4A1 gene mutation leading to dysfunction of the anionic exchanger type 1 (AE1). Otherwise, recessive forms are due to mutations of ATP6V1B1 gene encoding the B1-subunit of H+-ATPase expressed in the apical membrane of the alpha intercalated cells in collecting duct and in the cochlea. Those mutations lead to dRTA accompanied by sensorineural deafness. Also, mutations in ATP6V0A4 gene encode the accessory subunit a4 of the H+ATPase, leading to recessive forms of dRTA with preserved hearing or delayed signs of deafness. Molecular approach can identify mutations which are responsible for this pathology. The medical treatment is simple and involves an alkali load which allows curing the metabolic acidosis. Long-term outcome is usually good unless the patient's compliance is low or alkalizing treatment is insufficient.

[A case of hypernatremic dehydration due to breast-feeding]. / Déshydratation hypernatrémique au cours d'un allaitement maternel.

The authors report an 11-day-old exclusively breast-fed female, with a birth weight of 3 300 g, who had suffered from dehydration stage I, with acute renal failure and metabolic acidosis, with 170 mmol/L of serum sodium. Renal ultrasounds were normal but the rate of sodium in mother's milk was three times higher than controls (87 versus 21 mmol/L). Intravenous rehydration allowed the correction of hydroelectrolytic disorders.