[Comparative study of C-reactive protein and procalcitonin in the severity diagnosis of pyelonephritis in children]. / Étude comparative de la protéine C-réactive et de la procalcitonine dans le diagnostic de sévérité des pyélonéphrites aiguës de l'enfant.

OBJECTIVE: The aim of this study is to compare two biologic parameters; C-reactive protein (CRP) and procalcitonin (PCT) in the detection of acute renal lesions assessed by DMSA scintigraphy in the urinary tract infection in child. DESIGN: In a prospective study, serum PCT, CRP and leukocyte counts were measured for children admitted, between January and December 2010, with a first episode of febrile urinary tract infection. RESULTS: Seventy-five children were enrolled in the study. Thirty-three patients had renal lesions (group A) and 42 had a normal DMSA scintigraphy (group B). The mean PCT level was significantly higher in group A than in group B (8.81 ng/mL versus 1.7 ng/mL, P=0.01). In this study, using receiver operating characteristic (ROC) curve, we identified that the optimal cut-off value with ideal sensitivity and specificity for PCT in detection of renal lesions was 0.76 ng/mL and for CRP, it was 70 mg/L. The sensitivity, the negative predictive value and the indice of Youden of the cut-off value of PCT were significantly higher than CRP (82% versus 70%; 84% versus 70% and 0.58 versus 0.25). CONCLUSIONS: This study confirmed that the serum PCT level was more sensitive and specific than the CRP in the detection of renal lesions in the first urinary tract infection in child.

Tracking of lipids in schoolchildren: a four-year followup, population-based study in Sousse (Tunisia).

OBJECTIVE: Dyslipidaemia, which is now seen as one of the most important cardiovascular risk factors, is becoming more common in the younger population. The aim of this study was to assess the efficacy of tracking serum lipid levels over a four-year period in an urban population of schoolchildren. METHODS: The study began in 1999 with a cohort of 789 schoolchildren. Four years later this group was resurveyed and a further 452 adolescent were recruited to the study. RESULTS: The percentages of boys who were initially in the extreme quartile for total cholesterol (TC), low-density lipoprotein (LDL) cholesterol and triglycerides were 42.5, 54.8 and 40.4%, respectively. Similarly, the percentages of girls in the extreme quartile were 62.7, 53.8 and 38.2%. Four years later, both the boys and girls were still in the extreme quartile for these parameters. Therefore, the best predictor of followup level for each of the serum lipoprotein cholesterol fractions was the corresponding baseline level. Interestingly, the next best predictor in most of the groups was change in body mass index (DeltaBMI) and smoking status. CONCLUSION: Prevention of coronary heart diseases in adults must begin early on in childhood, and should be driven by health education towards achieving a healthy lifestyle.

Epidemiology of dyslipidemia among schoolchildren in Sousse, Tunisia.

In Tunisia, there is no available data on the CVD risk profile in the children population, although it is well known that risk factor development takes place during childhood. We undertook an epidemiological survey based on a representative sample of 1569 urban school children of Sousse in Tunisia to assess the prevalence of hypercholesterolemia and other lipid disorders. Prevalence of hypercholesterolemia (8.1%), high level of LDL-cholesterol (3.9%), high level of Lp(a) (14.5%), hypertriglyceridemia (1.3%) and hyper Apo B (3.4%) were found. These informations will be useful to set up a regional program of Heart Health promotion in schools.

Epidemiology of cardiovascular risk factors among schoolchildren in Sousse, Tunisia.

BACKGROUND: In Tunisia, where the epidemiological transition phenomenon is well established, there are no data available at the population level on the cardiovascular disease (CVD) risk profile for children, although it is well known that risk factor development takes place in childhood. METHODS: We report an epidemiological survey based on a representative sample of 1569 urban schoolchildren of Sousse in Tunisia to assess the following CVD risk factors: hypertension, hypercholesterolaemia and other lipid disorders, obesity and tobacco consumption. RESULTS: The main results showed that girls had significantly higher levels of body mass index (BMI), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol than boys, who however had significantly higher levels of systolic blood pressure (SBP). Total cholesterol was significantly correlated to BMI and decreased with age. Obesity (BMI = 27) was found in 7.9% of the study population and was significantly higher for girls (9.7%) than for boys (6%): chi 2 = 9.02, DF = 2, P = 0.011. Overweight (BMI = 25) was also significantly higher for girls (16%) than for boys (11.1%): chi 2 = 8.21, DF = 1, P = 0.0041. Smoking habit concerned 7.6% of the study population; it was significantly higher for boys (14.7%) than for girls (1.1%): chi 2 = 103.4, DF = 1, P < 0.00001. CONCLUSION: This study showed to some extent that Tunisia's urban population of schoolchildren is exposed early to CVD risk factors and all should be done to avoid the worsening of this profile. These results will serve as a baseline for assessment of future trends in the risk factors studied.

[Risk factors in cardiovascular diseases in a semi-urban community of the Tunisian Sahel]. / Facteurs de risque des maladies cardiovasculaires dans une communauté semiurbaine du Sahel Tunisien.

Cardiovascular diseases are the leading cause of mortality in the western countries at the same time they are beginning to appear with increasing frequency in developing countries. An epidemiologic study was carried out at Kalaa Kebira (Sousse-Tunisia) to determine the prevalence of the different risk factors of cardiovascular diseases. The study was performed on a representative sample of 555 adults of 20 years and more (response rate of 76%). There was a high proportion of adult males smokers (66%). The prevalence of hypertension varied from 15% to 25%, those of diabetes was 6.5%. An hypercholesterolemia greater than 6.2 mmole/l was observed for 12% of the sample and obesity for 20%.

Iodinated contrast agents: effect on acetylcholine hydrolase. In vitro study.

Several conventional and new contrast media were studied in vitro in order to evaluate their effects on acetylcholine hydrolase. Iohexol proved to be the most potent inhibitor of cholinesterase; all other conventional ionic agents are not inhibitors or they are weak inhibitors at the concentrations that are apparently achieved locally in clinical practice. The full clinical significance of the relationship between cholinesterase inhibition in vitro and contrast media toxicity must be reviewed.