La Tunisie médicale
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La Tunisie médicale · Mar 2011
Case ReportsPersistent omphalomesenteric duct causing small bowel obstruction in children.
Small bowel obstruction is a common surgical emergency and a frequently encountered problem in abdominal surgery, but persistent omphalomesenteric duct as a cause of this condition is an exceptional finding. ⋯ Although persistent omphalomesenteric duct is an extremely infrequent cause of small bowel obstruction in children patients. The practitioner has to think of this etiology in front of every patient without surgical histories presenting an occlusive syndrome to avoid the complications: occlusion and hemorrhage.
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La Tunisie médicale · Feb 2011
Review[Management of the first hour of the pediatric septic shock patient].
The pediatric septic shock mortality in Tunisia remains high (50%) and was markedly higher than in western countries (10%). The decrease in septic shock mortality has been obtained with the advent of the early goal directed therapy. ⋯ Septic shock must be rapidly suspected and early recognized. Adequate oxygenation and prompt correction of hemodynamic derangements has been shown to improve outcome through aggressive volume resuscitation, early empiric antibiotherapy and early initiation of vasopressor agents. Frequent reassessment has been emphasized to ensure appropriate management. This treatment must take into consideration the resources available in our area. We can reasonably hope to decrease mortality of patients with septic shock if the first line physicians keep in mind specific therapeutic goals.
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Acute generalized exanthematous pustulosis (AGEP) is an uncommon but severe dermatosis, characterized by acute occurrence of fever, and erythemato-oedematous rash, covered by sterile nonfollicular pustules. Most cases of AGEP have been described in association with the intake of drugs. ⋯ AGEP is a cutaneous side effect not to ignore, because of its severe prognosis in case of systemic involvement and the possibility of relapses in case of retake of the causal drug.
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La Tunisie médicale · Jun 2010
Case Reports[Nephrogenic ascites: an exceptional diagnosis. About one case].
Nephrogenic ascites is a clinical entity that manifests as refractory and exsudative ascites with unknown etiology in patients with end stage renal disease and often undergoing hemodialysis. This entity presents in practice many diagnostic and therapeutic difficulties. ⋯ We conclude that nephrogenic ascites is rare. Its diagnosis is an exclusion diagnosis based on exclusion of other causes of ascites, particularly exsudative forms with low leucocytes rate. Its management is based essentially on renal transplantation and its prognosis is very poor.