Arterial hypertension (HT) is common in renal transplant recipients (RTRs) and it is reported to occur from 50% to 80 % of cases. We report here the prevalence of HT in RTRs in our kidney transplantation center and it's predictive factors. Methods: Our study is about 78 RTRs from a living kidney donor in 97.5 % of cases in our kidney transplantation department from 2011 to 2018. Our report is about 78 KTR in one KT department (La Rabta Hospital Tunis Tunisia) from 2011 to 2018. We study here the prevalence of HT in KTR in our KT department. We performed a comparative study of 2 groups (HT recipients and normotensive recipients) in order to determine predictive factors for HT in KTR. Results: This study is about 78 KTR from a living kidney donor in 97.5 % of cases and deceased donor in 2,5 % of cases and it is about 51 males and 27 females with a mean age of 34AE7 years old. After KT, HT was noted in 46 patients (59.7 %) and 32 patients were normotensive (41%). Among normotensive patients, we noted that 6 patients (18%) had HT before KT which disappeared after KT. Among HT patients, HT was not controlled in 22% of cases (based on target blood pressure levels # 130/80 mm Hg). All these patients had at least 2 or 3 anti-hypertensive medications. In our report of 78 KTR, some factors were noted: dyslipidaemia in 2% of cases, obesity and overweight in 24% of cases and donor HT in 4 % of cases. Delayed graft function was noted in 6 cases (8%) and immunosuppressive therapy was based on steroids in all cases (Prednisone 10 mg/day reached at the first month and maintained for all patients), ciclosporin in 14 patients (18%), sirolimus in 10 patients (12%) and tacrolimus in 70 % of cases. Our comparative study showed that many factors can be predictive of HT after KT such as HT before KT, diabetes, tabaco, delayed graft function, creatinine at 1 year after KT > 1.5 mg/dl, immunosuppressive medicament such ciclosporin use and donor factors (age donor > 50 years old). All these correlations are statistically significant. Conclusions: Our data show that HT had a high prevalence in kidney recipient (59.7%). Our comparative study showed that many factors can be significantly predictive of HT after KT such as HT before KT, diabetes, tabaco, delayed graft function, creatinine at 1 year after KT > 1.5 mg/dl, immunosuppressive medicament such ciclosporin use and donor factors (age donor > 50 years old). Most of these factors are reported by authors to be HT predictive factors in KTR. Some of these factors can be prevented in KTR in order to control HT prevalence after KT to reduce cardio-vascular mortality and to improve graft survival.
Langerhans cell histiocytosis (LCH) is a proliferative histiocytic disorder relativily rare in the perdiatric group. This complex disease has no specific clinical or radiographic presentation. The scapula is one of the rarest site of LCH. Imaging and specially MRI are particularly helpful for characterizing the lesion and delineating the local and systemic extent. In this report, we present a rare case of Langerhans cell histiocytosis of the scapula in a 07 month-old baby.
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