ABSTRACT
Background: Digital necrosis is a frequent event in vascular pathology. They are multiple etiologies and are the translation of a general or locoregional pathology. The aim of our study was to clarify the various causes of digital necrosis in an internal medicine department
Methods: We conducted a retrospective study of 23 cases of digital necrosis collected in the internal medicine department of the hospital Habib Thameur over a period from January 1998 to April 2011
Results: There were 16 women and 7 men with mean age of 46 years. The cardiovascular risk factors were observed in 39.13% cases. Digital necroses were interested fingers in 73.91% and toes in 30.43% of the cases. The causes were dominated by the connective diseases. The treatment was symptomatic in all cases and etiologic in only two cases
Conclusion: In internal medicine, the causes are dominated by connectivites. The prognosis is especially functional. It remains unfavorable in spite of the improvement of the therapeutic and etiologic care
ABSTRACT
Takayasu's disease is a chronic inflammatory arteritis involving large vessels in young women. To assess the clinical, laboratory, and radiological features and course of Takayasu arteritis in Tunisia. This retrospective study analyzed 11 patients with Takayasu arteritis between 1999 and 2010 who met the criteria for inclusion proposed by the American College of Rheumatology [ACR]. The file review identified 11 women, with a mean age at diagnosis of 29.1 years [range: 17-50 years]. Our series included involvement of the aortic arch and its branches in 8 cases, while only 3 cases of the abdominal aorta. Arterial hypertension due to stenosis of the renal arteries was noted in 4 cases. Aortic insufficiency and pulmonary hypertension were noted in one case. In all, 3 patients had type I disease, 3 type V and one type IV. In all, 4 patients had glucocorticoid treatment, and one needed immunosuppressive therapy. Three patients required surgical intervention. Our patients were followed for a mean period of 67.5 months. Disease remained stable in all patients. Despite the small number of our patients, the clinical manifestations, angiographic data and course in our study were similar to those in other reported series
ABSTRACT
The occurrence of rheumatoid arthritis [RA] in elderly is frequent. If the reality of a real difference in clinical presentation between younger and older subjects is discussed, the central point remains that the prognosis is not better for the elderly. Finally, conventional treatment is as effective and safe as in younger patients, and the same stringent targets for management of the PR used for young subjects must be applied in the elderly. To identify the characteristics of RA in the elderly in its epidemiological, clinical, radiological, evolutive and therapeutic. We conducted a retrospective study of RA in the elderly aged 65 and over, we've compiled ten cases hospitalized over a period of 4 1/2 years in the service of Internal Medicine, Habib Thameur Hospital [Tunis]. There were 8 women and 2 men. The average age was 70.6 years. The onset of arthritis and the disease was progressive in seven cases. An inflammatory syndrome was present in seven cases. Rheumatoid factor was positive in eight cases. Five patients were classified as stage III and IV according to the radiological classification of Steinbrocker. The treatment was based on painkillers and anti-inflammatory drugs in all cases. Long-term treatment was initiated in seven patients. The outcome was favorable in all cases. Late-onset RA is a heterogeneous framework in which multiple clinical forms deserve to be individualized and should reflect this diversity, rather than approach to the problem of global RA after 60 years