ABSTRACT
Corticosteroids are widely prescribed products in the elderly particularly in systemic diseases. Corticosteroids were indispensable in controlling a variety of disease states. Various complications associated with this drug class warrant caution and monitoring with each formulation especially with old population. To evaluate the frequency and type of side effects and complications of long-term corticosteroid therapy in the elderly. We conducted a retrospective study of 23 patients aged 65 and older hospitalized in the internal medicine department of the Habib Thameur hospital during January 2000 to December 2004. Corticoid adverse effects were recorded throughout the follow up period. There are 20 women and 3 men aged 66 to 87 years with a mean age of 75.7 years. The diagnoses were 8 cases of temporal arteritis, 7 cases of rheumatoid arthritis, 3 cases of multiple myeloma, 2 scleroderma, 1 case of systemic lupus erythematosus, 1 case of retroperitoneal fibrosis and 1 case of psoriatic arthritis. We selected 66 complications. Infectious complications were found in 26 cases [39.3%], 11 cases [16.7%] of iatrogenic diabetes, arterial hypertension in 9 cases [13%], skeletal complications in both cases, psychiatric complications in two cases, ophthalmologic complications in one case. Despite lifestyle rules and adjunctive therapy, complications seem to be frequent. To minimize the disadvantages of prolonged corticosteroid treatment, regular monitoring and careful screening is imperative for the support and time
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
ABSTRACT
The association cancer and venous thrombosis is almost always an independent criterion of poor prognosis of cancer. Thus, venous thromboembolic disease is with infection and organ failure, one of the leading causes of death in patients with malignant disease. To identify the characteristics of the association between cancer and venous thrombosis in any patient with deep vein thrombosis of lower limbs seemingly unexplained. This is a retrospective study from January 1994 to December 2008, concerning 17 cases of patients with deep vein thrombosis of lower limbs associated with neoplasia, hospitalized in internal medicine department at Habib Thameur hospital between a total of 290 patients with deep vein thrombosis of lower limbs. Only patients hospitalized for deep vein thrombosis of lower limbs complicated or not by a pulmonary embolism were included. Our study concerned 17 patients. There were 10 women and 7 men with a sex ratio [Female / Male] at 1, 42. The average age was 68.7 years, with extreme ages ranging from 40 to 90 years. Cancer has formed 6% of the causes of deep venous thrombosis of lower limbs. Eight of our patients were known to suffer from a cancerous disease. Six cases of cancers were discovered at an advanced stage of evolution with multiple metastases. In seven cases the etiological could not be achieved. Deep venous thrombosis was complicated by pulmonary embolism in four inaugural events, five patients had recurrent thrombosis, and two cases of bleeding complications were noted. Venous thromboembolism is common in cancer patients. It can be the first manifestation of cancer completely silent. The course and prognosis depend on the stage of cancer combined
ABSTRACT
Systemic sclerosis [SS] is a generalized disorder of connective tissue and microvasculature characterized by tissue fibrosis and obliteration of the vessels. Several features of systemic scleroderma in men are discussed in the literature. To investigate the initial clinical features, evolution and prognosis of systemic sclerosis in men. patients with systemic sclerosis based on ACR's criteria were included. In this retrospective study we compared a cohort of men to a cohort of women, diagnosed between 2000 and 2010 in department of internal medicine. Fifty four patients were included amongst which nine men. The mean follow-up duration was 39.5 months. A higher proportion of cardiac, renal and lung involvement were noted at diagnosis. Localized cutaneous sclerosis was predominant in men. This work has highlighted several features of systemic sclerosis encountered in men. These results warrant confirmation by analyzing a larger population