Metanephric adenoma diagnosed on biopsy in an infant: a case report.

BACKGROUND: Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery. CASE PRESENTATION: A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flank retroperitoneal incision. The final histopathological examination confirmed the diagnosis. The postoperative course was uneventful. CONCLUSION: Preoperative diagnosis of metanephric adenoma is challenging. Because of the high probability of unnecessary radical nephrectomy, preoperative biopsy can be safe and determining to guide a more conservative approach so nephron-sparing surgery can be performed.

Evaluation of daily Laurus nobilis tea consumption on anxiety and stress biomarkers in healthy volunteers.

Laurus nobilis is known in the field of herbal medicine and in vitro studies for its antibacterial, antifungal, anti- diabetes, and anti-inflammatory beneficial effects. Laurus nobilis tea consumption was investigated with regard to its effects on anxiety and stress in healthy individuals, measured by subjective tools and by plasmatic cortisol levels. The study included thirty healthy Tunisian volunteers aged between 20 and 57 years consuming Laurus nobilis infusion, prepared from 5g of dried Laurus nobilis leaves in 100 ml boiled water, once a day during 10 days. Plasma concentrations of serum cortisol were measured before Laurus nobilis consumption and at the end of the experiment. Laurus nobilis tea consumption significantly decreased the concentration of plasmatic cortisol ([cortisol] D0= 93.5± 43.01ng/mL, D11=72.23± 25.37, p=0.001). A statistically significant decrease in PSS and STAI scores (p=0.006 and p=0.002 respectively) was also noted.These findings highlight the decrease in blood cortisol levels, which means a possible positive effect on reducing the risk of stress related-diseases in healthy volunteers consuming Laurus nobilis tea. However, more powerful studies with extended treatment periods are required.

[Smoking behavior, knowledge, and attitudes towards anti-smoking regulations of nursing students in Sousse, Tunisia]. / Comportement tabagique, connaissances et attitudes relatives à la lutte anti-tabac des étudiants infirmiers de la ville de Sousse, Tunisie.

BACKGROUND: Smoking prevalence has reached high rates among health professionals. Our study aimed to assess smoking behavior, knowledge and attitudes towards anti-smoking regulations of nursing students. METHODS: In 2013, we conducted a cross-sectional study among nursing students enrolled in private and state nursing institutions of Sousse (Tunisia). RESULTS: In our study, 440 students were selected. The mean age was 22 ± 2 years. The sex ratio was 0.65. The prevalence of smoking was 20.6%. It was significantly higher in men than women (50% vs 4.5%, P < 10(-3)). Strong dependency was noted in 9%. One-third of smokers stated they wanted to quit smoking. Prohibiting the sale of cigarettes to minors and smoking in enclosed public places were the two most mentioned anti-smoking regulations. CONCLUSION: Our rate was lower than those reported in the literature. This result should encourage policymakers to continue actions and ensure sustainability.

[Not Available]. / Diagnostic clinique et paraclinique des infections ostéoarticulaires digitales dans les brûlures thermiques de la main.

Infectious complications of finger-joints in association with hand burns are common and dominated by osteoarthritis. However, this issue has hardly ever been addressed in the literature. This ailment can either be identified while patients with extensive burns are undergoing intensive care, or during patient rehabilitation. In the former instance, it is difficult to recognize because patient sedation means the clinical signs are not obvious. In the latter phase, however, the pain, swelling (tumefaction), stiffness and radiological signs are clear. These infections should be diagnosed as soon as possible in order to preserve the function of the hand.

Role of the peritoneopleural pressure gradient in the genesis of hepatic hydrothorax. An isotopic study.

SUMMARY: Hepatic hydrothorax is defined as the development of significant pleural effusion in a patient with cirrhosis without primary pulmonary or cardiac disease. This complication is seen in 4-10% of patients with cirrhosis. The pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm. We report two patients with posthepatitis cirrhosis presenting with a significant pleural effusion. The peritoneopleural communication was demonstrated by peritoneal scintigraphy. The role of the peritoneopleural pressure gradient is discussed.