ABSTRACT
AIMS: To estimate the rate of red cell immunization in hemoglobinopathies. PATIENTS AND METHODS: Prospective study (1990-2009) about 84 patients: 44 homozygous sickle cell anemia, one heterozygous sickle cell anemia S/C, 30 thalassemia and nine sickle cell anemia-thalassemia. The mean age was 10.13 years (extremes: 1-45). The red cell units transfused were ABORH1 compatible, then RH-KELL phenotyped after 2006 and phenocompatible after alloimmunisation. The cross-match was realized using indirect antiglobuline test. Irregular red cell antibody screening was realized before every transfusional episode and the direct antiglobuline test was done when there was a poor transfusional efficiency. RESULTS: The number of red blood cells units transfused was 3545 (42.2/patient). The number of red cell antibody screening and the number of direct antiglobulin test were respectively 1474 (17.5/patient) and 272 (3.2/patient). Twenty-seven antibodies were identified (32.1%): 14 alloantibodies (16.6%, 16.6% in sickle cell disease, 16.6% in thalassemia, P=1), 16 antoantibodies (19.04%, 11.1% in sickle cell disease, 33.3% in thalassemia, P=0.018). There were three cases of association of allo- and autoantibodies. The most frequent alloantibodies were anti-RH3 and anti-KEL1 and were developed after transfusion of standard red cell units. There was no significant relation, neither between sex and risk of immunization, nor between the number of red cell units transfused and alloimmunization. On the other hand, there was a significant relation between autoimmunization and the number of red cell units transfused in thalassemia (P<0.001). CONCLUSION: This study proves the interest of using RH-KELL red cell units compatible in patients with hemoglobinopathies in order to reduce alloimmunisation rates.
Subject(s)
Anemia, Sickle Cell/immunology , Erythrocytes/immunology , Thalassemia/immunology , Adolescent , Adult , Anemia, Sickle Cell/therapy , Autoantibodies , Child , Child, Preschool , Erythrocyte Transfusion , Female , Humans , Infant , Isoantibodies/immunology , Male , Middle Aged , Prospective Studies , Thalassemia/therapy , Young AdultABSTRACT
It is thought that incisor protrusion could be ethnic-related because Tunisians, as Africans, might reflect the genetic influence of the incisal protrusion of their darker skinned neighbors. We first compiled local standards by determining the normal incisor positions of children of the Sfax region with balanced facial patterns. We selected 95 teenagers from 5 different high schools in Sfax (average age: 16 years 9 months), all having a normal dentition and a balanced facial pattern. This first study showed that upper and lower incisors were protruded 3 mm beyond American standards. Second, we studied incisor stability after four-first bicuspid extraction treatment. We selected 26 patients all having Class I molar relationships and upper and lower incisor protrusion. We compared x-ray incisor measurements of 3 radiographs: before treatment, after treatment and 2 or 3 years post-treatment. This study shows that incisor relapse ranges between 20 and 30%.
Subject(s)
Malocclusion/ethnology , Malocclusion/therapy , Adolescent , Adult , Cephalometry , Child , Female , Humans , Incisor/growth & development , Male , Orthodontics, Corrective , Recurrence , TunisiaSubject(s)
Orthopedics/history , History, 19th Century , History, 20th Century , Orthopedics/trends , TunisiaABSTRACT
The authors, try to establish an approach about ultrasonic pattern of capsulated peritonitis through study of four cases. The echographical semeology of this affection is based on: echoscopic signs which study the intestinal mobility and lumen, and the associated ascits: --echographic signs represented essentially by: --intestinal agglutination; --the presence of real or virtual capsula; --meso-retraction. The frequency of this affection seems to be not negligible in Tunisia. The tuberculosis is the most frequent cause, as an etiology.
