First data on latent tuberculosis infection in Syrian refugees with diabetes in Lebanon.

OBJECTIVE: The association between diabetes mellitus and tuberculosis is a health-threatening double trouble. Vulnerable populations such as refugees and conflict-displaced populations may be at higher risk of both diseases. Here, we examined the prevalence of latent tuberculosis infection (LTBI) and its associated risk factors in a population of Syrian refugees with diabetes in North Lebanon. STUDY DESIGN: This is a cross-sectional study. METHODS: A total of 87 Syrian refugees with diabetes were enrolled. Demographic and clinical data were collected using a structured questionnaire, and a blood sample was obtained from each patient. LTBI was examined using the last generation QuantiFERON-TB Gold Plus assay. RESULTS: The mean age of the study population was 54.1 ± 10.5 years, and the majority were women (79.3%). LTBI was found in 1 in 5 (17/87; 19.5%) enrolled patients, with the majority being originated from Aleppo (47.05%). Infection was significantly associated only with age (P = 0.009), and its risk was 4-fold higher in patients aged ≥60 years (odds ratio: 4.1, confidence interval: 1.4-12.5, P = 0.018). CONCLUSION: This study highlights the need to implement effective tuberculosis control strategies among refugees with diabetes, with particular attention to those at older age.

[Ossifying arachnoiditis in spondyloarthropathy patient]. / Araenoidite ossificante em espondilartropatia seronegativa.

A 52-year-old man, with the diagnosis of Ankylosing Spondylitis, since the age of 22, was admitted due to progressive neurological symptoms that had started two years before: paresthesias, impaired sensation and muscle weakness of the lower limbs; burning abdominal and lumbar pain; together with bladder, bowel and sexual dysfunction. Imaging investigations revealed severe lesions from D1 to L5: epidural calcification; spinal cord compression and syringomyelia. Based on this case, the authors review the neurological complications of Ankylosing Spondylitis.

[Which index to choose for quantification of the adequacy of filtration method in the hemodialysis patient?]. / Quel index choisir pour quantifier de manière adéquate l'épuration du patient hémodialysé?

On the basis of a retrospective re-analysis of the data from the National Cooperative Dialysis Study, Sargent and Gotch have proposed the normalized index KT/V as an index of the level of dialytic therapy. However the current methods of calculating KT/V are complex for routine clinical use and require great care in order to avoid major inaccuracies on the estimation of dialyzer urea clearance and the subsequent calculation of the volume of distribution of urea. As the pre to post-dialytic plasma urea ratio C0/CF is a function of dialyzer urea clearance, duration of dialysis and urea distribution volume of the patient, it might well correlate with KT/V. The simplified index I = 1.2 x ln (C0/CF) is well correlating (r = 0.9; n = 15) and well approximating (3%) with KT/V and with other indexes derived from various formulas. Consequently the use of this index is electively proposed for routine determination of the quantification of dialysis.