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Background: This study aimed to investigate the effects of intradialytic concurrent (resistance-endurance) training combined with melatonin (MEL) supplementation on oxidative stress, inflammation, and cellular damage in hemodialysis (HD) patients., Methods: Thirty-two HD patients were randomly assigned to three groups: Exercise (EX)-MEL, EX-Placebo (PLA), and Control (C)-PLA. Participants in the EX-MEL and EX-PLA groups underwent 12 weeks of concurrent training. Before nocturnal sleep, they ingested either 3 mg of MEL (EX-MEL) or a placebo (EX-PLA and C-PLA). Blood samples were collected at baseline and after 12 weeks of intervention to assess lipid peroxidation [malondialdehyde (MDA)], antioxidant biomarkers [ferric-reducing antioxidant power (FRAP), reduced glutathione (GSH), total thiol (THIOL)], total bilirubin (TBIL), uric acid (UA), biomarkers of muscle and liver damage [aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), creatine kinase (CK), lactate dehydrogenase (LDH), and Gamma-glutamyltransferase (Gamma-GT)], and inflammation [C-reactive protein (CRP)]., Results: EX-MEL demonstrated a decrease in MDA ( p < 0.05) and CRP ( p < 0.05), and an increase in FRAP ( p < 0.05) pre- and post-training. Both EX-MEL and EX-PLA showed an increase in GSH ( p < 0.001, and p < 0.05, respectively) and THIOL ( p < 0.01, and p < 0.05, respectively) pre- and post-training. No significant changes were observed in TBIL, UA, ASAT, ALAT, CK, LDH, or Gamma-GT pre- and post-training across all groups., Conclusion: Concurrent training combined with MEL supplementation enhances oxidant-antioxidant balance and reduces inflammation in HD patients more effectively than intradialytic concurrent training alone.

The authors report a case of disseminated mucormycosis presenting with left renal and muscular involvement in a 20-year-old immunocompetent man. The patient died rapidly before the diagnosis, established on histopathological examination of the nephrectomy specimen. This case illustrates the diagnostic difficulties and poor prognosis of this rare fungal infection.

Introduction: The chronic kidney failure is a source of dyslipidemia and accelerated atherosclerosis. No changes in the lipoprotein profile could be reversed by dialysis., Objective: Our aim was to study the lipid disturbances characteristics in end stage renal disease in order to assess their theorical atherogenic potential., Subjects and Methods: The patient population consisted of 36 patients on maintenance haemodialysis. Matched control subjects were recruited among apparently healthy normolipidemic Tunisians. Total cholesterol, triglycerides, high-density-lipoprotein cholesterol, low-density-lipoprotein cholesterol, apolipoprotein AI and apolipoprotein B concentrations were measured., Results: The triglycerides levels were significantly higher in patient group, unlike the high-density-lipoprotein cholesterol and apolipoprotein AI levels that were significantly reduced. We saw no increase in the levels of low-density-lipoprotein cholesterol and apolipoprotein B. The low-density-lipoprotein cholesterol/high-density-lipoprotein cholesterol ratio result wasn't helpful in the evaluation of the atherogenic risk., Conclusion: We confirm the quantitative lipid disorders associated with maintenance haemodialysis. The assessment of cardiovascular risk on the basis of these disorders seems difficult.

The authors report six cases of primary malignant paratesticular tumors. They reexamine the literature and emphasize the influence of the histopathological type of these tumors on the prognosis. Survival of the patients is better when tumors are differentiated and detected early.

The authors have made a study of 6 cases of malignant primary paratesticular tumor, and have also included a review of the literature on this topic. They emphasize the importance of the effect of histopathological type of tumor on disease outcome. There is an improved survival potential in cases where the tumors are differentiated, and discovered at an early date.

The authors report a series of seven patients suffering from severe trauma of the kidney, who were treated, after haemostasis and debridement, by wrapping the kidney in absorbable vicryl mesh. This perirenal prosthesis maintains the contused parenchymal fragments in contact with each other and ensures lasting haemostasis and recovery of normal renal function without cortical aschaemia or perirenal fibrosis.

We report our recent experience in the surgical treatment of severe closed renal trauma, describing the value of the initial tomography scan, the problems encountered with indications for surgery, and use of a resorbable peri-renal prosthesis made of polyglactine 910. During the last 4 years, 41 patients were hospitalized for renal trauma. Eleven of these patients were operated for severe lesions (Chatelain stage 3 and 4). Surgical treatment was as conservative as possible: total organ repair was possible in 5 cases and partial repair in 3, the kidney was lost in 3 cases.

Sixty-three cases of anuria secondary to renal stones were treated in the Sfax urology department between 1982 and 1990. The presenting symptoms are frequently polymorphic and non-specific. The prognosis of these patients largely depends on the infectious complications associated with anuria, the delay in management and, most importantly, the course of preexisting renal failure. Fifteen deaths (24%) were observed in this series, despite emergency urinary diversion and appropriate treatment to eliminate the obstruction.

The incidence of impotence increases with age. Its etiology is always complex and often multifactorial. The hidden organic causes of impotence are as follows in decreasing order of frequency: arterial, venous, neurological and endocrine. Paraclinical investigation of erection dysfunction plays an important role: hormone levels, arterial Doppler, digitalised rigidimetry, the intracavernous test, cavernometry-cavernography and internal iliac angiography, are used to define the diagnosis and determine appropriate management. It is stressed that supportive sex therapy is often indispensable and that penile prostheses are the final recourse, when treatment based upon etiology has failed.

Prostatic abscess is a rare complication of urinary tract infection, whose symptoms and signs are not often specific. Prostatic abscess can now be easily diagnosed by transrectal ultrasonography. The authors report six cases of prostatic abscess diagnosed by ultrasonography. These abscess were successfully drained by ultrasound-guided transrectal aspiration, which may constitute a useful solution, as the classical treatments to date consist of transurethral resection or rectotomy.

Based on a series of 55 children undergoing nephrectomy, the authors describe the clinical, laboratory, radiological, therapeutic and prognostic features for each aetiology. They define the criteria for resection of the affected kidney.

The authors report their experience of the use of the Lithoclast in endocorporeal lithotripsy in 19 patients. This modality allowed the fragmentation of 24 renal stones and 14 ureteric stones with complete success in 58% of cases and partial success in 42% of cases. No failures of stone fragmentation were observed in this series with the Lithoclast. The authors consider this apparatus to be an effective and inexpensive method of endocorporeal lithotripsy for all types of urinary stones.

Two cases of pseudotumoral lipomatosis in the renal sinus and responsible for clinical symptoms and radiological renal alterations are reported. Emphasis is put on the misleading features of this disease which may suggest a malignancy. Outcome is consistently favorable. Computed tomography ensures the preoperative diagnosis, avoiding an unnecessary nephrectomy.

The authors report 3 rare cases of liposarcoma occurring in the perineal or paratesticular regions. They review literature data concerning this particular form of soft tissue sarcoma and emphasize on prognosis which depends mainly on its histopathological type.

The authors report 3 rare cases of liposarcoma occurring in the perineal or paratesticular regions. They review literature data concerning this particular form of soft tissue sarcoma and emphasize on prognosis which depends mainly on its histo-pathologic type.

The authors report a series of 9 reno-ureteral obstructive uric acid calculi with recourse first to percutaneous nephrostomy. After attempt of stone dissolution by in situ alkalinization, the role of such a method among other uric acid stones management techniques is discussed.

The authors report thirty-two cases of children with staghorn calculi treated in the department of urology H. Bourguiba, Hospital of Sfax. Such calculi are frequently seen in young boys over the age of 6 years. Urinary tract infection by Proteus is the main etiologic factor of lithogenesis. Surgical treatment, still the most advocated, is laborious; it must ensure complete stone removal, while protecting renal function.

The authors report a series of nine reno-ureteral obstructive uric acid calculi initially treated by percutaneous nephrostomy. After attempting stone dissolution by in situ alkalinization, they discuss the place of such a method among the various treatments for uric acid stones.

The authors report their experience of calculus anuria in children. They based their study on a series of 12 cases. They point out, in particular, the diagnostic difficulties and prognostic risks which could be encountered. They also emphasize, the role of prompt renal drainage in the management of such an emergency and recommend percutaneous nephrostomy followed by cold nephrolithotripsy.

Between March 1982 and March 1986, 11 out of 72 patients (15%) undergoing chronic hemodialysis in a Tunisian hemodialysis unit developed septicaemia. The causative organism was a staphylococcus aureus in 8 patients, and the main portal of entry was the dialysis catheter (6/8). Septic pulmonary metastasis were observed in 3 cases. REmoval of the dialysis catheter and antibiotic therapy led to recovery in 7 cases. The 4 fatalities were attributed to respiratory failure in 3 cases and septic shock in one case. These results indicate that the prognosis of septicaemia in hemodialysis patients is poor.