[Multiple coronary artery-left ventricular fistulae. A case report].
The authors report the case of a patient with multiple coronary artery-left ventricular fistulae discovered in coronary angiography for exertional angina.
Adult↗
Biomedical subjects
Ali Cherif
Publications and source records attributed to Ali Cherif.
[Twenty years result of a corrective surgery of tetralogy of Fallot in a 50 years old woman].
The authors report the case of a woman operated at a 50 years of age for a tetralogy of Fallot with a good late result.
Age Factors↗
[Analysis of knowledge attitudes and practices of health care workers facing blood exposure accidents in a general surgery service].
In order to assess the degree of knowledge, attitudes and the personnel's practices exercising in a service of general surgery of the hospital Charles Nicolle of Tunis, concerning blood exposure accidents, we did a transverse survey during the month of January of the year 2002. A questionnaire has been addressed to 114 people while using the technique of the direct interview. The middle age of investigated is 35.7 years. The sex ratio is 0.7. Only the 2/3 declare have been vaccinated against the B hepatitis. The results show a good knowledge of the exposure risk to a communicable disease by blood (95.6%), but less good for the risk of contamination by the three viruses HBV, HCV and HIV. The resheathing of needles, considered like gesture to risk, is underestimated by 71.2% of investigated. The majority of investigated declare to know universal precaution principles (85.8%). However, to the maximum 4 measures only on the 10 advisable have been mentioned by investigated. The conduct to hold in case of blood exposure accident seems insufficiently known by our sample. It is represented, in 78.8% of cases, in the application of disinfectants Betadine type or alcohol iodized, whereas the practice of a serology to the patient source is ignored completely. 75% of investigated having had a blood exposure accident lasting the last 12 months (n = 44) didn't declare their blood exposure accident and only 11.4% declare to have undergone cares. Actions of information and formation, to the intention of the whole of the personnel of the service, on risks incurred by the nursing, gestures and procedures to risk, the universal precaution respect, the conduct to hold in case of a blood exposure accident, the interest of the declaration and the interest of the vaccination against the B hepatitis, are primordial.
Accidents, Occupational↗
[Predictive factors of morbidity and mortality after surgery in the elderly].
UNLABELLED: The aim of the study was to determine prognostic factors of post operative morbidity and mortality for patients aged 80 years and older. We compared two groups of patients aged 80 and over operated to determine predictive factors of morbidity and mortality: group of patients who presented post operative complication within 30 days after surgery and group of patients without any complication. Comparison of the two groups for global morbidity using univariate analysis showed only one prognostic factor: surgery of diabetic foot (p = 0.034). Predictive factors of mortality according to univariate analysis were: pre-operative shock (p = 0.001), abdominal wall pathology (p = 0.027), gastric or duodenal ulcer diseases (p = 0.011) and global morbidity (p = 0.006). After logistic regression, only pre-operative shock was an independent predictive factor of mortality (p = 0.0023). CONCLUSION: Risk for morbidity after surgery in the elderly 80 years and over is linked with type of surgery and not with soil. Likewise, risk for mortality is linked with advanced stage of disease that is presence of pre-operative shock and not with soil.
Aged↗
[Congenital aortic valve stenosis with left ventricular dysfunction: effect of percutaneous valvuloplasty].
Two girls aged 6 and 15 years with severe congenital valvular aortic stenosis and left ventricular (LV) dysfunction underwent successful balloon aortic valvotomy (BAV). Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement (cardiothoracic ratio 0.7 and 0.65) was evident in the chest roentgenograms. Immediately after BAV, the aortic valve peak-to-peak gradients decreased from 60 to 8 mmHg and 120 to 30 mmHg respectively, the LV end-diastolic pressures decreased from 47 to 13 mmHg and 40 to 15 mmHg, the LV ejection fractions improved from 40 to 65% in the second girl. On follow-up (30 and 36 ms respectively), both patients were asymptomatic with normalization of LV function and without a change in the residual gradient a cross the aortic valve.
Adolescent↗
[The immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries].
The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.5 +/- 1.1 mm. The right ventricular saturation increased from 37 +/- 17% to 67 +/- 13% (p < 0.001). There was no correlation between the atrial septal defect diameter and the increase of systemic saturation after BAS.
Age Factors↗
[Transradial approach for coronary angiography and angioplasty].
The transradial approach of coronary angiography and angioplasty is now become a good alternative to the femoral approach in patients with normal Allen test results, because low rate of access site complication, improved patient comfort and early ambulation. This approach is particularly interesting in obese patients, aortoiliac disease or in patients under anticoagulation treatment or thrombolytics.
Angioplasty, Balloon, Coronary↗
[Single coronary artery. A case report].
The authors report the case of a patient undergoing coronary angiography for an inferior myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from single ostia in the left sinus of valsalva.
Adult↗
Neuroendocrine tumours of the digestive tract report of two cases and literature review.
Neuroendocrine tumors (NET) of the digestive system are rare. They comprise only 1% of all the tumors of the gastrointestinal tract. The aim of this study is to report two cases of exceptional localization of non secretary neuroendocrine tumors. Their difficulty in diagnosis, treatment and controversy in chemotherapy merit their study in depth. These are two patients that were treated in the department of general surgery (Beau Séjour) in Charles Nicolle Hospital for non secretary (NET) of the pancreas and stomach. The first was presented as a painless epigastria mass with frequent diarrhea. The second was presented as a painful mass in the left hypochondriac area without any other symptoms. Biochemical evaluation confirmed their non secretary properties. Surgery remains the first line of treatment. It was possible for the gastric, but not for the pancreatic tumor. Both were very advanced and had metastasis. Histopathological evaluation and immunohistochemical study using the method of peroxydase antiperoxydase (PAP) complexes for some special monoclonal antibodies confirmed the diagnosis. Chemotherapy of both cases was mal tolerated and was discussed in details.
Adult↗
[Coronary-pulmonary arterial fistula in the adult: report of 6 cases and review of the literature].
Six new patients and 33 previously reported with coronary-to-pulmonary artery fistula were reviewed. The mean age at the time of diagnosis was 51 years. A male predominance was found (65%). Angina was the most common symptom. The artery mostly involved was the left anterior descending coronary artery and the fistula drained more often to the main pulmonary artery. The left-to-right shunt is small in the majority of patients and the associated significant coronary artery disease was detected in 18% of cases. Good results of surgical closure of the fistula are usually obtained. An alternative to surgical treatment is percutaneous transcatheter embolization of coronary artery fistulas.
Adolescent↗
[Cardiac retrograde arterial catheterization in children under 2 years of age. Indications, techniques and complications].
Thirty children (15 males and 15 females) under 2 years of age (mean age 14 +/- 6 months, range 1 to 24 months, mean weight was 8.3 +/- 2.5 kg) underwent diagnostic cardiac percutaneous femoral arterial and venous catheterization for congenital heart disease. The anticoagulation with heparin was not given in any patient. Appropriate arterial sheath varying from 4F to 5F were used for catheterization. The mean duration of the exploration was 38 +/- 16 mn. The mean duration of the left heart exploration was 9.5 +/- 2.5 mn. There were no hemorrhagic or ischemic complications in this series.
Cardiac Catheterization↗
[False left ventricular aneurysm: report of 5 cases].
Between 1972 and 2000, left ventricular false aneurysm was diagnosed in 5 patients. These patients consisted of three man and 2 women, aged between 58 and 70 years. Clinical presentation was characterized by severe heart failure, complicating a posterior myocardial infarction, in 4 patients. Left ventricular angiography, has confirmed the false aneurysm in all patients. Three patients underwent surgical management, with good result in 2 cases (follow-up of 9 and 13 years), and an early postoperative death in one case. Two patients refused surgery and died suddenly. Ischemic myocardial disease, represent the most frequent etiology. Left ventricular false aneurysm prognosis should be improved by emergent surgical management, preventing fatal rupture.
Aged↗
[Abdomino-pelvic actinomycosis: a case report].
The actinomycosis is a chronic suppurative granulomatosis disease. It is owed to a bacillus gram positive; actinomycès israelli. The cervical and thoracic localizations are most frequent. The digestive localization represents 20% of cases. It interest very rarely the pelvis and the genital tracts. We bring back the observation of a patient old of 30 years admitted for mass abdominal. To the exam, the patient had a sensibility of the left hypochondriac area and we found a mass of 6 cm of diameter. To the rectal touch, we found a mass in the bag of Douglas. The echography and the computed tomography revealed a collection under the spleen and a pelvic collection. A rectotomy is performed. The bacteriological study isolates actinomycès israelli. The collection under the spleen is drained under radiological control. Actinomycès israelli is also recovered in the pus brought back by the puncture. The patient is treated by Penicillin. The patient had a favourable evolution. No etiology is found at this patient. For this observation, the collection was accessible to a drainage permitting the diagnosis and the treatment of the actinomycosis while avoiding a mutilated surgery.
Actinomyces↗
[Immediate and mid-term results of balloon valvuloplasty in congenital aortic stenosis. Ten case reports].
From 1987 to 2000, 10 patients aged 0.5 to 20 years with congenital valvular aortic stenosis underwent percutaneous balloon aortic valvuloplasty. In one patient, balloon valvuloplasty was unsuccessful, this patient had acute artery thrombosis requiring surgical intervention. Hemodynamically successful dilatation was achieved in 9 patients. The peak systolic pressure gradient was reduced from 76 +/- 35 to 32 +/- 16 mmHg (p < 0.001). Aortic valve regurgitation on angiography appeared or increased in 2 patients (up to grade 2 in the 2 patients). There was no deaths during the procedure. Follow-up was available in 7 patients One patient died during the follow up period. Restenose was found in only one patient 5 years after valvuloplasty and the efficacy balloon aortic valvuloplasty continued significantly in 5 patients (mean follow-up 35 +/- 18 months) with a residual aortic valvular gradient of 34 +/- 15 mmHg.
Adolescent↗