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C Dziri

Publications and source records attributed to C Dziri.

At least 19 recordsLinked to original sources
PubMed2006

[Role of the Neurocom Balance Master in assessment of gait problems and risk of falling in elderly people].

INTRODUCTION: Falls in elderly people is currently a health service problem because of the multiple consequences. Numerous teams have been interested in predicting the risk of falling with clinical and instrumental tests. Our study investigated instrumental evaluation by use of the Neurocom Balance Master in the global assessment of gait problems and risk of falling in elderly people. PATIENTS AND METHODS: Transverse study concerning 60 subjects older than 65 years distributed in 2 groups of 30 subjects each according to the existence or not of falling incidents during the past year. Evaluation by the Balance Master involved the following items: 1) the modified Clinical Test for the Sensory Interaction on Balance (CTSIB), which estimates balance by measuring the speed of oscillation of the center of pressure (CP) with open then closed eyes and firm then mossy ground; 2) support monopodal 5" to the left then to the right, eyes open then closed in moderated speeds of oscillation of the CP; 3) passage from standing to sitting, in moderated speeds of oscillation of the CP; 4) limits of stability: the possibilities of moving the CP towards a predetermined target without moving the feet in moderated time and speed; 5) study of the step: determine length and width of the step as well as speed; 6) most about-turn: measure of speed of oscillation of the CP during the right then left about-turn; 7) clearing: the force of the impact and the oscillations of the CP during the clearing of an obstacle 10 cm high to measure leverage. RESULTS: The oscillation speed of the CP in the 2 groups during modified CTSIB, support monopodal 5", passage from standing to sitting, about-turn and clearing were significantly improved the group of the patients with falls (P < 0.05). The step, length and speed of these patients were significantly reduced, with no difference in width of the step between the 2 groups. In the evaluation of the limits of stability, only time necessary to reach the target was significantly increased in the group with falls. Finally, the indication of leverage and the force of impact on the ground measured by the test of clearing were more important in the group of fallers than in non-fallers. CONCLUSION: The Neurocom Balance Master estimates not only postural balance, but also the vestibulary system and reproduces the physiological conditions of daily life. It has a certain role in the early assessment of gait problems and the risk of falling. This system also allows for rehabilitation of the impaired balance and offers a profit with the biofeedback.

Accidental Falls↗
PubMed2005

[Conservative management of full-thickness rotator cuff tears. A prospective study of 24 patients].

OBJECTIVE: To evaluate the efficacy of conservative treatment of full-thickness rotator cuff tears. METHOD: A prospective open study of patients with full-thickness rotator cuff tears. The diagnosis was confirmed by ultrasonography examination. Therapeutic efficacy was evaluated before treatment, at the end of the treatment, and at 1, 3 and 6 months. Pain and handicap intensity were measured by a visual analogue scale, by the algo-functional Constant score, by articular mobility and, finally, by the resumption of daily and/or professional activities. Successful treatment was considered with a VAS pain score or=80. RESULTS: Twenty-four patients, mean age 59 years, with full-thickness rotator cuff tears for 9 months, on average, were included in the study. The parameters of pain function and handicap improved significantly since the end of treatment. The Constant score improved greatly, from 44.8 before treatment to 71.8 at the end of treatment and 74.2 at 6 months. This improvement continued until 3 months after treatment. The rate of success was 75% at 6 months. CONCLUSION: Despite the small sample size, our study confirm that rehabilitation should always be performed before a decision of surgical repair.

Adult↗
PubMed2004

Intramuscular bipenicillin vs. intravenous penicillin in the treatment of erysipelas in adults: randomized controlled study.

The objective of the study was to evaluate the efficacy of intramuscular penicillin: mixture of benzyl penicillin and procain penicillin (2 MU x 2 times daily) and intravenous benzyl penicillin (4 MU x 6 times daily) in the treatment of hospitalized adult patients with erysipelas. A prospective randomized unicentric trial was conducted. In total, 112 patients entered the study; 57 in the intramuscular group and 55 patients in the intravenous group completed the trial. The failure rate was 14% for intramuscular group and 20% for the intravenous group (P = 0.40). Local complications such as of the leg abscesses were observed in the two groups (intravenous 9.1%, intramuscular 7%; P = 0477). Of the patients treated with intravenous benzyl penicillin, 25.5% presented complications related to the route (venitis). Intramuscular penicillin should be considered an effective and well-tolerated treatment of erysipelas in adult patients.

Adult↗
PubMed2001

Laparoscopic hernia repair in 2000. Update of the European Association for Endoscopic Surgery (EAES) Consensus Conference in Madrid, June 1994.

The 1994 meeting of the European Association for Endoscopic Surgery (E.A.E.S.) in Madrid highlighted a consensus-developing conference on the then new laparoscopic procedure for hernia repair. The conference was chaired by A. Paul from Cologne, Germany, and A. Fingerhut, from Poissy, France. The other members of the jury were B. Millat (France), L. Nyhus (USA), J. Himpens (Belgium), J.-L. Dulucq (France), V. Schumpelick (Germany), E. Laporte Rosello (Spain), C. Klaiber (Switzerland), J. Mouiel (France), P. Go (Netherlands), and J.-H. Alexandre (France). At that time, there were, in all, only three randomized trials available for analysis. Today, there are more than 60 trials and more than 12,500 patients have been entered into them. An update, presented this year in Vienna, is summarized herein.

Evidence-Based Medicine↗
PubMed2001

Management of liver hydatid cysts with a large biliocystic fistula: multicenter retrospective study. Tunisian Surgical Association.

The large biliocystic fistula (> 5 mm) encountered with hydatic cyst of the liver produces clinical manifestations only when it allows the hydatic cyst content to pass into the common bile duct. Various therapeutic problems occur. The aim of this study was to evaluate the results of the therapeutic methods used by 14 Tunisian centers to treat this specific aspect of the hydatic cyst of the liver associated with a large biliocystic fistula. This study concerned a period of 5 years between January 1988 and December 1992, and it included 244 cases associated with hydatic content in the common bile duct (158 cases) and with cholelithiasis and choledocholithiasis (2 cases); 127 patients underwent an emergency operation (52%). The surgical procedures performed consisted in radical procedures (24 cases, 9.8%) and conservative procedures (220 cases, 90.2%). The latter included 52 cases of internal transfistulary drainage, 140 unroofing procedures associated in 20 cases with the fistula, in 93 cases with suture of the fistula, and in 27 cases with direct fistulization. In the 28 remaining cases, through the choledoctomy evacuation of the parasite was performed. The common bile duct was approached in 180 cases (73.7%). The postoperative course was uneventful in 57% of the cases and complicated in 38.5% others. The mortality rate was 4.5%. In conclusion, the presence (or not) of hydatic material in the common bile duct did not seem to be a determinant of the surgical procedure choice and did not influence the results. The only difficulty with treatment was the large biliocystic fistula itself. The internal transfistulary drainage on one part, and the unroofing procedure associated with suturing healthy fistula tissue and to omentoplasty or capitonnage of the remaining cavity on the other part, were easily performed and constituted efficient methods. Radical methods constituted operations that had excellent results, but they were feasible in only 10% of the cases.

Adolescent↗
PubMed2001

[Validity and reliability of spinal clinical measures in ankylosing spondylitis].

OBJECTIVES: To evaluate the validity and the reliability of the main clinical measures of mobility and sagittal spinal curves in ankylosing spondylitis (AS). METHODS: Criterion validity of the measure of the distance between C7 spinous process to plumbline (dorsal kyphosis), L3-plumb line (lumbar lordosis), lumbar, dorsolumbar and dorsal mobility. The gold standard was the value obtained from lateral radiological views of the dorsal and lumbar spine in standing position and maximum flexion. The correlation between radiological and clinical measures was assessed by a Spearman correlation coefficient (SCC). The reliability was assessed for all the clinical parameters and for chin-sternum distance (flexion, extension), chin-acromion distance (rotations) and chest expansion using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Were included patients with AS and needing dorsal and lumbar Xrays. RESULTS: Twenty-two patients (21 men), 32 +/- 11 year old, 51 +/- 10 kg weight, with a mean duration of the disease of 120 +/- 60 months. The ICC values were good or excellent for all parameters except for the measures of dorsal mobility. The validity was evaluated in 18 patients. The value of the SCC between clinical and radiological measures was good except the measures of dorsal kyphosis and dorsal mobility. CONCLUSION: The clinical measures of mobility and sagittal curves have metrological properties good enough to be used in the monitoring of AS mainly for the follow-up and the evaluation of the rehabilitation. The measurement of dorsal mobility should be restricted to the lower part only. Although apparently not valid the distance C7-plumbline can be used in management of AS because of its excellent reliability.

Adult↗
PubMed2000

Prevention of deep abdominal complications with omentoplasty on the raw surface after hepatic resection. The French Associations for Surgical Research.

BACKGROUND: Several methods have been suggested to treat the hepatic raw surface after resection. Among these, omentoplasty (OP) has been employed occasionally but there are no clinical studies that clearly demonstrate its usefulness. METHODS: Of 172 randomized patients undergoing hepatic resection between January 1991 and December 1994, 5 were withdrawn for protocol violation, leaving 167 who were randomly allotted to undergo OP (n = 87) on the hepatic raw surface or not (NO; n = 80). This procedure was performed for malignant tumor in 125 cases, benign tumor in 33, and for other causes in 15. Six patients had more than two types of lesions, and 32 patients had associated cirrhosis. Sixty-five major and 102 minor hepatic resections were performed. The main outcome measures studied were the number of patients with deep abdominal complications (DAC; deep bleeding or hematoma, deep infection, with or without pus discharge through drains, bile leakage), as well as repeat operations and postoperative death. Patients were divided into two strata according to the site of the lesion with respect to the diaphragm: (1) in contact (posterosuperior segments II, VII and VIII) or (2) not in contact (anterior segments III, IV, V, and VI). RESULTS: Both groups were comparable as regards patient demographics, intraoperative procedures, intraoperative search for bile leaks and intraoperative transfusion requirements. Fewer patients had DAC in OP (n = 11) than in NO (n = 15) (difference not significant). Ten patients (6%) required repeat operations: 4 in OP without immediate mortality and 6 in NO, 3 followed by death. One further patient in OP required repeat operation after discharge and died. Four patients died in OP and 7 in NO, 1 and 4 of DAC, respectively (not significant). Deep abdominal complications were significantly associated with major hepatic resection (P <0.05) whereas postoperative death was significantly correlated with cirrhosis (P <0.05). CONCLUSIONS: OP on the raw surface after hepatic resection lowers the rate of all complications related to DAC (except biliary leaks) and their severity (repeat operations and death) but not significantly so. OP is not recommended as a routine measure to complete elective hepatic resections.

Abdomen↗
PubMed2000

[Study of the incidence and cost of nosocomial infections in general surgery].

Nosocomial infection incidence and its cost were study. We have identified 61 infected patients and 75 infectious episodes, is an incidence of 9.4% infected for 100 hospitalized by trimester. Operative site infections are the most frequent (60%), operative site infection (9.1%), inferior respiratory ways infections (2.2%). Incriminated germs are represented essentially by negative gram Bacillus (77.3%) with predominance of enterobacterias (59%). Invasive technique usage, surgery types and contamination classes have been identified as risk factors of nosocomial infection occurrence. The supplementary stay duration estimated by simple comparison between infected group and no-infected one is 9.3% days, responsible of an over cost of 336 TD by infected patient and 273 TD by infectious episode. The curative antibiotic costs have been estimated at 70 TD by infected patient being equivalent to two hospitalization days and to 57 TD by infectious episode.

Adult↗
PubMed1999

Omentoplasty in the prevention of deep abdominal complications after surgery for hydatid disease of the liver: a multicenter, prospective, randomized trial. French Associations for Surgical Research.

BACKGROUND: Omentoplasty (OP) is thought to fill residual cavity, to assist healing of raw surfaces, and to promote resorption of serosal fluid and macrophagic migration in septic foci. Results published to date, whether retrospective or prospective, are not controlled and are discordant. STUDY DESIGN: The authors investigated whether OP, either filling the residual cavity after unroofing, or covering the hepatic raw surface after pericystectomy, could reduce the rate or severity of deep abdominal complications (DAC) after surgical treatment of hydatid disease of the liver. Between January 1993 and December 1996, 115 consecutive patients (51 males and 64 females, mean age 42+/-16 years [range 10 to 80 years]) with previously unoperated uni- or multilocular hydatid disease of the liver, complicated or not, without other abdominal hydatid disease, were randomly allotted to OP (n = 58) or not (NO) (n = 57) after unroofing, total, or partial pericystectomy. Patients were divided into 2 strata according to the site of the cyst with respect to the diaphragm: a) posterosuperior segments II, VII, and VIII or b) anterior segments III, IV, V, and VI. Main outcomes measures included deep bleeding, hematoma, infection, or bile leakage. Subsidiary measures included wound complications, extraabdominal complications, duration of operation, and length of hospital stay. RESULTS: Both groups were comparable regarding patient demographics, cyst characteristics, intraoperative procedures, search for bile leaks, and intraoperative transfusion requirements. On the other hand, more patients (86%) in NO had associated drainage of the abdominal cavity than in OP (64%) and the duration of operation was 9 minutes longer in OP, but neither of these differences was statistically significant. Less DAC occurred in OP (10%) than in NO (23%) (a posteriori gamma risk < 0.05) and fewer deep abdominal abscesses (0 versus 11%) (p < 0.03). Median duration of hospital stay, however, was similar. CONCLUSIONS: OP decreases the rate of DAC and especially deep abdominal abscess after surgical treatment (unroofing or pericystectomy) for hydatid disease of the liver and should be recommended in this setting.

Adolescent↗
PubMed1996

[Inspiratory aid with facial masks during acute respiratory failure without hypercapnia].

This prospective study assessed, in 10 conscious patients without a history of chronic respiratory disease, the feasibility of mechanical pressure support ventilation with PEEP by face mask for the treatment of acute respiratory failure without hypercapnia. Pressure support level was determined to obtain a VT of 5 to 10 mL.kg-1 and a decrease of respiratory rate of more than 20%. FIO2 and PEEP levels were determined to obtain a SpO2 > 92% and a PaO2 > 70 mmHg. The efficiency of the technique was assessed through the time course of respiratory rate, PaO2, PaCO2 and SaO2. The technique was efficient in all patients and tracheal intubation was not required. During face mask ventilation, a significant decrease in respiratory rate and an increase in PaO2 and SaO2 were observed. Pressure support ventilation with PEEP by face mask is an efficient technique for the treatment of acute non hypercapnic respiratory failure in conscious and cooperative patients.

Acute Disease↗
PubMed1995

[Adrenal myelolipoma. Apropos of 3 cases].

The authors report 3 cases of adrenal myelolipoma arising in 3 women who were respectively 36, 47 and 48 year old. The diagnosis was made on the surgical specimen in 3 cases, and the clinical symptomatology was dominated pain seen in all 3 cases. 2 patients have presented hypertensive access. After surgery, the evolution was favourable in all 3 cases.

Adrenal Gland Neoplasms↗
PubMed1994

[Surgical treatment of severe acute pancreatitis. Results of a prospective multicenter study of the Associations of Research in Surgery].

OBJECTIVES: The aim of this prospective study was to appreciate, in severe acute pancreatitis, the therapeutic choice of the surgeons for the treatment of pancreatic necrosis and the timing of operation in biliary pancreatitis. METHODS: Forty-six centers participated in the study. For every included patient, cause and severity criteria of the pancreatitis, timing of surgery, surgical management and necrosis features were recorded. Mortality and morbidity, number of surgical operations and clinical course were analyzed depending on necrosis infection. RESULTS: From August 1986 to January 1990, 143 patients were included in the present study. The main causes of pancreatitis were gallstones in 66 patients and alcohol in 45. Other causes were found in 32 patients. Overall mortality was 23.8%. Mortality was higher in 38 patients with infected necrosis than in 41 patients with sterile necrosis (39% vs 27%). In patients with severe acute biliary pancreatitis operated on within the first seven days of pancreatitis, mortality and number of reoperations were higher than in patients operated on later (30% vs 14% and 40% vs 21% respectively). CONCLUSIONS: These results suggest that clinical trials on the treatment of pancreatic necrosis and on the timing of the treatment of biliary pancreatitis are needed. The analysis of mortality shows that it will be difficult to organize these trials.

Acute Disease↗
PubMed1994

[Gastroduodenal intussusception on gastric tumor].

Gastroduodenal intussusception is a rarely documented condition. A distinction has to be made between complete gastroduodenal intussusception (CGDI) and either prolapse of a pedunculated tumor through the pylorus or mucosal prolapse through the pylorus. CGDI usually occurs secondary to a pedunculated benign gastric tumor. More rarely the tumor is malignant. We report a case of CGDI associated with gastric adenocarcinoma. We emphasize diagnostic difficulties that can be generated by CGDI.

Adenocarcinoma↗