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Biomedical subjects

D Sellami

Publications and source records attributed to D Sellami.

At least 19 recordsLinked to original sources
PubMed2006

[Two cases of subretinal neovascular membrane in Vogt-Koyanagi-Harada syndrome].

AIM: To report two cases of Vogt-Koyanagi-Harada syndrome (VKH) complicated by subretinal neovascularization. CASE REPORTS: The first patient was a 12-year-old girl in whom choroidal neovascularization occurred after VKH had evolved for 9 months. Fundus examination of the left eye revealed a macular extrafoveolar superior serous retinal detachment (SRD) centered by a grey-white pseudo-tumoral zone. A crown of exudates lined the SRD. Pigment epithelium impairment was substantial. Fluorescein angiography showed an early intensive and diffuse staining in the left eye corresponding to a neovascular membrane associated with a late impregnation of the SRD. Green monochromatic laser photocoagulation was considered but refused by the parents. The second patient was an 18-year-old girl followed up for VKH for 2 years. Ophthalmoscopy showed a serous retinal detachment with hemorrhage and hard exudates in the right eye. Fluorescein angiography showed early staining in the juxtapapillary region corresponding to a juxtapapillary neovascular membrane. High-dose systemic corticotherapy was instituted. Photocoagulation was not indicated because of the juxtapapillary topography of the neovascular membrane. CONCLUSION: VKH is a bilateral panuveitis that can be complicated by subretinal neovascularization in 2.5%-10% of cases. This complication must be diagnosed early. We discuss angiogenic factors and therapeutic modalities.

Adolescent↗
PubMed2006

[Ocular manifestations associated with nephronophthisis and genetic study in three Tunisian families].

PURPOSE: Nephronophthisis is a familial interstitial nephropathy with an autosome recessive mode of transmission. In some cases, it is associated with ocular manifestations such as retinitis pigmentosa in Senior-Løken syndrome. We report ocular abnormalities and genetic results in three affected Tunisian families. PATIENTS AND METHODS: Twenty-two members of these three families underwent a complete ophthalmologic examination (visual acuity, slit lamp biomicroscopy, ophthalmoscopy, and retinal electrophysiology). For genetic study, all individuals were genotyped and underwent a genomic sequence. RESULTS: Twenty-two subjects, nine of whom presented nephronophthisis, were included in this study. Retinitis pigmentosa was found in three cases. Our genetic study demonstrated that patients belonging to family 1 had homozygous deletions in NPHP1, all affected individuals from family 3 were linked to NPHP4 and presented a deletion in exons 2 and 3. Results are pending for patients in family 2. CONCLUSION: Senior-Løken syndrome is a rare hereditary disease that combines familial juvenile nephronophthisis and retinitis pigmentosa. This association was described in the literature in 39%-43% of cases. In our study, it was approximately 33% of cases. The genetic study can sometimes obviate the need for renal puncture, especially when the homozygous deletion of NPHP1 gene is confirmed.

Adolescent↗
PubMed2006

[Allgrove syndrome. Report on a family].

Triple A or Allgrove syndrome is a rare autosomal recessive disease with alacrima, achalasia, and ACTH-resistant adrenal insufficiency. It is usually associated with neurological disorders. Recently, mutations in the AAAS, a candidate gene mapped to chromosome 12q13, were identified. We report a family with seven affected siblings. All of them have signs of alacrima, four were operated on for achalasia, five have neurological abnormalities including cranial nerve abnormalities, amyotrophic lateral sclerosis, pyramidal syndrome, distal motor neuropathy, and amyotrophy, and two have adrenal insufficiency. Triple A syndrome should be considered in any young patient with alacrima.

Addison Disease↗
PubMed2005

[Phthiriasis pubis palpebrarum in children. Diagnosis and treatment].

INTRODUCTION: Phtiriasis palperarum is an unusual cause of blepharitis. This ectoparasitic infestation of the lashes is more frequent in adult; a pubic attack is usually associated. It is however rare in children. The goal of our study is to bring back four observations of infantile phtiriasis palpebrarum. PATIENTS AND METHODS: Four children presented themselves for palpebral itching and ocular redness. Slit lamp examination revealed evidence of small parasites attached to the proximal extreme of the eyelashes. A survey within the family was carried out and parasitological examination was realized. RESULTS: Parasitological examination had identified adult forms and nits of phtirus pubis. The bed linen was the way of contamination. Mechanical extraction of the parasite was tried but was very painful. Two patients were treated with a regimen of 1% yellow oxide of mercury ointment four times daily for 14 days, the two others was treated by Vaseline pomade because of a very important palpebral irritation. Evolution was favorable among all patients. DISCUSSION: We discuss in this work the ways of contamination of phtiriasis palpebrarum in children. In fact, eyelashes contamination in children is secondary to a contact with an adult carrier of a pubic phtiriasis. The transmission can be done following sexual maltreatments or by the means of infected clothing or bed linen. The diagnosis of phtiriasis palpebrarum is clinical confirmed by parasitological examination. Different therapeutic were proposed, the mechanical treatment must be carried out but it is seldom sufficient and it is often necessary to associate a chemical treatment (malathion to 1%, mercury oxide with 1%, fluorescein with 20%...) or physical treatment (cryotherapy, laser argon). CONCLUSION: Diagnosis of phtiriasis palpebrarum is easy and requires the detection of the source of contamination in order to prevent reinfestations.

Animals↗
PubMed2004

[Palpebral seborrheic keratosis: a case study].

INTRODUCTION: Seborrheic keratosis is the most frequent palpebral tumor, observed for the most part in the second half of life. It may be confused clinically with a basal cell carcinoma or a melanoma. The histopathological study confirms the diagnosis. OBSERVATION: A 69-year-old man presented with a giant superior palpebral tumor leading to ptosis of the eyelid, which had evolved over 5 years. Examination found a pigmented cerebriform multilobed granulated mass, with a smooth surface and a more or less seborrheic aspect, pedicled in places, covering the entire eyelid but sparing the internal angle. This aspect suggested melanoma, basal cell carcinoma or seborrheic keratosis. Histological biopsy revealed basal cell carcinoma. Excision with palpebral reconstitution using palpebral flaps was performed. The histopathological analysis of the tumor concluded in seborrheic keratosis. DISCUSSION: Seborrheic keratosis is a frequent tumor of the face and eyelids. Its highly pigmented clinical aspect can be confounded with a nevus or a melanoma, whereas the histological aspect can suggest basal cell carcinoma or squamous cell carcinoma, but the basal membrane is always intact. Several treatments have been proposed, including electrocoagulation, cryotherapy, dermabrasion, as well as CO2 laser treatment. However, when there is doubt with regard to the histological nature, surgery is preferred. CONCLUSION: This was a case of seborrheic keratosis, atypical in that it covered the entire upper eyelid and produced a highly disfiguring aspect and functional problems, requiring surgical treatment with eyelid reconstruction.

Aged↗
PubMed2002

[Purtscher-like retinopathy in systemic lupus erythematosus. Two cases].

Purtscher-like retinopathy is a retinopathy with vascular manifestations resembling Purtscher's retinopathy associated with autoimmune disorders such as lupus erythematosus. We report two cases of blurred vision associated with multiple whitish patches scattered over the macular and peripapillary areas. In the absence of trauma, these symptoms led us to systemic lupus erythematosus. The diagnosis was confirmed by the immunological and biological examinations. A steroid treatment was given with poor visual response. Purtscher-like retinopathy is a rare complication of systemic lupus erythematosus and there is some controversy about its pathogenesis and its treatment.

Adult↗
PubMed2001

Acute rejection following lung transplantation: limitations in accuracy of thin-section CT for diagnosis.

PURPOSE: To evaluate the sensitivity, specificity, predictive values, and accuracy of thin-section computed tomography (CT) for the diagnosis of acute rejection following lung transplantation and to determine whether any individual CT abnormalities are associated with histopathologically proved acute rejection. MATERIALS AND METHODS: Thin-section CT studies from 64 lung transplant recipients were retrospectively reviewed. CT studies were temporally correlated with various grades of biopsy-proved acute rejection (n = 34); 30 other CT studies were from a control group with no histopathologic evidence of acute rejection. Acute rejection was diagnosed as present or absent, and the diagnostic was calculated. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT for the diagnosis of acute rejection were as follows: 35%, 73%, 60%, 50%, 53%, respectively. No individual CT finding was significantly associated with acute rejection. The sensitivity of CT for the detection of various grades of acute rejection was 17% for grade A1, 50% for grade A2, and 20% for grade A3. The combination of volume loss and septal thickening, with or without pleural effusion, was never seen in the absence of acute rejection. CONCLUSION: Thin-section CT has limited accuracy for the diagnosis of acute rejection following lung transplantation, and no individual CT finding is significantly associated with this diagnosis.

Acute Disease↗
PubMed2000

CT of parenchymal and bronchial tuberculosis.

Tuberculosis (TB) remains a common disease in the World. Its incidence has risen steadily since 1985, despite a preexisting continuous decreasing of its frequency due to an effective chemotherapy. Nonwhite people, socioeconomically disadvantaged, chronically debilitated groups and AIDS patients are the most concerned. Chest radiography remains the first imaging modality to evaluate TB. Widely radiographic appearances can be encountered, including normal chest X-ray. CT can be useful in all stages of the disease, particularly when clinical and radiological findings are in disagreement and/or when imaging findings are equivocal. CT should be proposed at the end of an effective antituberculous treatment to better subsequently detect fine lesions suggestive of reactivation TB.

Acquired Immunodeficiency Syndrome↗
PubMed2000

[Infected aneurysm of abdominal aorta: early CT finding].

Infected abdominal aortic aneurysm is an uncommon but life-threatening disease, especially in case of salmonella infection. Early CT findings should be well known in order to allow immediate diagnosis and accurate management. The authors present an early CT finding of a salmonella infected aneurysm of abdominal aorta in an HIV-infected patient. This pattern consists in a slight-enhancing focal densification of periaortic soft-tissue, while aorta remains of normal size. Within two weeks, infection progressed to the constitution of an infected aneurysm. This CT finding seems to be initial to previously described signs.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Exophthalmos and blindness disclosing an ethmoidal-maxillary malignant non-Hodgkin's T-cell lymphoma. Apropos of a case].

BACKGROUND: We report a case of non-Hodgkin's malignant lymphoma of the cervicofacial region revealed by unilateral exophthalmos and blindness, an unusual mode of expression. CASE REPORT: A 40-year-old man with a 4-month history of diabetes mellitus had suffered from exophthalmos and blindness of the right eye for 20 years. Physical examination showed a homolateral hemifacial tumefaction and ophthalmoplegia. The right ocular fundus showed papillar edema and non-proliferative diabetic retinopathy. The left eye was normal. The otolaryngology explorations revealed a voluminous tumor in the anterior nasal cavity and in the cavum. Two biopsies were performed. Histology reported non-Hodgkin's T-cell lymphoma. Orbitocerebral and cervicofacial computed tomography visualized the aggressive ethmoidomaxillary extension with intraorbital and intracranial involvement. Chemotherapy (CHOP) combined with radiotherapy led to tumor regression and involution of the exophthalmos. Diagnostic difficulties, management and prognosis are discussed.

Adult↗
PubMed1999

[Diabetic fibrous mastopathy].

Diabetic fibrous mastopathy was first described in 1984. This mastopathy usually occurs in patients with autoimmune disorders and often occurs in patients with insulin-dependent diabetes. Little is known about this benign condition. Clinically and radiologically, this entity may simulate malignancy. The presence of an underlying auto-immune disorder or diabetes may suggest the correct diagnosis. The authors report two cases of fibrous mastopathy and suggest that core biopsy could replace surgical biopsy for diagnosis.

Adult↗
PubMed1998

[Contralateral axillary lymph node metastasis of cancer of the breast].

Contralateral axillary metastases (CAM) of breast cancer are uncommon, they state some diagnostics and therapeutics problems. From February 1993 until June 1996, 6 cases of CAM were detected in 123 women having a breast's cancer (4.9%). The diagnostic of CAM, was retained after a normal clinical and mammographic examination of ipsilateral breast, and a anatomopathological proof confirming the carcinomatous infiltration of axillary ganglions. These metastases were synchronous for 3 patients and metachronous for the 3 others with an appearance's mean delay of 12 months. The 6 patients were treated for a breast's cancer locally advanced and a tumour with internal or central seat in 5 cases. The CAM were associated to others metastatic areas in 2 patients. Five patients have had a locoregional treatment of CAM (curage and/or axillary radiotherapy), associated to chemotherapy. The 6th patient, is multimetastatic, had refused the treatment. Only 1 patient has developed a tumor of ipsilateral breast after a mean delay of 7 months, others metastatic localizations are appeared in 2 patients after a mean delay of 8 months. The CAM are considered a scare entity with physiopathological mechanism not yet well elucidated. They are perhaps, the prerogative of advanced tumors and the often before metastatic spreading. A problem remains to be raised: is it a question of a real CAM, or an expression of a ipsilateral breast's occult carcinomatous?

Adult↗
PubMed1996

[Serious urinary infections and pregnancy].

Retention of infected urine in the upper urinary tract which is due to obstruction is a serious condition during pregnancy. The authors report their experience on five cases and propose attitudes to adopt against such emergency. Ultrasounds allow accurate diagnosis of the obstruction and may be helpful to find its etiology. Plain X ray film could be of interest mainly for stone recognition after the third month of gestation. Surgical treatment, when possible allows either relief of obstruction and cure of the original disease, otherwise performance of percutaneous nephrostomy represents a better way of drainage until the end of pregnancy.

Adult↗
PubMedDate not supplied

[Intraoperative brachytherapy in the management of keloids. Apropos of 114 cases] .

PURPOSE: Keloid scars are unsightly, especially when located on the face or bare zones. The purpose of this study was to evaluate the therapeutic results of intraoperative brachytherapy in the management of keloids. MATERIAL AND METHODS: This retrospective study was based on the study of 82 patients with keloids treated in Salah Azaiz Institute (Tunisia) between 1982 and 1994 (65 women and 17 men). The mean age of patients was 23.4 years (+/- 8.4). A total of 114 lesions have been treated with surgical resection and intraoperative brachytherapy using an iridium source placed under the surgical scar. The length of iridium was chosen with the result that the radioactive thread exceeded 5 mm on each side of the surgical scar. The iridium source was loaded less than six hours after resection. Average iridium activity was 1.5 +/- 0.3 mCi/cm. Average iridium length was 56.8 +/- 34 mm. The referred isodose chosen for the target volume included the surgical scar and a margin of 5 mm around the iridium source, which was placed under the surgical scar. The average administered dose was 20.4 Gy (+/- 3.2 Gy). RESULTS: The 2-year local control rate was 87% for the whole group of lesions treated (n = 114). Local control rate of keloids processed by resection and intraoperative brachytherapy as the first treatment (59 cases) was 96% at two years. This rate was better than the local control of lesions that had been previously treated with anterior surgical resection (84% in 55 cases). For the latter group, lesions treated with a dose of more than 20 Gy had better local control, but the difference was not statistically significant (87 vs. 65% at two years, P = 0.41). CONCLUSION: Intraoperative brachytherapy is effective for improving local control of keloids and preventing a recurrence. A rigorous technique and an adequate dose according to previous surgical treatment allows very good results.

Adult↗
PubMedDate not supplied

[Cutaneous lymphoma in Tunisia: clinical profile and therapeutic results].

PURPOSE: The aim of this retrospective study was to investigate therapeutic result of cutaneous lymphoma in Tunisia. PATIENTS AND METHODS: Between January 1969 and June 1994, 100 patients with cutaneous lymphoma were referred either to Salah Azaiz Institute or the other University Hospitals of Tunisia. Fifty-one patients had epidermotropic lymphoma and 49 non-epidermotropic lesions. Eighty-seven patients received complete treatment. Puvatherapy and other local dermatologic treatments were used for early stage mycosis fungoïdes. Thirty-two patients benefited from radiotherapy, with curative dose in 28 cases. Chemotherapy including anthracyclin agents was used for high grade lymphoma. Thirteen patients had association of radiotherapy and chemotherapy. RESULTS: Five-year survival rates were 50% for patients with epidermotropic lesions and 56% for patients with non-epidermotropic cutaneous lymphoma. Statistical study has not identified any significant prognosis factor. CONCLUSION: Radiotherapy and chemotherapy are both effective. Treatment should depend on stage and histologic type.

Adolescent↗