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Biomedical subjects

E Sfar

Publications and source records attributed to E Sfar.

At least 19 recordsLinked to original sources

[Uterine sarcomas: clinical and therapeutic aspects (10 cases)].

PURPOSE: Uterine sarcomas are rare tumours characterized by clinical and histopathological diversity and poor prognosis. We analyzed diagnostic, prognostic and therapeutic difficulties encountered with these tumors by insisting on the importance of early diagnosis. PATIENTS AND METHODS: From 1997 to 2004 ten patients with uterine sarcoma who underwent surgery in the obstetrics and gynecology unit at the Tunis maternity center were included in this retrospective study. The tumors were classified at the time of diagnosis using the FIGO staging system. The histological diagnosis was based on the WHO classification. RESULTS: There were 5 cases of leiomyosarcoma, 2 cases of carcinosarcoma, 2 cases of endometrial stromal sarcoma and 1 adenosarcoma. There were four cases of stage I, two cases of stage II, two cases of stage III and two of stage IV tumors. The diagnosis of uterine sarcoma was strongly suspected and proved before the initial operation in 20% of cases and during this operation in 60% of cases. Diagnosis was only established at the histological exam in two cases. Total hysterectomy with bilateral salpingo-oophorectomy was performed in 90% of patients. Radiation therapy was performed in four. Chemotherapy was delivered in two patients. After an average of four years five patients were in remission, three had died and two were lost to follow-up. CONCLUSION: Early preoperative or intra-operative diagnosis is essential while awaiting for more effective chemotherapy protocols or therapeutic strategies.

Adolescent↗

[Diagnosis of holoprosencephalia. Report of 17 cases].

OBJECTIVE: To establish the epidemiologic profile of holoprosencephalia and determine benefits of ultrasound and foetopathologic examination to the diagnostic. METHODS AN MATERIAL: [corrected] Retrospective study about 17 cases of holoprosencephalia observed in CMNT between Janaury 1992 and September 2000. RESULTS: Ultrasound diagnosis was made in 13 cases (75%). Ultrasound criteria were; absence of median structure of the brain and unique ventricule. The prognosis was always bad. Foetopathologic examination revealed 7 cases of lobar holoproencephalia and 10 of semi lobar. Fascial dysmorphia were noted in 82% of cases. CONCLUSION: The foetopathology and genetic counselling looking for fascial, dysmorphia in family's members gives a good evaluation of recurrences.

Adult↗

[Fetal pathology study of 88 cases of letal spina bifida].

Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.

Adult↗

[A triple association: renal malacoplakia, bilateral vulvar hypertrophy, upper limb algodystrophy].

The authors report a case of malakoplakia of the left renal parenchyma, an uncommon site for an inflammatory disease first described in the bladder by Michaelis and Guttmann in 1902 and Von Hansmann in 1903. This case was observed in a 24-year-old girl with no urological history, presenting with bilateral vulval hypertrophy and reflex sympathetic dystrophy of the upper limbs, in whom malakoplakia of the left kidney was discovered incidentally. Intravenous urography showed two large kidneys with a stretched appearance of the renal pelvis. Pathological examination of the partial nephrectomy specimen revealed the diagnosis of malakoplakia, an inflammatory diseases of the renal parenchyma. The pathogenesis has been only partially elucidated, but probably involves a disorder of macrophage function.

Adult↗

[Uterine rupture during labor. Report of 106 cases at the Maternity Center of Tunis (Tunisia)].

This study involves 106 cases of the uterus seen at the Rabta Maternity and Neonatology Center (Tunis) over a period of 6 years. The incidence was 1.51% of labors and 75.4% of cases involved rupture of a scarred uterus. Rupture of a healthy uterus accounted for 24.6% of cases. The clinical picture was asymptomatic in 66.25% of cases involving a scarred uterus. Treatment of rupture of the uterus was essentially conservative by suture of the tear (73.6%). Maternal mortality was 2.8%. Perinatal mortality was high at 37.7%.

Adult↗

[Norplant contraception at the Rabta Tunis maternity hospital].

612 women had the benefit of contraceptive implants in the Maternity Hospital of La Rabta in Tunis over a period of 5 years (1988-1992). This study aimed at analysing the tolerance of this method by studying a group of 508 normal women and 104 women at risk (58 women were heart-diseased, 22 nursing, 13 diabetic, 11 hypertensive). The typical woman in this group is thirty years old, having 3 children, and weighing 61 kg. The implants were most of the cases withdrawn because of problems related to the menstrual cycle that were observed in 37% of the cases, equally distributed among both groups of the series. Contraceptive implants failed in 1.79% of the cases.

Adolescent↗

[Analysis of placenta accreta risk factors. 8 case reports].

The authors report 8 cases of placenta accreta during a 7-year period between March 1986 and January 1992. There were 72,399 deliveries at the Rabta Tunis Maternity and Neonatalogy Centre during this same period, i.e. a rate of 0.11%. Risk factors were dominated by multiparity (7 cases), uterine scars (7 cases) and placenta praevia (5 cases). Associated rupture of the uterus was seen in 2 cases. There was no ultrasonographic diagnosis of placenta accreta before delivery. The diagnosis invariably made at the time of delivery was confirmed histologically in all cases. Hysterectomy was performed in 7 cases and a partial resection of the uterine horn in 1 case. Maternal mortality was nil. There was perinatal mortality in 4 cases, linked twice to prematurity and twice to hypoxia secondary to severe hemorrhage. Analysis of these 8 cases and a review of the literature form the basis of a discussion of the epidemiological profile and clinical and paraclinical characteristics of this condition and an evaluation of foeto-maternal prognosis.

Adult↗