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Biomedical subjects

F Mghaieth

Publications and source records attributed to F Mghaieth.

13 recordsLinked to original sources

[Inhospital prognosis of acute myocardial infarction: comparison of two periods to ten years of interval].

Acute myocardial infarction prognosis depends on many factors relative to the patient, to the disease and to the quality and promptness of the treatment. The interventional revascularisation is superior to pharmacological revascularisation. The aim of the study is to compare acute myocardial infarction inhospital lethality in the coronary care unit before and after use of emergency angioplasty. The retrospective study compared inhospital lethality over two four years periods separated by an interval of ten years: [1991-1994] and [2001-2004]. Lethality had increased from 7.8% to 11.3%. During the second period emergency angioplasty (under 24 hours) primary (4.8%) or rescue (2.5%), not applied in the nineties, was not related to survival and did not allow an improvement of patients' hospital prognosis. The population of the second period was characterized by: a greater average age (60.8 vs. 58.6 years), more female subjects (20.1 vs. 14.6%), less nicotinic subjects (60.2 vs. 78.5%) and less patients receiving fibrinolytic treatment (43.0 vs. 50.4%). These parameters were as many factors related to the risk of hospital death in univariate analysis. The multivariate analysis showed that after adjustment on all the other factors the lack of thrombolysis remains unquestionably related to the hospital overlethality. The time delays for admission in the intensive care unit were relatively long and comparable over the two periods (8.2 vs. 7.5 hours). Within our hospital structure early angioplasty not being able to be realized in the hour, which follows the diagnosis on a large scale, and in a continual way, it would be preferable to always consider thrombolysis first in all cases apart from contraindications without excluding the possibility of a hybrid treatment.

Aged↗

[Inferior rhegmatogenous retinal detachments: clinical and therapeutic characteristics].

PURPOSE: To determine the epidemiological and clinical factors involved in inferior rhegmatogenous retinal detachments and to propose a therapeutic plan. PATIENTS AND METHODS: A retrospective case note review of 173 patients (175 eyes), 11-89 years old, who had been operated on for inferior retinal detachment over a 13-year period between 1990 and 2003. RESULTS: The retinal reattachment rate after initial surgery was 79.5%, the final anatomical success rate was 81.5%. Scleral buckling surgery was used for the primary repair of rhegmatogenous retinal detachments in 111 cases and it was successful in 81 cases. Fifty-eight patients underwent vitrectomy with internal silicone oil tamponade. Anatomical success was obtained in 55 cases (94.8%) without recurrence. Endocular surgery allowed surgeons to find missed causal tear in 76% of cases. Mixed surgery was undertaken in four cases, with three good results. Visual acuity improved in 81% of cases, remained unchanged in 15% of cases, and deteriorated in 4% of cases. The mean final visual acuity ranged from 2.5 to 3/10, while it was only 1/20 before surgery. The mean improvement in visual acuity was 2.5 lines. The mean follow-up in our study was 13+/-11 months. CONCLUSION: Inferior retinal detachment usually occurred in young myopic or old pseudophakic subjects. These patients are characterized by the absence of tears. Vitrectomy in primary repair with inferior retinal detachment improves their anatomical and functional prognosis.

Adolescent↗

[Treatment of subfoveal choroidal neovascularization in pathologic myopia with photodynamic therapy: outcomes at 1 and 2 years of follow-up].

PURPOSE: To evaluate the visual outcome of photodynamic therapy with verteporfin in patients with subfoveal choroidal neovascularization (CNV) caused by pathologic myopia. METHODS: Retrospective and noncomparative analysis of 42 patients with CNV secondary to pathologic myopia recruited between September 2001 and 2003, who were treated with a standard regimen of photodynamic therapy with verteporfin. RESULTS: Forty-two patients were followed up for 12 months; 15 out of 42 completed 24 months of follow-up. Initial visual acuity ranged from 1/10 to 5/10 with a mean of 1.6/10. Twenty-five (56.7%) eyes had stable or improved visual acuity at 12 months with a mean of 2.5/10. In the group of patients who completed 24 months of follow-up, six eyes (39.9%) had stable or improved visual acuity with a mean of 1.6/10 at 1 year and 1.25/10 at 2 years. The average photodynamic therapy treatment required in 1 and 2 years were 1.5 and 2.1, respectively, and they are less than those reported by the Verteporfin in Photodynamic Therapy (VIP) study. CONCLUSION: Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization caused by pathologic myopia maintained a visual benefit at 1 and 2 years.

Adult↗

[Late recurrent retinal detachment after scleral buckling].

PURPOSE: To analyze the physiopathologic mechanism, therapeutic modalities, and prognosis of late recurrent retinal detachment. METHODS: A retrospective study was conducted on late recurrent retinal detachment operated with episcleral surgery over a 15-year period. Ten patients were included in this study. RESULTS: Late recurrent retinal detachments occurred in 0.39% of all retinal detachments repaired by episcleral surgery over 15 years. Redetachment occurred 3-7 years after surgery, with etiologies including new retinal breaks (seven cases), reopening of old breaks (three cases), and removal of scleral explant (one case). Proliferative vitreoretinopathy (PVR) grade B was seen in three cases, grade C in six cases, and grade D in one case. After reoperation, the retina was reattached in nine cases. Three eyes were treated with scleral buckle, the others underwent vitreoretinal surgery. Failure occurred in one patient who had a very high level of vitreoretinal proliferation. CONCLUSION: Late recurrent retinal detachments are rare and vitreous base traction seems to be an important factor, although the associated PVR was probably a secondary factor. Treatment depends on PVR, with vitreoretinal surgery necessary in some cases. They usually have a good prognosis.

Adult↗

[Cardiac involvement in Emery-Dreifuss muscular dystrophy: a case report].

Emery Dreifuss muscular dystrophy (EDMD) is an uncommon hereditary myopathy characterized by 3 symptoms: slow progressive muscular atrophy, muscular contractures and cardiac disease which affect prognosis. We report a 22 year-old patient with EDMD which shows the typical features of the associated dilated cardiomyopathy, ventricular arrhythmia, atrio-ventricular block, atrial standstill then atrial paralysis.

Adult↗

[Cysts of the iris in an infant. 2 case reports].

Iris cysts are rare in children. They might be primary or secondary. Their treatment depends on their type and clinical evolution. The purpose of our study is to discuss the etiologies and therapeutic modalities of iris cysts.

Child↗

[Subtenon anesthesia by single injection at the inner canthus for surgery of the posterior segment].

PURPOSE: To evaluate a new technique of local anesthesia namely caruncular anesthesia (subtenon anesthesia by single injection at the inner canthus of the eye) in vitreoretinal surgery. PATIENTS AND METHODS: We carried out a prospective study from June 2002 to May 2004. We performed 140 consecutive vitreoretinal procedures that lasted less than two hours: 56% were endovitreal, 36% were episcleral and 8% were combined. RESULTS: The delay for anesthesia onset was 6 min (average time). We obtained a complete akinesia score in 83% of cases. Our reinjection rate was 11%. Sedative supplementation was given peroperatively in 11% of the cases. Surgeon satisfaction was complete in 78% of the cases, and patients satisfaction was complete in 84% of the cases. No complications were observed during the study. CONCLUSION: Caruncular injection as local anesthesia is an interesting technique for vitreoretinal surgery. Subtenon anesthesia is an interesting efficacious and secure technique that can be used during long and painful interventions with satisfactory results.

Adult↗

[Traumatic cataract: clinical and therapeutic aspects].

PURPOSE: To assess clinical and therapeutic outcomes in traumatic cataracts. METHODS: Retrospective study of 20 cases of traumatic cataracts seen between 2001 and 2004. Mean age at diagnosis was 35 years (5-72 yr), 25% were infants. There were 11 women and 9 men. Extracapsular cataract extraction was performed in eighteen patients (90% of cases), 13 were implanted in posterior chamber, 3 having zonular rupture were implanted in anterior chamber. Two patients remained aphakic because of retinal lesions. Two patients with lens subluxation underwent intracapsular cataract extraction with anterior chamber implantation. The mean delay of surgery was 4 weeks. RESULTS: Overall satisfactory with 55% of final visual acuity more than 1/10. Visual acuity was better in implanted eyes, poorer in infants and after ocular perforation. Fibrinous uveitis was the common early postoperative complication especially in children. CONCLUSION: The majority of eyes with traumatic cataract could be safely rehabilitated after surgery and lensimplantation. In traumatic cataract, the vision can be severely threatened, preventive methods should be encouraged.

Adolescent↗

[Simultaneous bilateral rhegmatogenous retinal detachment. 7 case studies].

PURPOSE: Simultaneous bilateral rhegmatogenous retinal detachments are rare. The purpose of our study was to examine the incidence, predictive factors, surgical results and prognosis of these retinal detachments. PATIENTS AND METHODS: A retrospective analysis of the medical records of 468 consecutive patients, 7-89 years of age (mean, 45.7 years), undergoing surgery for rhegmatogenous retinal detachment between 1993 and 2000. RESULTS: During this period, a total of 497 operations for rhegmatogenous retinal detachment were done. Thirty-two patients had bilateral rhegmatogenous retinal detachment. Simultaneous detachments were observed in seven patients (1.5%). In four cases, the diagnosis of retinal detachment was fortuitous. In fact, most patients presented with unilateral symptoms. The mean age (35 years) of patients suffering from simultaneous bilateral rhegmatogenous retinal detachment was younger than that of patients with unilateral or consecutive bilateral retinal detachments. Five patients were myopic. Multiple round retinal holes were the most frequent lesions responsible for retinal detachment. A preoperative proliferative vitreoretinopathy was found in 57% of cases. The retina was reattached in nine cases (81%). CONCLUSION: Simultaneous bilateral rhegmatogenous retinal detachment is usually found in relatively young myopic patients with atrophic retinal holes. They are rare but severe because of their frequent association with preoperative proliferative vitreoretinopathy.

Adolescent↗

[Prognostic significance of second and third degree atrioventricular block in acute inferior wall myocardial infarction].

High degree atrioventricular block complicates inferior wall acute myocardial infarction in 10 to 15% of cases. Its significance is still controversial. In this study, we have analysed 152 observations of acute inferior wall myocardial infarction during hospitalisation period. The mean age of our patients is 60 years, 48.7% of them have received fibrinolytic treatment. Second or third degree atrioventricular block was detected in 33 cases (21.7%). Mortality is higher in inferior wall myocardial infarctions with atrioventricular block than in those without atrioventricular block (12% versus 2.5%, p < 0.05). Hemodynamic complications like cardiogenic shock due to the extension of the infarction to the right ventricle and left ventricle insufficiency are more frequent (18% versus 3.4%, p < 0.01 and 12% versus 3.5%, p < 0.01 respectively). It appears that the infracted mass of myocardium is larger in case of atrioventricular block, this is assessed by comparing the average value of the peak of creatine Kinase in the two groups with and without atrioventricular block (1534 IU versus 1096 IU, p < 0.02) and by considering the rate of low ejection fraction (EF < 40%) in each group (44.6% versus 16%, p < 0.01). In our study, we note that thrombolysis does not affect the incidence of atrioventricular block (19% and 24% in thrombolyed and not thrombolyzed patients respectively) but it seems that thrombolysis improves the outcome of these patients. The occurrence of atrioventricular block in acute inferior wall myocardial infarction is related to the presence of an important right coronary artery that is occluded, the recanalisation of this vessel leads often to rapid regression of the block that is no longer pejorative.

Acute Disease↗

[Intumescent cataract with ocular hypertony].

INTRODUCTION: Intumescent cataract with ocular hypertony is a medicosurgical emergency. The purpose of our study is to define the clinical and therapeutic particularities of these cataracts. MATERIAL AND METHODS: This retrospective study includes 40 consecutive patients with angle closure secondary to intumescent cataract. All patients were examined between 1st January 1998 and 30 October 2000. RESULTS: The patient population consisted of 28 women (70%) and 12 men ranging in age from 59 to 88 years (mean age: 78 years). Preoperative visual acuity was negative in 17% of cases and limited to light perception in 83% of cases. Ocular pressure varied from 25 to 68 mmHg. Patients underwent surgery one to 23 days after diagnosis. Surgical techniques consisted in extracapsular cataract extraction with (35%) and without (65%) intraocular lens. Preoperative complications were: vitreous loss in 20% of cases and expulsive haemorrhage in 2 cases (5%). Postoperative visual acuity improved in 70% of cases. COMMENT AND CONCLUSION: Intumescent cataract with ocular overpressure gives therapeutic problems, which can be prevented by a preoperative hypotony. Functional results of this study encouraged us to operate the intumescent cataract even if visual acuity is bad.

Aged↗

[Management of posteriorly dislocated lenses: a report on 18 cases].

The posterior dislocation of the lens is a relatively frequent complication of ocular trauma. Treatment is medical, surgical and optical. The authors present a retrospective study of 18 patients (18 eyes) operated between January 1990 and December 1999 for a posterior dislocation of the lens. The age of the patients varied from 9 to 60 years, with a mean of 46 years. The etiology of the dislocation was an eye contusion in 15 cases and spontaneous dislocation in 3 cases. Vitrectomy was performed in all the patients, followed by extraction of the lens using one of two methods Results were good in both groups, with a final visual acuity better than 1/10 in 11 cases out of 18. Complications were substantially fewer than when using old techniques and included 4 cases of hypertonia, 3 cases of corneal edema, 2 cases of retinal detachment, and 1 case of macular edema. All of these complications were treated medically and/or surgically. The authors discuss the advantages and disadvantages of all lens extraction techniques and the benefits of the use of perfluorocarbon liquid in the treatment of the dislocated lens.

Adolescent↗