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Biomedical subjects

J Mnif

Publications and source records attributed to J Mnif.

At least 19 recordsLinked to original sources
PubMed2002

[Clinical case of the month. Iliac artery endofibrosis in a soccer player].

Arterial endofibrosis is a rare disease, usually affecting the external iliac artery in highly trained athletes. We report a case of external iliac endofibrosis in 42-year-old top level athlete. Clinical consequences were a high intensity exercise related sensation of swollen thigh, with normal clinical examination. Ultra sound investigation showed fibrotic thickening of the left external iliac artery. Angiography confirmed stenosis of the left external iliac artery. The patient was treated surgically, he underwent remodeling of his left external iliac artery with venous angioplasty. No complications occurred in the post operative course, and the patient return to training after three months.

Adult↗
PubMed2001

[Perrault's syndrome: two cases].

Perrault's syndrome is an autosomal recessive ovarian dysgenesis associated with sensorineural deafness. We report two cases in sisters issuing from consanguinous parents. Aged 16 and 21 years, both patients present the two cardinal symptoms of the syndrome. Magnetic resonance imaging in the second sister showed high intensity signals in the periventricular and subcortical white substance and in the central ovale, suggestive of cerebral leucodystrophy. This element may be one of a wide spectrum of neurological symptoms found in Perrault's syndrome. The discovery of the causal genes may allow better understanding of the biomolecular mechanisms involved in gonad and sensorineural differentiation.

Adolescent↗
PubMed1999

[Trans-ethmoid encephaloceles].

We report two cases of ethmoidal cephaloceles. Ethmoidal cephaloceles are very rare and most commonly present with recurrent episodes of meningitis or sometimes as a nasal mass. Diagnosis is made at MR and CT. Such imaging studies should be obtained in patients with recurrent meningitis or patients with polypoid nasal lesions prior to biopsy.

Adolescent↗
PubMed1998

[Fanconi disease: study of 43 cases in southern Tunisia].

BACKGROUND: To report the epidemiologic, clinical, biological features and course of Fanconi's anemia in southern Tunisia. PATIENTS AND METHODS: During a period of 12 years we observed 43 cases. For each patient, careful clinical, biological (hemogram, myelogram, bone marrow biopsy, hemoglobin electrophoresis, karyotype) and radiological (skeleton X-rays, abdominal echography and intravenous urography) examinations were performed. All the patients who were at a pancytopenia stage were given androgens. None had a bone marrow allograft. RESULTS: There were 24 girls and 19 boys. The mean age at diagnosis was 10 years and 9 months. The familial character was present in 53% of the cases. The most frequent initial complaint was anemic syndrome (69%). In ten cases (24%), the diagnosis has been established during a familial investigation. Malformations were present in all cases (abnormal pigmentation: 86%; skeletal maturation retardation: 83%; facial dysmorphy: 76%; statural hypotrophy: 65%; bone abnormalities: 53%; renal malformations: 44%). Anemia was present in 88% of the cases, thrombocytopenia and neutropenia in all cases. Bone marrow was hypoplastic or aplastic in all cases on biopsies. Spontaneous chromosomal breaks were found in 79% of the studied cases. Fetal hemoglobin was increased in 80% of the studied cases with a mean level of 20.5%. Actuarial survival rate at 5 years was 48%, but long survival durations were rare (eight out of 43 patients). DISCUSSION: This disease, rare in the world, seems to be frequent in southern Tunisia. A normal karyotype (with classical techniques), found in five patients, could not discard the diagnosis; for this reason, the use of sensitizing agents should improve the sensitivity of the test. Besides, an increased level of fetal hemoglobin enabled us to suggest the diagnosis in some cases. Androgenotherapy increased the survival duration to more than 5 years in eight patients. However, bone marrow allograft remains the only possibility of cure.

Adolescent↗
PubMed1997

[Ultrasonography in the diagnostic approach of septic arthritis].

PURPOSE OF THE STUDY: Septic arthritis is frequent in Tunisia and is responsible for orthopedic sequela. The purpose of this study was to establish the indication and the viability of ultrasound scanning in the early diagnosis of septic arthritis. MATERIAL AND METHODS: 82 patients were explored by ultrasonography for suspected septic arthritis. Mean age was 7 years (range 2 months to 37 years). All sonographic studies were performed using a 7.5 MHZ transducer. 52 patients were surgically treated or had joint aspiration. Only 39 patients had septic arthritis. The hip and the knee were the most frequent localisation (respectively 20 and 12 cases). RESULTS: Statistical analysis showed that the ultrasound scanning in the diagnosis of joint effusion had a sensitivity of 93.4 per cent and a specificity of 100 per cent. Matter floating within the joint effusion was noted in 50 per cent of septic arthritis. These changes were not found in other arthritis. The thickness of synovialis and joint capsule was not specific of septic arthritis. In hip septic arthritis (51 per cent of localisation) the mean width of the anterior synovial recess was 11.7 mm (5-20 mm). In the asymptomatic opposite hip, the mean width was 3.6 mm (2.6-5 mm). Cortical irregularities had suggested osteomyelitis of femoral neck in osteoarthritis of the hip in 4 cases. Subperiosteal abscess of the femoral neck was directly visualized in another patient. DISCUSSION AND CONCLUSION: Our expense highlights that sonography may be a useful tool in the management of patient with suspect septic arthritis. Sonography allows early diagnosis of joint effusion with high accuracy. Hyperechoĭc or mixed aspects of the fluid joint suggest septic origin.

Adolescent↗
PubMed1997

[Ultrasonography of acute osteomyelitis of the long bones in children. Diagnostic and prognostic value].

Between 1991 and 1994, ultrasonography was used to investigate 90 consecutive children with acute osteomyelitis. Ultrasonographic findings were analyzed taking into account the time elapsed from first symptoms. Outcome in 47 children who were treated and followed for at least 6 months was also studied. Deep soft tissue swelling adjacent to the affected bone was found to be an early but nonspecific sign which persisted all along the course of the disease. Periosteal elevation smaller than 3 mm, secondary to exsudation or septic fluid, confirmed the disease in earliest stage and was the most frequent ultrasonographic sign in first three days of disease. Treated at that stage, total resolution was obtained in 66% of patients and stabilization, in 34% of cases, without any evolution toward chronicity. Acute osteomyelitis with subperiosteal abscess progressed toward stabilization in 66% of cases and toward chronic osteomyelitis in 8% of cases. 32% of subperiosteal abscess were ruptured; in such situation, progression to chronicity was observed in 26% of patients. Since ultrasonography has been used in our institution for the diagnosis of acute osteomyelitis, the rate of evolution to chronicity spectacularly dropped from 63% to 11%. The main advantage of ultrasonography is an earlier detection of subperiosteal collection that indicates surgical drainage without any delay.

Acute Disease↗
PubMed1997

[The pathological prostatic utricle: two case reports].

The prostatic utricle is a small vestigial diverticulum on the posterior surface of the prostatic urethra. It is considered to be pathological when it is abnormally dilated. The prostatic utricle is revealed by signs of vesical irritation and dysuria, sometimes associated with a retrovesical mass on examination. The authors report two cases of pathological prostatic utricle. The first case was an 11-year-old boy presenting with dysuria. Retrograde cystourethrography confirmed the diagnosis. The utricle was resected via a transtrigonal intravesical approach. The second case was a 25-year-old man who presented with dysuria associated with a pelvic mass. IVU and ultrasonography suggested a diagnosis of retrovesical cyst. This patient underwent incomplete resection of the utricle via a retrovesical approach. Based on a review of the literature, the authors emphasize the need to look for a prostatic utricle in a young subject presenting with dysuria, particularly in patients with a malformation of the genitourinary tract (hypospadias, renal agenesis). All pathological prostatic utricles must be treated surgically. The incision is transtrigonal in medium-sized utricles and transperitoneal in large utricles. The utricular cavity must be resected as completely as possible.

Adult↗
PubMed1996

[Therapeutic attitude in postcatheterization symptomatic stenosis of the subclavian vein].

We report 4 cases of subclavian vein stenosis after hemodialysis occurring in 4 women with a mean age of 36 years. The duration of subclavian catheterization was 1 to 11 months. The diagnosis was established by angiography or phlebography. The treatment was always surgical: axillo-internal jugular bypass: 1 case; deviation of the internal jugular vein: 1 case; basilo-internal jugular bypass: 1 case; axillo-axillary bypass: 1 case.

Adult↗
PubMed1996

[Bladder hernia apropos of a case report].

The authors report a case of bladder hernia associated to prostatic benign hyperplasia. The diagnosis is confirmed by intra-venous urogram and computed tomography imaging. The reintegration of the bladder in the abdomen was performed in association to endoscopic resection of the prostate. Bladder hernia is rare condition. Surgical treatment of bladder hernia is associated to the etiology (prostatic benign hyperplasia...) of the hernia to prevent recurrence.

Diagnostic Imaging↗
PubMed1996

[Renal needle biopsy in children. Technical aspects and results].

Renal needle biopsy is still irreplaceable in children. The objectives of this retrospective study were to specify the technical aspects and the main nephropathies encountered. 152 children under the age of 16 years (13 +/- 3), 79 boys and 73 girls, underwent renal biopsy. The biopsy was performed after radiographic detection in 71 cases, and under continuous ultrasound guidance in 81 cases. The comparative study of these 2 techniques revealed the superiority of continuous ultrasound guidance, allowing biopsy of an essentially cortical fragment, rich in glomeruli with a limited number of punctures. Histological examination showed a predominance of glomerular nephropathy with, especially, visually normal kidney and membranoproliferative glomerulonephritis. These data encourage us to perform ultrasound-guided RNB in children and to eradicate sites of infection, particularly involving the upper respiratory tract.

Adolescent↗
PubMed1995

[Cancer of the testis in cryptorchidism. Apropos of 5 cases].

Five cases of cancer of the testicle in patients with cryptorchidism are presented. In one case the tumour occurred 16 years after cure for cryptorchidism at 15 years of age. In the other cases, the tumour developed on a testicle in an inguinal or intra-abdominal position. In two cases, it was impossible to remove the tumour which had developed on an intra-abdominal position. These patients died. These cases emphasize the importance of surgical cure in all cases of cryptorchidism, preferable before the age of 2 years, in order to improve functional prognosis and reduce the risk of cancerization. The gravity of cancer of the testicle in cases of cryptorchidism is often discovered too late.

Adult↗