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Biomedical subjects

K Ayadi

Publications and source records attributed to K Ayadi.

17 recordsLinked to original sources

Can careful ultrasound examination of the urinary tract exclude vesicoureteric reflux in the neonate?

The aim of the study was to determine whether a urinary tract appearing normal when assessed by meticulous ultrasound (US) examination may coexist with vesicoureteric reflux (VUR) and whether a normal US scan can be used to exclude VUR, thereby avoiding unnecessary voiding cystourethrography (VCUG). The US features of 35 neonates with known VUR were reviewed. Criteria studied included pelvic dilatation above 7 mm on a transverse scan, calyceal or ureteral dilatation, pelvic or ureteral wall thickening, absence of the corticomedullary differentiation (CMD) and signs of renal dysplasia (small kidney, thinned or hyperechoic cortex and cortical cysts); all signs that have been shown to result from or to be associated with VUR. 57 refluxing renal units (RRU) were found among the 35 patients. VUR was bilateral in 22. Among the 57 RRU, at least one US anomaly that would have prompted VCUG was present in 50 (87.7%). Pelvic dilatation above 7 mm was present in 29 RRU (50.9%) only. Calyceal dilatation was present in 24 RRU, the dilatation involving the calyces but not the renal pelvis in seven. Ureteral dilatation was observed in 15 RRU. Pelvic or ureteral wall thickening was present in seven RRU. CMD was absent in 32 RRU (56.1%). US signs of dysplasia were found in 19 RRU. No US anomaly was found in seven RRU (12.3%) in six patients. A careful and meticulous US examination of the neonatal urinary tract allows the detection of over 87% of RRU by showing at least one sonographic abnormality. It is concluded that a normal appearing urinary tract on US does not usually coexist with VUR and that in such cases VCUG is not necessary.

Dilatation, Pathologic

[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

[Abdominal emergencies of infectious origin].

Infectious disease is a common cause of acute abdomen. The diagnosis is based on clinical examination and basic laboratory tests. However, medical imaging routinely performed according to the clinical findings is frequently useful. Hepatic and splenic abscesses are correctly demonstrated by ultrasonography and computed tomography. Ultrasonography is the reference standard for the diagnosis of acute cholecystitis. The US examination is also performed for the diagnosis of appendicitis and its complications. Ultrasonography and barium enerna are commonly performed for the evaluation of signoid diverticulitis. Computed tomography is the reference standard to determine medical or surgical procedures.

Abdomen, Acute

[Acute pancreatitis].

The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients.

Acute Disease

[Thoraco-abdominal digestive duplication].

The authors report a case of a thoraco-abdominal duplication of the foregut, observed in a 10-year old boy. Thoraco-abdominal duplication is an expression of notochordodysraphia, as it is frequently associated with vertebral malformations. Barium meal, ultrasonography and CT-Scan should provide a preoperative diagnosis. One-stage total excision in a single stage is mandatory in order to treat the symptoms and avoid the risks of further progression.

Cardia

[Mondini's malformation. Apropos of a case].

Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.

Cerebrospinal Fluid Otorrhea

Hippocampal EEG responses induced by carbachol and atropine infusions into the septum and the hippocampus in the urethane-anaesthetized rat.

Infusion of 1 microgram of carbachol, a potent cholinergic agonist, into the lateral septum of the urethane-anaesthetized rat systematically caused the induction of clear-cut hippocampal theta (theta). However, infusion of an equivalent amount of the drug into the hippocampus, close to the recording electrode, failed to induce theta in 50% of the animals and produced a mixture of theta waves and desynchronized activity, resulting in atypical EEG patterns, in the remaining subjects. Both carbachol EEG effects were blocked by intraseptal infusion of the antimuscarinic agent, atropine. Our data demonstrate that muscarinic receptors in the septum are predominant sites for cholinergic agonist-antagonist action capable of generating or suppressing hippocampal theta in the rat. They also indicate that intraseptal cholinergic mechanisms play an important role in the initiation and generation of this rhythm.

Anesthesia

[Tuberculosis of the trochanter. Apropos of 17 cases].

This paper presents a short study of 17 cases of tuberculosis of the greater trochanter seen during a period of 19 years at the National Orthopaedic Institute in Tunis. The onset of the infection is slow with patients presenting at a mean of 7 years after initial symptoms. The diagnosis is confirmed by biopsy and culture of the organism. Management is based on treatment with antituberculous drugs, although surgical excision of the lesion is sometimes required. Successful resolution of the symptoms is usually achieved unless the hip joint becomes involved. Our patients showed good results at a mean follow up of 5 1/2 years.

Adolescent

[Malignant otitis externa (2 cases)].

Malignant external otitis is a progressive necrotizing otitis. It's a rare severe and evolutive clinical entities, old diabetics are the most victim. Pseudomonas aeruginosa is the bacteria responsible in the most cases. Prognostic vital can be affected, treatment must be energic, rapid and well adapted. The authors report two old diabetic women presenting a malignant external otitis and discuss etiopathogenic, physiopathologic, diagnosis and treatment of this illness.

Anti-Bacterial Agents

Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases.

Three-dimensional (3D) reconstruction in routine computerized tomography (CT) presupposes that the referring clinicians are motivated, software programs are of good quality, a second working console is available and manipulations are made by experienced persons. Maxillofacial surgery is the main, conventional indication, but the method is also used to plan the surgical treatment of craniofacial malformations and that of injuries and tumours. 3D reconstruction cannot replace a thorough analysis of the acquisition sections since its spatial definition is not as good as theirs. Without competing with pure research-work, a number of applications remain in the realm of speculative imaging, but it cannot be denied that 3D reconstruction has an interesting potential for teaching.

Adult

[The misleading blue tympanic membrane. Prolapse of the internal jugular vein].

The authors report a case of a jugular bulb dehiscence extending to the tympanic cavity. They alert that the finding of a blue mass in the middle ear should evok the possibility of a vascular variant or abnormalitie. High resolution CT is extremely helpful in the correct diagnosis by showing the subtle and characteristic bone changes.

Adolescent

[A rare cause of multiple lacunae of the cranial vault and temporal bone in adults: histiocytosis X].

Histiocytosis X is an uncommon disease. Temporal bone involvement is a frequent head and neck manifestation. Most patients are under fifteen years of age. The authors report a case of a bilateral extensive temporal involvement complicated with vertigo and peripheric facial palsy. CT plays a dominant role in the diagnosis because of the ability to identify bone destruction, soft tissue involvement and intra-cranial histiocytosis more accurately.

Facial Paralysis