[Value of long term central venous catheters im medical oncology:prospective study of 102 cases].
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Biomedical subjects
Publications and source records attributed to K Rahal.
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In preparation for the meeting of the World Health Organization Working Group on Monitoring and Management of Bacterial Resistance to Antimicrobial Agents, representatives of 10 countries were asked to provide brief reports on the status of surveillance in their countries. Some gave extensive information on the methods used to test susceptibility of nosocomial pathogens to a variety of antibiotics; some described in detail the network of reference laboratories available to hospitals and individual clinicians for monitoring, identifying, and testing infectious agents; others chose to describe how their countries deal with the resistance of the most frequently isolated pathogen to a commonly used drug. The following summary of these reports shows the broad range of problems encountered and solutions undertaken by these 10 countries in dealing with the increasingly alarming problem of bacterial resistance to antimicrobial agents.
We report a case of minimal deviation adenocarcinoma of the uterine cervix in a 32 year old women who present a Peutz Jeghers syndrome. This patient also had fibroadenoma of the breast and dystrophic mastopathy. This case represent an example of predisposition to developing tumors of the Peutz Jeghers syndrome.
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Two epidemic outbreaks of cholera occurred in eastern Algeria in 1994. Sixteen strains of Vibrio cholerae El Tor were isolated from stools and contaminated water. Studies to determine antibiotic sensitivity documented multiresistance in these strains. Minimal inhibiting concentrations ranged from 6 to 32 micrograms/ml for chloramphenicol, from 8 to 24 micrograms/ml for tetracycline except minocycline, and from 15 to 32 micrograms/ml for furanes. Higher values were found for other antibiotics such as trimethoprime (1,500 micrograms/ml), streptomycine (128 micrograms/ml) and sulfamides (128 micrograms/ml). High-grade resistance of Vibrio cholerae El Tor to streptomycine and trimethoprime in association with resistance to 0:129 suggests that transposon is the underlying genetic factor. All resistance markers were located on a single structure that can be transferred to a Escherichia coli receptor and belongs to an Inc J incompatibility group. The fact that plasmid DNA could not be visualized on agarose gel after extraction is also evidence for a transferable transposon.
BACKGROUND: Leiomyosarcomas of the digestive tract are very rare in children. They must be differentiated from benign tumors (leiomyoma, schwannoma...) and from other malignant tumors, sometimes with the aid of immuno-histochemical study. CASE REPORT: A five-year old girl suffered from an abdominal mass associated with fever and alteration of the general condition. An ileal tumor, 8 cm in diameter, was resected. Histological and immunohistochemical studies (anti-vimentin antibodies, anti-actin antibodies and PS100) confirmed the diagnosis of leiomyosarcoma. Uncomplete adjuvant chemotherapy failed to prevent relapse of the tumor. CONCLUSION: This case confirms the bad prognosis of such a tumor.
A series of 133 patients, 35 years or less in age (mean: 31.8) presenting with a carcinoma of the cervix and treated at Salah Azaiz Institute from 1969 to 1989 was analysed and compared to a control group of patients older than 35 years (mean: 54). Neither clinical nor epidemiological particularities were found in the younger patients group, except an early sexual life and a high proportion of early stage tumours (33% versus 15.9% in the older women group). Overall survival of the younger women was dramatically worse than that of the older women: 40% and 50% at 5 years, 20% and 40% at 10 years, and 14% and 30% at 15 years, respectively. This difference is statistically significant in stage I-II patients. Young age, non-sterilization of the tumour after brachytherapy, and anemia, are associated with a poor prognosis.
Microcyst adenomas of the pancreas are rare tumours with characteristic cysts lining the cubic and cylindric epithelia with a clear cytoplasm rich in glycogen. Unlike, mucinous cyst adenomas, there is no tendency toward malignancy. We report a case in a 58-year-old woman and emphasize the importance of precise pre- or per-operative diagnosis in order to avoid excessive exeresis for benign tumour. Certain authors propose abstention and follow up.
Seven cases with echinococcal infection of the ovary, including 3 on both sides, were collected at the Salah Azaiz Institute of Tunis during a period of 23 years. This localisation is rare, even in an endemic country. The aetiology and pathogenesis of this affection may give rise to many different clinical signs, problems with pre-operative diagnosis. It is important to follow up these cases after operation in order to sport recurrences. The objective of surgical treatment is to achieve cure of both the hydatic cyst of the ovary and the primitive cyst simultaneously. Following this treatment, two difficulties may arise: the first one is preoperative rupture of the cyst; the second concerns fertility in these young women after two-sided salpingo-oophorectomy. Finally, when a pelvic cyst is observed systematic hydatic serology must be performed.
Within a multifactorial etiology of cancers and a bio-psycho-social approach of patients, considering, among the risk factors, those related to personality in a preventive view, the authors investigate, by an epidemiologic methodology, for a correlation between break-down phenomena and the development of a cancer. The study was carried out at the Salah Azaïez Institute in 1992 and included 707 patients aged from 15 to 82 years, 44% presenting a malignant tumour. For a retrospective evaluation of break-down semiology, the study is based on DSM-III criteria of break-down diagnostic. Search for a clinic/psychic diagnostic relation reveals the difficulty of coexistence between break-down signs and the development of a cancer. That difficulty increases in case of an organised break-down.
The authors report 5 cases of breast angiosarcoma collected in the Salah Azaiz Institute of Tunis, the only oncology center in this country, between 1969 and 1990. They enumerated 4,000 malignant breast tumors during this period; i.e. an incidence of 1.25%, higher than that in the world literature (0.4%). The mean age of patients was 44. Three were post-menopausal, and two were of childbearing age, one of whom was pregnant. This rare tumor is virtually limited to women. Affection is scarce, it affect's almost exclusively women. It generally present as a painless, ill-defined mass, without regional lymphadenopathy. The diagnosis of angiosarcoma is difficult since the histologic appearance is sometimes identical to that of a hemangioma. Hence the value of very thorough histologic examination of the entire operative specimen. Treatment is based upon mastectomy. The usefulness of adjuvant chemotherapy and/or radiotherapy is uncertain. The prognosis remains gloomy despite early diagnosis and treatment. The authors attempt in this study to identify the various features of this serious and uncommon condition, based upon the rare published cases in the world literature.
Four cases of struma ovarii were seen among 308 ovarian tumors removed surgically at the Salah Azaiz Institute, Tunis, Tunisia, between 1980 and 1989. This yields an occurrence rate of 1.3%, which is comparable to previously publishes rates (0.3% to 2%). One of the four tumors was malignant. Malignant transformation of struma ovarii is very rare (5% to 10%). The histologic diagnosis of malignancy is difficult, particularly in well-differentiated follicular forms. The prognosis is relatively favorable even in patients with metastases. Based on their personal experience and on a review of the literature, the authors discuss the diagnosis, management, and outcome of struma ovarii, in particular with malignant transformation.
Granular cell tumors of the breast are rare. The clinical presentation, the poor macroscopical delimitation and the infiltrating appearance of the tumor cells between the mammary lobules and within the adipose tissue may lead to a diagnosis of carcinoma, especially on frozen section. The authors present two cases of granular cell tumor of the breast occurring in two women aged 19 and 59 respectively. Before surgery, the diagnosis was that of a malignant tumor. In both cases, frozen section suggested the diagnosis of a granular cell tumor, which was confirmed by immunohistochemical study in one patient.
During a nosocomial epidemic of Salmonella mbandaka in Algeria, 99 strains were isolated from specimens. Study of 22 of them revealed minimum inhibiting concentrations ranged from 4 to 32 micrograms/ml for cefotaxime, 2 to 32 micrograms/ml for ceftazidime and 2 to 16 micrograms/ml for ceftriaxione. The mechanism underlying resistance was enzymatic with production of broad-spectrum beta-lactamase enzyme. Clavulinic acid at a dose of 2 micrograms/ml restored the activity of hydrolyzed beta-lactamases. Resistance to all antibiotics including cefotaxime was due to a single plasmid structure. The plasmid did not belong to any known compatibility group. All strains studied contained a plasmid of 26MDa and produced TEM-1 and TEM-2 beta-lactamases. Strains resistant to cefotaxime also synthetized a broad-spectrum beta-lactamase derived from TEM.
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It concerns comparative studies between two children groups: One group who had previous RAA. A second group who had anginas only. This work shows the interest to associate two streptococcal serologic tests (ASLO, ASD) in order to increase the number of recent diagnostic streptococcal infectious. The remaining immunity is missing in children less than 5 years old; more than 50% of above 10 years an antistreptococcal answer although they have not streptococcus infections presently.
During 1967 to 1985, three cases of listeriosis were reported in Algeria; at that time Listeria monocytogenes caused several thousand cases of meningitis and sepsis in the world. In order to determine the frequency and bacteriologic characteristics of strain isolated in Algeria, a prospective investigation was carried from 1985 to 1989 in humans and animals samples. Sensitivity tests to antibiotics (MIC) point out that all isolates strains are resistant to cephalosporins (first and third generation), but are susceptible to Ampicillin and Gentamicin which ought to constitute the treatment basis of listeriosis.
Serotyping of Listeria has contributed to bring to light on the origin of outbreaks listeriosis; on the other hand, it is also an additional expression for the identification of Listeria genus. In order to get better in this field, we have produced five factors sera: I, I/II, V/VI, VI, VII.