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Biomedical subjects

L Jemni

Publications and source records attributed to L Jemni.

At least 19 recordsLinked to original sources

[Neurological complications in adults following rabies vaccine prepared from animal brains].

OBJECTIVES: Despite well-known neurological complications, post-exposure semple-type rabies vaccine is still used in Tunisia. We retrospectively studied neurological manifestations following post-exposure rabies vaccine. METHODS: Over a 3-year period, semple-type phenol inactivated lamb nerve tissue vaccine (Pasteur Institute, Tunis) was given to 1392 adults after exposure to rabies. RESULTS: The frequency of neurological complications was 1/200. Seven patients presented complications 4 to 14 days after the first vaccine injection (median 11 days). Central nervous system manifestations occurred in all 7 patients with peripheral neuropathy in 5. Manifestations were meningoradiculitis (n = 3), meningomyeloradiculitis (n = 2), meningomyelitis (n = 1) and myelitis (n = 1). No vaccine-associated death occurred, but one patient suffered persistant paraplegia. CONCLUSION: Semple-type adult animal nerve tissue vaccine produces an unacceptable rate of severe post-vaccinal neurological complications in adults. Human diploid cell rabies vaccine should be used for post-exposure rabies vaccination.

Adolescent

[Pyomyositis in adults in central Tunisia. Apropos of 10 cases].

Ten adult patients treated for pyomyositis between 1988 and 1994 in Sousse's university hospital (Tunisia) were retrospectively reviewed. Due to the non specific symptoms, the diagnosis was often delayed (mean = 17 days) and other primary diagnoses were considered, mainly including synovitis. The muscles around hip and thigh were most commonly involved (ten patients), and Staphylococcus aureus was the most common pathogen (nine patients). Ultrasonography was very helpful in the accurate diagnosis of the infection. Incision, drainage, and antibiotic therapy eradicated the infection in all patients. No residual functional limitations and no residual symptoms were noted. Our study showed that pyomyositis is present in central Tunisia and not associated with HIV infection. Clinical features and prognosis are similar to those previously described in the literature.

Adult

Unusual presentation of gastric dilatation. Dramatic complete atrioventricular block.

We report a case of gastric dilatation in a ventilated 18-year-old woman, which was revealed by the acute onset of hypotension, sinus bradycardia, and complete atrioventricular block. Hypotension and cardiac rhythm disturbances resolved with intravenous injection of atropine, but recurred a few minutes later and required a second bolus of atropine, which had a transient beneficial effect. Only gastric decompression, as soon as gastric distention was recognized, was able to restore normal cardiac rhythm and adequate blood pressure. This case highlights the seriousness of gastric dilatation and argues for the vagal mechanism of cardiac rhythm and conduction troubles complicating gastric dilatation.

Adolescent

[Superior caval syndrome in adults in central Tunisia. Apropos of 26 cases].

We report 26 cases of superior vena cava obstruction (SVC) observed in Sousse University Hospital (TUNISIA). The diagnosis was confirmed by CT scan and/or superior vena cava angiography. The underlying disease was revealed by SVC on 76.9% of cases. Malignant underlying disease was noted on 61.53% of cases. Non malignant causes of SVC was Behçet disease (4 cases) and mediastinal fibrosis (5 cases). SVC revealed Behçet disease in the 4 cases.

Adult

[Kidney carbuncle: diagnostic, bacteriological and therapeutic considerations. Apropos of 11 cases].

Renal carbuncle is a cortical lesion following bacteremia, occurring in patient without any urologic known problems. The analysis of 11 consecutive renal carbuncles showed that one should consider the diagnosis of renal carbuncle in young patients with flank pain, fever, and absence of significant leucocyturia. Our study confirms that renal carbuncle is always caused by staphylococcus aureus and that treatment is based on appropriate antibiotherapy. Isolation of the bacteria was difficult unless ponction of carbuncle under ultrasound control was performed. The usefulness of ultrasonography for the diagnosis of renal carbuncle and for its distinction from other suppurative renal lesions is emphasized.

Adolescent

Juvenile idiopathic chronic calcifying pancreatitis: report of 10 cases from central Tunisia.

A series of 10 cases of chronic calcifying pancreatitis from central Tunisia are reported. The mean age at presentation was 23 years and the male to female ratio was 1.5. The main clinical manifestations of the disease were abdominal pain (eight cases), weight loss (four cases), and diarrhea (three cases). Diabetes was recorded in four cases. The etiological investigations yielded negative results in all the patients. It is concluded that central Tunisia should be added to the regions where juvenile chronic calcifying pancreatitis of the "tropical type" may be observed.

Adult

[Pyogenic abscess of the psoas].

11 cases (7 primary and 4 secondary) of pyogenic psoas abscesses are reported. In all cases Staphylococcus aureus was isolated on blood culture or pus drained under ultra-sonographic control. US is very useful for diagnosis and the follow up of psoas pyogenic abscesses. Percutaneous aspiration and drainage of psoas abscesses under ultrasonographic control combined to antibiotherapy is an effective therapeutic procedure. Our experience suggests that antibiotherapy alone is an effective therapy of presuppurative pyogenic psoas abscesses and even in collected and non complicated primary psoas abscesses.

Abscess