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Biomedical subjects

M Hamdi

Publications and source records attributed to M Hamdi.

16 recordsLinked to original sources
PubMed1999

Deep inferior epigastric perforator flap in breast reconstruction: experience with the first 50 flaps.

Abdominal wall function is a major concern for plastic surgeons performing breast reconstruction with TRAM flaps. The deep inferior epigastric perforator (DIEP) free flap spares the whole rectus abdominis muscle, includes skin and fat only, and therefore, preserves adequate abdominal wall competence. Between January of 1995 and May of 1997, a total of 50 breast reconstructions in 42 patients were performed by using the DIEP flap. Eight patients had bilateral procedures. Five breast reconstructions were immediate and 45 were delayed. All patients were collected prospectively and no patients were excluded from this study. The average age of patients was 47 years (range, 22 to 59 years) and the average weight was 65 kg (range, 51 to 103 kg). Seventy percent of patients had one or more risk factors for TRAM flap reconstruction. The mean postoperative follow-up period was 13 months (range, 3 to 30 months). Twenty consecutive patients (17 single and 3 bilateral DIEP flap breast reconstructions) within this group underwent evaluation of their abdominal wall function preoperatively and then 3 and 6 months postoperatively by using Lacote's muscle grading system. Average flap harvesting time was 120 minutes and average blood loss was 420 cc. Total flap loss and partial necrosis occurred in one (2 percent) and three flaps (6 percent), respectively. Abdominal wound infection occurred in seven patients (17 percent). Unfortunately, one patient died of adult respiratory distress syndrome on the seventh postoperative day. Fat necrosis was found in three flaps (6 percent). Postoperative abdominal wall examination did not reveal any hernia, but bulging was found in two patients (5 percent). All patients were able to resume their daily activities. Abdominal wall function tests in the series of 20 patients showed that all patients had reached or even improved their preoperative level of upper and lower rectus muscle function 6 months after the operation. The external oblique muscles were the most affected by the procedure of flap harvesting, but only two patients (10 percent) were found to have a measurable impairment after 6 months. Patient satisfaction with the reconstructed breast and the donor site was rated high. The free DIEP flap is, therefore, a reliable and valuable method of breast reconstruction. The donor site morbidity was decreased, and the more tedious flap dissection did not affect the overall outcome.

Abdominal Muscles↗
PubMed1996

Distally planned lateral arm flap.

The lateral arm flap presents some drawbacks: the vascular pedicle is short (2-6 cm), and the flap is rather thick. An anastomotic network between the posterior radial collateral artery and the recurrent radial artery, demonstrated by our previous anatomical dissections, enables one to locate the skin paddle solely over the epicondylar region and the proximal forearm. Furthermore, since no skin is harvested over the lateral aspect of the arm, a random-type vascularisation for the distal skin can be excluded. This modification increases pedicle length up to 100% and limits the amount of subcutaneous fat. A series of 13 consecutive distally based lateral arm flaps was performed, and eight patients were followed up for a minimum of 12 months postoperatively. Flap size ranged from 8 x 5.5 cm to 23 x 7 cm (average, 14 x 6 cm), and pedicle length ranged from 9 to 14 cm (average, 10.5 cm). No venous grafts were needed. The mean flap harvesting time was 60 minutes. All the donor sites were closed primarily. One flap suffered from an arterial thrombosis and only partially survived, and another healed uneventfully after successful re-exploration of a venous thrombosis. Only one flap had to be partially debulked. The donor site scar was enlarged in one patient. Elbow mobility was unaffected by surgery. Patient self-assessment on the appearance of both the reconstruction and the donor site showed a high satisfaction rate. The distally planned lateral arm flap presents decreased bulk and a longer pedicle when compared with the classical lateral arm flap with no added technical difficulties or morbidity.

Adult↗
PubMed1996

Internal hemipelvectomy.

Until recently, tumours involving the pelvis were usually treated by hemipelvectomy, otherwise called "hindquarter amputation". A more recent approach of treating these tumours is the 'conservative hemipelvectomy', which consists of removing the tumour and sparing the lower extremity. A patient with Ewing's sarcoma of the pelvis underwent such a procedure. The femoral head was fixed temporarily to the remaining parts of the acetabulum and the iliac wing by a Steinman pin. The Steinman pin was removed 6 weeks after the operation and the patient was then put into traction for another 6 weeks. Weight-bearing was gradually allowed after 3 to 6 months. The patient remodelled a neoacetabulum, which gave sufficient stability to the hip joint. Walking without external help was possible. The patient presented with a 2 cm limb-shortening. No local recurrence was observed during a follow-up of 30 months. This experience with internal hemipelvectomy shows an encouraging result in terms of tumour control and gait function.

Adult↗
PubMed1996

Gallbladder volvulus: a case report. Could the ultrasound be the key of the early diagnosis?

Gallbladder volvulus is a rare disease which may affect the elderly. It mimics clinically an acute cholecystitis, but the ultrasound signs may provide an early diagnosis: a very large, anteriorly floating gallbladder, with very thickened, multi layered wall, could orientate the physician to this rare disease. We present one case of gallbladder volvulus with its radiological signs. The symptoms, the etiology and the radiological examinations are discussed.

Aged↗
PubMed1995

[Study of a custom in Somalia: the circumcision of girls].

Female circumcision and infibulation is a common practice in parts of Africa. The present report describes the results of a study conducted in Somalia during Operation "Restore Hope". Using pre-defined questionnaire, a total of 300 women and 70 men were interviewed in order to evaluate the prevalence of this practice in Somalia, the procedures used, and the psychologic implications for the population. Fully 100% of the women interviewed had been circumcized and 80% had undergone infibulation. In most cases the procedure had been performed before the age of 10 years. Infection, hemorrhage and double episiotomy were reported by 60%, 20%, and 10% of responders respectively. All but 10 responders expressed support for the practice and many had already had the procedure performed in their children. The findings of this study demonstrate that the practice remains widespread in Somalia where a large proportion of the population is favorable despite the fearful childhood memories of many women.

Adolescent↗
PubMed1992

[Lymphoid hyperplasia of the intestine in children. 15 cases].

Fifteen cases of nodular lymphoid hyperplasia (NLH) of the bowel in patients aged 17 months to 15 years are reported. Fourteen patients had NLH confined to the small bowel and one had involvement of both the small bowel and colon. Mean age at diagnosis was 10 years. The most common presenting symptoms were intestinal manifestations (86%). Diagnosis was suspected upon roentgenographic studies in one case and digestive endoscopy in ten cases. Histologic confirmation was obtained in all fifteen patients. Immunohistochemical studies, done in 8 patients, demonstrated a paucity of IgA plasmocytes in one patient with an immune deficiency and a polyclonal plasmocyte population with mainly IgA plasmocytes in the seven other patients. Five patients had a deficiency in humoral immunity, with variable expression hypogammaglobulinemia in three patients and IgA deficiency in two; intestinal giardiasis was found in eight patients. Histologic outcome was documented in five cases; evidence of NLH disappeared in only one patient. Metronidazole improved clinical symptoms in most instances.

Adolescent↗
PubMed1979

Transfer of persistence across behaviors.

Two experiments tested the applicability to human beings of findings with animals that the number of performances required for the reinforcement of one behavior affects the subsequent effort expended in other instrumental behaviors. In the first experiment, adult depressed psychiatric patients worked on a sorting task for the approval of a staff psychologist. The time spent and the work completed were increased by prior approval from a ward attendant for each completion of several custodial tasks, as compared to the ward attendant's approval for each completion of a single task or a no-pretreatment control condition. In the second experiment, preadolescent learning-disabled students who were required to read and spell correctly a greater number of words per reward token later spent more time and completed more work for reward tokens in mathematics, and handwriting. Two alternative interpretations of these results are evaluated: (a) The degree of accustomed effort per reinforcer becomes a learned component of behavior, or (b) high effort increases the habituation of frustration-produced disruptive responses. The results suggest that individual differences in general persistence may arise, in part, from an accumulation of effort training in the natural environment.

Adult↗
PubMedDate not supplied

Adult intussusception. A case report.

The intussusception in adults is very rare. Symptoms are atypic and diagnosis is difficult. We present the case of an 85-year-old female admitted for vague intermittent diffuse abdominal pain since 3 months, with episode of diarrhoea. A mobile mass was palpable in the right iliac fossa. The barium transit demonstrated a filiform stenosis of the last segment of ileum in the caecum. Scanner showed a "target mass". An ileal intussusception on caecal tumour was suggested and confirmed by laparotomy. This entity is confronted with the literature reports. The aetiology, clinical presentation, diagnosis and treatment are discussed.

Adenocarcinoma↗