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Biomedical subjects

Rachid Mechmeche

Publications and source records attributed to Rachid Mechmeche.

17 recordsLinked to original sources
PubMed2006

Acute myocarditis and myocardial infarction induced by Paraphenylenediamine poisoning. Interest of angiocoronarography.

We present 2 cases of myocardial damage induced by Paraphenylenediamine (PPD) poisoning in young patients without any history of cardiovascular disease. ECG findings revealed the presence of localized ST segment elevation in precordial leads (V1-V4) in the first case and (V3-V6) in the second associated to an increase of the serum troponine T level at 23 ng/ml (case 1) and 29.7 ng/ml (case 2). The transthoracic echocardiography was in favour of diffuse myocarditis in the first case and of localized myocarditis or septo-apical myocardial infarction in the second. The angiocoronarography performed for the first time in the second case conclude on a septo-apical hypokinesia of the left ventricular resulting of a coronary spasm of the anterior interventricular artery.

Acute Disease↗
PubMed2006

[The pathophysiology of irritable bowel syndrome].

The irritable bowel syndrome (IBS) is a frequent gastrointestinal disorder (10 -15% of the population). It is characterized by chronic abdominal pain with modification in the bowel habits. The diagnosis is based of ROME II criteria. The pathophysiology of the SII remains unknown . It result from visceral hypersensitivity with anomalies of the digestive motility. These anomalies are secondary of dysfunction of the brain - gut axis modulated by environmental and the psychosocial factors. The understanding of the pathophysiological mechanisms of the SII and in particular the function of the brain-gut axis will permit a better handling of the patients. Indeed, the present knowledge of the neurotransmitter implied in the communication between the central nervous system and the digestive tract are currently the basis of the new therapies aimed to modulate the mechanisms implicated in the causation of the several symptoms of IBS. These novel pharmacotherapy should reduce the indirect societal and costs of IBS.

Brain↗
PubMed2006

[Return to work after acute myocardial infarction].

OBJECTIVES: The aim of this work was to study the professional repercussions of acute myocardial infarction and to analysis medical, social and occupational factors which could influence return to work. MATERIAL AND METHODS: Our study concerns 70 patients less than 66 years old, working before their hospitalization and having been admitted for acute myocardial infarction between January 1-st, 1999 and December 31, 2000 in the Department of Cardiac Resuscitation of hospital La Rabta of Tunis. Data were collected from retrospective review of folders and answers to a questionnaire for which the patients have been summoned in 2002. RESULTS: There were 70 patients almost exclusively men (n=69). The mean age was 49.0 +/- 6.8 years. The mean follow-up was 27.2 +/- 7.7 months. Sixty one patients (87.1%) have initially been back to work and eight of them lost it secondarily. The average delay of return to work has been 91+/- 111 days. The direct repercussions of myocardial infarction on the professional capacities was observed at the majority of patients. CONCLUSION: Despite an important professional repercussions of acute myocardial infarction, our study showed a high rate of return to work with relatively short delays.

Adult↗
PubMed2006

[Consultation of congenital heart diseases in pediatric cardiology in Mauritania].

OBJECTIVES: The aim of this study is to describe the epidemiological profile of congenital heart diseases in Mauritanian children. MATERIAL AND METHODS: Our population was composed of children referred by the different cardiologists of the country on the occasion of two missions of pediatric cardiologists in December 2001 and November 2002. All patients had physical examination, chest radiogram, electrocardiogram, and echocardiogram. RESULTS: There were 84 patients aged between 2 months and 16 years. Mean age was 6.1 +/- 5.0 years. Forty eight children (57.1%) were males and 36 (43.9%) females (sex ratio was 1.3). Ventricular septal defect (17%), tetralogy of Fallot (13%) and pulmonary stenosis (12%) were the predominant pathologiese. Surgery was initially indicated for in 61 infants (73%), realized in 22 of them (26%) and considered out of date in 10 patients (12%). CONCLUSION: Congenital heart diseases pose a major problem of treatment in Mauritania. They are dominated by the left to right shunts. The age of diagnosis is relatively late (6 years) exposing to the risk of complications. Therefore, a team of paediatric cardiologists on the spot and the setting up of cardiovascular surgery facilities are necessary.

Adolescent↗
PubMed2004

[Anatomic repair of transposition of the great arteries or arterial switch operation. Report of 62 cases].

Between January 1990 and September 2003, 62 patients underwent anatomic repair of a transposition of the great arteries. Mean operative age is 40 days. Transposition of the great arteries was simple in 38 cases and associated to a large ventricular septal defect in 24 cases. 44 patients have had an atrial septostomy of Rashkind and 45 an infusion of prostaglandin E 1.5 patients with simple transposition of the great arteries have had left ventricular retraining before arteriel switch. In association to arterial switch, were performed closure of ventricular septal defect in 24 cases, cure of coarctation of the aorta in 4 cases and cure of an abnormal partial pulmonary venous return in 1 case. Early mortality was 6,45%. After a mean follow up of 3 years, one patient died suddenly (late mortality is 1.72%) and one patient had to have 2 reoperations. Results of anatomic repair are now excellent. Late mortality is essentially related to coronary complications so that a careful follow-up is mandatory.

Cardiovascular Surgical Procedures↗
PubMed2004

[Genetics of inflammatory bowel disease].

The Inflammatory Bowel Disease (IBD) are multifactorial diseases involving the interaction of genetic and environmental factors. In genetic terms, the IBD are polygenic and multigenic disorders with incomplete penetrance. In the late decade, investigators have applied the complementary techniques of genome-wide scanning and candidate gene analysis to search susceptibility genes. The IBD susceptibility regions, widely replicated, are in chromosomes 16 (IBD1), 12 (IBD2) and 6 (IBD3). Recently, a significant association have been reported with Crohn's disease and NOD2/ CARD15 gene. This gene is an appropriate candidate gene because its localization and function. More studies is necessary to confirm this association, search an other variants of this gene and other candidate gene. This studies provide best comprehension of the disease pathogenesis and deliver clinical application.

Genetic Predisposition to Disease↗
PubMed2004

[Congenital aortic valve stenosis with left ventricular dysfunction: effect of percutaneous valvuloplasty].

Two girls aged 6 and 15 years with severe congenital valvular aortic stenosis and left ventricular (LV) dysfunction underwent successful balloon aortic valvotomy (BAV). Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement (cardiothoracic ratio 0.7 and 0.65) was evident in the chest roentgenograms. Immediately after BAV, the aortic valve peak-to-peak gradients decreased from 60 to 8 mmHg and 120 to 30 mmHg respectively, the LV end-diastolic pressures decreased from 47 to 13 mmHg and 40 to 15 mmHg, the LV ejection fractions improved from 40 to 65% in the second girl. On follow-up (30 and 36 ms respectively), both patients were asymptomatic with normalization of LV function and without a change in the residual gradient a cross the aortic valve.

Adolescent↗
PubMed2004

[The immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries].

The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.5 +/- 1.1 mm. The right ventricular saturation increased from 37 +/- 17% to 67 +/- 13% (p < 0.001). There was no correlation between the atrial septal defect diameter and the increase of systemic saturation after BAS.

Age Factors↗
PubMed2003

Effect of low-dose perindopril/indapamide on albuminuria in diabetes: preterax in albuminuria regression: PREMIER.

Microalbuminuria in diabetes is a risk factor for early death and an indicator for aggressive blood pressure (BP) lowering. We compared a combination of 2 mg perindopril/0.625 mg indapamide with enalapril monotherapy on albumin excretion rate (AER) in patients with type 2 diabetes, albuminuria, and hypertension in a 12-month, randomized, double-blind, parallel-group international multicenter study. Four hundred eighty-one patients with type 2 diabetes and hypertension (systolic BP > or =140 mm Hg, <180 mm Hg, diastolic BP <110 mm Hg) were randomly assigned (age 59+/-9 years, 77% previously treated for hypertension). Results from 457 patients (intention-to-treat analysis) were available. After a 4-week placebo period, patients with albuminuria >20 and <500 microg/min were randomly assigned to a combination of 2 mg perindopril/0.625 mg indapamide or to 10 mg daily enalapril. After week 12, doses were adjusted on the basis of BP to a maximum of 8 mg perindopril/2.5 mg indapamide or 40 mg enalapril. The main outcome measures were overnight AER and supine BP. Both treatments reduced BP. Perindopril/indapamide treatment resulted in a statistically significant higher fall in both BP (-3.0 [95% CI -5.6, -0.4], P=0.012; systolic BP -1.5 [95% CI -3.0, -0.1] diastolic BP P=0.019) and AER -42% (95% CI -50%, -33%) versus -27% (95% CI -37%, -16%) with enalapril. The greater AER reduction remained significant after adjustment for mean BP. Adverse events were similar in the 2 groups. Thus, first-line treatment with low-dose combination perindopril/indapamide induces a greater decrease in albuminuria than enalapril, partially independent of BP reduction. A BP-independent effect of the combination may increase renal protection.

Adult↗
PubMed2003

[Transradial approach for coronary angiography and angioplasty].

The transradial approach of coronary angiography and angioplasty is now become a good alternative to the femoral approach in patients with normal Allen test results, because low rate of access site complication, improved patient comfort and early ambulation. This approach is particularly interesting in obese patients, aortoiliac disease or in patients under anticoagulation treatment or thrombolytics.

Angioplasty, Balloon, Coronary↗
PubMed2003

[Single coronary artery. A case report].

The authors report the case of a patient undergoing coronary angiography for an inferior myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from single ostia in the left sinus of valsalva.

Adult↗
PubMed2003

[Coronary-pulmonary arterial fistula in the adult: report of 6 cases and review of the literature].

Six new patients and 33 previously reported with coronary-to-pulmonary artery fistula were reviewed. The mean age at the time of diagnosis was 51 years. A male predominance was found (65%). Angina was the most common symptom. The artery mostly involved was the left anterior descending coronary artery and the fistula drained more often to the main pulmonary artery. The left-to-right shunt is small in the majority of patients and the associated significant coronary artery disease was detected in 18% of cases. Good results of surgical closure of the fistula are usually obtained. An alternative to surgical treatment is percutaneous transcatheter embolization of coronary artery fistulas.

Adolescent↗
PubMed2003

[Cardiac retrograde arterial catheterization in children under 2 years of age. Indications, techniques and complications].

Thirty children (15 males and 15 females) under 2 years of age (mean age 14 +/- 6 months, range 1 to 24 months, mean weight was 8.3 +/- 2.5 kg) underwent diagnostic cardiac percutaneous femoral arterial and venous catheterization for congenital heart disease. The anticoagulation with heparin was not given in any patient. Appropriate arterial sheath varying from 4F to 5F were used for catheterization. The mean duration of the exploration was 38 +/- 16 mn. The mean duration of the left heart exploration was 9.5 +/- 2.5 mn. There were no hemorrhagic or ischemic complications in this series.

Cardiac Catheterization↗
PubMed2002

[False left ventricular aneurysm: report of 5 cases].

Between 1972 and 2000, left ventricular false aneurysm was diagnosed in 5 patients. These patients consisted of three man and 2 women, aged between 58 and 70 years. Clinical presentation was characterized by severe heart failure, complicating a posterior myocardial infarction, in 4 patients. Left ventricular angiography, has confirmed the false aneurysm in all patients. Three patients underwent surgical management, with good result in 2 cases (follow-up of 9 and 13 years), and an early postoperative death in one case. Two patients refused surgery and died suddenly. Ischemic myocardial disease, represent the most frequent etiology. Left ventricular false aneurysm prognosis should be improved by emergent surgical management, preventing fatal rupture.

Aged↗
PubMed2002

[Immediate and mid-term results of balloon valvuloplasty in congenital aortic stenosis. Ten case reports].

From 1987 to 2000, 10 patients aged 0.5 to 20 years with congenital valvular aortic stenosis underwent percutaneous balloon aortic valvuloplasty. In one patient, balloon valvuloplasty was unsuccessful, this patient had acute artery thrombosis requiring surgical intervention. Hemodynamically successful dilatation was achieved in 9 patients. The peak systolic pressure gradient was reduced from 76 +/- 35 to 32 +/- 16 mmHg (p < 0.001). Aortic valve regurgitation on angiography appeared or increased in 2 patients (up to grade 2 in the 2 patients). There was no deaths during the procedure. Follow-up was available in 7 patients One patient died during the follow up period. Restenose was found in only one patient 5 years after valvuloplasty and the efficacy balloon aortic valvuloplasty continued significantly in 5 patients (mean follow-up 35 +/- 18 months) with a residual aortic valvular gradient of 34 +/- 15 mmHg.

Adolescent↗