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Biomedical subjects

S Kachboura

Publications and source records attributed to S Kachboura.

12 recordsLinked to original sources

[The role of B type natriuretic peptide in the assessment of post myocardial infarction prognosis].

Recently cardiac peptides have received close attention as cardiovascular markers. Brain (B type) natriuretic peptide is a neurohormone synthesized predominantly in ventricular myocardium. Previous studies have shown that this hormone can provide prognostic information in patients with myocardial infarction. The aim of this review is to evaluate the impact of plasma levels of BNP on prediction of left ventricular ejection fraction and remodelling and major cardiac events after myocardial infarction.

Humans↗

[Syphilitic aortic aneurysm. A case report].

The incidence of tertiary syphilis has declined in recent years owing to the early recognition of the disease and use of antibiotics. As a result, syphilitic aortic aneurysms are rarely encountered nowadays. We report the case of a 65 years old man, who was admitted to our hospital in June 2004 for dyspnea, cough and chest discomfort. On physical examination, blood pressure was 130/80 mmHg with no significant laterality, pulse rate was 70 per minute and there was a decrease of breath sounds over the right lung. Laboratory findings revealed a slight elevation of the erythrocyte sedimentation rate. Serological studies for syphilis showed a positive venereal disease laboratory test (VDRL) at 1/32 and a positive Treponema pallidum hemagglutination test (TPHA) at 1/2560. The chest radiography showed a right para cardiac opacity measuring 16 x 12 cm. Fiber optic bronchoscopy showed an extrinsic compression of the right upper lobar bronchus. Gadolinium-enhanced magnetic resonance angiography and 16 multidetector-row spiral computed aortography showed a huge partially thrombosed saccular aneurysm of the ascending aorta measuring 132 mm in diameter. The circulating lumen measured 53 mm in its largest diameter. This aneurysm involved the innominate artery. There was no other arterial involvement. The patient was given a three week course of intravenous penicillin followed by a successful surgical procedure in September 2004 with ascending aortic replacement and innominate artery reimplantation. This case illustrates well a formerly common, but now extremely rare disease.

Aged↗

[The first Tunisian cardiovascular diseases register: processes and results].

BACKGROUND: In Tunisia, cardiovascular diseases are the leading causes of death (30%) and a few studies conducted in the population have demonstrated that the level of their risk factors is increasing. For policy makers, the health system impact of these diseases is currently a crucial issue. The National Public Health Institute has identified the implementation of a morbidity register as a priority. METHODS: A CVD morbidity register is implemented since 2001, in 3 different geographical populations having contrasted levels of health status (Tunis, Ariana and Ben Arous). The 3 regions are covering about 2 millions inhabitants which is the fifth of the overall Tunisian population. All coronary heart events occurring among adults 25 years old and above in the 3 populations are recorded. The diagnosis of events, case fatality and classification are defined according to MONICA criteria. The data are recorded from public and private hospitals, death certificates and autopsies. RESULTS: During the year 2001, the total number of myocardial infarction events was estimated at 942: in men, the age-standardized rates were 163.8/100000 in Tunis population vs. 161.9 in Ariana and 170.5 in Ben Arous. In women, the rates were respectively 43.4, 61.1 and 44.6. Medical causes of death registration was the most crucial problem in spite of the implementation of the death certificate designed according to WHO model. Specific surveys for clinical assessment and surveillance of risk factors were conducted in the register populations. CONCLUSION: It is the first time that data on coronary heart disease incidence and fatality are available in Tunisia through this experience which highlights the practical difficulties experienced in registering and coding coronary events in a developing country. The data source quality should be improved and the register should be integrated in the local health system.

Adult↗

[A dead and calcified right ventricular hydatic cyst. The limits of imaging].

INTRODUCTION: Cardiac echinococcosis is rare and only represents around 0.5% of all hydatic locations. Right ventricular location is exceptional. OBSERVATION: We report the case of a 72 year-old man having a chronic obstructive pulmonary disease. During an acute respiratory failure, cardiac ultrasonography showed a right ventricular tumour. After respiratory stabilisation, surgical intervention found the tumour, the histopathological study of which concluded in a dead and calcified hydatic cyst. DISCUSSION: This case report demonstrates the limits of modern imaging and the difficulties in diagnosing a calcified right intra-ventricular hydatidosis. It is important to emphasize the exceptional nature of this form and the scarcity of its localisation. Surgical treatment is crucial in the majority of cases and helps to confirm the diagnosis. CONCLUSION: In endemic areas, the discovery of an intra-cardiac tumour must evoke and eliminate echinococcosis. Calcification of a cardiac location remains exceptional.

Acute Disease↗

[Brugada syndrome].

The Brugada syndrome is a clinical-electrocardiographic diagnosis characterised by syncopal or sudden death episodes in patients with a structurally normal heart with a characteristic electrocardiographic pattern consisting of ST segment elevation in the precordial leads V1 to V3 and a morphology of the QRS complex resembling a right bundle branch block. In many patients with the Brugada syndrome, the electrocardiographic manifestations transiently normalize; leading to underdiagnosis of the syndrome. The administration of sodium channel blockers such as ajmaline, flecainide or procainamide accentuate the ST segment elevation and can be used to unmask concealed and intermittent forms of the disease. The incidence of sudden death in this syndrome is very high and can only be prevented by implanting a cardioverter-defibrillator. Because of high incidence of familial occurrence, the extension of the testing to family members is important.

Bundle-Branch Block↗

[Hypertrophic cardiomyopathy and pregnancy].

We report the case of a 32 years old patient, with a known diagnostic of hypertrophic cardiomyopathy; who has presented at the first trimester of pregnancy a ventricular fibrillation treated by electric shock with a favorable outcome. The risks for the mother and the foetus are discussed; The recommendations for the conduct of the delivery are reviewed.

Adult↗