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Biomedical subjects

S Kammoun

Publications and source records attributed to S Kammoun.

At least 19 recordsLinked to original sources

[Diverticulum of the left atrium detected antenatally. Management of a case].

Cardiac diverticulae are rare, most often affecting the ventricles rather than the atria. We report the case of a diverticulum of the left atrium discovered during routine fetal echocardiography. The diagnosis was confirmed at birth with cardiac echography and an MRI. In view of the patient's age and asymptomatic nature, it was decided to defer surgery and to observe the infant with regular echocardiography. Surgery was eventually performed via a left thoracotomy after the appearance of signs of cardiac compression, and there were no complications in the post-operative period.

Adult↗

[Massive hemoptysis: experience of a surgical unit].

Massive hemoptysis is a clinical entity characterized by its unpredictable and potential lethal course. We studied retrospectively the observations of 25 patients hospitalized in our surgical unit. We collected all the demographic, clinical and surgical data. A male predominance with a sex-ratio of 2,1 was noted. The average age was 45 years, with extremes of 17 and 75. The dominant cause was bronchiectasis. Twenty patients were operated on. The surgery consisted of a pulmonary resection in 9 cases (45%), an atypical lung resection in 4 cases (20%), a resection of an aspergilloma in 2 cases (10%), a kystectomy of hydatic cyst in 4 cases (20%) and one arterial ligature (5%). Five patients (25%) had emergent surgery, and 15 (75%) delayed surgery. Hospital mortality was 20% in the first group and 6.66% in the second. No recurrence of bleeding was observed after an average follow-up of 7 months. Surgery remains a therapy of choice for massive hemopysis. It must as far as possible be avoided during active bleeding.

Adolescent↗

[Mediastinal localisation of a thoracic duct lymphocele--account of a surgical case].

INTRODUCTION: Lymphocele of the thoracic duct is a rare pathological entity occurring as a consequence of deterioration and cystic dilation wall of this vessel. It may be of congenital or degenerative origin. OBSERVATION: We report the case of a 47 year old patient, operated on for a symptomatic cyst localised by CT scan to the inferoposterior mediastinum. At postero-lateral thoracotomy it was identified as a lymphocele and completely resected. Chemical analysis of the liquid and histopathology study of the cystic wall confirmed the diagnosis. The patient's post operative course was uneventful. CONCLUSION: This case demonstrates the clinical characteristics of this entity and describes diagnostic techniques and surgical management.

Follow-Up Studies↗

[Post-traumatic hypopituitarism].

BACKGROUND: Post-trauma hypopituitarism is a rare disease, accounting for only 3% of all cases of hypopituitarism reported in the literature. CASE REPORT: A 56-year old woman developed central diabetes insipidus immediately after severe cranio-facial trauma. Four years later, she suffered severe asthenia and hypoglycemia faintness. The diagnosis of isolated corticotrope insufficiency was retained. Magnetic resonance imaging evidenced an intrasellar arachnoidoceae with extinction of the posterior pituitary gland's spontaneous hypersignal. DISCUSSION: Most cases of post-trauma hypopituitarism occur after high-energy head trauma. Hypopituitarism exceptionally involves only one hormone, particularly growth hormone. The pathogenesis involves hypothalamic failure more often than pituitary gland failure.

Asthenia↗

Production of protease by Bacillus subtilis grown on sardinelle heads and viscera flour.

Fish flours from Sardinelle (Sardinella aurita) were prepared and tested for protease production by Bacillus subtilis. Protease synthesis was strongly induced when cells were grown in media containing only a combined head and viscera preparation. Sardinelle heads and viscera flour enhanced protease production up to 100% more than commercial peptones. The enhancement could have been due to a high lipid content, which might have contained nutritional factors acting as inducers, since defatting fish meal led to a decrease in protease production.

Bacillus subtilis↗

[The aging lung: structural and functional modifications related to aging].

Ageing is accompanied by numerous structural and functionnel pulmonary modifications. Structural modifications concern the thoracic well- and the broncho-pulmonary system. Functionnel modifications are numerous and concern specially respiratory changes, pulmonary circulation, adaptation to exercise, biochemical system and pulmonary defences. The knowledge of these modification allows better care of the aged affected by respiratory diseases.

Age Factors↗

[Perrault's syndrome: two cases].

Perrault's syndrome is an autosomal recessive ovarian dysgenesis associated with sensorineural deafness. We report two cases in sisters issuing from consanguinous parents. Aged 16 and 21 years, both patients present the two cardinal symptoms of the syndrome. Magnetic resonance imaging in the second sister showed high intensity signals in the periventricular and subcortical white substance and in the central ovale, suggestive of cerebral leucodystrophy. This element may be one of a wide spectrum of neurological symptoms found in Perrault's syndrome. The discovery of the causal genes may allow better understanding of the biomolecular mechanisms involved in gonad and sensorineural differentiation.

Adolescent↗

Immediate causes of death of demented and non-demented elderly.

OBJECTIVE: To investigate the immediate causes of death, in autopsied demented and non-demented elderly. DESIGN: Retrospective clinicopathologic correlations. SETTING: Acute and intermediate care geriatric hospital. PARTICIPANTS: 342 hospitalized demented and non-demented elderly (mean age 84.94 +/- 6.9 years) who underwent consecutive postmortem examinations: 120 demented patients with either vascular dementia (VaD, n = 34), mixed dementia (MD, n = 65) or Alzheimer's disease (AD, n=21) neuropathologically confirmed and 222 nondemented elderly. RESULTS: Primary causes of death were similar in both demented and non-demented patients; the commonest were cardiovascular disease and bronchopneumonia. Cardiac causes of death and especially cardiac failure were more frequent in VaD than in AD or MD (respectively P = 0.027 and 0.005). Dementia was an underlying but never a primary cause of death. CONCLUSIONS: Immediate causes of death are similar in elderly demented and non-demented patients.

Aged↗

[Percutaneous implantation under local anesthesia of an implantable automatic defibrillator: report of the first Tunisian case].

We report the case of a 58 years old male affected by a severe relapsing ventricular tachycardia despite a well administered anti arrhythmic therapy. Etiology is an arrhythmogene right ventricular dysplasia. Considering the severity of this arrhythmia we proceed to percutaneous implantation of an automatically implantable defibrillator under local anesthesia. Evolution was favorable with a follow-up of 3 months.

Anesthesia, Local↗

Hydatid cyst of the heart located in the interventricular septum.

Cardiac hydatosis is a rare condition, and the localization of a hydatid cyst within the interventricular septum is exceptional. A 61-year-old man found to have a hydatid cyst of the interventricular septum is reported. Presenting manifestations were congestive heart failure and signs suggestive of an aortic valvulopathy. Diagnosis was made by Doppler echocardiography and confirmed by magnetic resonance imaging. The cyst was approached surgically by right ventriculotomy. Despite a technically successful intervention without rupture of the cyst or appearance of a conduction delay, the patient died on the 20th postoperative day because of acute respiratory distress syndrome complicating infectious pneumonia.

Animals↗

[Sleep apnea syndrome].

Sleep Apnea Syndrome is an understimated disease. We describe its diagnostic criterion and principal epidemiologic data. After a brief rememory about sleep and respiration, its physiopathologic consequences (especially respiratory, cardiovascular and cerebral) were detailed. The diagnostic of its different clinical presentations is suspected clinically but confirmed by polysomnography. His treatment, usually based on the CPAP, permits to prevent its complications.

Diagnosis, Differential↗

[Acute dissection of the ascending aorta complicating aortic coarctation successfully treated with surgery].

Vascular complications and arterial hypertension are major risk factors in the evolution of disease connected with coarctation of the aorta. Supra- and sub-stenotic aortic aneurysms are classical findings, whereas a dissecting aneurysm is a rare occurrence. In this study, we report on a case of acute dissection of the ascending aorta complicating a poorly followed-up coarctation of the aorta in a ten-year-old girl. The diagnosis, determined by X-ray of the thorax, was confirmed by echocardiography and magnetic resonance imaging. The first operative stage consisted of treating the aneurysm. After resection of the latter, an impregnated dacron prosthesis was inserted in termino-terminal. The immediate result is satisfactory, and a second operation is planned for the aortic coarctation.

Acute Disease↗

[Right coronary-ventricular fistula. Diagnosis and course. Apropos of 2 cases].

The authors report two cases of coronary-right ventricular fistulas diagnosed in a 7-month-old infant and a 9-year-old girl. The discovery of the heart disease was incidental in both cases, following detection of a low continuous murmur. Doppler ultrasonography established the diagnosis, which was confirmed by haemodynamic studies and coronary angiography. The left anterior descending artery was involved in both cases and the recipient cavity was the right ventricle. The first patient was cured by early operation with distal ligation of the artery. In the second patient, the natural course was complicated by aneurysmal dilatation of the coronary artery. The authors recall the value of colour Doppler ultrasound in the noninvasive diagnosis, especially of the recipient cavity by colour Doppler and the need to rapidly treat coronary fistulas to prevent the development of complications reported after an average age of 20 years.

Child↗

[Respiratory manifestations of carbamazepine. Apropos of a case].

A 14-year-old girl developed skin rash, fever and dyspnea. The chest roentgenogram showed diffuse reticulonodular infiltration. Pulmonary function tests revealed mild restrictive defect and blood oxygen pressure at 71 mm Hg. BAL showed increased cell counts with lymphocytosis at 15% and neutrophilia at 3%. Outcome was good after carbamazepine withdrawal and without corticosteroid therapy. Relapse was observed after patient-induced rechallenge.

Adolescent↗