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Biomedical subjects

S Trabelsi

Publications and source records attributed to S Trabelsi.

At least 19 recordsLinked to original sources
PubMed2006

[Prevalence of Pneumocystis jiroveci pneumonia in Tunisian primary immunodeficient patients].

UNLABELLED: Pneumocystis Jiroveci pneumonia (PJP) is a rare opportunistic infection in immunodeficient patients in Tunisia, as well as in other Africain countries including those with a high prevalence of AIDS. In the literature, PJP has been reported in primary immunodeficiency diseases (PID) namely SCID T-B- or T-B+ or X-linked hyper-IgM syndrome. OBJECTIVE: To evaluate the prevalence of PJP in the different PID observed in Tunisia. PATIENTS AND METHODS: This retrospective study concerned 290 cases of PID confirmed by immunological investigation including the study of specific and/or non-pecific humoral and cellular immunity. The identification of P. Jiroveci in patients suspected of pneumocystosis was achieved by parasitological investigation in bronchoalveolar lavages. RESULTS: A PID associated to a parasitologically confirmed pneumocystic infection was found in 9 out of 290 patients (3%) among whom the majority (7 patients) had an HLA class II combined immunodeficiency. The latter is an autosomic recessive disease which has been reported mainly in North African families. Indeed, this population is characterized by a high rate of consanguinity. Interestingly, no PJP has been observed neither in SCID T-B- or T-B+ nor in X-linked hyper-IgM syndrome. DISCUSSION AND CONCLUSION: PJP seems to be particularly frequent in HLA class II deficiency patients, since 7 out of 22 patients with this deficiency had a PJP (31%). Due to this defect, antigen presenting cells are unable to present the antigen to T lymphocytes demonstrating the critical role of CD4+ T lymphocytes responses in the immune response to this pathogen.

Female↗
PubMed2006

Chondroid syringoma of the arm: an unusual localization.

Chondroid syringoma (CS) is an uncommon, benign, sweat-gland tumor. The usual presentation is of an asymptomatic, slowly growing mass, typically located on the head and neck region. We present a case of a CS located in the right arm of a 43-year-old woman. This tumor developed slowly over 8 years. The diagnosis of CS was made by histopathological examination; it showed an abundant chondroid stroma intermingled with a fibro-adipoid tissue. There was no recurrence after total excision of the tumor with a 2-year followup. The unusual localization of chondroid syringoma made an accurate preoperative diagnosis difficult and diagnosis was achieved only by microscopy. Surgical tumor excision remains the best therapeutic option to avoid relapses of this tumor. Close followup is recommended because malignant transformation, although rare, is possible.

Adenoma, Pleomorphic↗
PubMed2004

[Fixed drug eruption induced by sulfaguanidine].

INTRODUCTION: Fixed drug eruption is a lesion induced by drugs. The family of drugs usually incriminated are sulfonamides, tetracyclines and pyrazols. We describe nine cases of fixed drug eruption induced by sulfaguanidine, a sulfonamide with local action. CASE REPORTS: All the patients presented one or more fixed drug eruption reactivation lesions induced by sulfaguanidine as self-medication for diarrhea. The number of lesions increased in 7 cases after reactivation. The delay in occurrence of the fixed drug eruption decreased during the different episodes. The lesions predominated on the hands in 8 cases of 9. DISCUSSION: The sulfaguanidine must be added to the list of drug-induced fixed drug eruptions with limited absorption from the gastrointestinal tract.

Adolescent↗
PubMed2003

[Rosai-Dorfman disease with orbital and rhinopharyngeal localizations. A case report].

OBJECTIVES: We present a case report of Rosai-Dorfman disease with multiple extranodal involvement and favorable outcome after steroid therapy. MATERIAL AND METHODS: Rosai-Dorfman disease was diagnosed in a 17-year-old man with orbital, lacrymal, and rhinopharyngeal localizations. Histopathologic examination of lymphadenopathy biopsy revealed the diagnostic of Rosai-Dorfman disease. We present the histological findings leading to diagnosis and radiological data. RESULTS: Conservative treatment with oral steroids resulted in the resolution of cervical lymphadenopathy and extranodal lesions. The patient was free of problems nine mouths after discontinuation of his treatment, demonstrating its efficacy and safety. CONCLUSION: Rosai-Dorfman disease is a benign disorder and steroid treatment must be initiated in cases with significant cosmetic deformity.

Adolescent↗
PubMed2002

Broadband microwave wheat permittivity measurements in free space.

Use of broadband horn/lens antennas with a collimated beam in a free-space measurement set-up with a network analyzer operating between 3 and 13 GHz and applying time-domain gating improved the accuracy of permittivity (dielectric properties) measurements on grain. Measurements were taken in the transmission mode on samples from five different classes of wheat over ranges of moisture content, temperature, and bulk density. Dielectric properties were divided by bulk density of the grain for comparison of different wheat lots. No differences in permittivity data were noted among the different wheat classes, so data were combined for presentation. The new data agree well with those reported previously. For further research, to provide dielectric properties over a very broad frequency range for a given grain sample, use of time-domain spectroscopy is suggested.

Electric Conductivity↗
PubMed2001

[Disseminated peritoneal leiomyomatosis: apropos of a case with immunohistochemical study].

We report one case of leiomyomatosis peritonealis disseminata in a 40-year-old woman, G4P4, who never used oral contraceptives. She had relapsing uterine leiomyoma resected twice by hysteroscopy. Clinical findings and imaging studies concluded to peritoneal carcinomatosis. The patient had hysterectomy, salpingo-oophorectomy, omentectomy and resection of an intestinal segment which surface is studied with firm nodules ranging in size from 1 to 50 mm. Microscopic examination showed a smooth-muscle cell proliferation with no mitosis, no atypia and no necrosis. Immunohistochemical analysis showed diffuse and strong labeling for progesterone receptors and weak labeling for estrogen receptors. The patient is well 16 months later. In the literature, over than 100 cases are reported, eight were malignant.

Adult↗
PubMed2001

[Subcapsular liver hematoma. Two case reports and review of the literature].

The authors report two cases of complicated toxaemia by subcapsular haematoma of liver in the gynaecology obstetrics ward of the Mongi Slim university hospital in Marsa, Tunisia during six years. The diagnostic was made after delivery in all cases. Evolution was been favourable only in one case, the other is complicated by superinfection which required surgical draining. The literature review determiner the poor prognosis of the subcapsular haematoma of the liver.

Adult↗
PubMed2001

[Death of one fetus in multiple pregnancies during the second and third trimesters. Maternal-fetal complications].

The authors report 7 cases of death of one foetus during multiples pregnancies in 107 pregnancies during the second and the third quarter. The rate is 6.54%. Five cases are complicated by toxaemia which increased the caesarean rate. The placenta is monochorial in 4 cases. The hemostasis check up shows a drop of fibrinogen and the rate of thrombin, which normalised after delivery. One patient developed in septicaemia after caesarean delivery. Concerning the surviving foetus: 5 of them had en intra uterine under development, 2 of them were premature and one developed an encephalopathy.

Adult↗
PubMed1991

[Comparison of long-term results of the Starr and Saint-Jude mitral valve prostheses].

Two groups of patients having undergone mitral valve replacement with a Starr-Edwards (Group A = 149 patients) or Saint Jude (Group B = 87 patients) prosthesis between 1981 and 1987 were included in this study. The aim of the study was to evaluate and compare the mortality, the morbidity--especially with respect to thromboembolic events--and echo Doppler haemodynamic profiles of the two types of prosthesis. The two patient groups were comparable with respect to age, aetiology and preoperative haemodynamic status. Late mortality was greater in Group A (13% versus 4.5%) and the 5 year survival was significantly better in Group B (95% versus 89%). Thromboembolic events were significantly more common in Group A (2.6% per patient year versus 0.5% per patient year in Group B, p = 0.01). Five years survival without thromboembolic event was 94% in Group B versus 86% in Group A. The haemodynamic Doppler echocardiography profiles were compared on random samples of 30 cases from each group, the only exclusion criterion being suspected or confirmed prosthetic valve dysfunction.

Adult↗
PubMed1989

Results of percutaneous mitral commissurotomy in 200 patients.

To assess the feasibility and efficacy of percutaneous mitral commissurotomy (PMC), the procedure was attempted in 200 patients with severe mitral stenosis. There were 154 women and 46 men, their mean age was 43 +/- 16 years (range 13 to 79) and 15 were older than 70 years of age. Forty-four had had previous surgical commissurotomy. Forty were in New York Heart Association class II, 152 in class III and 8 in class IV. In regard to valvular anatomy, 67 had calcified valves, 58 had pliable valves and only mild subvalvular disease, and 75 had flexible valves but extensive subvalvular disease. Grade 1+ mitral regurgitation was present in 62 and grade 2+ in 2. In 11 patients the procedure was discontinued because of complications in 3 and technical failure in 8. Six of the 8 technical failures occurred during the first 15 attempts. Effective PMC was performed in 189 patients using 1 balloon in 23 and 2 balloons in 166. After PMC, there was a significant improvement in mean left atrial pressure (21 +/- 7 to 12 +/- 5 mm Hg, p less than 0.0001), mean mitral gradient (16 +/- 6 to 6 +/- 2 mm Hg, p less than 0.0001), cardiac index (2.6 +/- 0.8 to 3.1 +/- 0.8 liters/min/m2, p less than 0.001) and valve area assessed by hemodynamics (1.1 +/- 0.3 to 2.2 +/- 0.5 cm2, p less than 0.0001) and 2-dimensional echocardiography (1 +/- 0.3 to 1.9 +/- 0.4 cm2, p less than 0.0001). No patient died. Embolism occurred in 8 (4%), with no further sequelae. Sixteen (8%) had atrial septal defect detected by oxymetry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Outcome more than 10 years later of mechanical mitral valve prostheses in children].

Between 1966 and 1975, fifty-one children aged from 8 to 15 years underwent mitral valve replacement for mitral valve disease of rheumatismal origin. The mechanical prosthesis was a Starr Edwards 6120 N degrees 2 valve in 48 of the children. Late mortality was 20 p. 100; death was due to valve thrombosis in 3 cases, aortic valve regurgitation in 2 cases and left ventricular dysfunction in 2 cases; it was of unknown origin in 3 cases. Four patients were lost sight of, and 36 have survived up to now with a mean follow-up period of 13 years. The life of these 36 patients has been marked by three types of complication. The first complication was thromboembolic accidents which occurred in 10 patients, were virtually always isolated and regressed completely. The incidence of these accidents was highest in patients treated with antivitamin K irregularly. In 23 patients who did not receive antivitamin K the incidence was only 2.27 thromboembolic accidents per 100 patient-years. The second complication, which affected only 4 patients, was functional stenosis of the prosthesis; it developed very late and was always due to periannular fibrosis either isolated or associated with remodelling of the mitral valve left in situ. The third complication was the development, with or without patent rheumatismal activity, of a lesion of the aortic orifice which required reoperation in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1988

[Percutaneous mitral commissurotomy. Apropos of 130 cases].

In order to evaluate the effectiveness and risks of percutaneous mitral commissurotomy (PMC), we tried this procedure in 130 patients. Nine attempts were unsuccessful due to pre-PMC complications (haemopericardium 2, air embolism 1) or to technical failure (6 cases, 5 of which occurred in the first 15 attempts). PMC could be performed in 121 patients: 88 women and 33 men aged from 13 to 79 years (mean 42 + 15 years); 22 patients had previously been operated upon, 5 had a history of embolism, 99 were in functional stage III or IV. Echocardiography divided these patients into 3 groups: 29 had calcified leaflets (group 1), 42 had flexible leaflets and little alteration of the subvalvar system (group 2), and 49 had flexible leaflets with alteration of the subvalvar system (group 3). Mitral regurgitation grade 1/4 was present in 32 cases. PMC was performed with one balloon (Trefoil 3 x 12 mm) in 14 patients and therafter with two balloons (Trefoil 3 x 10 mm plus conventional 15 or 19 mm balloon) in 107 patients. PMC resulted in significant improvement in haemodynamic values: the mean capillary pressure fell from 20 +/- 7 to 11 +/- 5 mmHg (p less than 0.0001) and the mean mitral gradient from 16 +/- 6 to 6 +/- 2 mmHg (p less than 0.0001), while the cardiac index rose from 2.7 +/- 0.6 to 3.1 +/- 0.7 l/mn/m2 (p less than 0.001) and the mitral valve area (MVA) from 1.1 +/- 0.2 to 2.2 +/- 0.5 cm2 (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Mitral balloon valvuloplasty in adults.

To assess the feasibility of percutaneous mitral commissurotomy, we undertook dilatation of mitral stenosis in 26 adults. The procedure was unsuccessful in six patients (hemopericardium in one, and five failures). In 20 patients (mean age: 41 +/- 13 years) the procedure was successful. We used a single balloon (Trefoil 3 X 12 mm) in eight patients and two balloons in 12 (Trefoil 3 X 10 mm + 19 mm). After valvuloplasty, valve function was improved: the mean transvalvular gradient decreased from 14 +/- 4 mm Hg to 7 +/- 2 mm Hg (P less than 0.001) and valve area increased from 1.1 +/- 0.2 cm2 to 2.2 +/- 0.4 cm2 (P less than 0.01). In a patient with severe valvular and subvalvular disease, mitral regurgitation increased from grade I to grade III. From this preliminary series, we conclude firstly that percutaneous valvuloplasty is feasible in adults with mitral stenosis, and secondly, that it results in a significant improvement in valve function with a low incidence of complications.

Adult↗
PubMed1987

[Percutaneous mitral valvuloplasty].

Thirty six adults with severe mitral stenosis underwent attempted percutaneous mitral commissurotomy. The valvuloplasty could not be performed in 6 cases; post-transseptal haemopericardium (1 case), inability to cross the mitral valve or the septum (5 cases). Therefore percutaneous commissurotomy was performed in 30 cases; the average age was 43 +/- 17 years (range 20-79 years). Eight patients had undergone previous valve surgery; 24 patients were very symptomatic (NYHA Classes III or IV). The valvuloplasty was performed with a single balloon in 22 cases and by simultaneous inflation of two balloons in 8 cases. Moderate mitral regurgitation present before the procedure was significantly aggravated in 2 cases leading to secondary surgery. In the other patients percutaneous commissurotomy led to a clear-cut haemodynamic improvement; the transvalvular pressure gradient fell from 15 +/- 4 to 6 +/- 2 mm Hg, p less than 0.01 and mitral valve surface area increased from 1.1 +/- 0.2 to 2.2 +/- 0.4 cm2, p less than .001. The best results were obtained with the double balloon technique in patients with little valve destruction. Percutaneous mitral valvuloplasty is therefore a tempting alternative to closed heart mitral commissurotomy in pure mitral stenosis with pliable valves. Larger series with a longer follow-up are needed to assess the morbidity and long-term results of this technique.

Adult↗
PubMed1986

Cardiac valve prostheses, anticoagulation, and pregnancy.

The course of 76 pregnancies is reported in 51 women who became pregnant after replacement of one or more heart valves. Age at conception ranged from 17 to 39 years (mean 25). There have been 71 deliveries and five women are still pregnant at the time of writing. In the 71 pregnancies, oral anticoagulants were given during 53, heparin during five, and no anticoagulants during 13. Fetal complications consisted of 12 spontaneous abortions (eight in pregnancies in which oral anticoagulants were given, three in which heparin was given, and one in which no anticoagulants were given), of 12 premature deliveries with seven stillbirths (three on oral anticoagulants and four without anticoagulants), and there were three neonatal deaths (in all all three instances oral anticoagulants had been given during pregnancy). The maternal complications were as follows. Two women with mitral valve prostheses on heparin had thromboembolic episodes. Four women on oral anticoagulants died and 11 developed haemorrhage or systemic embolism. Two of the deaths were caused by bacterial endocarditis, one was the result of obstruction of a mitral valve prosthesis, and one was due to haemorrhage. One patient developed pulmonary oedema during delivery which rapidly resolved. Seven patients had uterine bleeding after delivery (three of them were on heparin and one was on an antiplatelet agent).

Abortion, Spontaneous↗