Primary hydatidosis of the central nervous system: A retrospective study of 39 Tunisian cases

Objective

To analyze epidemiological characteristics, clinical symptoms, radiological aspects, treatment and outcome of central nervous system hydatidosis and compare our results with those reported in literature.

Patients and methods

In our retrospective study, we reviewed 39 cases of primary central nervous system hydatid cysts operated on in our hospital between 1998 and 2007.

Results

There were 20 male and 19 female patients (sex-ratio M/F = 1.05) between 2 and 68 years of age (mean = 26.5 years). Thirteen of the patients were children (33.3%) with a mean age of 6.8 years and 26 were adults (66.7%) with a mean age of 36.3 years. The location of hydatid cysts was intracranial in 27 cases (69.2%) and spinal in 12 cases (30.8%). Headache and motor deficits were the predominant symptoms in patients with intracranial hydatidosis whereas back pain and spinal cord compression syndrome were the most frequent clinical presentations in patients with spinal hydatidosis. All patients underwent surgical resection of the cyst. Pathologic findings were consistent with hydatid cyst in all cases. During the follow-up period which ranged between 12 months and 5 years, 12 patients had recurrence (30.7%). Only one patient with intracranial hydatid cyst died postoperatively due to anaphylactic shock.

Conclusion

Despite all the advances in imaging techniques and therapeutic methods, central nervous system hydatidosis remains difficult to cure and patient outcomes are not satisfactory especially in case of spinal involvement due to the high incidence of recurrence.     

Introduction of <Emphasis Type="Italic">in vitro</Emphasis> transcribed <Emphasis Type="Italic">ENO1</Emphasis> mRNA into neuroblastoma cells induces cell death

Background  

Neuroblastoma is a solid tumour of childhood often with an unfavourable outcome. One common genetic feature in aggressive tumours is 1p-deletion.     

Focus on the various techniques of anaesthesia in ophthalmologic surgery

Ophthalmologic surgery is not a vital one. It mostly concerns patients in extreme ages: children and old people. The risk of anaesthesia mainly depends on the health conditions of the patient. General anaesthesia through use of intravenous drugs alters the balance of the endocrine and sympathetic systems. Tracheal airway intubation constitutes an added constraint and stress especially for the vascular system. Retrobulbar anaesthesia is not devoid of risks: ptosis, diplopic, orbit haematoma, lesion of the optic nerve, eye perforation, vascular occlusion, intra arterial injection, neurologic and cardiovascular toxic effects of local anaesthetics, are all ever present risk Topical anaesthesia with its various variants (single topic or associated with intracameral injection, subconjunctival, circumferential perilimbal, subtenon) represents an interesting alternative for it is simple, less toxic and harless. In our experience, this method is indicated in surgery of eye's anterior segment. We find it safe, efficacisious and economical. Regional anaesthesia is preferred to general anaesthesia especially in the surgery of dacryocystitis and ptosis. General anaesthesia in stell indicated in case of children.     

Effect of combined active recovery from supramaximal exercise on blood lactate disappearance in trained and untrained man

The purpose of this study was to determine the effect of different modalities of individualized active recovery on blood lactate disappearance after supramaximal exercise in subjects with different levels of aerobic fitness. Fourteen healthy subjects (7 trained and 7 untrained subjects mean age 20 +/- 1.5 and 19.5 +/- 1.5, respectively) participated in this study. They performed three supramaximal intermittent exercises at 60 % of the time to exhaustion at 120 % of the maximum aerobic power (MAP) with 5-min recovery periods (2 x 5 min). The third exercise was followed by 20 min of recovery. The effects of four types of recovery were compared in trained and untrained subjects: passive recovery (PR), an active recovery at an intensity corresponding to the first anaerobic ventilatory threshold minus 20 % (VT1), an active recovery at an intensity corresponding to the second anaerobic ventilatory threshold minus 20 % (VT2) and a combined active recovery (CR) which consisted of 7 min at VT2 followed by 13 min at VT1. Blood lactate levels were measured at rest and during the recovery periods. Peak blood lactate after supramaximal exercise was observed significantly earlier with VT2 and CR (4th min) than VT1 and PR (7th min) in trained and in untrained subjects. Combined active recovery (CR) showed a significantly faster lactate disappearance than did PR, VT1, or VT2 from the 7th min of recovery in trained subjects (p < 0.05) and at the 20th min in untrained subjects (p < 0.05). CR and VT2 conditions showed earlier peak blood lactate (4th min) than PR or VT1 (7th min). Blood lactate disappearance was faster in trained than untrained subjects during combined active recovery. This result suggests that the level of physical fitness plays an important role mainly in the pattern of blood lactate decrease during combined active recovery.     

IGFBP-3, a sensitive marker of physical training and overtraining

Objective: To investigate the response of the somatotrope axis (insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3)) to intense exercise in relation to tiredness. Methods: The study involved 11 rugby players who completed a questionnaire intended to evaluate fitness or, conversely, overtraining and who agreed to plasma samples being taken before and after an international rugby match. Results: The main finding of our study is that we observed strong negative correlations between IGF-1 (r = 0.652) and IGFBP-3 (r = 0.824) levels and the overtraining state estimated using the French Society of Sport Medicine questionnaire. In particular, there was a fall (of up to 25%) in IGFBP-3 levels after the match in the more fatigued subjects compared to an increase (of up to 40%) in fit subjects. Conclusions: A fall in IGFBP-3 in response to an intense bout of exercise may represent an index of tiredness in highly trained sportsmen, as indicated by the scores obtained from the overtraining questionnaire.     

Jaccoud arthropathy and pyrophosphate arthropathy: a rare association

Jaccoud's arthropathy (JA) is a chronic deformity affecting hands and feet, which are voluntarily correctable by the patients. JA was usually reported in association with rheumatic fever and systemic lupus erythematosus. We describe an exceptional association between a pyrophosphate arthropathy and JA of the hands. It is a 48-year-old woman, having a 13 years history of polyarthritis involving shoulders, elbows, hips and knees, and 4 years after, a progressive unlar deviation of the fingers of the hands. Calcium pyrophosphate dihydrate crystals were identified in the synovial knee biopsy. Hands x-rays as RMI don't identify erosions and confirmed the JA.     

Epidemio-clinical profile of human scabies through dermatologic consultation. Retrospective study of 1148 cases

We report a retrospective study of all scabies cases collected in the department of Dermatology of Charles Nicolle Hospital during a 8 year-period (1993-2000). 148 cases of scabies were collected with a mean incidence of 144 new cases/year (65-204). Diagnosis was made clinically in all cases. Parasitological exam was done in case of doubtful diagnosis. Our purpose is to try to define an epidemio-clinical profile of scabies in Tunisia and to estimate the incidence of this parasitosis through our dermatological consultation with reviewing the literature data.     

A cytogenetic approach to the effects of low levels of ionizing radiation (IR) on the exposed Tunisian hospital workers

Objectives

The aim of this study is to assess chromosomal damage in Tunisian hospital workers occupationally exposed to low levels of ionizing radiation (IR).

Materials and Methods

The cytokinesis-block micronucleus (CBMN) assay in the peripheral lymphocytes of 67 exposed workers compared to 43 controls matched for gender, age and smoking habits was used. The clastogenic/aneugenic effect of IR was evaluated using the CBMN assay in combination with fluorescence in situ hybridization with human pan-centromeric DNA in all the exposed subjects and controls.

Results

The study showed a significant increase of the micronucleus (MN) frequency in the lymphocytes of the exposed workers compared to the control group (13.63±4.9‰ vs. 6.52±4.21‰, p < 0.05). The centromere analysis performed in our study showed that MNs in hospital staff were predominantly centromere negative (72%) and the mean negative labeled micronucleus (C-MN) frequency was significantly higher in the exposed subjects than in the controls (9.04±4.57‰ vs. 1.17±0.77‰). The multivariate regression analysis, taking into account all confounding factors, showed that only the time of exposure to IR had a significant effect on the level of MNs and C-MN.

Conclusion

The present study shows that chromosomal damage leading to the formation of micronucleated lymphocytes is more frequent in the hospital workers exposed to IR than in the controls, despite the low levels of exposure. The results of the study confirm the well-known clastogenic properties of ionizing radiation. In regards to health monitoring, detection of early genotoxic effects may allow for the adoption of preventive biological control measures, such as hygienic improvements in the workplace or reduction of hours of occupational exposure.