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71.
Thirty out of 287 patients (10.4%) admitted to hospital for infective endocarditis between December 1970 and January 1990 had neurological complications. Twenty-three patients had native valve infectious endocarditis and 7 had prosthetic valve endocarditis. The clinical features were characterized by the frequency of aortic valve involvement (23 out of 30) and other complications, especially cardiac failure (16 cases) and peripheral vascular manifestations (7 cases). The commonest organism was the staphylococcus (53% of identified organisms) but the number of negative blood cultures was high (50% of cases). The neurological complication was often the presenting symptom of the endocarditis (19 cases) but it occurred after bacteriological cure in 4 cases. The complications observed were cerebral ischemia (16 cases), cerebral haemorrhage (11 cases), coma (2 cases), and one peripheral neuropathy causing a Claude Bernard Horner syndrome. These complications presented with hemiplegia in 17 cases, a meningeal syndrome in 8 cases, a convulsion in 1 case, a Von Wallenberg syndrome in 1 case, and a Claude Bernard Horner syndrome in 1 case. Twelve patients had a transient or permanent neurological coma. Cerebral CT scan showed ischemic lesions in 7 cases and haemorrhagic lesions in 10 cases. Carotid angiography demonstrated mycotic aneurysms in 6 patients. Twelve patients died: the cause of death was neurological coma (7 cases), low cardiac output (4 cases) and haemorrhagic shock (1 case). Four patients underwent neurosurgery: 3 for clipping a mycotic aneurysm and 1 for drainage of an intracerebral haematoma. Poor prognostic factors were: coma, cardiac failure, cardiac valve prosthesis and, above all, the extent and multiplicity of the neurological lesions. The authors propose the following measures to improve the prognosis: early surgery in cases of large and/or mobile vegetations especially when the infecting organism is a staphylococcus and when a systemic embolism has occurred; routine CT scanning and/or digitised cerebral angiography in all patients with infective endocarditis to detect surgically accessible mycotic aneurysms. 相似文献
72.
73.
Ben Saida N Ben Abdallah H Hannachi N Boukadida J 《Médecine et maladies infectieuses》2005,35(6):363-366
OBJECTIVE: The methicillin resistance of Staphylococcus aureus MRSA is a major problem for human infections. The authors present a genotypic study of these bacteria to understand the spreading of these strains in a university hospital. PATIENTS AND METHODS: We collected 19 strains of MRSA (September 2003-March 2004) for which the presence of gene mecA had been confirmed by PCR. They were then genotyped in pulsed-field Gel electrophoresis (CHEF variety). RESULTS: Resistant strains accounted for 12.9% of all collected S. aureus strains. Most samples came from patients hospitalized or consulting in dermatology. Eleven different antibiotypes and four genotypic profiles were determined: type A (with 8 subtypes), type B (with 2 subtypes), type C, and D. CONCLUSION: MRSA strains have a multiclonal distribution in our hospital with a dominant endemic clone in the dermatological unit. Skin infections are the main hospital source for these strains. 相似文献
74.
Hannachi Sassi S Mansouri D Abbes I Dhouib R Driss M Mrad K Ben Ayed F Ben Romdhane K 《Revue de chirurgie orthopédique et réparatrice de l'appareil moteur》2005,91(7):671-675
We report a case of epithelioid hemangioendothelioma observed in soft tissue in a 35-year-old man who presented a painful mass of the right arm which progressed in size for two years. Imaging revealed a 7-cm poorly limited expansive tumor process located in the medial muscle compartment of the right arm. Surgical resection was performed. Histological and immunohistochemical examination led to the diagnosis of soft tissue epithelioid hemangioendothelioma. The tumor recurred in the right arm and the right axillary fossa with development of multiple nodules in the contralateral thoracic wall and pleural effusion. Adjuvant chemotherapy and radiotherapy were performed, but the patient died at two years. 相似文献
75.
Hanaa Amrani Hassani Joutei Nabila Marchoudi Wafaa Mahfoud Ilham Sadaoui Taoufiq Fechtali Hakima Benomar 《Arab Journal Of Gastroenterology》2018,19(4):155-158
Background and study aims
Targeted therapies have an increasing importance in digestive oncology. To our knowledge, we are the first to report the distribution of PI3KCA and BRAF mutations in Moroccan HER2 overexpressed patients, in order to introduce targeted therapy in the arsenal of therapeutic modalities for management in Morocco.Patients and methods
98 gastric adenocarcinoma tissue samples were collected. Further histological and immunohistochemical examinations were carried out at the Laboratory of Anatomy Pathology in Pasteur Institute-Morocco, in order to select HER2 positive cases. Out of 98 cases, 16 were found to be HER2-positive. The molecular study was performed for 55 good quality tissue samples including the HER2-positive ones, and activating mutations in H1047R PI3KCA and V600E BRAF were analyzed by Cast-PCR and Real-time PCR, respectively, at the Department of Molecular Biology, ANOUAL Specialized Center-Casablanca, Morocco. Statistical analyses were performed using the Epi-info software (version 6.09).Results
Pi3KCA mutation was present in 8 cases (14,54%). BRAF mutation was present in 4 cases (7,27%) and 3 cases showed concomitant mutations. In total, 9 cases (16,36%) had PI3KCA and/or BRAF mutations.Conclusion
The association between HER2 expression and PI3KCA alteration in gastric adenocarcinoma is most probably necessary to identify trastuzumab responders. Consequently, the 83,64% rate of HER2-positive patients harboring wild-type mutations possibly represents the portion of patients responding to trastuzumab while the 16,36% rate of patients carrying at least one of the studied mutations represents the portion of potentially non responsive patients to the targeted therapy, and thus may be considered as good candidates for multi-drug targeted therapy. 相似文献76.
Hannachi Sassi S Khattech R Dhouib R Rameh S Mrad K Douik M Ben Romdhane K 《Revue de chirurgie orthopédique et réparatrice de l'appareil moteur》1999,85(8):865-870
A variety of tissues in bone can be the origin of neoplastic primitive lesions. Consequently, it can be the site of various sarcomas of tissue type, incursing leiomyosarcoma. The leiomyosarcoma of the bone is considered as primitive after exclusion either a bony extension of a soft tissue tumor of vicinity or the presence of a leiomyosarcoma elsewhere. We report a case of a primary leiomyosarcoma arising on the left femur of a 40-year-old woman. The diagnosis was confirmed by immuno-histochemistry and electron microscopic study. A bloc resection followed by a prothesis was performed. The patient underwent a fractioned postoperative radiotherapy with a total dose of 75 Gy. The postoperative course one year later revealed local recurrence and pulmonary metastases. Despite the resection of pulmonary metastases and the amputation of left lower limb, the patient had developed local recurrence on the stump of amputated limb and was on the outside of all therapeutic resource. In this report, we present the clinicopathologic, immuno-histochemical and ultrastructural profiles of these rare primary bone tumors. 相似文献
77.
N. Hannachi S. HidarI. Harrabi S. MhallaM. Marzouk H. GhzelH. Ghannem H. KhairiJ. Boukadida 《Pathologie-biologie》2011,59(5):e115
Objectives
The study was conducted to investigate the prevalence and risk factors for hepatitis E virus (HEV) infection in Tunisian pregnant women.Methods
A total of 404 pregnant women were enrolled. Data were collected through a standard questionnaire which covered sociodemographic characteristics and risk factors. Blood samples were collected and were tested for HEV IgM and IgG antibodies, IgG against hepatitis A (anti-HAV IgG), hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV). Risk factors were analyzed using univariate and multivariate logistic regression models.Results
Prevalence of anti-HEV IgG, anti-HEV IgM, anti-HAV IgG, HBs Ag and anti-HCV was 12.1 %, 0 %, 97 %, 3 % and 0,5 %, respectively. In multivariate analysis age (>30 years) and the number of persons per room (>2) in the house were independent factors predicting HEV infection. History of agricultural work, kind of water, sewage treatment, use detergent to wash vegetables, contact with animals and parenteral risk factors were not correlated with the presence of anti-HEV IgG.Conclusion
The important seropositive rate among pregnant women is compatible with endemicity of HEV in Tunisia. Hepatitis E should be considered in the diagnosis of acute hepatitis during pregnancy. Our result suggests that infection occurs sporadically by person-to-person transmission route but further investigations are needed to determine the natural reservoir of infection. 相似文献78.
Zbiti N Alhamany Z Houssaini TS Rhou H Benamar L Ezaitouni F Bayahia R Ouzeddoun N 《Néphrologie & thérapeutique》2010,6(7):602-605
We present two cases of renal lymphoma revealed by acute renal failure (ARF), which remains a rare clinical entity. Case 1 was a 29-year-old man with an ARF. The diagnosis was a primitive kidney immunophenotype B lymphoma. The patient died after three courses of chemotherapy due to rapid spread lymphoma. The second case was a high-grade renal lymphomatous infiltration, with an unusual computer tomography image of two large kidneys compressing the stomach. Death happened early before initiating therapy. In both cases the diagnosis has been established by renal pathology. Early diagnosis is a key component of therapeutic success, however, the rapid spread of lymphoma worsened renal and vital prognosis. 相似文献
79.
N Hannachi R Mechmèche M Ayari M Ben Ismail 《Annales de cardiologie et d'angeiologie》1989,38(6):327-331
The objective is here to study the long and intermediate term clinical and haemodynamic effects of enalapril during chronic heart failure resistant to the classic digitalis-diuretics treatment. The study involves 16 patients (12 males and 4 females), with a mean age of 50 years. Before being given enalapril, 12 patients were at stage IV and 4 patients at stage II of the NYHA; the mean capillary pressure was quite elevated (30 +/- 6.3 mmHg), the cardiac index has collapsed (2.12 +/- 0.38 l.min.m2) and the stroke fraction (SF) is 0.28 +/- 0.08. At the 1st month control, there is a definite functional and haemodynamic improvement of the pre-charge as well as the post-charge. This improvement is still present at 6 months. The ventricular function is improved (SF = 0.38 +/- 0.13; p less than 0.001). The clinical tolerance of enalapril is excellent and the only adverse reaction is a transient deterioration of the renal function in a patient with diabetic glomerulopathy. 相似文献