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Biomedical subjects

A Daoud

Publications and source records attributed to A Daoud.

At least 37 records · Page 2Linked to original sources
PubMed1995

The clinical spectrum of Henoch-Schönlein purpura in infants and young children.

UNLABELLED: Henoch-Schönlein purpura is a common cause of childhood vasculitis. The rarity of the disease under 2 years of age has been the subject of few reports. We present the clinical spectrum of Henoch-Schönlein purpura in 12 children younger than 2 years of age at presentation. The median age at presentation was 11 months. The purpuric skin rash was present in all patients and involved the face in 10 of them. While oedema was a prominent feature in all of our patients only one third had involvement of the kidneys, gastro-intestinal tract or joints. All patients recovered completely after a mean duration of follow up of 10.6 months (range 2-39 months). CONCLUSION: Henoch-Schönlein purpura under the age of 2 years is characterized clinically by oedema and a purpuric skin rash which frequently affects the face. Involvement of the joints, kidneys and gastro-intestinal tract is uncommon and the prognosis is excellent. The clinical spectrum in this age group is a continuation with that of Henoch-Schönlein purpura in older children suggesting a nosological entity.

Age of Onset↗
PubMed1995

[Rhino-orbito-cerebral zygomycosis (mucormycosis) in diabetes insipidus].

A case of rhino-orbito-cerebral zygomycosis in a diabetic patient treated with insulin is reported. Diagnosis was suspected because of extensive necrotic lesions of the face and was confirmed by mycologic tests. During hospital stay the patient developed a diabetes insipidus and the outcome was lethal because of the extension of lesions in spite of convenient antimycotic therapy.

Adult↗
PubMed1995

[Munchmeyer's disease in children].

The clinical features of two children with myositis ossificans progressiva are described. Skeletal malformations can be observed in many sites: hand, femur, tibia and spine. Phalangeal abnormalities (shortened hallux, hallux valgus) are essential to the diagnosis. We recommend systematic roentgenographic examination to search for other skeletal malformations for congenital hallux valgus in young children because it can be the first sign of myositis ossificans progressiva. Progression of disability does not seem to be influenced by any form of medical treatment. Surgical removal of ectopic bone is thought to be followed inevitably by rapid recalcification at the original site.

Abnormalities, Multiple↗
PubMed1994

[Surgical treatment of chronic hematogenous osteomyelitis. A series of 42 cases].

INTRODUCTION: Chronic hematogenous osteomyelitis (C.H.O.) is still a scourge of the non-industrialized countries. The authors operated on 420 cases of C.H.O. in Algeria between 1968 and 1987. A computerized analysis of the results of the surgical treatment of these 420 cases was made in Brussels, Belgium, by two of the authors. The results of this computerized study are exposed. MATERIAL AND METHODS: 67.1 per cent of the patients were male and 37.9 female. 68 per cent were operated before 16 y. of age. 381 lesions involved tubular bones: femur, tibia and humerus were the most frequent locations. Only 4 per cent of the cases had never presented a suppuration. Cultures of Staphylococcus were positive in 82 per cent of the cases. Surgical procedure was classical--bone window opening, sequestrectomy and saucerisation--in 359 cases. Operation was limited to soft tissues in 22 cases and bone resection was performed in 39 cases. Post-operative antibiotherapy was administered for a period of 10 to 60 days according to the patients. RESULTS: After the first operation with the classical procedure, results were satisfactory in 72 per cent of the cases but "healing" was achieved in 95 per cent of the cases after 2, 3, 4 and up to 6 operations. After bone resection, the rate of permanent healing was of 100 per cent. Follow-up was of more of 1 year (up to 22 y.) in 80 per cent of the cases. DISCUSSION: As far as classical procedure is concerned, a computerized analysis made according to 34 variables, led to the conclusions that the following variables could have a positive influence upon the prognosis: surgical team's experience, young age of the patient at the time of operation, subacute onset of the disease, location on the humerus, diaphysis of long bones, membranous and short bones, small number of sinuses, sclero-geodic radiologic appearance of the lesions, thin perifocal radiologic condensation, periosteal reaction, post-operative administration of two antibiotics. Excellent results of bone resection are pointed out but attention is drawn on the dangers of extending the indications for resection to the tubular bones. CONCLUSION: The authors conclude that improvement in the results of the surgical treatment of C.H.O. may only take place after improvement of the quality and duration of chemotherapy: that is confirmed by the results of a clinical trial they organized on the role of post-operative administration of Amoxicilline + Clavulanic Acid for a period of 60 days after surgery: 44 patients, 2 lost to follow-up, 4 failures and 38 "healings" (90.5 per cent) at 2 years and more.

Adolescent↗
PubMed1992

[Clinical results of the treatment of chronic hematogenous osteomyelitis of the femur by operation. A series of 165 cases].

Between 1968 and 1987 the authors treated 165 cases of chronic haematogenous osteomyelitis of the femur by operation. The procedure used combined decompression, sequestrectomy and saucerization in 161 cases, and sequestrectomy alone in 4. Chemotherapy was used in association for between 10 and 60 days. Eleven patients, thought to be healed, were lost to follow-up after 4 months. The remainder were reviewed for between 4 and 252 months, 124 for more than one year. After the first operation 105 lesions (64%) healed completely, while 60 (36%) relapsed. Of these, 48 were treated by further operation and 12 by drainage of the abscess. Nine patients relapsed twice and there were 3 or more relapses in a further 9. When last seen, 147 lesions were healed and 18 had a permanent sinus. Special features in relation to the femur are discussed, including destructive lesions of the knee and hip joints, the high incidence of stiffness of the knee even in the absence of radiographic evidence of destruction (48.5%), and the danger of injuries to the femoral vessels when using an approach through a medial sinus. The frequency of occurrence of lesions on both medial and posterior aspects of the femur has led the authors to recommend definitive surgical approaches, especially the true postero-lateral and antero-medial routes. Unsatisfactory results after operation may be due to the difficulty in performing sequestrectomy in deep and extensive lesions, problems in undertaking adequate saucerization and the lack of muscle to fill the residual cavity.

Abscess↗
PubMed1991

[Results of the surgical treatment of chronic hematogenous osteomyelitis of the tibia. A series of 122 cases].

Between 1968 and 1987 the authors treated 122 cases of chronic haematogenous osteomyelitis of the tibia by operation. The procedures used were drilling, sequestrectomy, and saucerisation, with bone resection in 2 cases. Operation was combined with chemotherapy for between 10 and 60 days. Eleven patients, thought to be healed, were lost to follow-up after 4 months. The remainder were reviewed for between 4 and 288 months, 97 for more than one year. After the first operation 102 patients healed completely, while 20 relapsed. Of these, 12 were treated by further operation and 8 by drainage of the abscess. Two patients relapsed twice and another 4 times. When last seen 110 patients were healed, 6 had an intermittent discharge and 6 had a permanent sinus. Special features of chronic osteomyelitis of the tibia are discussed, including destructive lesions of the knee and tibio-tarsal joints, a high incidence of axial deformity, indications for particular surgical approaches, the use of cancellous grafts and arguments against bone resection. The lesions carry a relatively good prognosis.

Adolescent↗
PubMed1991

Verrucous carcinoma of the maxillary antrum.

Verrucous carcinoma is a rare variant of squamous cell carcinoma which occurs most frequently in the oral cavity and larynx. In this article we describe a patient with verrucous carcinoma of the maxillary antrum, and present a review of the literature.

Aged↗
PubMed1990

[Neonatal diagnosis of hip luxation].

Examination of the hips had been performed in an algerian maternity ward on nearly 15,000 neonates. The results show an important number of babies lost from control, either after they have left the maternity or after one or two orthopedic weekly examinations. There were various causes to explain this important number of babies lost from control but the attempts to reduce this number were disappointing during the six years of the study. We suggest that, for a better control of the babies, the personal of public health administration must be concerned in the neonatal prevention of congenital dislocation of the hip in a developing country under the medical supervision of a pediatrician or an orthopedist. Moreover, a too high number of neonates had been submitted to the abduction treatment, because there was a difficulty in differentiating Ortolani's and Barlow's signs. The abduction treatment is proposed for all the babies that could not be under medical examination in the developing countries to reduce the number of late diagnosis of congenital dislocation of the hip.

Algeria↗
PubMed1989

[Nutritional copper deficiency. Apropos of a case].

Copper deficiency developed in a five-month-old prematurely born infant with an abdominal wall closure defect and a small bowel fistula under long-term parenteral nutrition. The first manifestations were typical bone changes including diffuse osteoporosis, delayed bone age, widened cupped metaphyses with beaks and a fracture, subperiosteal hematomas and ossifications in the shafts of long bones, and a diaphyseal fracture. Other findings that confirmed the diagnosis included edema of the limbs with pseudoparalysis, neurologic abnormalities, anemia, leukoneutropenia, and very low serum levels of copper and ceruloplasmin. Following initiation of copper supplementation, clinical, hematological and biological disorders resolved within a few days and roentgenologic bone abnormalities within four months. Copper deficiency develops only in the presence of specific risk factors, that are often combined in a single patient: inadequate stores due to prematurity, excessive loss due to chronic diarrhea, exudative enteropathy, a proximal stoma, or a biliodigestive fistula; and inadequate intake due to malabsorption or long-term exclusive parenteral nutrition (EPN). Appropriate copper supplementation is needed in all these high risk situations. Early, continuous copper supplementation is required for young children under EPN. Serum copper assays should be included among the periodically monitored biochemical parameters.

Copper↗
PubMed1989

Treatment of sequestra, pseudarthroses, and defects in the long bones of children who have chronic hematogenous osteomyelitis.

We reviewed the results, after follow-up ranging from twenty-three months to six years, in thirty-four patients who were treated during childhood for hematogenous osteomyelitis of a major long bone complicated by sequestration of a portion of the diaphysis and by pseudarthrosis or segmental bone loss, or both. Of the thirty-four lesions, twenty-four were in the tibia, eight were in the femur, and two were in the humerus. In twenty-three patients (Group I), the infection was still active, while in the other eleven (Group II), it was quiescent at the time of admission to the hospital. In nine of the patients in Group I (four tibial and five femoral lesions), an involucrum bridged the osseous defect, indicating that the periosteal tube had not been destroyed. In these nine patients, sequestrectomy and débridement, appropriate antibiotic therapy, and prolonged immobilization in a plaster cast resulted in healing of the defect without recurrence of the infection. In the remaining fourteen patients (twelve tibial and two femoral lesions), there was no periosteal new-bone formation, and operative treatment consisted of two stages: the first, to resolve the infection, and the second, to heal the osseous defect with corticocancellous iliac grafts. In the eleven patients in Group II (eight tibial, one femoral, and two humeral lesions), there were no involucra. All of these patients were treated with cancellous bone grafts and prolonged immobilization. In twenty-two of the thirty-four patients (thirteen in Group I and nine in Group II), there were varying degrees of angular deformity at the pseudarthrosis, necessitating correction by manipulation when the plaster cast was applied postoperatively (ten patients), by fibular transposition (six patients), or by fibular osteotomy in addition to manipulation (six patients). Excluding complications specific to the fibular transfer procedure, the complications in the Group-I patients (six recurrent postoperative infections, one fracture of the graft, and one non-union of a fibular strut graft) were approximately as frequent as those in the Group-II patients (one failure of fusion and two fractures of the graft). Operative treatment resulted in healing of all but one tibial lesion, in a patient who nonetheless had good function at follow-up. Of the seven limb-length discrepancies of 2.8 centimeters or more, by the latest follow-up two had been treated uneventfully: one by femoral and the other by tibial lengthening.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

[Ferguson's procedure in the treatment of congenital dislocation of the hip. Apropos of 42 cases].

A series of 42 hips in children aging 5 to 26 months treated initially by the Ferguson's technique is reported. The mean duration of the follow-up was 41 months. The place of this therapeutic method in the general plan of treatment of CDH was evaluated. The reduction of the femoral head was obtained in 93 p. cent of the cases, but with a lateralized position of the epiphysis postoperatively in one third of the cases. This excentration improved and the centering of the epiphysis was obtained spontaneously during the postoperative immobilization. One case of redislocation reduces the rate of success to 90.5 p. cent. An hypertrophy of the ossified nucleus of the femoral head was noted in 23 p. cent of the cases. This aspect is probably more frequent than reported when considering the bilateral cases, and must be considered as a complication of the arthrotomy. An ischemic necrosis of the femoral epiphysis complicated the operation in 5 cases (12 p. cent) causing in 4 cases an epiphyseal involvement (type 1 of Bucholz and Ogden). There has been 3 failures in obtaining the reduction peroperatively: these 3 hips have been treated subsequently by a conservative means in 2 hips and surgical reduction through an anterior approach in one hip. Two pelvic osteotomies have been necessary to treat a severe pelvic dysplasia that did not correct spontaneously. We think that this operation has a definite place among the methods of treatment of CDH. It should be indicated only in cases of failures of a conservative treatment.

Casts, Surgical↗
PubMed1984

[Tuberculous osteoarthritis of the foot and ankle joint].

The authors have reviewed 26 cases of tuberculosis of the foot and 32 of the ankle, which they have treated personally. All the patients were adults and most presented with advanced destruction of bone and joints. Bacterial and histological confirmation of the diagnosis was obtained in 56 patients. All were treated by chemotherapy; the drugs and regime varied over the years. All responded well to this treatment, but one relapsed after 24 months. Orthopaedic problems were usually managed by immobilisation in plaster casts, but 6 patients required arthrodesis, 5 of the ankle and one triple fusion. The functional results of the standard treatment were generally good. Arthrodesis is seldom needed and should be performed only for permanent pain or crippling deformity.

Adolescent↗
PubMed1984

[Neglected luxations of the elbow. 25 surgical reductions].

During the past 8 years the authors have seen 47 old dislocations of the elbow. In 16 instances, function was acceptable with more than 90 degrees flexion and in 31 it was not acceptable. Twenty five elbows were operated on with 23 satisfactory results and 2 stiff elbows. The importance of long-term rehabilitation is stressed. Reduction achieved a better position of the elbow but only slight improvement in the range of movement. The need for surgical reduction should only be considered after several months of rehabilitation since some older cases can be improved without surgery. More recent cases should be operated on as soon as possible.

Adult↗
PubMed1983

[Surgical treatment of dislocated hips after 5 years of age].

Fifty dislocated hips after the age of 5 were treated between 1975 and 1980. The surgical procedures performed combined tenotomy of the iliopsoas and adductor muscles, shortening of the femur, capsulorraphy and a pelvic osteotomy usually for re-orientation (Salter procedure) and rarely for widening of the acetabulum (Chiari procedure). It is thought that tenotomies and femoral shortening were more efficient than pre-operative traction which produced osteoporosis. However post-operative traction was used. In some cases plaster cast immobilisation was not used. The advantages of this technique were an acceleration of the surgical programme, better articular stability and early mobilisation. Osteochondritis and post operative stiffness were rare. The average range of movement included 90 degrees of flexion and lumbar balance was the most significantly improved factor. This type of surgical procedure aims to slow the development of coxarthrosis but it cannot diminish the risk. The limit of age for such treatment appears to be 10 years. After that, the indications need to be assessed carefully.

Age Factors↗