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Biomedical subjects

A Farah

Publications and source records attributed to A Farah.

At least 19 recordsLinked to original sources
PubMed2001

Classification of epilepsy syndromes and role of genetic factors.

In this report the types of epilepsy syndromes seen in children in a tertiary referral center in Beirut, Lebanon were studied and the importance of consanguinity and family history in the occurrence of these syndromes was investigated. Records of 230 pediatric patients evaluated during a 1-year period with the diagnosis of single seizure, febrile seizure, or epilepsy were reviewed. Each patient was classified according to the International League Against Epilepsy classification. The occurrence of consanguinity, of family history of febrile seizures or epilepsy, and of other variables was noted. Thirty-six percent of patients were diagnosed with localization-related epilepsy, 21.7% with generalized epilepsy, 11.7% with undetermined generalized or focal, and 24.3% with special syndromes. Twelve percent of patients were diagnosed with idiopathic, 15.1% with symptomatic, and 30.3% with cryptogenic epilepsies. Consanguinity was more common in patients with symptomatic and cryptogenic epilepsies than in patients with idiopathic epilepsies or with incidental seizures (P < 0.05). Family history of epilepsy was more common in patients with symptomatic, cryptogenic, and idiopathic epilepsies than in patients with incidental seizures (P < 0.05). Family history of febrile seizures but not consanguinity was more common in patients with febrile seizures (P < 0.05). We conclude that genetic factors are important not only in idiopathic epilepsies and febrile seizures but also in cryptogenic and symptomatic epilepsies.

Adolescent↗
PubMed2000

Thrombus formation at the site of radiofrequency catheter ablation.

A 55-year-old woman with a history of resected atrial myxoma with residual patched atrial septal defect (ASD) underwent a successful radiofrequency (RF) ablation of reentry atrial tachycardia. She presented with progressive dyspnea 5 days later. Transesophageal echocardiography revealed a 1-cm right atrial mass attached to the intraatrial septum at the ablation site. Repeat study after anticoagulation for 5 weeks showed complete resolution of the thrombus. Thrombus formation at the site of RF ablation is a potential complication that may require aggressive anticoagulation. Patients with patched ASD might be at higher risk.

Catheter Ablation↗
PubMed1999

Survey of the impact of randomised clinical trials on surgical practice in France. French Associations for Research in Surgery (AURC and ACAPEM). Association Universitaire de Recherche en Chirurgie. Association des Chirurgiens de l'Assistance Publique pour l'Evaluation Médicale.

OBJECTIVE: To evaluate the impact of randomised clinical trials (RCT) on decision-making and therapeutic policies among general and gastrointestinal surgeons in France. DESIGN: Telephone questionnaire. SETTING: Multicentre study, France. SUBJECTS: A random sample of 152 surgeons, mean (SD) age 50 (8) years. INTERVENTIONS AND MAIN OUTCOME MEASURE: Surgeons were asked 12 questions about their knowledge of RCT and how trials were conducted; influence of RCT on their treatment policies; means of obtaining information about treatments; how they evaluated their own results; whether they were willing to take part in RCT; and personal details including age, speciality, and type of practice. Surgeons were stratified according to age and type of practice. RESULTS: 148 questionnaires were suitable for analysis. 83 surgeons (56%) were under 50 years old, 38 (26%) were exclusively gastrointestinal surgeons, 82 (56%) worked in private practice, and 36 (24%) worked in teaching and university hospitals. The rest undertook mixed duties. When asked to say where they obtained their knowledge about antibiotics, 91 (61%) referred to RCT; these were mainly hospital-based, gastrointestinal, and younger surgeons. Asked to name a RCT-based policy, 81 (55%) gave medical rather than operative examples. 80 (54%) had already participated in a RCT; 79 (53%) said that they were willing to participate in a RCT that included random allocation of patients (there were no statistically significant differences in answers according to speciality or type of practice, although younger surgeons answered "yes" to both questions). Specialised journals were the main source of information for 115 (78%), and surgeons read a mean of 40 issues/year. 142 (96%) read journals in French and 66 (45%) in English, but this number fell to 10 (15%) of the 65 surgeons aged 50 or more. Personal experience was considered a more important source of therapeutic knowledge by older and specialist surgeons. 109 surgeons (74%) recalled patients during the first month postoperatively to evaluate their results. CONCLUSIONS: French surgeons, particularly those aged 50 or over, are not well informed about the nature, conduct, and value of RCT. Most of their information is acquired through reading and attending scientific meetings and congresses. Surgeons tended to attach more importance to the fame of the author than to the conduct of the study. The overall impact of RCT was weak among the surgeons questioned.

Adult↗
PubMed1998

[Acute mesenteric ischemia: changes in 1985-1995. Surgical Research Associations].

AIM OF THE STUDY: Acute mesenteric ischaemia (AMI) resulting in intestinal ischaemia and/or infarction is associated with an extremely serious prognosis and a mortality rate ranging from 40% to 100%. The aim of the study is to appreciate the epidemiological, therapeutic and prognostic changing aspects of the AMI over a decade. PATIENTS AND METHODS: Two retrospective and multicentric series (492 and 305 patients, respectively) identically collected between 1980-1985 and 1990-1995 by the French Associations of Surgical Research were compared. Comparisons concerned the patients' clinical features, the aetiology of AMI and the surgical management. The mortality was analysed taking into account the former items. RESULTS: The overall mortality rate decreased from 77% to 59% (P < 0.0001). The patients' preoperative clinical features improved but collapse remained the main serious factor. The rate of venous origin AMI increased significantly (P < 0.02) with a mortality decrease (51% to 19%, P < 0.0001). The mortality rate of thrombotic origin AMI decreased (83% to 63%, P < 0.0001). The results of surgical management improved, even though the frequency of angiographies, vascular and second-look procedures did not increase. CONCLUSION: Even though the prognosis of AMI remains extremely serious, a significant decrease of the overall mortality rate is observed. Two ways of progress can be recommended: the first, successfully initiated involving better management of the patients with a greater number of classical surgical procedures; the second, more aggressive treatment advocated by more specialised surgical teams.

Acute Disease↗
PubMed1996

[Acute appendicitis in patients over 70 years of age].

OBJECTIVES: We assessed preoperative diagnosis of appendicitis and perforations in elderly patients in our unit to determine whether the overall higher rate of appendectomy in France (3 to 4 times higher than in anglo-saxon countries) has an effect. METHODS: We analyzed retrospectively the cases of all patients over 70 years of age who undervent appendectomy for histologically confirmed appendicitis between February 1, 1990 and 31 January 1995. RESULTS: There were 20 patients (15 women 5 men) in the study group (age range 70-89 years). The site of abdominal pain was atypical in 10 cases (50%) and acute bowel occlusion occurred in 9 (45%). The diagnosis of appendicitis was made before surgery in 10 patients; surgery was performed within 24 hours of admission in only 8. The high rate of perforations (70%) was not correlated with age. Complications occurred in 70% of the cases and were related to perforation (p < 0.02) and an American Society of Anesthesia (ASA) score > 2 (p < 0.05). CONCLUSION: Acute appendicitis in the elderly patient is a serious condition. The atypical nature of the clinical presentation in half of the patients often requires computed tomography or laparoscopy for diagnosis.

Acute Disease↗
PubMed1996

[Yersinia enterocolitica: a cause of acute intestinal intussusception].

OBJECTIVES: Yersinia enterocolitica infection is a rare cause of intestinal intussusception, especially in adults. We report here a case in a 29-year-old man and review the literature on diagnosis and therapy. CASE REPORT: A 29-year-old man presented with a 2-week history of diarrhea and weight loss. Ultrasonography revealed acute intestinal intussusception localized at the site of enlarged mesenteric nodes. At laparostomy, intestinal resection was not required. Histology examination of the mesenteric nodes showed follicular hyperplasia. Serology was positive for Yersinia enterocolitica. Outcome was favorable after treatment with tetracycline for 15 days. DISCUSSION: Yersinia enterocolitica are Gram negative bacilli that grow at low temperature. Food contamination is the most frequent source of infection in man, usually in children. Clinical manifestations include gastroenteritis or pseudoappendicular syndrome. Intestinal intussusception is rare. Operative reduction by taxis is generally sufficient. Histology examination of the lymph nodes excludes lymphoma. The diagnosis is confirmed by serology. A 10 to 15-day antibiotic regimen is needed.

Acute Disease↗
PubMed1996

ECT after cerebral aneurysm repair.

Cerebral aneurysms or recent surgical repair of aneurysms are relative contraindications for electroconvulsive therapy (ECT), yet the literature contains at least three cases in which ECT resulted in no known CNS complications. The following case describes a course of ECT in a patient 4 months after he had undergone surgical repair of a posterior cerebral artery aneurysm. Blood pressure control in patients with CNS aneurysms and repaired aneurysms can be achieved through choice of anesthetic agent, and intravenous antihypertensives, thus reducing the risk of cerebrovascular complications.

Blood Pressure↗
PubMed1995

ECT administration to a hyperthyroid patient.

There are few reported convincing cases of hyperthyroid depressed patients receiving electroconvulsive therapy (ECT). We describe a depressed 66-year-old woman with catatonic depression diagnosed with new-onset hyperthyroidism due to Grave's disease. After commencing propylthiouracil, her Grave's disease was partially treated, but her depression was no better. She subsequently received a course of seven ECT with resolution of her depression and no adverse sequelae.

Aged↗
PubMed1995

[Hydatid cyst of the psoas].

Recurrent hydatic cyst of the psoas is an exceptional disease in France but should not be missed in patients coming from endemic areas. A case report and a review of the literature on the aetiopathology, diagnosis and therapy are presented. Abdominal pelvic CT scan should give the diagnosis. Surgical treatment is indicated, with complete exeresis to avoid early relapse.

Adult↗