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Biomedical subjects

K Rahal

Publications and source records attributed to K Rahal.

At least 19 recordsLinked to original sources
PubMed2001

[Evaluation of implantable sites in medical oncology in Tunisia. Prospective study of 205 cases].

OBJECTIVE: To evaluate the insertion and use of implantable central venous accesses in medical oncology at the Institute Salah Azaïz. METHODS: From January 1992 to June 2000, 205 patients including 179 adults (118F/61M) and 26 children aged 7 months to 72 years (mean 37 years) required the insertion of an implantable port (IP). Tumoral pathology was dominated by metastatic breast carcinoma (93/179), digestive cancer (42/179) and paediatric cancer (26 cases). RESULTS: Excluding 3 initial failures, we inserted 205 IP for 202 patients. The supraclavicular anatomic way (Yoffa) was used in 156/205 cases and the subclavicular (Aubaniac) for the resting 32 cases with a jugular conversion in 17 cases. Initial complications were represented by 6 arterial puncture (2.9%), 3 pneumothorax (1.5%) and 1 catheter migration in the right pulmonary artery. Median life duration of the material was 210 days (3 to 1460 days) for adults and 185 days (3 to 1460 ays) for children. Mean life duration for the 205 IP was 240 days +/- 239 (3 to 1460 days) with a total of 49,200 IP-days. We explanted 17 IP for infection (8 cases), cutaneous ulceration (8 cases) and actinomycin extravasation (1 case). We observed 6 cases (2.9%) of subclavian and jugular thrombosis treated by anticoagulants and conservation management of the port. Presently, 58 patients are alive with IP in place. CONCLUSION: Implantable ports represent a useful option in medical oncology for patients treated with prolonged chemotherapy and adjuvant treatments such as antibiotics, transfusion. This method allows a good comfort for the patients and also the treating team but requires a prealable training for the nursing team.

Adolescent↗
PubMed2001

[Pulmonary scintigraphy with MAA-Tc 99m perfusion in the diagnosis of pulmonary embolism].

Perfusion lung scintigraphy is vital to guide the diagnosis even without a ventilation scintigraphy. A customised strategy could be useful to optimise the use of perfusion scintigraphy when not coupled with a ventilation scintigraphy. We report about a retrospective study on 300 patients received in our department for suspected lung migrations. The patients underwent a perfusion scintigraphy only: a normal scintigraphy would discard the diagnosis when achieved between 6 and 72 hours after the accident. On the other hand, the evidence of one or two perfusion defects would allow to maintain the pulmonary embolism suspicion and establish an effective heparinic treatment. A second control comparative scintigraphy, a few weeks after the first one, very often confirms the diagnosis, allows the assessment of the heparinotherapy and if necessary, indicate to stop it.

Diagnosis, Differential↗
PubMed2000

[The use of neuron specific enolase in the prognosis and followup of neuroblastoma in children. Results of a retrospective series of 21 patients].

OBJECTIVE: To report the results of seric neuron specific enolase in pediatric neuroblastoma. PATIENTS AND METHODS: Our retrospective study concerns 21 children treated in our institution from 1992 to 1998 for neuroblastoma. Seric NSE was determined by immunoenzymology technique at different stages of the disease and the treatment. RESULTS: Mean value for the 39 dosages of the whole patients was 127.9 ng/ml with a sensitivity of 56%, five patients has presented normal values. Mean value for the 18 patients in stage IV was 132.38 ng/ml. We also observed in 3 patients, an evolution of the seric NSE parallel to this of the disease under chemotherapy. CONCLUSION: NSE represents a moderate sensitive and specific tumor marker for pediatric neuroblastoma. However, it represents a good value in prognosis and follow-up after chemotherapy.

Biomarkers, Tumor↗
PubMed1999

Restriction fragment length polymorphisms of virulence plasmids in Rhodococcus equi.

Virulent Rhodococcus equi, which is a well-known cause of pyogranulomatous pneumonia in foals, possesses a large plasmid encoding virulence-associated 15- to 17-kDa antigens. Foal and soil isolates from five countries-Argentina, Australia, Canada, France, and Japan-were investigated for the presence of 15- to 17-kDa antigens by colony blotting, using the monoclonal antibody 10G5, and the gene coding for 15- to 17-kDa antigens by PCR. Plasmid DNAs extracted from positive isolates were digested with restriction endonucleases BamHI, EcoRI, EcoT22I, and HindIII, and the digestion patterns that resulted divided the plasmids of virulent isolates into five closely related types. Three of the five types had already been reported in Canadian and Japanese isolates, and the two new types had been found in French and Japanese isolates. Therefore, we tentatively designated these five types 85-kb type I (pREAT701), 85-kb type II (a new type), 87-kb type I (EcoRI and BamHI type 2 [V. M. Nicholson and J. F. Prescott, J. Clin. Microbiol. 35:738-740, 1997]), 87-kb type II (a new type), and 90-kb (pREL1) plasmids. The 85-kb type I plasmid was found in isolates from Argentina, Australia, Canada, and France. Plasmid 87-kb type I was isolated in specimens from Argentina, Canada, and France. The 85-kb type II plasmid appeared in isolates from France. On the other hand, plasmids 87-kb type II and 90-kb were found only in isolates from Japan. These results revealed geographic differences in the distribution of the virulence plasmids found in the five countries and suggested that the restriction fragment length polymorphism of virulence plasmids might be useful to elucidate the molecular epidemiology of virulent R. equi in the world.

Plasmids↗
PubMed1998

[Sensitivity to beta lactams and macrolides of Streptococcus pyogenes isolated at the services from 1994 to 1998].

The identification and antibiotic sensibility of 188 strains of streptocoques pyogenes had been performed from 1994 to March 1998. We were interested on active antibiotics against streptocoques pyogenes: beta lactamins (penicillin-ampicillin) and macrolids (erythromycin). The aim of this study is to reveal resistances and calculate percentages of resistant strains to these antibiotics. The WHO recommend to treat streptococcal sore throat with penicillin, and with erythromycin when there is a proved inhibility to the penicillin. No penicillin resistant streptocoques pyogenes has been found in the world, that concords with our study: all strains (188 sp.) are penicillin sensitive. Macrolids resistant strains of streptocoques pyogenes has been described by a lot of countries with different distributions. In our study global percentage of resistant strains to erythromycin is 24% and 29% for throat specimen.

Anti-Bacterial Agents↗
PubMed1998

[In vitro activity of trovafloxacin (CP-99,219) against 434 bacterial strains: comparative study with other fluoroquinolones].

We have evaluated the activity of a new fluoroquinolone, trovafloxacin (CP-99,219), against 434 strains; 24 of them are resistant to ciprofloxacin. Against gram-negative bacteria, trovafloxacin has the same activity as the others fluoroquinolones. Against gram-positive bacteria, this antibiotic agent is very active. (MIC = 0.016 to 0.5 microgram/ml); Streptococcus is the most sensitive species. The ciprofloxacin resistant strains are also resistant to trovafloxacin.

Anti-Infective Agents↗
PubMed1997

Reports on surveillance of antimicrobial resistance in individual countries.

In preparation for the meeting of the World Health Organization Working Group on Monitoring and Management of Bacterial Resistance to Antimicrobial Agents, representatives of 10 countries were asked to provide brief reports on the status of surveillance in their countries. Some gave extensive information on the methods used to test susceptibility of nosocomial pathogens to a variety of antibiotics; some described in detail the network of reference laboratories available to hospitals and individual clinicians for monitoring, identifying, and testing infectious agents; others chose to describe how their countries deal with the resistance of the most frequently isolated pathogen to a commonly used drug. The following summary of these reports shows the broad range of problems encountered and solutions undertaken by these 10 countries in dealing with the increasingly alarming problem of bacterial resistance to antimicrobial agents.

Algeria↗
PubMed1997

[Inc J plasmids identified for the first time in Vibrio cholerae El Tor].

Two epidemic outbreaks of cholera occurred in eastern Algeria in 1994. Sixteen strains of Vibrio cholerae El Tor were isolated from stools and contaminated water. Studies to determine antibiotic sensitivity documented multiresistance in these strains. Minimal inhibiting concentrations ranged from 6 to 32 micrograms/ml for chloramphenicol, from 8 to 24 micrograms/ml for tetracycline except minocycline, and from 15 to 32 micrograms/ml for furanes. Higher values were found for other antibiotics such as trimethoprime (1,500 micrograms/ml), streptomycine (128 micrograms/ml) and sulfamides (128 micrograms/ml). High-grade resistance of Vibrio cholerae El Tor to streptomycine and trimethoprime in association with resistance to 0:129 suggests that transposon is the underlying genetic factor. All resistance markers were located on a single structure that can be transferred to a Escherichia coli receptor and belongs to an Inc J incompatibility group. The fact that plasmid DNA could not be visualized on agarose gel after extraction is also evidence for a transferable transposon.

Algeria↗
PubMed1996

[Primary leiomyosarcoma of the small intestine in a child].

BACKGROUND: Leiomyosarcomas of the digestive tract are very rare in children. They must be differentiated from benign tumors (leiomyoma, schwannoma...) and from other malignant tumors, sometimes with the aid of immuno-histochemical study. CASE REPORT: A five-year old girl suffered from an abdominal mass associated with fever and alteration of the general condition. An ileal tumor, 8 cm in diameter, was resected. Histological and immunohistochemical studies (anti-vimentin antibodies, anti-actin antibodies and PS100) confirmed the diagnosis of leiomyosarcoma. Uncomplete adjuvant chemotherapy failed to prevent relapse of the tumor. CONCLUSION: This case confirms the bad prognosis of such a tumor.

Child, Preschool↗
PubMed1996

[Invasive carcinoma of the cervix in young women in Tunisia].

A series of 133 patients, 35 years or less in age (mean: 31.8) presenting with a carcinoma of the cervix and treated at Salah Azaiz Institute from 1969 to 1989 was analysed and compared to a control group of patients older than 35 years (mean: 54). Neither clinical nor epidemiological particularities were found in the younger patients group, except an early sexual life and a high proportion of early stage tumours (33% versus 15.9% in the older women group). Overall survival of the younger women was dramatically worse than that of the older women: 40% and 50% at 5 years, 20% and 40% at 10 years, and 14% and 30% at 15 years, respectively. This difference is statistically significant in stage I-II patients. Young age, non-sterilization of the tumour after brachytherapy, and anemia, are associated with a poor prognosis.

Adult↗