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Biomedical subjects

M Souissi

Publications and source records attributed to M Souissi.

36 records · Page 2Linked to original sources
PubMed1992

Hellp syndrome: incidence and maternal-fetal outcome--a prospective study.

OBJECTIVE: To determine the incidence of Hellp syndrome (HS) and the maternal fetal outcome associated with its occurrence. DESIGN: A prospective study during a 6-month period. SETTING: The department of obstetrics and gynecology and the Intensive Care Unit of a 700 bed teaching hospital. PATIENTS: Sixty-two consecutive preeclamptic and eclamptic women. MEASUREMENTS AND RESULTS: All patients were systematically investigated for the biological markers of HS. The effects of the occurrence of HS on maternal and fetal prognosis were evaluated by comparing for prognosis indicators usually assessed in gravidic hypertension, pre-eclamptic and eclamptic woman who exhibited HS (HS+ subgroup) with HS free patients (HS- subgroup). HS was found in 12 out of the 62 pre-eclamptic and eclamptic women (19.3%). Its occurrence was associated with higher maternal mortality (16.7% vs 0%; p = 0.03), a greater incidence of eclamptic crisis (50% vs 20%; p = 0.03), severe hypertension (33% vs 8%; p = 0.03) and episodes of acute renal failure (66% vs 30%; p = 0.02). Mean proteinuria was also higher in HS+ patients (4.6 +/- 3.3 vs 2.2 +/- 2.5 g/day; p = 0.001). However, fetal outcome was not significantly altered. CONCLUSION: Pre-eclampsia and eclampsia may be more severe in the presence of HS with a worsening of maternal prognosis while fetal outcome seems not altered.

Adult↗
PubMed1992

Percutaneous balloon mitral valvuloplasty in eight pregnant women with severe mitral stenosis.

Normal gestation is associated with a hyperdynamic adaptive state. The circulatory changes represent an additional burden on the cardiovascular system of women with rheumatic mitral stenosis (MS). Life-threatening complications can occur in pregnant women with severe MS. We successfully performed percutaneous balloon mitral valvotomy (PMV) in eight pregnant patients (mean age 28 +/- 6.9 years, range 21-38 years). Pregnancy mean age was 24.6 +/- 6.5 weeks. Five patients were in NYHA functional class III and three patients were in class IV. Emergency PMV seemed to be life saving to both mother and foetus in one case. All patients but one had pliable valves. PMV was achieved using the double balloon transseptal technique. To protect the foetus from radiation, the patient's pelvic-abdominal area was shielded and left ventriculography was not performed. The total mean time of PMV was 72 +/- 19 min and that of fluoroscopy was 16.6 +/- 7.8 min. Gorlin's mitral valve area increased from 0.83 +/- 0.15 to 2.4 +/- 0.34 cm2 and the cardiac index from 3.1 +/- 0.77 to 4.2 +/- 0.79 l.min-1.m-2. Left atrium pressure decreased from 29 +/- 10 to 14 +/- 5 mmHg and mitral valve gradient from 21 +/- 7 to 6 +/- 3 mmHg. There were no complications or residual MS. At a mean follow-up of 13.2 +/- 9.4 months, all patients were in NYHA class I and had a normal course of pregnancy. The eight women delivered healthy full-term babies. At 1-25 months post-partum follow-up, the eight infants had shown normal growth and development.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Gd-DOTA-enhanced MR imaging and color Doppler US of renal allograft necrosis.

In 21 recipients of renal transplants suspected of allograft necrosis, the authors correlated the results of imaging to pathologic and histologic data in order to describe the magnetic resonance (MR) imaging and color Doppler ultrasonographic (US) characteristics of infarction. All patients underwent MR imaging performed with and without gadolinium tetraazacyclododecanetetraacetic acid (DOTA) and color Doppler US. Nonenhanced T1-weighted images showed no obvious changes, whereas nonenhanced T2-weighted images demonstrated a slight increase in signal intensity in areas of ischemic necrosis and low or heterogeneous signal intensity in areas of hemorrhagic necrosis. Gd-DOTA-enhanced MR images showed no contrast material uptake in infarcted areas. Color Doppler US characteristics of infarction included absence of Doppler signal and alteration of the cortical echogenic structure, particularly in cases of ischemic necrosis. Color Doppler US allows measurement of vascular resistance and assessment of intrarenal vasculature and the renal pedicle. Gd-DOTA-enhanced MR imaging is useful in confirming the diagnosis of infarction and provides an accurate evaluation of the extent of the infarct.

Adult↗
PubMed1992

[Desmoid tumor of the mesentery. An uncommon cause of ureteral obstruction].

Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune...) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.

Adult↗
PubMed1992

[Color doppler echography in the exploration of vasculogenic impotence].

102 patients with suspected vasculogenic impotence were evaluated with color doppler sonography. Measurement of normal systolic and diastolic velocities were obtained from the cavernosal arteries of patients responding by a full erection after intra-cavernosal injection of 20 mg of Papaverine. A correlation with cavernosometry was obtained in 61 patients and with selective internal pudendal arteriography in 11. The 10 patients with abnormal arteriograms had a systolic velocity < 25 cm/sec. 13 out of the 15 patients with an end diastolic velocity > 5 cm/sec had a venous leak defined by a maintenance flow rate of erection during cavernosometry > 25 ml/mn. End diastolic velocity is an excellent index of the function of the veno-occlusive system, provided the systolic velocity remains at a normal value. In case of arterial insufficiency, a diastolic flow < 5 cm/sec is of no value and cavernometry is mandatory to detect a mixed arterio-venous impotence. The addition of color doppler sonography permitted a more rapid detection of vessels and an easily reproducible measurement of velocities which makes color doppler sonography an excellent screening test for examining patients with potential vasculogenic impotence.

Adult↗
PubMed1992

[Role of MRI in the diagnosis of cancer of the kidney].

The recent technical developments in magnetic resonance imaging (MRI) and the use of paramagnetic contrast media (gadolinium compounds) have considerably improved the performances of MRI for the detection and characterization of renal tumors. MRI does not have specific merits for the diagnosis of the typical form of cancer, nor for the detection of small kidney tumors, both being mainly based on computed tomography (CT). On the other hand, it can be used for the diagnosis of atypical forms of cancers (small, hypovascular, cystic or hemorrhagic cancers) which raise problems of differential diagnosis with some pseudotumoral lesions, complex cysts and benign tumors. Its complementarity to CT for the characterization of an atypical mass results from the signal information it provides, from a better contrast resolution, and from the possibility to make sections in all planes of space. Except for angiomyolipoma, which has a fatty content, there is no really specific MR criterion as present to evidence benign renal tumors. Concerning regional extension, CT remains the primary technique of choice, as it allows studying the limits of the tumor, the renal compartment and its walls, the renal vein and the inferior vena cava, the neighboring organs and the contralateral kidney all together. Its findings allow defining the indications of MRI, which, as a complementary exploration, is often decisive to assess venous invasion.

Adenocarcinoma↗
PubMed1991

[Color and pulsed Doppler of renal masses. Angiographic and anatomo-pathological correlation].

We report the results of a prospective study about the detection of tumoral neovascularization, the renal vein involvement and the characterization of renal tumors by color and pulsed doppler. Twenty-six renal tumors including 19 renal carcinomas and 7 benign tumors (2 angiomyolipomas, 2 oncocytomas, 2 complex cysts and one adenoma) were prospectively explored. Benign cysts were excluded from the study. The results were correlated to pathologic (24/26) and angiographic datas (24/26). Doppler ultrasonography seems to be an accurate method for the detection of a neovascularization (19 true-positives/19 vascularised tumors, no false-positive) but pulsed doppler (no false-negative) is more sensitive than color doppler imaging (3 false-negatives), the results of color doppler were improved by using a new software for the color detection of very low flow. Spectral analysis found 3 different types of doppler curves inside the masses, but all of them were observed in benign and malignant tumors. We did not find any correlation between the size of the tumor and the peak systolic velocity. The specificity of Doppler regarding the renal vein and inferior vena cava involvement seems to be good (no false-positive). But as, in our series, we do not have any case of main renal vein involvement, the sensitivity of this technique cannot be assessed.

Adult↗
PubMed1991

[Desmoid tumor of the mesentery. An uncommon cause of ureteral obstruction].

Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune, ... ) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.

Adult↗
PubMed1989

[Echography of the flexor tendons of the fingers].

The accuracy of high-resolution real-time ultrasonic examination of the flexor tendons of the fingers was tested in a retrospective study of 27 patients treated surgically. In ruptured tendons (8 cases) the method proved sensitive and specific, except in cases of partial rupture. Ultrasound made it possible to distinguish between extrinsically developed palmar masses (8 cases) and masses involving the tendons (4 cases). A fluid collection inside the tendon sheath was detected in 5 cases of tenosynovitis, without false-positive results. The post-operative follow-up of surgically treated tendons (2 cases) was easier with ultrasound.

Adolescent↗
PubMed1989

[Ultrasonic study of the soft tissues of the hand. I. Study technic and normal anatomy of the palm].

Ultrasound enables a worthwhile static and dynamic study of the soft tissues of the hand, provided that a high-resolution real-time is used. Accurate examinations are feasible after a several months of training because of the difficulty of the anatomy. The authors, studying 200 normal hands, describe their technique based upon the use of a 7.5 MHz multifocused linear phased-array real-time transducer and the normal ultrasonic anatomy.

Fingers↗
PubMed1989

[Ultrasonic study of the soft tissues of the hand. II. Tumors and pseudotumors of soft tissues. Preliminary results apropos of 12 surgically treated cases].

Thirty patients underwent a sonographic examination of the hand because of nodular masses. In 12 out of these, the surgical removal exhibited 5 benign tumors (2 giant cell tumors, 1 angioma, 1 lipoma, 1 myoma), 5 pseudo-tumors (1 granulomatous tenosynovitis, 1 nodular tendinitis, 2 sebaceous cysts, 1 synovial cyst) and 2 congenital abnormalities of the lumbrical muscles. Except the lipoma and the nodular tendinitis, all the masses were hypoechoic or anechoic. The major interest of sonography in such a disease is a precise localization of the mass and the description of its connections with the surrounding anatomical structures.

Adolescent↗
PubMed1989

[Ultrasonic study of the soft tissues of the hand. III. Traumatic and inflammatory pathology of the flexor tendons of the fingers].

The accuracy of the high-resolution real-time ultrasonic examination of the flexor tendons of the fingers of the hand has been tested on the retrospective study of 27 patients treated surgically. The method is sensitive and specific in the rupture of the tendons (8 cases), except when the latter is partial. Ultrasound enables the discrimination between palmar masses developed extrinsically (8 cases) and those involving the tendons (4 cases). A fluid collection inside the tendon's sheath has been detected in all the 5 cases of tenosynovitis, without false positive. The post-operative follow-up of operated tendons is easier by ultrasound.

Adolescent↗
PubMedDate not supplied

[Profile of referred pregnancies from the Tunisian Sahel].

Investigation of the referral system for pregnancies from peripheral maternity units to the Maternity clinical of the main teaching hospital (CHU) in the region of Monastir has shown that one in five pregnancies is referred. The referred pregnancies account for 30 percent of the obstetrical activity of the CHU and reveal a high risk sociodemographic profile. The outcome of pregnancy is generally less good than that of non-referred cases. Evaluation of the referral system has shown that some of the cases did not require referral. The effectiveness of this system can be improved by used a grid to refer high-risk pregnancies.

Adolescent↗
PubMedDate not supplied

[Prenatal surveillance and determinants of prenatal follow-up in the Monastir health district].

Prenatal monitoring is a prime strategy to improve the end of pregnancy. To estimate the prevalence rate and the conditions determining such a monitoring, the authors carried out a survey on 1190 pregnant women in the Monastir district (Tunisia). The rate of satisfactory monitoring (4 check-up and more) is 45.8 p.c. Age and high parity have a negative influence, but instruction, occupation and a bad out come of the last pregnancy favour a satisfactory prenatal monitoring.

Adolescent↗