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Biomedical subjects

S Madi

Publications and source records attributed to S Madi.

7 recordsLinked to original sources

[Thoracic splenosis. Review of the literature apropos of a case].

Thoracic splenosis consists of autotransplantation of splenic tissue in the thorax following thoraco-abdominal trauma. The authors report a case of thoracic splenosis in a 35 year old woman who suffered a thoraco-abdominal gunshot wound 12 years previously. Sixteen cases of thoracic splenosis have been reported in the literature. Always asymptomatic, the thoracic lesions were discovered by chance on chest x-rays performed for various reasons 9 to 32 years after the initial trauma. Surgery was required in 13 patients in order to establish the diagnosis. In 2 cases Tc99 and Indium 111 isotope scans revealed the diagnosis, avoiding the need for surgery.

Adult

[Postoperative agitation. A new cause].

Thirty-three patients, operated on between 1981 and 1986, and presenting post-operative confusion and restlessness are analyzed. Two groups are identified: group 1 are patients who regularly received BZD before their present hospitalization; in group 2 patients were given high-dose BZD in the early postoperative period. Symptoms were anxiousness in 15 patients, restlessness in 14, myoclonia in 14, delirium in 3, coma and seizures in 1. BZD withdrawal syndrome was considered after the other causes of post-operative agitation were eliminated and the diagnosis was confirmed by the administration of BZD that relieved the symptoms and by the plasmatic concentration of BZD. This syndrome appears 1 to 5 days after BZD withdrawal and severity of symptoms seems to be directly proportional to the doses and duration of BZD therapy. Propranolol was proposed to reduce the intensity of the symptoms. Nevertheless, progressive withdrawal of BZD remains the best way for managing such patients.

Akathisia, Drug-Induced

Infective endocarditis: a prospective study of 60 consecutive cases.

Sixty cases of infective endocarditis were studied prospectively between May, 1985 and December, 1988. There were 40 males and 20 females with a mean age of 28 years. Endocarditis was found on normal valves in 13 patients, on rheumatic valves in 30, on congenital lesions in 8, on prosthetic valves in 4 and on mitral valve prolapse in 5 cases. Positive blood cultures were detected in 35 patients (58%). In addition bone marrow culture was positive in 1 and valves removed on surgery grew causative organisms in eight. Thus the total culture positive cases were 44 (73%). The commonest infective organism was Streptococcus viridans. Uncommon organisms accounted for 10 cases (17%). Two dimensional echocardiography (2D-Echo) was done in all cases and vegetations were detected in 48 patients (80%). 2 D-Echo was helpful not only in the detection of vegetations but also in the demonstration of other complications of endocarditis like ring abscesses, ruptured chordae, ulceration of aortic root, interventricular septum abscess, and mitral xenograft obstruction. Early surgery was performed in 31 patients. In this group of patients severe heart failure was present in 21, embolization in 10, persistence of fever in 15 and large vegetations in 19. Of the 29 patients treated medically, 2 died. The mortality in the surgical group was seen in 5 (16%) with a mean follow-up of 15 months. The major reason for a large number of our patients undergoing surgery is the fact that this is a referral Center and patients were sent later or when there was a failure of medical treatment.

Adult