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Biomedical subjects

Salem Ajmi

Publications and source records attributed to Salem Ajmi.

12 recordsLinked to original sources

[Renal amyloidosis complicating Crohn's disease: report of two cases and review of literature].

Secondary amyloidosis is caused by the extracellular store of the fragment AA of the circulatory protein in serum amyloid-A. It can complicate diseases such as family mediterranean fever, rheumatoid arthritis or Crohn's disease. Renal amyloidosis is a rare but serious complication of Crohn's disease. We report two cases of Crohn's disease associated with a nephrotic syndrome due to renal amyloidosis. It is important to recognize this complication, especially since Colchicine has been proposed as a possible treatment. So, the search for proteinuria seems to be important for an early diagnosis of renal amyloidosis in Crohn's disease.

Adult↗

[Epidemiologic profile of gastric carcinoma: study of 140 cases].

The authors make a retrospective study of a series of 140 patients aged 59 years in average, followed up from 1995 to 2002 for adenocarcinoma of the stomach. Surgical resection was performed in 79 percent of the patients with total gastrectomy in 15.4%, partial gastrectomy in 50.6%. Resection was considered as curative in 66%. Lymph node metastases were present in 42, 9 percent of the patients. Margins of resection were involved in 24, 5% of the specimens. The mean survival rate was 26.5 months, 13 months and 5 months after curative resection, palliative resection and without resection.

Adenocarcinoma↗

[Predictive factors of recurrence in Crohn's disease].

BACKGROUND AND AIMS: The aim of this study is to determine the factors associated with high risk of recurrence of Crohn disease. PATIENTS AND METHODS: During 12 years period from January 1987 till December 1999, 98 patients treated for Crohn's disease were included in this study. The risk of recurrence was studied using the Kaplan-Meier method. The possible predictive factors of recurrence were studied using the LOGRANK test. RESULTS: During the follow-up period, 50 (66%) patients developed a recurrence of Crohn's disease. The factors associated with a high risk of recurrence of the diseases were female (p=0.03), long delay before the diagnosis of the disease (p=0.03) and the presence of extra-intestinal lesions (p=0.05). Concerning other factors such as the age, smoking, inflammatory syndrom and ano-perineal lesions, the study showed no relationship between these factors and the recurrence of the disease. CONCLUSION: This study showed that the group of patients treated for Crohn's disease and who have predictive factors of recurrence should have prophylactic medical treatment to prevent recurrence of the disease.

Adolescent↗

[Biliary attacks of surgery of the liver hydatid cyst].

The goal of this work was to describe secondary biliary attacks due to liver hydatid cyst surgery and see their different physiopathological mechanisms again. We report three cases of secondary sclerosing cholangitis. There were three women aged 20, 40 and 60 years, respectively. Icterus was the primary sion in the three cases. The three patients were operated on for liver hydatid cyst with a peroperative injection of the scolicide product. The diagnosis of secondary sclerosing cholangitis was based on the thin aspect of the biliary ducts. The generally benign liver hydatid cyst disease may be the cause of a serious and final biliary attack.

Adult↗

[Importance of vaccination chronic hepatitis B].

Weak therapeutic responses and weak immune cytotoxic CD8 and CD4 response in chronic hepatitis B emphasize the necessity to find new therapeutic strategies especially as specific immunotherapy. Vaccination, whose principle was to widen immune repertoire, was used as a curative treatment of chronic hepatitis B. It would be the therapeutic procedure with the lowest cost and the potentially greatest benefit. Our purpose was to enhance the interest of therapeutic vaccination in chronic hepatitis B in order to debate later its usefulness in developing countries.

Hepatitis B Vaccines↗

[Modalities and interest in followup of colorectal cancers after curative surgery].

Recurrence is found in 24 to 50% in patients undergoing surgery for colorectal cancer. The main purpose of follow-up is the screening of local or metastatic recurrence. Actually, the follow-up can not be justified only if there is a real advantage for the patient. Optimal modalities of surveillance of colorectal cancers resected have not been determined. The search of liver or lung metastases is actually preferred. The same pattern is used for searching colorectal lesions after a resection of colorectal cancer and after a polypectomy. The cost/effectiveness deontological value must be considered in the choice of further exams. However, the contribution of a cancerology follow-up is always controversial. Only prospective and randomized trials with a sufficient number of patients would prove the usefulness of a follow-up. In order to minimize the cost's problem, it is interesting to propose follow-up for a target population with a greater individual risk for recurrence.

Biomarkers, Tumor↗

[Biological markers of hepatocellular carcinoma].

Hepatocellular carcinoma is a rapidly fatal tumor. The only hope for a cure lies in early diagnosis. It follows that an effective screening strategy should be used in high-risk populations. Screening currently relies on tumor markers such as alfa fetoprotein (AFP) and imaging modalities. Because the AFP assay lacks sensitivity and specificity in patient with small tumors, other serum markers are being evaluated.

Biomarkers↗

[Non alcoholic steatohepatitis: an emergent and potentially serious pathology].

Nonalcoholic steatohepatitis is an acquired liver disease, usually metabolic characterised by histologic lesions with steatosis, intralobular necrosis and inflammatory infiltrates. Liver biopsy findings are identical to those seen in alcoholic hepatitis. Nonalcoholic steatohepatitis is increasingly reported in industrial countries because of an increase of the prevalence of obesity and diabetes which are the most common risk factors of this disease. The diagnosis of nonalcoholic steatohepatitis is based on a confrontation between clinical and anatomic data and an exclusion of an excessive intake of alcohol and other hepatic disease. Liver biopsy has a prognosis and histologic benefit especially when there is risk factors of fibrosis. This disease is potentially severe with a potential risk for progression to cirrhosis. Progress in pathogenesis is noted but no definite therapy exist. The aim of this review is to indicate current knowledge for the gravity of nonalcoholic steatohepatitis and its consequence and to understand the pathogenesis to prevent cirrhosis.

Fatty Liver↗

[Octreotide in the treatment of acute gastrointestinal hemorrhage caused by ruptured esophageal varices].

AIMS: To asses the value of octreotide in the control of acute bleeding esophageal varices in a retrospective study. METHODOLOGY: Fourty two patients admitted for esophageal variceal bleeding confirmed at endoscopy were recruited. An initial 50 micrograms bolus of octreotide followed by a two day continuous infusion of 25 micrograms/h were evaluated for the control of bleeding. RESULTS: Twenty nine patients were endoscopic stigmata of recent bleeding and thirteen were active bleeding at emergency endoscopy. Octreotide was found to be effective regarding hemostasis at 48 hours and on day 7 after the index bleeding episode. 30-day mortality was 11.9%. Echec of octreotide was significantly associated with severity of cirrhosis (p<0.03). CONCLUSION: These results suggest that octreotide is effective in the treatment of esophageal variceal bleeding and it is a valuable adjuvant treatment in association with endoscopic management.

Acute Disease↗

[Primary hepatic vipoma].

Vipoma is a rare neuroendocrine tumor most frequently localized in the pancreas. When it is extrapancreatic, it is most often neurogenic. We report a case of primary extrapancreatic vipoma that is non neurogenic localized in the right liver in a patient with severe diarrhea and hypokaliema. Computed tomography, magnetic resonance imaging, intraoperative tomography and surgical exploration did not show any other extrahepatic primary lesion. The diagnosis was performed by immunochemistry, tumorous cells were positives with anti-VIP antibody. Forty two months after right hepatectomy, the patient was asymptomatic.

Adult↗

[Gastrointestinal stromal tumors. Current data].

GIST anatomical concept, recently elucidate, they are characterized by the expression of the protooncogene C Kit The diagnosis is relatively easy but prognosis evaluation is not usually possible. The treatment is based on the surgical resection. The rewardable clinical response of tumors that express C-Kit to treatment with the tyrosine kinase inhibitor STI 571 is a triumph of molecular pharmacology.

Antineoplastic Agents↗

[Nephrogenic ascites. A case report].

Nephrogenic ascites is a clinical diagnosis defined as a refractory ascites in patients with end-stage renal disease. The exact cause of ascites formation is unknown. Patients frequently present with moderate to massive ascites and cachexia. The ascitic fluid is an exudate. The diagnosis is one established only by exclusion of the others causes of exudative ascites. Only continuous ambulatory peritoneal dialysis and renal transplantation appear to be effective in controlling ascites formation. The prognosis is dismal. We described here one patient case with nephrogenic ascites and review of the literature.

Adult↗