Publications by authors named "H Snene"

13 Publications

  • Page 1 of 1

[Diagnostic and therapeutic management of operable bronchopulmonary carcinoid tumours].

Rev Mal Respir 2021 Mar 2;38(3):249-256. Epub 2021 Mar 2.

Faculté de médecine de Tunis, université de Tunis El Manar, service de pneumologie allergologie, CHU Mongi-Slim La Marsa, 2047, Sidi-Daoued, Tunis, Tunisie.

Introduction: Bronchial carcinoid tumours (CT), divided into typical carcinoid (TC) or atypical carcinoid (AC), are rare tumours whose therapeutic management remains unspecified.

Methods: Retrospective study collecting cases of bronchial CT operated at the thoracic surgery department of Abderrahmane-Mami hospital of Ariana and recruited from the pneumology departments of Northern Tunisia, during a 12-year period.

Results: Ninety patients were collected (74 cases of TC and 16 cases of AC). The mean age was 45 years and the sex ratio H/F=0.5. The chest X-ray was normal in 11 cases, as well as flexible bronchoscopy in seven cases. The tumour was classified: stage IA (10 cases), IIA (28 cases), IIB (31 cases), IIIA (15 cases) and IIIB (six cases). Surgery resulted in a complete resection in 78 patients, an extensive resection in six patients, and a conservative resection in six patients. Adjuvant chemotherapy was given in 10 patients. The survival was 84% at five years and 42% at 10 years.

Conclusion: The prognosis of CT depends directly on the histological subtype. It is excellent for TC after complete resection, unlike ACs that are similar to well-differentiated bronchial carcinomas.
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http://dx.doi.org/10.1016/j.rmr.2021.02.062DOI Listing
March 2021

[Sleep disorders and psycho-affective problems in paramedical personnel working an atypical schedule].

Rev Mal Respir 2021 Feb 3;38(2):147-156. Epub 2021 Feb 3.

Service de pneumologie et allergologie, université de Tunis El Manar, faculté de médecine de Tunis, CHU Mongi Slim La Marsa, Tunis, Tunisie.

Introduction: Shift work can cause health problems and sleep disorders and therefore affect mental health. These psycho-affective disorders can, in return, worsen sleep disorders and thus establish a vicious circle. The aims of our study were to assess the frequency of sleep and psycho-affective disorders among paramedical personnel doing shift work and to screen them for obstructive sleep apnoea-hypopnoea syndrome (OSA).

Methods: It was a cross-sectional study carried out among paramedical staff at the University Hospital Center Mongi Slim La Marsa in Tunis. Three questionnaires translated into Arabic (the Berlin questionnaire, the Spiegel questionnaire and the Hospital Anxiety and Depression Scale [HAD]) were presented by the same investigator during the survey.

Results: One hundred and fifty-eight paramedics were interviewed (46.2% were nurses, 23.4% were blue-collar workers, 19% were senior technicians and 11.4% were health care aides, midwives and physiotherapists). The average duration of shift work was 10.27 years, the average age was 36.48 years and there was a female prevalence of 70.9%. Sleep disorders were detected in 40.5% of the cases, OSA in 24%, anxiety in 53.2% and depression in 17.1%.

Conclusion: Sleep and psycho-affective disorders are frequent among paramedical personnel undertaking shift work in hospitals. Screening consultations in occupational medicine are necessary in order to detect these disorders at an early stage.
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http://dx.doi.org/10.1016/j.rmr.2021.01.004DOI Listing
February 2021

[Confusion in the diagnosis of endobronchial tumor].

Pan Afr Med J 2020 29;37:201. Epub 2020 Oct 29.

Université de Tunis El Manar, Faculté de Médecine de Tunis, Centre Hospitalier Universitaire Mongi Slim La Marsa, Service de Pneumologie Allergologie, Tunis, Tunisie.

Bronchopulmonary cancer is the leading cause of death in men and the second in women. Some endoscopic or radiological features may guide histological diagnosis and thus facilitate therapeutic management. We here report the case of a 54-year old man, with a history of smoking and recent coronary stent implantation, presenting with haemoptysis and worsening of dyspnea which had evolved over the last month. Chest x-ray showed left pulmonary hemifield lucency with signs of retraction. Bronchial fibroscopy objectified raspberry bud formation spontaneously bleeding, originating from the left main bronchus and suggesting carcinoid tumor. Chest computed tomography (CT) scan showed poorly enhanced endoluminal tissue process at the level of the left main bronchus, located four cm from the carina and complicated with atelectasis. Diagnostic and therapeutic surgery helped to adjust to a diagnosis of endobronchial amartocondroma.
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http://dx.doi.org/10.11604/pamj.2020.37.201.22896DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813657PMC
February 2021

Esophageal leiomyomas presenting as a mediastinal mass.

Tunis Med 2020 Jun;98(6):475-479

Although benign tumors of the esophagus are very rare, the leiomyomas are frequently recorded. Most of them are small, asymptomatic and without risk of malignant degeneration. These benign tumors are usually discovered fortuitously on endoscopy. Sometimes, they may manifest clinically by dysphagia, hematemesis or other signs. They may mimic the esophageal cancer, which is more frequent, or some mediastinal tumors. The diagnosis can be oriented by the barium swallow esophagogram or other imaging methods, yet, only the histological examination gives the confirmation of the diagnosis. We report the case of a 50-year-old man, non-smoker, complaining of dysphagia, epigastric pain and deterioration of general condition. The clinical and radiological presentation mimicked a mediastinal tumor. Surgery was performed, and histological examination concluded to two leiomyomas of the esophagus.
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June 2020

[Assessment of body composition during pulmonary tuberculosis].

Rev Mal Respir 2021 Jan 8;38(1):34-40. Epub 2021 Jan 8.

Service de pneumologie allergologie (Unité de recherche LR18SP02), faculté de Médecine de Tunis, université de Tunis El Manar, CHU La Rabta, Tunis, Tunisie.

Background: Although the body mass index (BMI) is the most commonly used tool to assess the nutritional status of patients with active tuberculosis (TB), it does not assess changes in body composition. This study aims to assess the contribution of bioelectrical impedancemetry (BIA) for the assessment of body composition during the course of TB compared to BMI and to examine the associated factors.

Methods: Cross-sectional study carried out in patients with active TB at the pulmonology department of CHU la Rabta in Tunis, Tunisia. The nutritional assessment was based on the measurement of BMI and the analysis of body composition by BIA. Malnutrition was accepted when the lean mass index (LMI) was ≤16kg/m in men and 15kg/m in women.

Results: Ninety-five patients were included. According to their LMI, 38 patients were undernourished. The decline in LMI was associated with the severity of TB. Although BMI and LMI were correlated, the use of BMI alone failed to recognize lean mass loss in one in ten patients.

Conclusion: Undernutrition is frequent in patients with active TB. It is correlated with the severity of the disease. In addition to anti-tuberculosis drugs, nutritional management of these patients is essential.
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http://dx.doi.org/10.1016/j.rmr.2020.12.003DOI Listing
January 2021

Psychological impact of the Pandemic COVID-19 Outbreak Among Medical Residents in Tunisia.

Asian J Psychiatr 2020 Oct 18;53:102349. Epub 2020 Aug 18.

Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia; Razi Hospital, Mannouba, Tunisia. Electronic address:

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http://dx.doi.org/10.1016/j.ajp.2020.102349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434457PMC
October 2020

46th Medical Maghrebian Congress. November 9-10, 2018. Tunis.

Authors:
A Alami Aroussi A Fouad A Omrane A Razzak A Aissa A Akkad A Amraoui A Aouam A Arfaoui A Belkouchi A Ben Chaaben A Ben Cheikh A Ben Khélifa A Ben Mabrouk A Benhima A Bezza A Bezzine A Bourrahouat A Chaieb A Chakib A Chetoui A Daoudi A Ech-Chenbouli A Gaaliche A Hassani A Kassimi A Khachane A Labidi A Lalaoui A Masrar A McHachi A Nakhli A Ouakaa A Siati A Toumi A Zaouali A Y Condé Abdeddayem Haggui Abdelaziz Belaguid Abdelkader Jalil El Hangouche Abdelkarim Gharbi Abdelmajid Mahfoudh Abderrazek Bouzouita Abir Aissaoui Abir Ben Hamouda Abir Hedhli Adel Ammous Afef Bahlous Afef Ben Halima Ahlem Belhadj Ahlem Bezzine Ahlem Blel Ahlem Brahem Ahmed Banasr Ahmed Meherzi Ahmed Saadi Ahmed Sellami Ahmed Turki Aicha Ben Miled Aida Ben Slama Aida Daib Alaa Zommiti Ali Chadly Ali Jmaa Ali Mtiraoui Alia Ksentini Alia Methnani Alya Zehani Amal Kessantini Amani Farah Amani Mankai Amani Mellouli Amani Zaouali Amany Touil Ameni Hssine Amine Ben Safta Amine Derouiche Amine Jmal Amir Ferjani Amira Djobbi Amira Dridi Amna Aridhi Anis Bahdoudi Anis Ben Amara Anis Benzarti Anouar Youssef Ben Slama Anouer Oueslati Aouatef Soltani Aschraf Chadli Asma Aloui Asma Belghuith Sriha Asma Bouden Asma Laabidi Asma Mensi Asma Ouakaa Asma Sabbek Asma Zribi Assia Green Atef Ben Nasr Aymen Azaiez Aza Yeades Azza Belhaj Azza Mediouni Azza Sammoud Azza Slim B Amine B Chelly B Jatik B Lmimouni Bachir Daouahi Badereddine Ben Khelifa Bechir Louzir Ali Dorra Besma Dhahri C Ben Nasrallah C Chefchaouni C Konzi C Loussaief C Makni Chadli Dziri Chaker Bouguerra Chaker Kays Chekib Zedini Cherif Dhouha Cherif Mohamed Chiraz Aichaouia Chiraz Dhieb D Fofana Dalila Gargouri Dhekra Chebil Dhilel Issaoui Donia Gouiaa Dorra Brahim Dorra Essid Dorra Jarraya Dorra Trad E Ben Hmida E Sboui Ehsen Ben Brahim Elyes Baati Emna Talbi Eya Chaari Eya Hammami Ezzeddine Ghazouani F Ayari F Ben Hariz F Bennaoui F Chebbi F Chigr F Guemira F Harrar F Z Benmoula F Z Ouali F M R Maoulainine Faten Bouden Faten Fdhila Fatiha Améziani Fatma Bouhaouala Fatma Charfi Fatma Chermiti Ben Abdallah Fatma Hammemi Fatma Jarraya Fatma Khanchel Fatma Ourda Fatma Sellami Fatma Trabelsi Ferdaous Yangui Feten Fekih Romdhane Fethi Mellouli Fethi Nacef Jomli Fethia Mghaieth G Draiss G Elamine G Kablouti G Touzani G B Manzeki Ghada Garali Ghassen Drissi Ghazi Besbes H Abaza H Azzouz H Said Latiri H Rejeb H Ben Ammar H Ben Brahim H Ben Jeddi H Ben Mahjouba H Besbes H Dabbebi H Douik H El Haoury H Elannaz H Elloumi H Hachim H Iraqi H Kalboussi H Khadhraoui H Khouni H Mamad H Metjaouel H Naoui H Zargouni H O Elmalki Habib Feki Habib Haouala Habib Jaafoura Habiba Drissa Habiba Mizouni Hager Kamoun Haifa Ouerda Haifa Zaibi Haithem Chiha Hajer Kamoun Hajer Saibi Hajer Skhiri Hamza Boussaffa Hamza Majed Hana Blibech Hana Daami Hana Harzallah Hanan Rkain Hanen Ben Massoud Hanene Jaziri Hanène Ben Said Haroun Ayed Hassen Harrabi Hatem Chaabouni Hayet Ladida Debbache Hayett Harbi Haythem Yacoub Hela Abroug Hela Ghali Hela Kchir Hela Msaad Héla Ghali Héla Manai Hend Riahi Hiba Bousselmi Hiba Limem Hichem Aouina Hichem Jerraya Houda Ben Ayed Houda Chahed Houda Snéne I Lahlou Amine I Nouiser I Ait Sab I Chelly I Elboukhani I Ghanmi I Kallala I Kooli Ibtissem Bouasker Ilhem Fetni Imen Bachouch Imen Bouguecha Imen Chaabani Imen Gazzeh Imen Samaali Imen Youssef Imen Zemni Imene Bachouche Imène Youssef Ines Bouannene Ines Kasraoui Ines Laouini Ines Mahjoubi Ines Maoudoud Ines Riahi Ines Selmi Ines Tka Islem Hadj Khalifa Islem Mejri Ismail Béjia J Bellagha Jallel Boubaker Jalloul Daghfous Jamel Dammak Jamila Hleli Jihen Ben Amar Jihen Jedidi Jihen Marrakchi K Kaoutar K Arjouni K Ben Helel K Benouhoud K Rjeb Kacem Imene Kais Samoud Kaouther El Jeri Karem Abid Kays Chaker Khadija Abid Khadija Bouzghaîa Khaled Kamoun Khaled Zitouna Khalil Oughlani Khaoula Lassoued Khaoula Letaif Khaouther Hakim L Cherif Alami L Benhmidoune L Boumhil L Bouzgarrou L Dhidah L Ifrine Lamia Kallel Latifa Merzougui Leila Errguig Leila Mouelhi Lina Sahli M Maoua M Rejeb M Ben Rejeb M Bouchrik M Bouhoula M Bourrous M Bouskraoui M El Belhadji M El Belhadji M Essakhi M Essid M Gharbaoui M Haboub M Iken M Krifa M Lagrine M Leboyer M Najimi M Rahoui M Sabbah M Sbihi M Zouine M C Chefchaouni M H Gharbi M M El Fakiri M R Tagajdid Maha Shimi Maha Touaibia Mahbouba Jguirim Maher Barsaoui Maissa Belghith Maissa Ben Jmaa Makram Koubaa Makram Tbini Malak Boughdir Mamia Ben Salah Manel Ben Fraj Manel Ben Halima Manel Ben Khalifa Manel Bousleh Manel Limam Manel Mabrouk Manel Mallouli Manel Rebeii Mariem Ayari Mariem Belhadj Mariem Ben Hmida Mariem Boughattas Mariem Drissa Mariem El Ghardallou Mariem Fejjeri Mariem Hamza Mariem Jaidane Mariem Jrad Mariem Kacem Mariem Mersni Mariem Mjid Mariem Sabbah Mariem Serghini Mariem Triki Maroua Ben Abbes Maroua Boussaid Maroua Gharbi Maroua Hafi Maroua Slama Maroua Trigui Marouen Taoueb Marouene Chakroun Marwa Ben Cheikh Marwa Chebbi Marwa Hadj Taieb Marwa Kacem Mehdi Ben Khelil Mehdi Hammami Mehdi Khalfallah Mehdi Ksiaa Mehdi Mechri Mehdi Mrad Mehdi Sboui Mejda Bani Melek Hajri Menel Mellouli Mohamed Allouche Mohamed Amine Mesrati Mohamed Amine Mseddi Mohamed Amri Mohamed Bejaoui Mohamed Bellali Mohamed Ben Amor Mohamed Ben Dhieb Mohamed Ben Moussa Mohamed Chebil Mohamed Cherif Mohamed Fourati Mohamed Kahloul Mohamed Khaled Mohamed Machghoul Mohamed Mansour Mohamed Morched Abdesslem Mohamed Ali Ben Chehida Mohamed Ali Chaouch Mohamed Ali Essid Mohamed Ali Meddeb Mohamed Chawki Gharbi Mohamed Habib Elleuch Mohamed Hédi Loueslati Mohamed Mehdi Sboui Mohamed Nabil Mhiri Mohamed Osman Kilani Mohamed Riadh Ben Slama Mohamed Ridha Charfi Mohamed Said Nakhli Mohamed Sami Mourali Mohamed Selim El Asli Mohamed Taher Lamouchi Mohammed Cherti Mohsen Khadhraoui Mokhtar Bibi Moncef Hamdoun Mondher Kassis Mongi Touzi Monia Ben Khaled Monia Fekih Monia Khemiri Monia Ouederni Monjia Hchicha Monther Kassis Mossadak Ben Attia Moufida Yahyaoui Mouna Ben Azaiez Mouna Bousnina Mounir Ben Jemaa Mounir Ben Yahia Mounir Daghfous Mourad Haj Slimen Msadak Assidi N Belhadj N Ben Mustapha N El Idrissislitine N Hikki N Kchir N Mars N Meddeb N Ouni N Rada N Rezg N Trabelsi Nabiha Bouafia Nabil Haloui Nacéra Benfenatki Naceur Bergaoui Naceur Yomn Nadia Ben Mustapha Nadia Maamouri Nadia Mehiri Nadia Siala Najeh Beltaief Najet Aridhi Najet Sidaoui Najia Walid Najla Mechergui Najla Mnif Nariméne Ben Chekaya Nawel Bellil Nawel Dhouib Nazek Achour Nejib Kaabar Nejib Mrizak Nejla Mnif Nesrine Chaouech Nesrine Hasni Nesrine Issaoui Nidhal Ati Nidhal Balloumi Nidhal Haj Salem Nizar Ladhari Nora Akif Nora Liani Nouha Hajji Nouha Trad Nour Elleuch Nour El Houda Marzouki Noureddine Larbi Nourelhouda M'barek Nouri Rebai Noursaf Bibani Nozha Ben Salah O Belmaachi O Elmaalel O Jlassi O Mihoub Olfa Ben Zaid Olfa Bouallègue Olfa Bousnina Olfa Bouyahia Olfa El Maalel Omar Fendri Ons Azzabi Ons Borgi Ons Ghdes Oussama Ben Rejeb R Rachid R Abi R Bahiri R Boulma R Elkhayat R Habbal R Rachid R Tamouza Rabaa Jomli Rabiaa Ben Abdallah Racha Smaoui Radhouene Debbeche Radhouene Fakhfakh Rafik El Kamel Rahma Gargouri Raja Jouini Ramzi Nouira Rana Fessi Rania Bannour Rania Ben Rabeh Rania Kacem Rania Khmakhem Raouf Ben Younes Raouf Karray Rezaik Cheikh Riadh Ben Malek Ridha Ben Slama Ridha Kouki Rim Baati Rim Bechraoui Rim Fakhfakh Rim Fradi Rim Lahiani Rim Ridha Rim Zainine Roua Kallel S Rostom S Ben Abdallah S Ben Hammamia S Benchérifa S Benkirane S Chatti S El Guedri S El Oussaoui S Elkochri S Elmoussaoui S Enbili S Gara S Haouet S Khammeri S Khefecha S Khtrouche S Macheghoul S Mallouli S Rharrit S Skouri Saan Helali Sabrine Boulehmi Sahar Abid Sahbi Naouar Saida Zelfani Salah Ben Amar Salem Ajmi Salem Braiek Salem Yahiaoui Salima Ghezaiel Salma Ben Toumia Salma Thabeti Salsabil Daboussi Salwa Ben Abderahman Samar Rhaiem Sami Ben Rhouma Samia Rekaya Samir Haddad Samir Kammoun Samira Merai Samira Mhamdi Rabaa Ben Ali Sana Gaaloul Sana Ouali Sana Taleb Saoussen Zrour Sarah Hamdi Sarah Zaghdoudi Sarra Ammari Sarra Ben Abderrahim Sarra Karaa Sarra Maazaoui Sarra Saidani Sarra Stambouli Seif Mokadem Selim Boudiche Selim Zaghbib Shema Ayedi Sinda Jardek Siwar Bouselmi Sonda Chtourou Sondos Manoubi Sonia Bahri Sonia Halioui Sonia Jrad Sonia Mazigh Sonia Ouerghi Sonia Toujani Soraya Fenniche Souad Aboudrar Souad Meriem Amari Souhaiel Karouia Soumaya Bourgou Soumaya Halayem Soumaya Rammeh Sourour Yaïch Syrine Ben Nasrallah Syrine Chouchane Syrine Ftini Syrine Makni Syrine Manoubi Syrine Miri Syrine Saadi Syrine Azza Manoubi T Khalfallah Takwa Mechergui Taoufiq Dakka Tarek Barhoumi Tej El Baha M'rad Thouraya Ajmi Trad Dorra Uta Ouali W Hannachi Wael Ferjaoui Wafa Aissi Wafa Dahmani Wafa Dhouib Wafa Koubaa Wafa Zhir Wafe Gheriani Wajdi Arfa Wajih Dougaz Wajih Sahnoun Walid Naija Y Sami Y Bouteraa Y Elhamdaoui Y Hama Yacine Ouahchi Yassine Guebsi Yassine Nouira Yosr Daly Yosra Mahjoubi Yosra Mejdoub Yosra Mosbahi Yosra Said Yosra Zaimi Yosra Zgueb Yousr Dridi Yousra Mesbahi Youssef Gharbi Youssef Hellal Z Hechmi Z Zid Z Elmouatassim Z Ghorbel Z Habbadi Zahra Marrakchi Zaki Hidouri Zeineb Abbes Zeineb Ouhachi Zied Khessairi Zied Khlayfia Zied Mahjoubi Zied Moatemri

Tunis Med 2019 Jan;97(1):177-258

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January 2019

Preoperative assessment in pulmonary resection surgery.

Tunis Med 2017 Dec;95(12):229-234

Pulmonary resection can be associated with a significant risk of morbidity and mortality, which depends on the nature and extent of pulmonary resection but also on the patient himself. This risk can be apprehended by a preoperative assessment which estimates the immediate operative risk as well as the physiological state and the post-operative quality of life which can require more conservative therapies. Currently, preoperative exploration of a patient is based on various technological tools, which can range from simple electrocardiogram or simple spirometry to a complex exploration such as a cardiorespiratory effort test. These multiple evaluation tools require the rationalization of good practice processes according to international recommendations, taking into account the patient's specificity and the country context. This approach makes it possible to prioritize examinations according to their availability and accessibility in order to identify patients with high operative risk and to offer them an appropriate therapeutic choice.
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December 2017

[Home non-invasive ventilation for chronic obstructive pulmonary disease].

Rev Pneumol Clin 2018 Sep 9;74(4):235-241. Epub 2018 Apr 9.

Service de pneumologie, faculté de médecine de Tunis, université Tunis el Manar, hôpital la Rabta, UR12SP096 Tunis, Tunisie.

Introduction: The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial.

Aim: To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population.

Methods: We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital.

Results: There were 27 patients with an average age of 64 and a sex ratio (M/F) of 0.92. Active smoking was reported in 96.3%. A persistent hypercapnia following an acute exacerbation of COPD with failure to wean the NIV was the main indication of long-term NIV. We noted a reduction in hospital admissions in the first year of 60% and in intensive care of 83.3% (P<10). There was no non-significant decrease of PaCO (4.5mmHg). There was no modification in FEV 1 and in FVC (P>0.05). The survival rate was 96.3% at 1 year, 83.3% at 2 years and a median survival of 24 months.

Conclusions: Our study suggests that home NIV contributes to the stabilization of some COPD patients by reducing the hospitalizations rates for exacerbation. More prospective studies are needed to better assess the impact of NIV on survival and quality of life and to better define the COPD patients who require NIV.
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http://dx.doi.org/10.1016/j.pneumo.2018.03.007DOI Listing
September 2018

[Tuberculous pseudotumour, a challenging diagnosis].

Rev Mal Respir 2018 Mar 5;35(3):295-304. Epub 2018 Apr 5.

Université de Tunis El Manar, faculté de Médecine de Tunis, CHU Mongi Slim, service de pneumologie allergologie (unité de recherche 12SP06), La Marsa, Tunisie.

Introduction: The pseudotumorous form of tuberculosis is a rare entity. Whatever its location, it can simulate neoplasia by its radiological and/or endoscopic appearances. We highlight the diagnostic difficulties associated with this type of presentation.

Methods: We performed a retrospective study of inpatient records from 2003 to 2016 in the pneumology department of La Rabta Hospital to identify cases of thoracic tuberculous pseudo-tumor.

Results: Seventeen patients were identified. The median age was 41 years and their symptomatology was dominated by cough and general debility. All had abnormal radiology with 10 cases of suspect lesions. Fibre-optic bronchoscopy revealed endobronchial abnormalities in 11 cases. The median overall diagnostic delay was 97 days. The diagnosis was confirmed bacteriologically in five cases, histologically in 14 cases and based on clinical presumption in one case. The progression was favourable: 13 patients have been declared cured and four patients are still undergoing treatment.

Conclusion: Making a positive diagnosis of thoracic tuberculous pseudotumour can be difficult, as bacteriological samples are often negative. This can lead to a significant delay in diagnosis and treatment.
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http://dx.doi.org/10.1016/j.rmr.2017.03.038DOI Listing
March 2018

Abstracts of the Communications of the Sixteenth Francophone Allergology Meetings Hammamet, 4-7 October 2017.

Authors:
A Abdelghani M Abouda K Adelmoulah C Aichaouia Nadia Ajmi A Akad Ines Akrout Jamel Ammar Zeineb Amouri S Aouadi Hichem Aouina A Aounallah S Atitallah H Ayadi N Ayadi Sirine Ayadi Saloua Azzabi Mohamed Ali Baccar N Bahloul B Bdira D Bejar M Beji C Belajouza I Belhadj Rafik Belhaja H Ben Abdelghaffar Jihen Ben Amar E Ben Jemia L Ben Mahmoud Amani Ben Mansour M Ben Romdhane A Ben Saad H Ben Saad S Ben Saad N Ben Salah Nawel Ben Salem A Ben Tkhayat M Benzarti Anissa Berraïes Hamdi Besma Hayet Bouakkez M Bouhoula K Boussetta L Boussoffara Hanene Bouzekri A Brahem I Brini N Chaouech Ilhem Charfeddine M R Charfi Rihab Charrad S Chatti R Cheikh S Cheikh M'hamed S Cheikh Rouhou Hela Cherif J Cherif S Dabboussi Hafaoua Daghfous J Daghfous Awatef Dahmouni M Denguezli Besma Dhahri Joseph Djaman Allico L Douik El Gharbi Leila El Gharbi S El Guedr A El Kamel O El Maalel Leila Elfekih Maha Essalah N Fahem R Fessi W Fki R Gammoudi A Garrouch N Ghariani H Gharsalli H Ghedira Abdelmoneem Ghorbel H Ghozzi Najla Ghrairi Dorra Greb Y Gribaa S Guedri A Gueriani E Guermazi Chaima Habouria S Hadj Hassine S Hajjej Bassma Hamdi B Hamdia Amal Hammami S Hamouda Agnes Hamzaoui Kamel Hamzaoui Hela Hassen M Hayouni A Hedhli Y Houaneb Marghli S Jdidi S Joober Wajih Kaabachi I Kacem R Kaddoussi H Kalboussi Nesrine Kallel Souha Kallel S Kammoun Hela Kamoun H Kchouk W Ketata M Khadhraoui F Khalsi A Khattab Amin Khbou Z Khessain Z Khessari R Khmekhem I Khouaja H Khouani Z Khssairi Eudes Kpan Sea H Kwas Oussema Lahmer L Loued Sabrine Louhaichi B Louzir S M'saad S Maalej Sarra Maazaoui M Maoua Donies Masmoudi N H Mbarek Mohamed Lamine Megdiche N Mehiri I Mejri S Mhamdi M Mjid N Mkaouar Z Moatemri S Mokni N Mrizak Jean David N'guessan R Nouira Y Ouahchi S Oujani Sawsen Raies Sonia Rouatbi N Rouetbi H Rouis D Sakka Mariem Salhi M Slama Hanen Smadhi H Snene N Souissi A Tabboubi F Tinsa S Toujeni G Trigui M Triki Fatma Tritar Sadok Yalaoui F Yangui I Yangui Chiaye Yapo-Crezoit Haifa Zaibi A Zaim Ines Zayani K Zayen I Zendah

Tunis Med 2017 Aug - Sep;95(8-9):806-836

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June 2018

The Z-score: A new tool in the interpretation of spirometric data.

Tunis Med 2017 Aug - Sep;95(8-9):767-771

Spirometry is an important tool in the diagnosis and management of patients with respiratory pathology. An appropriate interpretation of the spirometric data requires the use of a population-specific reference equation. However, the most widely used equations were established in European populations with limited age groups. The extrapolation of these equations, based on a specific population, and their uses for a different population led to measurement and interpretation biases. In 2012, an international working group conducted a multicenter study and published new reference equations called The Global Lung Initiative (GLI). These enabled the modeling of spirometric parameters from a very large sample collected in several ethnic groups using modern statistical techniques to establish continuous equations for all ages and in many countries. The GLI also recommends the use of a new statistical tool for the expression of results: The Z-score. This tool allows to express, in a simple way: how many standard deviations a subject is deviated from its reference value. The Z-score is calculated by the ratio of the difference between the measured value and that predicted with the residual standard deviation. This simple approach has reduced the false positive results found by the use of the conventional limits of 80% compared to a predicted value or 0.70 in absolute value for the definition of bronchial obstruction that remain still used.
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July 2019

Childhood tuberculosis: A descriptive study in a pneumo-pediatrics department in Tunisia.

Tunis Med 2016 Apr;94(4):259-264

Objective to assess the different localizations of tuberculosis (TB) in children in a pneumopediatric department in Tunisia and to describe its diagnosis tools since clinical investigations of childhood TB are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. Methods Forty-six cases of TB in children were studied between 2008 and 2013. Clinical history, examination and chest radiography were reported. Several investigations have been conducted to confirm the diagnosis of TB such as: tuberculin skin test (TST), bacteriological and histological investigations. Anti-tuberculosis treatment was prescribed according to the national guidelines. Results Cough and deterioration in general condition were the most frequent symptoms (47.8% and 43.7%). The other children presented cervical swelling (19.5%), chest pain (17.4%) and hemoptysis (4.3%). Abnormalities have been found in chest radiography in 35 cases (76%). TST was positive in 73% of cases. Diagnosis of TB was confirmed in 56.6% of cases by Mycobacterium tuberculosis (MT) isolation and/or biopsy. The diagnosis was made on presumptive arguments in 20 cases (43.4%) based on a history of TB contact, suggestive symptoms and a positive TST. A surgical biopsy was necessary for diagnosis in 17 cases (nasopharynx, bone, cervical, mediastinal and mesenteric lymph nodes). Pulmonary TB was diagnosed in 52% of cases. Two children were diagnosed with disseminated TB. A diagnosis delay was noted with an average of 20 days and a contact history was found in 52% of the children. All children were treated according to the national guidelines without major side effects. Healing without sequelae was achieved in 91% of cases. Conclusion Children represent a population at high risk for TB especially after a household contact with a higher frequency of multifocal forms compared to adults. The difficulty of the diagnosis in children may explain partially the diagnosis delay, but efforts must be done to improve prevention and diagnosis in our country.
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April 2016