[Radiation protection in orthopedic theatre in Tunisian Charles Nicolle hospital]

Orthopaedic theatre personnel [OTP] are exposed to ionizing radiation by the use of Image intensification in the operating room. The aims of this study are to determine OTP knowledge about ionizing radiation risks and the availability of radiation protection clothes, to propose appropriate corrective measures. This descriptive study was performed during an orthopaedic operating theatre equipped with a mobile Image intensifier unit in Charles Nicolle hospital, in March 2010. We have performed an orthopaedic theatre visit to identify the availability of radiation protection clothes. We used a questionnaire in order to identity OTP knowledge about ionizing radiation. We established a global score of knowledge to classify our population. We identified 65 professionals exposed to ionizing radiation. 54 of them [83%] responded to our questionnaire. 65% were men and sex ratio was 0,54. The median of the age was 32 years [23-51]. Orthopaedic theatre personnel were 35% surgeons, 32% nurses, 20% superior technicians and 13% service workers. The mean of the Global score of knowledge was 8,4 /20 [3,6 -15,2]. The Kruskal-Wallis test showed that this score increases significantly with grade. Because availability of lead aprons, they were worn by 67% of the staff. In the present study, the results indicate insufficiency in OTP knowledge and in radioprotection tools availability. In order to minimize all unnecessary radiation, attempts should be made to increase orthopaedic theatre personnel knowledge about radiation protection. Safety culture is a referral method to reduce radiation exposure as low as possible

Imaging of benign lipomatous tumours of the limbs in children

Lipomatous tumours of the limbs in children are rare, and lipoblastoma is the most common soft tissue tumour. Most of them have typical imaging features, but their clinical presentation and their management may vary, depending on the exact histological subtype.The aim of our study is to illustrate the main clinical, radiological and histological features of the different benign lipomatous tumours in children. review of the literature. it is about a descriptive study of paediatric cases of benign lipomatous tumours of limb in children. The imaging findings are helpful and can provide essential components for the diagnosis

Quality control - patient doses - guidance dose levels from diagnostic radiology in Tunisia

Radiation doses from diagnostic radiology are the most important exposure collective doses of the man. Entrance Surface Dose is one of the basic dosimetric quantities for measuring the patient dose and hence, an excellent tool for optimization purposes and for comparison with the international reference values. The aim of the study was to assess the delivred quantitis of rayon x to patients who undervent radiography; For the first time in Tunisia the doses delivered to the patient undergoing the most common type of X ray examinations [chest, abdomen, lumbar spin] were performed in two university hospitals of Tunis. Entrance Surface Dose measurements were conducted using thermoluminescent dosimeters calibrated at the National Centre of Radiation Protection. Before measurements, quality control tests were carried out on each radiological equipment used for examinations. From this study of 112 patients, it was deduced that the obtained values were comparable to the internationally recommended guidance levels. The diagnostic guidance dose levels established for Tunis area are preliminary results. The study should therefore be implemented on a national scale as an approach to establish the national guidance levels

[Air radon in Tunisia dwellings]

Radon is a natural radioactive gas produced by decay of uranium and radium present in soils. Diluted in air, in confined atmospheres, it may accumulate in high concentration. Inhalation of radio and its progeny is thought to increase lung cancer risk. For the first time, air radon concentrations were determined in 1151 dwellings situated in all the inhabited regions of Tunisia, using open alpha-track dosimeters exposed during two months. The median of 1864 measurements was 36 B[q] m[-3] [with a maximum of 512 B[q] M[-3] most of tem being less than 100 B[q] M[-3]. All results were under the International Instances recommended range

kyste hydatique du poumon chez l'enfant a propos de 54 cas

The purpose of this retrospective study is to clarify the clinical, radiological and evolutionary aspects of the hydatid cyst of the lung. Over a period of 9 years [January, 1983 - December, 2001], we brought together in the pediatric service B of Children's hospital of Tunis, 54 cases of hydatid cyst of the lung. The average age is of 7 years 3 months [extremes 2 and 14 years], and the sex- ratio of 1, 16. 61% of the children are of rural origin. Bronchpulmonary infection is the most frequent circumstance of discovery [72% of cases], hemoptysis is revealing in 37% of cases. Discovery is fortuitous in 7% of cases. The radiography of the chest is of a big diagnostic contribution. The radiological aspects obtained are: a homogeneous opaqueness [61%], a diverse opaqueness [26%], an image of lung abscess [22%], an aspect of floating membrane [4%], a pleural effusion [9%], and an opaqueness with growing gas [4%]. Chest echography was contributory in 77% of cases. 74% of the children were operated without complications. The others were lost

[Chronic septic granulomatosis in children revealed by invasive pulmonary aspergillosis]

Chronic granulomatosis disease [GCD] is a hereditary abnormality of phagocytic cells, frequently revealed by invasive pulmonary Aspergillosis. The authors report the case of 8 year old girl investigates for hypotrophia, recurrent lung disease and hemoptysia. She was treated for pulmonary tuberculosis because of biological inflammatory syndrome, right alveolar, opacity and positive tuberculin skin test. The course was marked by the development of a thoracic wall mass. Anti- aspergillus serology was positive; culture of the thoracic mass puncture and bronchoalveolar lavage isolated fumigatus Aspergillus. GCD was suggested and confirmed by the NBT test

Lymphome T primaire du pancreas chez l'enfant

Involvement of the gastrointestinal tract is frequently reported among the extranodaI sites of non-Hodgkin's lymphoma, but primary lymphoma of the pancreas is very rare. We report the case of an 11-year-old boy explored for epigastric pain with fever leading to the diagnosis of high-grade primary non Hodgkin's T-cell lymphoma originating from pancreas. This pancreatic lesion is documented by sonography, CT and MRI. This patient died quickly with severe infection

[Osteopetrosis with carbonic anhydrase II deficiency: about 24 cases]

Twenty four patients suffering from osteopetrosis caused by carbonic anhydrase II deficiency are colliged. This pathology seems to be frequent in Tunisia. Mental retardation is present in 52%, 85% of patients have short stature and 25% have optic atrophy. All affected subjects show craniofacial disproportion and dental anomalies. Twenty patients have at least one bone fracture. Metabolic acidosis is constant: it is profound during the first life decade. A severe selective reduction of carbonic anhydrase II in erythrocyte is confirmed in 18 cases. Osteosclerosis and defective skeletal modelling are constant, cerebral calcification can be seen at the scanner approximately at the age of two years and six months. All patients are homozygous for a splice junction mutation in intron 2 of the carbonic anhydrase II gene, this mutation doesn't seem to protect patients from bone fractures nor to induce a severe metabolic acidosis

Premiere crise convulsive de l'enfant. Strategie d'exploration

We have curried out a retrospective study on 51 children aged between 2 years 3 month and 13 years in order to determine the findings and to define the indications of neuroimaging modalities in children with a first unprovoked seizure. Children who had neuroimaging studies were divided into two groups based on the results of neuroimaging normal or abnormal. We have compared the two groups according to each clinical and electroencephalographic parameters studied. Neuroimaging abnormalitie were found in 47% of cases. According to our results and literature review, we concluded that the imaging should be done if we have at least one of the criteria: an abnormal neurological examination after the seizure and focal slowing waves on the electroencephalogram

Osteoarthropathie hypertrophiante revelant un thymome malin chez un enfant. Apport de l'imagerie

Association of hypertrophic osteoarthropathy and malignant thymoma is very rare in children. Authors report a case of a 14 year old girl followed for rheumatic fever since she was 8 years old. She was explored for arthralgia. The exam showed Hippocratic fingers, soft tissues hypertrophy of lower limbs and dyspnoea. Plain radiography had demonstrated symmetrical ossifying periostisis in tubular bones of lower limbs evocating hypertrophic osteoarthropathy diagnosis. Chest radiography has demonstrated bilobate anterior mediastinal mass. Ultrasonography and MRI revealed a voluminous anterior mediastinal mass with cystic and fleshy components. Thymic adenocarcinoma diagnosis was made by surgical biopsy