Hiperplasia pseudoangiomatosa nodular gigante de la mama / Pseudoangiomatous stromal hyperplasia (pash) of the breast

La hiperplasia pseudoangiomatosa (PASH) es una lesión proliferativa benigna de la mama, poco frecuente, caracterizada por la existencia de lagos pseudovasculares embebidos en una gran proliferación del estroma mamario. Probablemente, el desarrollo de la PASH tenga una influencia hormonal, por lo que típicamente se diagnostica en mujeres en edad fértil. La PASH es un hallazgo histopatológico casual en las piezas quirúrgicas y biopsias mamarias realizadas por otra patología. La presentación clínica en forma de masa palpable es poco frecuente. El principal diagnóstico diferencial debe realizarse con el angiosarcoma de bajo grado. El tratamiento de la PASH nodular es una correcta exéresis quirúrgica asegurando borde sano amplio. El pronóstico es excelente, con un mínimo riesgo de recidiva si se realiza una adecuada cirugía. Se presenta el caso de una mujer de 37 años que acude a consulta por un nódulo mamario de crecimiento rápido.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare benign proliferative mesenchymal lesion characterized by the presence of open slit like spaces embedded in a hyalinized fibrous stroma. The development of PASH is probably subject to hormonal influence so it typically affects women in the reproductive age group. Pseudoangiomatous stromal hyperplasia is frequently an incidental histologic finding in breast surgeries or biopsies performed for other injuries. In rare cases, it presents as a localized breast mass. The most important differential diagnosis is low-grade angiosarcoma. Tumorous PASH is treated by local surgical excision with clear margins. The prognosis is excellent, with minimal risk of recurrence after adequate surgery. The presented case was a 37-years-old woman who was admitted with a rapidly growing breast tumor.

Les effets indesirables dus aux antibiotiques : etude retrospective sur trois ans au centre regional de pharmacovigilance de Sfax

Les effets indesirables aux antibiotiques constituent un reel probleme de sante publique. Dans ce travail; ont ete analyses la frequence; les types; les facteurs predisposant et la gravite des effets indesirables aux antibiotiques. Notre etude; de type retrospectif; porte sur les cas d'effets indesirables aux antibiotiques obtenus par notification spontanee au centre regional de pharmacovigilance de Sfax durant une periode de trois ans. Parmi 249 cas d'effets indesirables medicamenteux; 82 cas (32;93) ont ete lies aux antibiotiques. L'age variait de 5 a 86 ans. Il s'agissait de 55 femmes et de 27 hommes. Soixante dix effets indesirables lies aux antibiotiques (85.36) parmi 82 etaient de nature immunoallergique. Dans 60 cas (73.17); les patients avaient des antecedents medicaux: atopie; allergie medicamenteuse; maladies auto-immunes ou pathologies chroniques necessitant une polymedication. 54 patients (65.85) prenaient 3 medicaments ou plus. Les formes graves ont ete observees chez 12 patients parmi 82 (14.63). La polytherapie; les maladies chroniques et l'age avance sont des facteurs favorisant la survenue des effets indesirables aux antibiotiques. Nos resultats soulignent le risque augmente chez les sujets ayant un antecedent d'allergie a un antibiotique de developper une allergie a un autre antibiotique

[Identification of some microorganisms in Al-Arish sewage water treatment station]

The study aims to classify some microorganisms, which are reproduced in Al-Arish station for sewage water treatment. The result has revealed the presence of Coli form bacteria, Sulfur bacteria. Cyanobactria, Green algae and Protozoa. Those organisms play important role in degradation of organic compounds in wastewater

[ study on the biological phenomenon of greenness, light emission and odours in Aden beaches]

The study aims to disclose the causes of greenness, emission of light and harmful odours in Aden beaches. Water samples were collected during the period of January March 2006, and were examined by light microscope connected to CCD camera. Isolation and identification of microalgae were carried directly by light microscope, while isolation and identification of bacteria were carried by using several bacterial culture. The result has revealed the presence of green gelatinous colonies, the diameter of one colony is about 1 cm. The colonies contain microalgae called Phyaeocystis sp. and two bacteria species that belong to Vibrio genus: V. fischeri and V. harveyi. The source of Bioluminescence and the harmful odours are resulting from bacterial metabolic activity, while the greenness are from the algae

Compression triple fusion using screws fixation

Fourteen patients complaining of painful and/or deformed foot resistant to conservative management treated by using triple fusion were included in this study aiming to evaluate the results of the efficiency of double approach exposure and compression internal fixation in improving the results of triple fusion. Ten feet had peroneal spastic foot, three had post traumatic arthritis and one had unstable paralytic foot. All were treated using medial and lateral exposure and rigid internal fixation. After a mean follow up period of 19 months, pain, gait, walking ability of the patients were improved in all but one patients. Triple fusion is a good salvage option for the treatment of resistant painful foot, if proper surgical technique is followed

Posterior subscapularis release combined with transfer of latissimus dorsi and teres major for treatment of shoulder internal rotation contracture secondary to Erb's plasy

Fifteen children complaining of internal rotation contracture of the shoulders after obstetrical palsy, their mean age was 8.3 years, were included in this study. The preoperative average abduction and external rotation were 70 and 50 degrees, respectively. All patients had subscapularis release from the scapula and transfer of latissimus dorsi and teres major to rotator cuff. At the final follow up, all patients had an improvement of abduction and external rotation. The mean active abduction was improved to 120 degrees postoperatively. The average postoperative external rotation was 57 degrees. Subscapularis release and Hoffer transfer improved the shoulder abduction and external rotation in cases of birth palsy. All patients noticed an improvement of their functional activities of daily living as well as cosmoses

Fractures of the ulnar styloid in young adults: to fix or not?

In this study, 44 cases of fracture base of the ulnar styloid were treated by open reduction and internal fixation using tension band wiring. 68% of the cases were associated with unstable distal radius fracture. In 10% of the cases, the ulnar styloid fracture was isolated; in 11% of the cases, it was associated with carpal injuries, fractures and or dislocation as well as 11% were associated with Galeazzi fracture. The assessment of stability of the distal radio-ulnar joint was tested after fixation, during surgery. An additional percutaneous fixation of distal radio ulnar joint [DRUJ] by KW was done in four cases. The results were encouraging, 85% of the patients had painless free range of supination-pronation. A residual prominence of the ulnar head was observed in two cases

Percutaneous reduction and fixation of transscaphoid perilunate fracture dislocations

In this study, 12 manual worker men sustained high energy trauma presented with this injury were treated by closed reduction under fluoroscopic image intensifier control and percutaneous fixation. Their mean age was 31.4 years. The injury involved the undominant hand in eight patients. The average duration of follow up was 16.3 months. At the end of follow up, 11 patients were satisfied, had no or mild pain. Eight patients had more than 75% of the range of motion of that of the uninjured side. Ten patients had excellent and good results

Hypertension in the elderly.

OBJECTIVES: To study the clinical profile of hypertension in the elderly, development of end organ complications and the effect of hypertension with other risk factors in producing these complications. METHODS: One hundred and thirty six elderly patients attending the Hypertension Clinic were included in the study. A detailed history was taken that included presenting illness, family history of hypertension, diabetes, coronary artery disease, dyslipidaemia and history of addictions. Physical examination included systemic examination with measurement of waist to hip ratio and fundoscopy for retinopathy. Renal and liver function tests (RFT, LFT), blood sugar, lipid profile, X-ray chest, electrocardiography (ECG), 2-D echocardiography, abdominal ultrasound and computed tomography (CT) scan head (if indicated) were other important investigations done. RESULTS: Seventy-nine patients were in the age group of 60-65 years, of which 42 (30.9%) were males. Headache was the commonest chief complaint in 77.9% patients; whereas 24 patients were asymptomatic. Obesity, diabetes, alcohol, dyslipidaemia and family history were important determinants of hypertension. Lipid profile was abnormal in 55.9% patients. Isolated systolic hypertension (ISH) was found in 56.6% patients. Grade II hypertensive retinopathy was observed in 29.4% patients with uncontrolled blood pressure. Left ventricular hypertrophy (LVH) was the commonest ECG manifestation seen in 36.8% patients of which 26.5% had uncontrolled blood pressure. LVH could be diagnosed in 46.4% patients by 2-D echo. Patients with uncontrolled blood pressure and ISH had increased incidence of cardiovascular and cerebrovascular complications. Cardiovascular complications were seen in 19.1% patients having dyslipidaemia and hypertension. Cerebrovascular complications were seen in 15.4% patients having hypertension with LVH. Treatment included calcium channel blockers and/or other drugs. CONCLUSIONS: The elderly hypertensive patients tend to have ISH. Family history of hypertension is an important determinant of hypertension. Uncontrolled hypertension, ISH, LVH and other associated risk factors are responsible for cardiovascular and cerebrovascular morbidity.

Biological fixation of metaphyseo-diaphyseal fractures of long bone

Forty cases of fracture of the proximal or distal metaphases of the femur or tibia with or without diaphyseal extension but not extended to the joints were treated using indirect reduction of the fracture and biological fixation. There were 23 femoral fracture and 17 tibial fractures. After mean follow up of 19 months, bony union was achieved without any mechanical failure in all patients except two, three cases had delayed union and required bone grafting

Diagnostic significance of immunoglobulins and adenosine deaminase in pleural effusion.

OBJECTIVES: 1) To evaluate the diagnostic significance of ELISA for detection of antibodies to antigen A60 of Mycobacterium tuberculosis and adenosine deaminase (ADA) in patients with pleural effusion without prior history of tuberculosis, 2) To study the importance of the above tests in patients with HIV infection and pleural effusion. METHOD: Eighty one patients with pleural effusion were studied. In addition to diagnostic paracentesis and pleural biopsy, pleural fluid specific IgG, IgM, IgA against antigen A60 and fluid ADA were estimated. HIV testing (ELISA) was done in all patients. RESULTS: Out of 81 patients, 13 were HIV positive. IgG anti A60 had a sensitivity and specificity of 90.71% and 33.33% respectively. The combination of IgG and IgM had a sensitivity and specificity of 96.3% and 55.55% respectively. IgA alone or in combination did not offer any diagnostic advantage. ADA had a sensitivity and specificity of 76% and 60% respectively. In presence of HIV infection, antibodies against A60 had a sensitivity of 76.92% and ADA had a sensitivity of 61.54%. CONCLUSIONS: In patients with pleural effusion, immunoglobulins against antigen A60 have a limited diagnostic role with high false positive rates. Co infection with HIV further reduces the value of above diagnostic tests.