[Management of acute myocardial infarction: the experience of a Tunisian hospital]. / Prise en charge therapeutique de l'infarctus du myocarde a la phase aigue: Expérience d'un hôpital de Tunis.

UNLABELLED: The aim of this work was to study some aspects of the management of acute myocardial infarction. MATERIAL AND METHODS: Data concerning 153 patients had been collected during one year between July 1st, 2000 and June 30, 2001 from patients' databases. RESULTS: Our population was constituted of 126 men (82.4%) and 27 women (17.6%). The average age was 61 years. 101 patients (66.0%) were treated by thrombolysis with an average delay of 5.3 +/- 2.8 hours. Streptokinase was the thrombolytic agent used in all cases. Percutaneous transluminal coronary angioplasty was performed in thirteen patients (8.5%) (5 primary angioplasties, 4 rescue angioplasties and 4 programmed angioplasties). Stents were implanted in 12 patients. A cardiac surgery was performed in three patients (2 coronary artery bypass graft surgery and 1 closure of ventricular septal defect) in acute phase of their myocardial infarction. The global rate of revascularisation was 71%. CONCLUSION: The thrombolytic therapy remains the most used means of revascularisation in our country because it is available and not expensive. The use of coronary angioplasty in emergency remains exceptional because the technical means were insufficient.

[Postvaccination myelitis. Aspect and course followed by MRI]. / Myélite post-vaccinale. Aspect et évolution en IRM.

We report the assessment by MRI of a case of radiculomyelitis after vaccination against tetanus-poliomyelitis. In the acute stage the appearance was an isolated myelitis of the conus medullaris with contrast enhancement. The upper thoracic cord presented central areas of high signal intensity on T2 weighted images. Rapid clinical recovery was correlated with resolution of abnormal enhancement. Follow-up MR at 5 months showed persistence of slight T2 prolongation in the conus medullaris and syringohydromyela of the thoracic cord. A single lesion of the spinal cord is a rare presentation of acute disseminated encephalomyelitis, the course of such lesions, to date not previously displayed by MR, is unknown. Proper diagnosis should help prevent administration of further vaccine doses.