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1. Simulation training for continuing professional development of nurses in cardiology and cardiovascular surgery.

Author

Boudiche S, Zelfani S, Ben Hammamia M, Mghaieth Zghal F, Ouaghlani K, Ben Halima M, Manai H, Ziadi J, Rekik B, Rajhi M, Gharsallaoui O, Farhati A, Ouali S, Larbi N, Denguir R, Daghfous M, and Mourali MS

Subjects
Cardiopulmonary Resuscitation standards, Case-Control Studies, Clinical Competence, Educational Measurement, Humans, Learning, Nursing Evaluation Research, Cardiology education, Cardiopulmonary Resuscitation education, Cardiovascular Surgical Procedures education, Cardiovascular Surgical Procedures nursing, Education, Nursing, Continuing methods, Simulation Training methods, Simulation Training standards
Abstract

Background:   Nurses play a key role in cardiac arrest management, especially those assigned to cardiac intensive care units, where they are often actively involved in cardiopulmonary resuscitation., Aim: To evaluate the effect of simulation training in in continuing professional development of nurses in this setting., Methods: A comparative study using paired samples (where the candidate was his own control with repeated measures before and after intervention), was conducted among nurses working in the cardiology and cardiovascular surgery division of our institution. The primary endpoint was the change in skills judged on the basis of competency score of 20 assessed before and after simulation training., Results: 32 nurses participated in the training session. Despite a median job seniority of 8.5 years [4.0 - 12.5], only 44% of nurses had already participated in a simulation session. Although most of the candidates (84%) had previously performed chest compressions, only 34% had delivered an electrical defibrillation during their exercise. We showed a significant increase in overall scores from 8.0 [5.0 - 9.8] to 17.5 [17.0 - 19.0] after the simulation training session (p<0.0001). All the criteria judged in the evaluation grid (basic life support, manual electrical defibrillation) were significantly improved and the most positive effect was observed in the manual defibrillation where the prior experience of the participants was limited., Conclusions: Simulation learning had a major positive impact on the development of nurses' skills in terms of cardiopulmonary resuscitation.

Published
2020

2. Left ventricular non compaction and septal defects.

Author

Mghaieth Zghal F, Boudiche S, Ben Halima M, Rekik B, Larbi N, and Mourali MS

Subjects
Amino Acid Substitution genetics, Dystrophin-Associated Proteins genetics, Female, Glutamic Acid genetics, Heart Defects, Congenital genetics, Heart Septal Defects, Atrial complications, Heart Septal Defects, Atrial genetics, Humans, Lysine genetics, Mutation, Missense, Neuropeptides genetics, Young Adult, Heart Defects, Congenital diagnosis, Heart Septal Defects, Atrial diagnosis, Heart Ventricles abnormalities
Abstract

We report the case of a 23-year-old woman with a not yet described (to the best of our knowledge) association of left ventricle non-compaction with both atrial and ventricular defects. Family genetic survey concluded to, a probably sporadic, E101K gene mutation.

Published
2020

3. Feasibility and safety of Same-Day Discharge after transradial percutaneous coronary intervention: a Tunisian monocentric study.

Author

Boudiche S, Mechri M, Ben Halima M, Rekik B, Khader N, Larbi N, Farhati A, Mghaeith F, Ouali S, and Mourali MS

Subjects
Aged, Feasibility Studies, Female, Humans, Male, Middle Aged, Radial Artery, Retrospective Studies, Tunisia, Ambulatory Surgical Procedures adverse effects, Length of Stay, Patient Discharge, Percutaneous Coronary Intervention methods
Abstract

Background: The continuing increase in care, needs and costs in cardiology with the advances in percutaneous coronary intervention (PCI) techniques represent the ideal scenario for considering same-day discharge (SDD) PCI program., Aim: The primary endpoints were to examine feasibility and safety of SDD-PCI., Methods: We conducted a comparative observational study of a prospective cohort (April 2017 to September 2017) where patients benefited from SDD-PCI with a retrospective cohort (October 2016 to March 2017) where patients were conventionally managed. We established pre-procedural eligibility criteria and per and post-procedural exclusion criteria to estimate feasibility of SDD-PCI. Safety was assessed at 24 hours and 30 days comparatively in both groups., Results: In the one-year study period, 709 PCI were performed. The eligibility for SDD-PCI was 17.2% (122 patients) and feasibility was 14.7% (104 patients). Ultimately, 50 out of 370 patients in the prospective cohort (SDD-group) and 54 out of 339 patients in the retrospective cohort (control-group) had or could have benefited from SDD-PCI. The transradial access was the most used (98.1%). 59.7% of treated lesions were B2 or C type, 53.8% interested the left anterior descending artery and 29.8% were bifurcations. In both groups, no complications were observed at 24 hours. At 30 days, one single non-fatal myocardial infarction related to subacute stent thrombosis occurred in the SDD-group and was attributed to antiplatelet therapy interruption., Conclusion: SDD-PCI is feasible and safe on the condition of strict stratification criteria of patients before judging their discharge the same day after PCI.

Published
2019

4. Unprotected left main percutaneous coronary intervention: prognostic value of SYNTAX score II.

Author

Boudiche S, Guermazi O, Azaiez F, Ben Halima M, Rekik B, Khader N, Aloui H, Farhati A, Larbi N, Mghaieth F, Ouali S, and Mourali MS

Subjects
Coronary Stenosis therapy, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Retreatment, Shock, Cardiogenic etiology, Stents, Stroke etiology, Thrombosis etiology, Coronary Artery Disease therapy, Percutaneous Coronary Intervention, Risk Assessment
Abstract

Background: Unprotected left main (LM) coronary artery disease (CAD) represents a challenging lesion with a major prognostic impact., Aim: Evaluate the clinical outcome and major adverse cardiac events (MACE) predictors of unprotected LM percutaneous coronary intervention (PCI) in an "all-comers" population., Methods: We performed a prospective observational study of patients with unprotected LM stenosis treated by PCI. MACE were defined as the composite endpoint of all-cause death, myocardial infarction and target lesion revascularization., Results: From January 2012 to December 2017, 150 consecutive patients who underwent unprotected LM PCI were included. The mean age was 64±12 years and 75.3% were males. Diabetes was noted in 50.7%. Emergent revascularization was performed in 20.7% of cases, including 3.3% patients with cardiogenic shock. Distal LM was involved in 76.7% of cases. A majority of patients (94.0%) had low or intermediate SYNTAX Score I (≤32). The median SYNTAX score II was 31.1. Drug-eluting stents were used in 78.7% and bare metal stents in 21.3% of patients, mainly in emergent setting where the former were unavailable. In distal LM PCI, provisional approach was mostly used (81.7%). The median follow-up was 13.4 months. MACE occurred in 23.3% with an estimate of 37.9% at 5 years. Significant predictors of MACE were cardiogenic shock, bare metal stents use, previous PCI, and SYNTAX score II ≥30., Conclusion: Unprotected LM PCI presents encouraging short and long term outcomes. SYNTAX score II might represent a predictor for long-term outcome in this particular lesion subset.

Published
2019

5. Outcome predictors of cardiogenic shock complicating ST-segment elevation myocardial infarction.

Author

Boudiche S, Guermazi O, El Ayech F, Ben Halima M, Aouinti MA, Ouaghlani K, Rekik B, Khader N, Aloui H, Larbi N, Farhati A, Mghaieth F, Ouali S, and Mourali MS

Subjects
Aged, Cohort Studies, Comorbidity, Female, Humans, Intra-Aortic Balloon Pumping adverse effects, Intra-Aortic Balloon Pumping mortality, Male, Middle Aged, Mortality, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Postoperative Complications mortality, Prevalence, Prognosis, Risk Factors, ST Elevation Myocardial Infarction complications, ST Elevation Myocardial Infarction epidemiology, Shock, Cardiogenic complications, Shock, Cardiogenic epidemiology, Treatment Outcome, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction surgery, Shock, Cardiogenic diagnosis, Shock, Cardiogenic surgery
Abstract

Background: Cardiogenic shock complicating ST elevation myocardial infarction is burdened by a high mortality. There is only limited evidence for the management except for early revascularization and the relative ineffectiveness of intra-aortic balloon pump., Aim: Our objectives were to evaluate outcome and predictors of early all-cause 30-day mortality in the setting of cardiogenic shock complicating ST elevation myocardial infarction., Methods: From January 2009 to August 2018, all patients who presented within the first 48 hours of ST elevation myocardial infarction complicated by cardiogenic shock and receiving invasive management were prospectively included., Results: The study cohort comprised 122 consecutive patients. The mean age was 65±12 years and 74.5% of patients were males. Left ventricular failure was the most common etiology of cardiogenic shock (72.1%) and mechanical complications occurred in 8.2% of cases. Percutaneous coronary interventions were proposed for all patients and performed in a primary setting in 72.1%. A high prevalence of no reflow was noted (15.6%). Multivessel coronary artery disease was noted in 64.8% and multivessel percutaneous coronary interventions at the index procedure were performed in 22.1% of cases. Intra-aortic balloon pump was used in 17.2% of patients. The 30-day mortality was 58.2%. The only predictor of early mortality was the immediate multivessel percutaneous coronary intervention (OR=4.1, 95%CI 1.1-14.5; p=0.031)., Conclusion: Despite invasive management strategies, 30-day mortality of cardiogenic shock complicating ST elevation myocardial infarction remained as high as 58.2%. Immediate multivessel percutaneous coronary intervention was the only predictor of early mortality.

Published
2019

6. Factors associated to adequate time in therapeutic range with oral vitamin K antagonists in Tunisia.

Author

Ouali S, Mechri M, Ben Ali Z, Boudiche S, Ben Halima M, Rejaibi S, Mourali MS, Larbi N, and Meghaieth F

Subjects
Administration, Oral, Adult, Aged, Aged, 80 and over, Anticoagulants administration & dosage, Anticoagulants pharmacokinetics, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology, Atrial Fibrillation metabolism, Cardiovascular Diseases drug therapy, Cardiovascular Diseases epidemiology, Cardiovascular Diseases metabolism, Drug Monitoring statistics & numerical data, Female, Humans, Male, Middle Aged, Outpatients statistics & numerical data, Prevalence, Socioeconomic Factors, Thromboembolism drug therapy, Thromboembolism epidemiology, Thromboembolism metabolism, Time Factors, Treatment Outcome, Tunisia epidemiology, Vitamin K administration & dosage, Vitamin K pharmacokinetics, 4-Hydroxycoumarins administration & dosage, 4-Hydroxycoumarins pharmacokinetics, Indenes administration & dosage, Indenes pharmacokinetics, Vitamin K antagonists & inhibitors, Assessment of Medication Adherence
Abstract

Introduction:   The quality of chronic anticoagulation and predictor factors of poor anticoagulant control in patients under acenocoumarol were unknown in North Africa., Methods: It is an observational study, carried out between November 2015 and November 30, 2016. The international normalized ratio (INR) values were prospectively obtained, and TTR was calculated using the Rosendaal method., Results: Overall, 215 patients were included in this study, with a mean age of 63±0,8 years. The prevalence of poor anticoagulation control was 78.1%; 95% CI [72.2-83.2] (168 patients with TTR less than 65%). The median TTR with the Rosendaal method was 44.4%. After multivariate adjustment, variables significantly associated with adequate anticoagulation level were: history of ischemic stroke (Adjusted OR equal to 4.3, 95% CI: 1.4-12.9), associated prescription of antiplatelet therapy (Adjusted OR equal to 3.5, 95% CI: 1.1-11.2), daily prescribed dose of coumarins less than 6 mg (Adjusted OR equal to 6.4, 95% CI: 1.1- 36) and lower risk of bleeding assessed as HAS-BLED score (Adjusted OR: 0.5, 95% CI: 0.3-0.8)., Conclusion: The quality of anticoagulation management with VKA among outpatients who received acenocoumarol was suboptimal. Strategies should be undertaken by clinicians and patients to improve the quality of anticoagulation, to address challenges to adverse cardiovascular outcomes in individuals treated with chronic anticoagulation.

Published
2019

7. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis.

Author

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, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, 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, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, 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, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, 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 S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, and Moatemri Z

Subjects
Africa, Northern epidemiology, Anatomy education, Education, Medical history, Education, Medical methods, Education, Medical organization & administration, History, 21st Century, Humans, Internship and Residency standards, Internship and Residency trends, Job Satisfaction, Pathology, Clinical education, Tunisia epidemiology, Education, Medical trends, Medicine methods, Medicine organization & administration, Medicine trends
Published
2019

8. [Contrast-induced nephropathy after cardiac catheterization: a prospective study of 180 patients].

Author

Mghaieth F, Ayari J, Ben Rejeb R, Mbarki S, Farhati A, Larbi N, Boussaada R, Mourali MS, and Mechmeche R

Subjects
Adult, Aged, Aged, 80 and over, Coronary Angiography, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Acute Kidney Injury chemically induced, Cardiac Catheterization, Contrast Media adverse effects
Abstract

Background: Contrast-induced nephropathy (CIN) is associated with an increased cardiovascular morbi-mortality. Little is known about the incidence and risk factors of CIN after cardiac catheterization in Tunisian patients., Aim: To determine the incidence of CIN and its predictors after coronary angiography as well as its prognostic and therapeutic repercussions in a Tunisian patients' cohort., Methods: In this prospective single center study, 180 consecutive patients who underwent cardiac catheterization were enrolled; all patients were followed-up for 3 months., Results: The incidence of CIN defined as an absolute increase in serum creatinine ³ 5 mg/l (44μmol/l) and/or a relative increase in serum creatinine ³ 25%, was 17.2%. In multivariate logistic regression, independent predictors of CIN were: diabetes mellitus (Odds Ratio (OR)=2.26 ; 95% confidence interval (95%CI) : 1.29- 3.98, p=0.005), creatinine clearance < 80ml/mn (OR=2.87 ; 95%CI : 1.59-5.19, p<0.001), left ventricular ejection fraction (LVEF) < 45% (OR=2.03 ; 95%CI : 1.22-3.39, p=0.007) and use of a volume of contrast media > 90ml (1.72 ; 95%CI : 0.99-2.99, p=0.05). Perprocedural hypotension was the strongest independent predictor of CIN in our study (OR=3.99; 95% CI: 1.65-9.66, p=0.002). CIN was totally regressive within one month in 27 patients (86.7%) while 3 patients (10%) had a residual renal dysfunction at the end of the follow-up period (3 months)., Conclusion: More than one angiocoronarography on 6 resulted in CIN in our population. CIN affects cardiovascular prognosis even if renal function normalization is usually obtained within one month after the investigation. Besides identifying risk factors of CIN in order to apply preventive measures in risky patients, we stress the necessity of insuring a good hemodynamic status while achieving the procedure.

Published
2012

9. [Pancreatic hydatid cyst. Diagnostic and therapeutic management].

Author

Larbi N, Bouchoucha S, Ben Mansour Z, Kaabi S, and Ghilani M

Subjects
Adult, Female, Humans, Male, Middle Aged, Pancreatic Cyst diagnosis, Pancreatic Cyst surgery, Echinococcosis diagnosis, Echinococcosis surgery, Pancreatic Cyst parasitology
Published
2008

10. [Cross sectional ultrasound of the liver].

Author

Salem A, Larbi N, Mkhinini W, Bouchoucha S, and Mnif N

Subjects
Abdominal Pain etiology, Appendix pathology, Diagnosis, Differential, Digestive System Fistula etiology, Humans, Liver diagnostic imaging, Liver Abscess etiology, Liver Neoplasms diagnosis, Male, Middle Aged, Necrosis, Radiography, Ultrasonography, Liver Abscess diagnosis
Published
2007

11. [Cardiac involvement in Emery-Dreifuss muscular dystrophy: a case report].

Author

Chabrak S, Ammar S, Ammar N, Ouali S, Mghaieth F, Larbi N, Kafsi N, Hentati F, and Mechmeche R

Subjects
Adult, Cardiomyopathy, Dilated diagnosis, Cardiomyopathy, Dilated etiology, Echocardiography, Electrocardiography, Follow-Up Studies, Heart Block diagnosis, Heart Block etiology, Heart Block therapy, Heart Diseases diagnosis, Heart Diseases physiopathology, Heart Diseases therapy, Humans, Male, Muscular Dystrophy, Emery-Dreifuss diagnosis, Pacemaker, Artificial, Prognosis, Stroke Volume, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular etiology, Tachycardia, Ventricular therapy, Time Factors, Heart Diseases etiology, Muscular Dystrophy, Emery-Dreifuss complications
Abstract

Emery Dreifuss muscular dystrophy (EDMD) is an uncommon hereditary myopathy characterized by 3 symptoms: slow progressive muscular atrophy, muscular contractures and cardiac disease which affect prognosis. We report a 22 year-old patient with EDMD which shows the typical features of the associated dilated cardiomyopathy, ventricular arrhythmia, atrio-ventricular block, atrial standstill then atrial paralysis.

Published
2006

12. [Gastric and intestinal bezoars].

Author

Larbi N, Kaâbi S, and Ben Salah K

Subjects
Adult, Aged, Cactaceae, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Tunisia, Bezoars pathology, Bezoars surgery, Intestine, Small pathology, Stomach pathology
Abstract

The authors report a retrospective study of 10 cases of gastric and small bowel bezoars. There was one gastric trichobezoar diagnosed by an abdominal mass and 9 small bowel obstruction due to phytobezoars. All patients underwent surgery: the gastric trichobezoar was removed through a gastrotomy; small bowel bezoars were treated either by enterotomy (n = 3), fragmentation (n = 5) or bowel resection (n = 1). Non operative treatment is efficient in gastric phytobezoars. Surgery is advisable for trichobezoars and small bowel bezoars. Prevention is main and patients who have gastric surgery must be alarmed from consumption of cactus in our country Tunisia.

Published
2003

13. [Prognosis of intraventricular septal rupture in myocardial infarct: apropos of 13 cases].

Author

Larbi N, Lakhdar R, Chabrak S, and Kafsi MN

Subjects
Aged, Echocardiography, Female, Humans, Male, Middle Aged, Prognosis, Ventricular Septal Rupture diagnostic imaging, Ventricular Septal Rupture surgery, Ventricular Septal Rupture mortality
Abstract

The authors report the experience about 13 cases of postinfarction ventricular septal rupture. Patients (9 men and 4 women) aged 60 to 76 years average 68 years. The site of necrosis was the anterior wall in 8 cases and the posterior wall in 5 cases. The diagnosis of septal rupture was confirmed by echocardiography and/or angiography. 6 patients died after averages: 7 days. Surgical intervention was performed in 7 cases after a mean of 51 days following the date of the myocardial infarction after an intensive care. We emphasize to demonstrate the helpful of intensive care and the role of early surgery for a good prognosis.

Published
1999

14. [Coronary transluminal angioplasty factors predictive of restenosis].

Author

Lakhdar R, Larbi N, Zouari B, and Kafsi MN

Subjects
Adult, Aged, Coronary Disease classification, Coronary Disease diagnosis, Coronary Disease etiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Recurrence, Risk Factors, Severity of Illness Index, Survival Analysis, Treatment Outcome, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary methods, Coronary Disease therapy
Published
1999

15. [Myocardial infarct on a myocardial bridge (apropos of a case)].

Author

Larbi N, Kafsi N, Gharbi M, and Selmi A

Subjects
Adult, Coronary Angiography, Coronary Vessel Anomalies diagnostic imaging, Humans, Male, Myocardial Infarction diagnostic imaging, Risk Factors, Coronary Vessel Anomalies complications, Myocardial Infarction complications
Published
1997

16. [Left intra-auricular myxoma. 13 cases].

Author

Drissa H, Zaouali RM, Larbi N, and Abid F

Subjects
Adolescent, Adult, Aged, Cardiac Catheterization, Cardiac Surgical Procedures methods, Child, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Atria, Heart Neoplasms pathology, Heart Neoplasms surgery, Humans, Male, Middle Aged, Myxoma pathology, Myxoma surgery, Neoplasm Recurrence, Local, Heart Neoplasms diagnostic imaging, Myxoma diagnostic imaging
Published
1991

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