CHU Farhat Hached

Sousse, Tunisia

CHU Farhat Hached

Sousse, Tunisia
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PubMed | Cardio B CHU Fattouma Bourguiba, Hopital regional Ben Guerdene, Clinique de Tunis, Hopital regional Ibn El Jazzar and 15 more.
Type: Comparative Study | Journal: Annales de cardiologie et d'angeiologie | Year: 2015

FAST-MI Tunisian registry was initiated by the Tunisian Society of Cardiology and Cardio-vascular Surgery to assess characteristics, management, and hospital outcomes in patients with ST-elevation myocardial infarction (STEMI).We prospectively collected data from 203 consecutive patients (mean age 60.3 years, 79.8 % male) with STEMI who were treated in 15 public hospitals (representing 68.2 % of Tunisian public centres treating STEMI patients) during a 3-month period at the end of 2014. The most common risk factor was tobacco (64.9 %), hypertension (38.6 %), diabetes (36.9 %) and dyslipidemia (24.6 %).Among these patients, 66 % received reperfusion therapy, 35 % with primary percutaneous coronary interventions (PAMI), 31 % with thrombolysis (28.6 % of them by pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 and 358 min for PAMI, respectively. The in-hospital mortality was 7.0 %. Patients enrolled in interventional centers (n=156) were more likely to receive any reperfusion therapy (19.8 % vs 44.6 %; p<0.001) than at the regional system of care with less thrombolysis (26.9 % vs 44.6 %; p=0.008) and more PAMI (52.8 % vs 8.5 %; p<0.0001). Also the in-hospital mortality was lower (6.4 % vs 9.3 %) but not significant.Preliminary results from FAST-MI in Tunisia show that the pharmaco- invasive strategy should be promoted in non-interventional centers.


Meyer E.,University of Birmingham | Ricketts C.,University of Birmingham | Morgan N.V.,University of Birmingham | Morris M.R.,University of Birmingham | And 16 more authors.
American Journal of Human Genetics | Year: 2010

Proliferative vasculopathy and hydranencephaly-hydrocephaly syndrome (PVHH), also known as Fowler syndrome, is an autosomal-recessively inherited prenatal lethal disorder characterized by hydranencephaly; brain stem, basal ganglia, and spinal cord diffuse clastic ischemic lesions with calcifications; glomeruloid vasculopathy of the central nervous system and retinal vessels; and a fetal akinesia deformation sequence (FADS) with muscular neurogenic atrophy. To identify the molecular basis for Fowler syndrome, we performed autozygosity mapping studies in three consanguineous families. The results of SNP microarrays and microsatellite marker genotyping demonstrated linkage to chromosome 14q24.3. Direct sequencing of candidate genes within the target interval revealed five different germline mutations in FLVCR2 in five families with Fowler syndrome. FLVCR2 encodes a transmembrane transporter of the major facilitator superfamily (MFS) hypothesized to be involved in regulation of growth, calcium exchange, and homeostasis. This is the first gene to be associated with Fowler syndrome, and this finding provides a basis for further studies to elucidate the pathogenetic mechanisms and phenotypic spectrum of associated disorders. © 2010 The American Society of Human Genetics.


Mama N.,Sahloul Hospital | H'mida D.,CHU Farhat Hached | Lahmar I.,Sahloul Hospital | Yacoubi M.T.,CHU Farhat Hached | Tlili-Graiess K.,Sahloul Hospital
Pediatric Radiology | Year: 2014

PHACES syndrome consists of the constellation of manifestations including posterior fossa anomalies of the brain (most commonly Dandy-Walker malformations), hemangiomas of the face and scalp, arterial abnormalities, cardiac defects, eye anomalies and sternal defects. We present a case with a possible PHACES syndrome including sternal cleft and supraumbilical raphé, precordial skin tag, persistent left superior vena cava and subtle narrowing of the aorta with an endobronchial carcinoid tumor. All these anomalies were discovered on chest multi-detector CT. This is a unique case of PHACES syndrome associated with carcinoid tumor. Review of the literature revealed 3 cases of PHACES syndrome with glial tumor. The authors tried to find the relationship between PHACES syndrome and carcinoid tumors or gliomas, which all derive from the neural crest cells. © 2013 Springer-Verlag.


Noichri Y.,Biochemistry Laboratory | Chalghoum A.,Biochemistry Laboratory | Chkioua L.,Biochemistry Laboratory | Baudin B.,University Paris Est Creteil | And 3 more authors.
Diagnostic Pathology | Year: 2013

Background: An imbalance between pro-oxidants and antioxidant systems has been suggested to be implicated in the physiopathology of acute myocardial infarction (AMI). We aimed to evaluate the antioxidant capacity in Tunisian patients and to assess the possible relationship between erythrocyte catalase enzyme activity and hyperhomocysteinaemia.Methods: 108 patients with AMI and 81 healthy subjects were enrolled in this study. Catalase erythrocyte enzyme activity was determined spectrophotometrically whereas " total antioxidant status" (TAS) concentration was measured by a commercially available method. Serum total homocysteine (tHcy) level was determined by a fluorescence polarization immunoassay (FPIA). Lipid peroxidation was measured with a fluorimetric method as " thiobarbituric acid reactive substances" (TBARS).Results: Compared with healthy subjects, patients with AMI had significantly lower catalase activity (P<0.001), TAS concentrations (P<0.001), and significantly higher serum tHcy (P<0.001) and TBARS levels (P<0.001). Erythrocyte catalase enzyme activity was negatively correlated with serum tHcy and TBARS while serum tHcy and TBARS were in positive correlation. Furthermore, the unbalance between pro-oxidants and antioxidants seems to be more aggravated in patients with Q wave AMI compared to patients with non-Q wave AMI.Conclusion: Our results suggest the involvement of hyperhomocysteinaemia in the drop of erythrocyte catalase activity related to myocardial ischemia reperfusion. Hyperhomocysteinaemia may increase the myocardial wall dysfunction under ischemia reperfusion by excessive production of reactive oxygen species which is made evident by increased lipid peroxidation.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1623509866881834. © 2013 Noichri et al.; licensee BioMed Central Ltd.


Guedda I.,University of Liège | Taminiau B.,University of Liège | Ferjani A.,CHU Farhat Hached | Boukadida J.,CHU Farhat Hached | And 2 more authors.
Journal of Infection in Developing Countries | Year: 2014

Introduction: Salmonella Livingstone is one of the most common serotypes responsible for nosocomial outbreaks in Tunisia. In this study, 42 isolates of Salmonella Livingstone were analyzed. Most of these were isolated from humans (31 strains from Tunisia and 9 strains from Belgium) and 2 isolates came from food products (beef and pork). Methodology: All strains were characterized by antibiogram, multilocus sequence typing (MLST), and virulotyping. This last technique was carried out by simple PCR of five chromosomal genes (agfA, hin/H2, iroB, phoP/Q, and slyA) and two plasmid genes (spvA and spvC). Results: All Tunisian strains were resistant to amoxicillin, amoxicillin-clavulanic acid, ticarcillin, cefalotin, gentamicin, and kanamycin. They were also resistant to third-generation cephalosporin antibiotics (cefotaxim and ceftazidim). Belgian isolates were susceptible to all antibiotics tested. Further to MLST analyses, Tunisian strains belonged to the same sequence type, ST543. For Belgian isolates, eight strains had a ST543 profile, two strains had a ST638 profile, and one strain had a ST457 profile. Analyses of the virulence gene contents showed that strains isolated in different years and from different origins had the same virulence profile. These carried all five chromosomal genes and lacked plasmid-located virulence genes spvA and spvC. Conclusions: A combination of different typing methods showed that the majority of Belgian strains and all Tunisian strains were closely related; they belonged to the same sequence type (ST543) and had the same virulence profile, but different antibiotic resistance profiles depended on the country of origin. © 2014 Guedda et al.


Dandana A.,CHU Farhat Hached | Gammoudi I.,CHU Farhat Hached | Chalghoum A.,CHU Farhat Hached | Chahed H.,CHU Farhat Hached | And 3 more authors.
Journal of Clinical Laboratory Analysis | Year: 2014

Background: Cystatin C has been proposed as a novel marker of renal function and predictor of cardiovascular risk. The aim of this study was to investigate the role of cystatin C level as a predictor of cardiovascular events in patients with coronary artery disease (CAD). Methods: Three hundred and five coronary artery patients were included in this study. Serum cystatin C levels, high-sensitive C-reactive protein (hs-CRP), and oxidative stress were measured. Estimated glomerular filtration rate (eGFR) and the CAD severity score were calculated. Results: Cystatin C was correlated with the CAD severity score (r = 0.631, P < 0.0001) and was significantly elevated in the CAD severity score >50. Every 0.1 mg/l increase in cystatin C, 2 mg/l increase in hs-CRP, 0.2 mmol/l decrease in high-density lipoprotein cholesterol, 13.7 ml/min decrease in eGFR, and 1.51 μmol/l increase in homocysteine caused a 34, 12, 5, and 22% increase in the risk of having CAD, respectively. Conclusion: Cystatin C could be a useful laboratory biochemical marker in predicting the severity of CAD. Cystatin C is associated with biochemical atherosclerosis markers such as CRP and homocysteine. © 2014 Wiley Periodicals, Inc.


Magdoud K.,University of Monastir | Dendana M.,University of Monastir | Herbepin V.,CHU de Saint Etienne | Hizem S.,University of Monastir | And 5 more authors.
Human Reproduction | Year: 2012

Background We investigated the association of vascular endothelial growth factor (VEGF) gene polymorphism with recurrent spontaneous miscarriage (RSM). Methods VEGF-2578C/A,-1154G/A,-634G/C, 936C/T single nucleotide polymorphisms (SNPs) were assessed in 304 RSM patients, and 371 age-and body mass index-matched control subjects using real-time PCR.RESULTSHigher minor allele frequency of-1154G/A (P < 0.001) and 936C/T (P < 0.001), but not-2578C/A (P 0.55) or-634G/C (P 0.87) SNPs, were seen in patients. Significant differences in the distribution of-1154G/A (P 0.006) and 936C/T (P 0.015), but not-2578C/A (P 0.473) or-634G/C (P 1.000) genotypes, were seen in cases compared with control women. Of the possible 16 VEGF haplotypes, 9 were found to be common, and were included. A significantly lower frequency of C G C C (P 0.008), and A G G C (P < 0.001) haplotypes, and a higher frequency C G C T (P 0.020), and C G T (P 0.004) haplotypes were seen in patients. Conclusions These results strongly support that VEGF polymorphisms, in particular-1154G/A and 936C/T, are significantly associated with RSM. Our results confirm, in the largest sample to date, previous works in other populations on VEGF polymorphism in RSM. © 2012 The Autho.


Selma W.B.,CHU Farhat Hached | Ziadi S.,CHU Farhat Hached | Gacem R.B.,CHU Farhat Hached | Amara K.,CHU Farhat Hached | And 3 more authors.
Pathology Research and Practice | Year: 2010

The association between human papillomavirus (HPV) infection and development of bladder cancer is variable. Furthermore, the prevalence of HPV DNA in bladder carcinoma subtypes varies from study to study. To clarify the impact of HPV infection on the development of bladder carcinoma, we performed a retrospective study on Tunisian patients to determine the status of HPV infection in urothelial carcinoma, squamous cell carcinoma, and adenocarcinoma.A total of 125 formalin-fixed, paraffin-embedded archival tissue specimens of bladder carcinoma were reviewed and classified according to the World Health Organization (WHO) classification of tumors (119 urothelial carcinomas, five squamous carcinomas, and one adenocarcinoma). Anogenital HPV DNA detection was performed using three different polymerase chain reaction (PCR) techniques: the first one used primers pU-2R/pU-1M specific to high-risk oncogenic HPV; the second one used primers PU-2R/PU-31B specific to low-risk oncogenic HPV; and the third one employed consensus primers (E1-547R/E1-350L).No evidence of HPV infection was detected by morphological examination and PCR in any case of bladder carcinoma.Our study shows that the anogenital HPVs investigated are not associated with the pathogenesis of bladder cancer in Tunisia; however, the question of whether other subtypes of HPV contribute to bladder carcinogenesis remains to be clarified. © 2010 Elsevier GmbH.


Msolly A.,CHU Farhat Hached | Gharbi O.,CHU Farhat Hached | Ben Ahmed S.,CHU Farhat Hached
Medical Oncology | Year: 2013

This report examined the relationship between menstrual and reproductive factors and breast cancer risk. The case-control study was conducted on 400 women with histological confirmed breast cancer operated during the 2006-2009 period at Farhat Hached University Hospital, Sousse, Tunisia, and 400 cancer-free controls, aged 25-75 years. The menstrual and reproductive history was assessed using a structured questionnaire. Odds ratios (ORs), 95 % confidence intervals (CI) and a full confounding assessment, included in this analysis, were derived using logistic regression. A positive family history of breast cancer was associated with a significantly increased risk of breast cancer (OR = 5.15, 95 % CI 1.48-17.94). Significant risk reduction was found with later age at menarche (P = 0.02). There was an insignificant increase in risk with later age at menopause (≥51 years; OR = 1.87), later age at first live birth (≥26 years; OR = 1.76) and nulliparous women compared to parous women (OR = 2.35). An insignificant decrease in risk was observed with increasing parity number (≥3 delivery; OR = 0.86). A significantly reduced risk of breast cancer was found for those women whose lifetime duration of breastfeeding was 73-108 months and for those who breastfed for ≥109 months (P = 0.00). Our findings suggest that age at menarche and breastfeeding history have great effects on breast cancer risk among Tunisian women. © 2013 Springer Science+Business Media New York.


Awatef M.,CHU Farhat Hached | Olfa G.,CHU Farhat Hached | Imed H.,CHU Farhat Hached | Kacem M.,CHU Farhat Hached | And 4 more authors.
Cancer Causes and Control | Year: 2010

In this report, we examined the relationship between mother's breastfeeding history and her risk of breast cancer, in a case-control study in Tunisia between 2006 and 2009. About 400 breast cancer cases and 400 controls were included. Cases and controls were interviewed using a standardized structured questionnaire to obtain information on breastfeeding and other risk factors. Mean duration of breastfeeding per child was significantly associated with a reduced risk of breast cancer for women who breastfed for >24 months per child. The OR was 0.46 (95% CI, 0.28-0.76) when compared those who breastfed for <6 months. The test for trend was significant (p = 0.01). A significantly reduced risk of breast cancer was found for those whose lifetime duration of breastfeeding was 73-108 months (OR = 0.65, 95% CI, 0.361.18) and for those who breastfed for > 109 months (OR = 0.42, 95% CI, 0.20-0.84). Stratification by menopausal status showed a reduced risk of breast cancer associated with a longer duration of breastfeeding for both pre- and postmenopausal women. The risk reduction was more consistent for lifetime duration of breastfeeding, the test for trend being significant for both pre- (p = 0.03) and postmenopausal (p = 0.01) women. These results support an inverse association between breastfeeding and breast cancer risk.

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