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Ben Jemaa A.,University of Carthage | Bouraoui Y.,University of Carthage | Sallami S.,Hospital of la Rabta Tunis | Banasr A.,Hospital of Charles Nicolle Tunis | And 5 more authors.
Journal of Experimental and Clinical Cancer Research | Year: 2010

Background. The present study was undertaken to relate the co-expression of prostate-associated antigens, PSMA and PSA, with the degree of vascularization in normal and pathologic (hyperplasia and cancer) prostate tissues to elucidate their possible role in tumor progression. Methods. The study was carried out in 6 normal, 44 benign prostatic hyperplastic and 39 cancerous human prostates. Immunohistochemical analysis were performed using the monoclonal antibody CD34 to determine the angiogenic activity, and the monoclonal antibodies 3E6 and ER-PR8 to assess PSMA and PSA expression, respectively. Results. In our study we found that in normal prostate tissue, PSMA and PSA were equally expressed (3.7 0.18 and 3.07 0.11). A significant difference in their expression was see in hyperplastic and neoplastic prostates tissues (16.14 0.17 and 30.72 0.85, respectively) for PSMA and (34.39 0.53 and 17.85 1.21, respectively) for PSA. Study of prostate tumor profiles showed that the profile (PSA+, PSMA-) expression levels decreased between normal prostate, benign prostatic tissue and primary prostate cancer. In the other hand, the profile (PSA-, PSMA+) expression levels increased from normal to prostate tumor tissues. PSMA overexpression was associated with high intratumoral angiogenesis activity. By contrast, high PSA expression was associated with low angiogenesis activity. Conclusion. These data suggest that these markers are regulated differentially and the difference in their expression showed a correlation with malignant transformation. With regard to the duality PSMA-PSA, this implies the significance of their investigation together in normal and pathologic prostate tissues. © 2010 Ben Jemaa et al; licensee BioMed Central Ltd. Source


Kouki S.,Military Hospital of Tunis
BMJ case reports | Year: 2013

Spontaneous pneumomediastinum and subcutaneous emphysema (Hamman's syndrome) are rare but potentially dangerous complications of labour. The authors reported a case of a 23-year-old primigravida, admitted to our hospital for delivery after 40 weeks of pregnancy. She delivered a baby of 4.27 kg after 9 h from the start of labour. A few minutes after delivery, the patient developed dyspnoea and chest tightness, which made her doctor suspect pulmonary embolism. A chest X-ray and CT scan revealed pneumomediastinum and subcutaneous emphysema. The patient had been followed up for 3 days in our hospital, without specific therapy. Source


Malek R.,Ferhat Abbas University Setif | Ajili F.,Military Hospital of Tunis | Assaad-Khalil S.H.,Alexandria University | Shinde A.,Novo Nordisk AS | And 2 more authors.
Diabetes and Metabolism | Year: 2015

Objective: This study aimed to demonstrate the non-inferiority of 50-week treatment with stepwise insulin intensification of basal-bolus insulin analogues [insulin detemir (IDet) and aspart (IAsp)] versus biphasic insulin aspart 30 (BIAsp30) in insulin-naive type 2 diabetes mellitus (T2DM) patients not controlled by oral glucose-lowering drugs (OGLDs). Research design and methods: In this open-label multicentre, multinational, randomized, parallel-arm treat-to-target trial, 403 insulin-naive patients with T2DM in four African countries were randomized to either an IDet+IAsp (n=200) or BIAsp1-2-3 (n=203) treatment group. Stepwise insulin intensification was performed at the end of 14, 26 and 38weeks, depending on HbA1c values. The primary endpoint was change in HbA1c after 50weeks of treatment. Safety variables were hypoglycaemia incidence, occurrence of adverse events and weight gain. Results: Non-inferiority of the IDet+IAsp versus BIAsp1-2-3 treatment regimen was demonstrated by their similar HbA1c levels at the end of trial (IDet+IAsp: baseline 8.6%, 50 weeks 7.4%; BIAsp1-2-3: baseline 8.7%, 50 weeks 7.3%; full analysis set difference: 0.1% [95%CI: -0.1, 0.3]; per protocol: 0.2% [95%CI: -0.1, 0.4]). At week 50, 40.3 and 44.9% of patients achieved HbA1c <7.0% with IDet+IAsp and BIAsp1-2-3, respectively. The rate of overall hypoglycaemia during the trial was also similar in both groups (IDet+IAsp: 9.4 events/patient-year; BIAsp1-2-3: 9.8 events/patient-year). Conclusion: Insulin initiation and intensification using IDet+IAsp was not inferior to BIAsp1-2-3 in insulin-naive patients with T2DM not controlled by OGLDs. Both regimens led to similar reductions in HbA1c values after 50 weeks of treatment. © 2014 Elsevier Masson SAS. Source


Oudi M.E.,Research Unit UR 09DN02 | Bouguerra C.,Military Hospital of Tunis | Aouni Z.,Research Unit UR 09DN02 | Mazigh C.,Research Unit UR 09DN02 | And 2 more authors.
Annales de Biologie Clinique | Year: 2011

Recently, homocysteine and newinflamatory biomarkers are demonstrated to be involved in cardiovascular diseases. These risk factors are not well studied in acute coronary syndrome. We investigated the distribution of homocysteine and inflammatory markers in patients with acute coronary syndrome and evaluated the association between these parameters and severity of the disease. One hundred and twenty-two patients with acute coronary syndrome were recruited in the cardiac intensive unit care of military hospital of Tunis. Classic risk factors, lipid parameters, total homocysteine, HsCRP, IL-6 and TNF-α were determined for all participants. We investigated the distribution of these parameters according to the number of diseased vessels in patients with acute coronary syndrome. Patients with three affected vessels showed significant elevated homocysteine, HsCRP, IL-6, TNF-α, total cholesterol, LDL-cholesterol and Lp (a) compared to those with one and those with two affected vessels. Homocysteine (OR = 1.14; 95%IC: 1.04-1.25; P = 0.006), TNF-α (OR = 1.27; 95%IC: 1.13-1.44; P=10-3), HsCRP (OR = 1.09; 95%IC:1.03-1.16; P = 0.005) and IL-6 (OR = 1.15; 95%IC: 1.06-1.25; P = 0.001) were significant predictors of severity of the disease. We conclude that homocysteine and inflammatory biomarkers appear to enhance the degree of affected arteries and so the severity of coronary artery disease. Source


Kouki S.,Military Hospital of Tunis | Fares A.A.,CHU Sint Pierre Brussels
BMJ Case Reports | Year: 2013

Spontaneous pneumomediastinum and subcutaneous emphysema (Hamman's syndrome) are rare but potentially dangerous complications of labour. The authors reported a case of a 23-year-old primigravida, admitted to our hospital for delivery after 40 weeks of pregnancy. She delivered a baby of 4.27 kg after 9 h from the start of labour. A few minutes after delivery, the patient developed dyspnoea and chest tightness, which made her doctor suspect pulmonary embolism. A chest X-ray and CT scan revealed pneumomediastinum and subcutaneous emphysema. The patient had been followed up for 3 days in our hospital, without specific therapy. Copyright 2013 BMJ Publishing Group. All rights reserved. Source

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