A cardiac hydatid cyst underlying pulmonary embolism: a case report

Hydatid cysts located in the interatrial septum are especially rare but when they occur, they might cause intracavity rupture. We report on a patient with acute pulmonary embolism caused by an isolated, ruptured hydatid cyst on the right side of the interatrial septum. A 16-year-old-boy with an uneventful history was hospitalized for exercise-induced dyspnea and blood expectorations. Multiple and bilateral opacities were visualized on standard chest x-ray. Signs of right-sided hypertrophy were seen on ECG. Imaging findings led to the diagnosis of pulmonary embolism complicating cardiac hydatid cysts. An operation was performed through median sternotomy to remove the cardiac cyst. The pleural cavity was entered through the fifth intercostal space to withdraw lung hydatid cysts. Operative recovery was uneventful and the patient resumed his normal activities 19 months later. Prompt diagnosis and an appropriate surgical treatment prevented a potentially fatal outcome.Key words: Echinococcosis, Hydatidosis, Pulmonary embolism, cardiac, hydatid cys

Patterns and Characteristics of Children with Developmental Dysplasia of the Hip Treated in Saudi Arabia: Data from the National Saudi Program for Developmental Dysplasia of the Hip

The National Hip Dysplasia Program (NHDP) was launched in December 2016 to treat children with developmental dysplasia of the hip (DDH) in Saudi Arabia; however, its outcomes have not been examined or published yet. Therefore, our aim in this study was to report the findings of this unique program. In this retrospective study design, we included data of patients with DDH who received interventions provided by the NHDP, from two major Saudi regions (Northern Borders and Al-Jouf regions), from April 2017 to February 2021. Outcomes reported included age at first surgery, sex, involved side, interventions provided, and recurrence rates for failed surgeries. Independent t -tests compared age differences between Northern Borders region and Al-Jouf region, whereas chi-square tests determined the differences between Northern Borders region and Al-Jouf region regarding sex and the involved side of DDH distributions. Out of 404 children with DDH, 300 (82.3% were females and 17.7% were males) were included and were first seen at the age of 20 months in the Northern Borders region and at the age of 22 months in Al-Jouf region. We found a significant difference in the number of bilateral DDH cases between the Northern Borders ( n = 129; 70.1%) and Al-Jouf ( n = 59; 51.0%) ( P = 0.003) regions. In the Northern Borders region, the majority of children with unilateral DDH were treated by open reduction (right side = 40.7%; left side = 60.7%), with recurrence rates of 14.8% for the right side and 7.1% for left side. In the Al-Jouf region, the majority of children with unilateral DDH were treated by femoral shortening with graft (right side = 69.2%; left side = 54.9%), with a recurrence rate of 7.7% for the right-sided DDH. More than half of the children with bilateral DDH underwent operations for both sides (Northern Borders region = 62.0%; Al-Jouf region = 57.9%). The study provides a detailed analysis of DDH among children in the Northern Borders and Al-Jouf regions, highlighting significant regional differences in both the prevalence and treatment outcomes. Future studies need to develop strategies to prevent and minimize potential long-term effects of DDH

Sleep Habits and Disturbances Among Tunisian Adults: A Cross-Sectional Online Survey [Response to Letter]

Sameh Msaad,1 Nouha Ketata,2 Nesrine Kammoun,3 Rahma Gargouri,1 Rim Khemekhem,1 Sourour Abid,1 Saeb Bader,1 Sabrine Efidha,4 Narjes Abid,5 Jamel EL Ghoul,6 Imen Sahnoun,4 Hazem Altalaa,1 Jihene Jdidi,2 Mohamed Jlidi,7 Nadia Keskes Boudaouara,8 Imen Gargouri,9 Najla Bahloul,1 Samy Kammoun1 1Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 2Department of Preventive Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 3Tunisian Occupational Health and Safety Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 4Department of Pneumology, Abderrahman Mami University Hospital of Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 5Department of Pneumology, Mohamed Taher Maamouri University Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 6Department of Pneumology, Habib Bourguiba University Hospital of Mednine, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 7Orthopedics and Traumatology Department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis EL Manar, Tunis, Tunisia; 8Department of Pneumology, Taher Sfar University Hospital of Mahdia, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia; 9Department of Pneumology, Farhat Hached University Hospital of Sousse, Faculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaCorrespondence: Sameh Msaad, Email [email protected]

Chronic Obstructive Pulmonary Disease and Lung Cancer: Underlying Pathophysiology and New Therapeutic Modalities

Chronic obstructive pulmonary disease (COPD) and lung cancer are major lung diseases affecting millions worldwide. Both diseases have links to cigarette smoking and exert a considerable societal burden. People suffering from COPD are at higher risk of developing lung cancer than those without, and are more susceptible to poor outcomes after diagnosis and treatment. Lung cancer and COPD are closely associated, possibly sharing common traits such as an underlying genetic predisposition, epithelial and endothelial cell plasticity, dysfunctional inflammatory mechanisms including the deposition of excessive extracellular matrix, angiogenesis, susceptibility to DNA damage and cellular mutagenesis. In fact, COPD could be the driving factor for lung cancer, providing a conducive environment that propagates its evolution. In the early stages of smoking, body defences provide a combative immune/oxidative response and DNA repair mechanisms are likely to subdue these changes to a certain extent; however, in patients with COPD with lung cancer the consequences could be devastating, potentially contributing to slower postoperative recovery after lung resection and increased resistance to radiotherapy and chemotherapy. Vital to the development of new-targeted therapies is an in-depth understanding of various molecular mechanisms that are associated with both pathologies. In this comprehensive review, we provide a detailed overview of possible underlying factors that link COPD and lung cancer, and current therapeutic advances from both human and preclinical animal models that can effectively mitigate this unholy relationship

Detecting falls and estimation of daily habits with depth images using machine learning algorithms

International audienceDifferent approaches have been proposed in the literature to detect the fall of an elderly person. In this paper, we propose a fall detection method based on the classification of parameters extracted from depth images. Three supervised learning methods are compared: decision tree, K-Nearest Neighbors (K-NN) and Random Forests (RF). The methods have been tested on a database of depth images recorded in a nursing home over a period of 43 days. The Random Forests based method yields the best results, achieving 93% sensitivity and 100% specificity when we restrict our study around the bed. Furthermore, this paper also proposes a 37 days follow-up of the person, to try and estimate his or her daily habits. © 2020 IEEE

The Arabic Version of the Tegner Activity Scale in Patients with Anterior Cruciate Ligament Reconstruction: Translation, Validation, and Cross-Cultural Adaptation

Background: The Tegner activity scale is a patient-reported questionnaire that is frequently used to measure activity levels in patients with anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to translate, cross-culturally adapt, and validate the Tegner activity scale into Arabic. Methods: The Tegner activity scale–Arabic version (TAS-Ar) was forward and backward translated, cross-culturally adapted, and validated according to established guidelines. Seventy-five patients who underwent ACLR were instructed to complete the TAS-Ar, the International Knee Documentation Committee (IKDC) subjective knee evaluation form, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) scale. The test-retest reliability of the TAS-Ar was assessed in 39 patients. Statistical tests were conducted to test the reliability and construct validity of the TAS-Ar. Results: The TAS-Ar showed excellent test-retest reliability, with intraclass correlation coefficients of 0.836 (p &lt; 0.001). The TAS-Ar was significantly correlated with the IKDC (Spearman’s rho = 0.476, p &lt; 0.001), all KOOS subscales (Spearman’s rho = 0.195–0.497, p &lt; 0.05), and the KOOS total score (Spearman’s rho = 0.469, p &lt; 0.001). Conclusions: The Arabic version of the Tegner activity scale is a reliable and valid measure that can be used to evaluate the activity level of Arabic-speaking patients following ACLR.</jats:p

Arabic Version of the Short Anterior Cruciate Ligament–Return to Sport After Injury Scale: Translation, Cross-cultural Adaptation, and Validation

Background: The short version of the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scale is a self-reported questionnaire developed to assess the psychological readiness of patients to return to sports after ACL reconstruction (ACLR). Purpose: To translate, cross-culturally adapt, and validate the short version of the ACL-RSI scale into the Arabic language (ACL-RSI-Ar). Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The original short version of the ACL-RSI scale was forward and backward translated, cross-culturally adapted, and validated following international standardized guidelines. Sixty patients who participated in sports activities and underwent ACLR completed the ACL-RSI-Ar, the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and Knee injury and Osteoarthritis Outcome Score (KOOS) scales. To assess test-retest reliability, 34 participants completed the ACL-RSI-Ar scale twice. Statistical tests were conducted to test the internal consistency, reliability, and construct and discriminant validity of the ACL-RSI-Ar scale. Results: The ACL-RSI-Ar showed adequate internal consistency (Cronbach alpha = 0.734) and excellent test-retest reliability (intraclass correlation coefficient, 0.871). The ACL-RSI-Ar was strongly correlated with the IKDC (Spearman ρ = 0.515, P &lt; .001) and weakly to strongly correlated with all KOOS subscales (Spearman ρ = 0.247-0.590, P &lt; .05). Patients who returned to sports had significantly higher scores on the ACL-RSI-Ar scale when compared with those who did not return to sports ( P = .001). Conclusion: The short ACL-RSI-Ar scale, as translated, was internally consistent, reliable, and valid for evaluating psychological readiness to return to sports after ACLR in Arabic-speaking patients. </jats:sec

"STOP BANG" Questionnaire: Validity to Screen Obstructive Sleep Apnea Syndrome in North African Population

Background: The aim of this study was to validate the predictive value of the questionnaire "STOP BANG" in the detection of obstructive sleep apnea syndrome syndrome (OSAS) and to identify patients at high risk of OSASS in anesthesia consultation in North African population. Methods: Prospective clinical study, consecutive, about 759 patients proposed for elective surgery and enjoying a remote anesthesia consultation in H. Bourguiba hospital in Sfax, Tunisia. Included patients answered the questionnaire "STOP BANG". Patients with a score below 3 are considered low risk and represent the group (1). Patients with a score greater than or equal to 3 are considered high risk and represented the group (2). All patients were investigated by ventilator polygraphy to confirm the diagnosis of obstructive apnea syndrome. The apnea hypopnea index (AHI) greater than or equal to 5 confirmed the diagnosis of OSAS. Results: One hundred and fifty patients were included in the study. 41 patients had low risk of OSAS and represented the group (1) and 27.33% of included patients. 109 patients had high risk of OSAS and represented the group (2) and 72.66% of included patients. The diagnosis of OSAS was confirmed among 127 patients including 99 in the group (1) and 28 in the group (2). In our study results showed that the sensitivity of the score STOP BANG questionnaire was to the order of 87.1%, specificity was 47.8%, with positive and negative predictive values 90% and 40.74 respectively. The sensitivity of the questionnaire increased significantly with increasing AHI, it was 91.3% for IAH ≥ 15/H and 93.9% for AHI ≥ 30/H. Similarly, the predictive negative value of the questionnaire increased parallel with the increase in the AHI, it was 70.37% for AHI ≥ 15/H and 88.9% for AHI ≥ 30/H. Conclusion: The sensitivity, specificity, positive and negative predictive value vary by IAH and score STOP BANG. These results show that the STOP BANG questionnaire is a good simple screening tool, easy, particularly suitable for anesthesia consultation. The questionnaire has excellent sensitivity and specificity to identify patients at high risk of OSAS