Slaheddine Sellami - Academia.edu (original) (raw)
Papers by Slaheddine Sellami
Case Reports, Mar 24, 2011
Le Pied du diabetique est un pied a risque. L'assise plantaire dont l'examen sur podoscop... more Le Pied du diabetique est un pied a risque. L'assise plantaire dont l'examen sur podoscope recherche l'existence d'eventuels troubles statiques. Ceux-ci sont domines par le pied creux et surtout par les troubles statiques de l'avant pied. Ils sont a l'origine d'hyperpressions source d'hyperkeratose (durillon, cor). L'hyperkeratose fait le lit du mal perforant plantaire. L'osteoarthropathie diabetique est due a la neuropathie Le pied est indolore et deforme par les destructions osteo-articulaires. Le traitement des hyperkeratoses repose sur le port d'ortheses plantaires pour decharger les zones d'hyperpression.
La Tunisie médicale, 2012
Carpal tunnel syndrome (CTS) is the most frequent ductal syndrome. Few epidemiological studies in... more Carpal tunnel syndrome (CTS) is the most frequent ductal syndrome. Few epidemiological studies in Tunisia exist. To describe clinical, biological and electromyographic data of Tunisian patients with CTS METHODS: A retrospective study including 80 patients with CTS, during the period going from 2009 to 2010. A female predominance was observed with an average age of 52 years. Acroparesthesia was the main complaint, followed by night awakenings and muscular weakness. Physical examination showed a positive Tinel (91.2%) and Phalen (82.5%) tests, a decrease of tactile sensitivity (26.2%) and a thenar amyotrophy (10%). The Electromyography was abnormal in 85% cases. The most revealing lesions were demyelinating, sensitivo-motor predominance (66%) abnormalities. on Biology, hyperglycemia (12.5%), hyperuricemia (8.7%) and renal failure (7.5%) were the most observed. Medical treatment was drawn on analgesics and anti-inflammatory for 90% of our patients. Local steroid injections were indicat...
La Tunisie médicale, 2006
The study was aimed to evaluate the frequency and types of articular manifestations in a group of... more The study was aimed to evaluate the frequency and types of articular manifestations in a group of Crohn's disease patients, and to determine the risk factors. We included 68 Crohn's disease patients. All patients had a complete rheumatological examination. Radiographs of the sacroiliac joints and lumbar spine were performed. 40 men and 28 women with a mean age of 31 years were included. Articular manifestations were observed in 41 patients. Twenty two patients suffered of peripheral articular manifestations: arthralgias in 18 patients and arthritis in 10 cases. Peripheral articular manifestation were significatly associated to ileal location of intestinal disease. Their frequency was of 41.3% in ileal location group versus 13.6% in colic location group (p = 0.02). Axial manifestations were observed in 32 patients: ankylosing spondylitis was diagnosed in 11 cases, undifferentiated spondylarthropathy in 7 patients, sacroiliitis in 10 cases, inflammatory back pain in 3 patients...
Climacteric, 2015
Objectives Osteopenia is characterized by intermediate values of bone mineral density (BMD) as co... more Objectives Osteopenia is characterized by intermediate values of bone mineral density (BMD) as compared to normal and osteoporotic subjects. BMD, a surrogate phenotype for osteoporosis, is influenced in part by genetic factors. Among the genes associated with BMD, the vitamin D receptor (VDR) was the first gene studied as a potential candidate associated with BMD in adult and postmenopausal bone loss. However, results are controversial. Methods To determine whether VDR polymorphisms ApaI and TaqI are associated with BMD, osteopenia, osteoporosis and low-impact fracture risk in North Africans, these genotypes were analyzed in 566 postmenopausal Tunisian women. Results In postmenopausal Tunisian women, the GT ApaI genotype seems to be protective against osteoporosis development (p = 0.02; odds ratio = 0.54). Moreover, the presence of the combined GT/TT genotype of ApaI and TaqI polymorphisms is more frequent in normal BMD women than in osteoporotic women (p = 0.00; odds ratio = 0.41). Interestingly, the GG ApaI genotype is associated with osteopenia development (p = 0.02; odds ratio = 1.86) and also the TT TaqI polymorphism (p = 0.02; odds ratio = 1.53). The GG ApaI genotype is associated with a three times risk of vertebral fracture. Conclusions The ApaI polymorphism showed an association with osteopenia and low-impact vertebral fracture incidence but not with osteoporosis. The TaqI polymorphism is associated specifically with the osteopenia phenotype. The presence of the two polymorphisms increases the risk to develop osteopenia in postmenopausal Tunisian women. Osteopenia seems to be genetically determined. However, osteoporosis is the result of interaction between genetic and environmental factors.
Revue du Rhumatisme, 2008
Resume L’association de certaines connectivites, telles que la polyarthrite rhumatoide ou la poly... more Resume L’association de certaines connectivites, telles que la polyarthrite rhumatoide ou la polymyosite aux cancers, est connue. La survenue de neoplasie au cours de l’evolution d’une maladie de Behcet (MB) est en revanche rare. Nous rapportons une nouvelle observation d’un lymphome associe a une MB et nous discutons l’etiopathogenie d’une telle association. Un patient âge de 46 ans suivi depuis 14 ans pour une MB (criteres internationaux) avec des aphtes refractaires traites par dapsone, a presente en decembre 2003 un lymphome malin non Hodgkinien B de l’amygdale droite. Le patient a ete traite par trois cures de chimiotherapie associees a une radiotherapie (45 Gy) amenant une disparition totale de la tumeur. Il est actuellement en remission avec un recul de quatre ans.
Climacteric, Apr 28, 2017
Biotechnic and Histochemistry, 2009
The Notch family is involved in cell differentiation during embryogenesis. Osteoarthritic chondro... more The Notch family is involved in cell differentiation during embryogenesis. Osteoarthritic chondrocytes undergo morphological and biochemical changes leading to the de-differentiation process. In the study reported here, we were interested in the involvement of the Notch pathway in murine articular chondrocyte de-differentiation. Articular chondrocytes were subjected to several cell culture passages and treated with or without a Notch inhibitor, N-[N-(3,5-difl uorophenacetyl-L-alanyl)]-S-phenylglycine t-Butyl Ester (DAPT). Chondrocyte morphology was studied using optical microscopy. Immunocytochemistry and immunoblot were performed to study the expression of collagens and Notch family members. Without DAPT treatment, chondrocyte de-differentiation resulted in fi broblast-like morphology. This was confi rmed by immunocytochemical staining and immunoblot analysis, which showed an increase in collagen type I (col I) and a decrease in collagen type II (col II) expression. With DAPT treatment, de-differentiation was delayed. Immunocytochemistry and immunoblot analysis showed during the fi rst passages inhibition of col II expression, which then was re-instituted during the last passage, suggesting chondrocyte re-differentiation. In the study reported here, we showed that inhibition of the Notch receptor not only delayed the de-differentiation process, but also chondrocyte re-differentiation, which confi rms the involvement of the Notch pathway in chondrocyte de-differentiation.
PubMed, Dec 1, 2011
Background: Rheumatic manifestations of genetic hemochromatosis are frequent with axial or periph... more Background: Rheumatic manifestations of genetic hemochromatosis are frequent with axial or peripheral arthropathies (mono-, oligo- or polyarticular). These manifestations are characterized by articular damage and osteoporosis. Aim: To review the rheumatic manifestations of genetic hemochromatosis. Methods: A narrative review of literature. Results: The diagnosis should be brought to mind when we discover arthropathy resembling degenerative joint disease with involvement of unusual articular sites, almost identical to the arthropathy in calcium pyrophosphate dihydrate crystals deposition disease (chondrocalcinosis). Conclusion: There is a significant bone loss in HC that cannot solely be explained by hypogonadism or cirrhosis and must lead to measure bone mass density to each patient with HC.
Revue du Rhumatisme, Nov 1, 2006
PubMed, Feb 1, 2012
Background: Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often l... more Background: Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often late. MRI detects erosions at an early stage and visualizes synovitis, bone edema and tenosynovitis. Aim: To assess the value of MRI for diagnosis of early forms of rheumatoid arthritis. Methods: Prospective study involving 20 patients who had non erosive rheumatoid arthritis lasting for less than 2 years. MRI of the hand was performed by sequences coronal and axial T1-weighted, T2 with saturated fat signal (FatSat) FatSat and T1 with gadolinium injection. Results: The median age of patients was 52 years and sex ratio M/F of 0.05. The median disease duration was 9 months. Ten patients had antibodies Anti-Cyclic citrullinated protein positive. The MRI was abnormal in 75% of patients. This review found 36 erosions which 50% were in carpal bones, 55 joints with synovitis mainly localized midcarpal and metacarpophalangeal. Bone edema was found mainly in carpal bones. Tenosynovitis affected most frequently the flexor tendons. Seventy percent of patients without anti-Cyclic citrullinated protein had a pathological MRI. Conclusion: MRI has an important role in detecting infraradiological lesions in early RA. This contributes to early diagnosis and initiation effective treatment.
Case Reports, Feb 2, 2011
BACKGROUND Sweet's syndrome (SS) is the most common neutrophilic dermatosis (ND). It is most ofte... more BACKGROUND Sweet's syndrome (SS) is the most common neutrophilic dermatosis (ND). It is most often idiopathic but may be associated with a wide range of diseases, especially malignant conditions, infectious diseases or infl ammatory diseases. CASE PRESENTATION We report the case of a 28-year-old woman with a 2-year history of seropositive and destructive rheumatoid arthritis (RA) associated with a secondary Sjögren's syndrome, who was treated by methotrexate (15 mg/week) and lowdose prednisone (5 mg/day). She presented with a widespread cutaneous eruption that involved the face, trunk and four limbs, associated with fever, arthralgia, bilateral conjunctivitis and deterioration of general condition. This symptomatology occurs 5 days after a nasopharyngitis. Clinical examination objectifi ed the fever at 38.5°C and demonstrated well-demarcated erythematous papules, with centrifugal extension involving the face, arm, back Unusual association of diseases/symptoms
Revue de Médecine Interne, Aug 1, 2007
Introduction.-L'arthrose est la maladie articulaire la plus commune dans le monde. Avec le vieill... more Introduction.-L'arthrose est la maladie articulaire la plus commune dans le monde. Avec le vieillissement progressif de la population, elle devient un problème majeur de santé publique. Il s'agit d'une affection dégénérative caractérisée par un ensemble de désordres aboutissant à un défaut structural et fonctionnel d'une ou de plusieurs articulations. Actualités et points forts.-Dans cette revue, nous nous intéressons aux principaux mécanismes inflammatoires touchant le cartilage articulaire au cours de l'arthrose primaire. Nous présentons aussi quelques facteurs de prédisposition dont l'implication dans la pathogenèse de cette maladie a été formellement établie tel que l'âge, la surcharge pondérale ou les facteurs génétiques. En effet, l'arthrose est le résultat d'un déséquilibre entre les processus de dégradation et les tentatives de réparation élaborées par le chondrocyte qui est le seul type cellulaire présent au niveau du cartilage. Les phénomènes de dégradation observés sont le résultat de l'action de plusieurs substances chimiques telles que des enzymes protéolytiques (les métalloprotéases) et des cytokines pro-inflammatoires essentiellement représentées par l'interleukine 1β. Face à ces processus de dégradation, le chondrocyte va entamer des tentatives de réparation en secrétant des facteurs de croissance (transforming growth factor et insulin growth factor) ou des cytokines à action anti-inflammatoire (interleukines 4 et 10) mais n'arrive pas à contrecarrer la réponse catabolique aboutissant aux modifications observées au niveau du cartilage arthrosique. Perspectives.-Une meilleure compréhension de la physiopathologie de l'arthrose permettra une meilleure prise en charge de cette maladie fréquente et invalidante.
La Tunisie médicale, 2013
The physical activity during adolescence seems to correlate with bone mass at the end of the grow... more The physical activity during adolescence seems to correlate with bone mass at the end of the growth period. aim : To determine the effect of handball regularly practiced by teenage girls on the anthropometric parameters and bone mineral density. Cross-sectional case-control, made in the rheumatology department of the Rabta hospital, has enrolled adolescent handball players of high level, which were compared to a control group matched by age and sex, but sedentary. We evaluated our two groups for anthropometric parameters and BMD. The lean mass (LM), fat mass (FM), the mean values of BMD at the lumbar spine and femur of our sports were significantly higher than that of sedentary controls. On bone mineral content (BMC), a statistically significant difference was observed between groups of sedentary and athletic teenagers. Positive and significant correlations were found between anthropometric parameters and measurements of BMD, BMC and of bone area. The regular practice of handball se...
La Tunisie médicale, 2003
Palmar fasciitis and arthritis was reported in association with several neoplasms and in particul... more Palmar fasciitis and arthritis was reported in association with several neoplasms and in particular with the cancers of the ovary. We report the case of a 37 year old patient who was hospitalized in our service for investigation of sever palmar fasciitis and to whom various investigations allowed to make the diagnosis of a light chains myeloma. Through the study of the various cases of the literature, we remind the various characteristics of this syndrome.
Bulletin de la Société de pathologie exotique (1990), 2002
It is a retrospective study, reviewing all cases of vertebral tuberculosis recorded between 1989 ... more It is a retrospective study, reviewing all cases of vertebral tuberculosis recorded between 1989 and 1999 in La Rabta Hospital (Tunis). 29 patients have been included whose average age was 49 years. The main symptoms which appeared within a average period of six months were vertebral pain, associated with fever in half of the cases. The diagnosis of infectious spondylitis was made according to the results of Computer tomography in 26 cases. The diagnosis of infection was confirmed by characteristic histological pattern and/or culture biopsy. 27 patients were cured without complications except for 2 of them who developed a spinal cord compression. This complication was quickly stemmed by steroid therapy.
Revue du Rhumatisme, 2006
La Tunisie médicale, 2010
Case Reports, Mar 24, 2011
Le Pied du diabetique est un pied a risque. L'assise plantaire dont l'examen sur podoscop... more Le Pied du diabetique est un pied a risque. L'assise plantaire dont l'examen sur podoscope recherche l'existence d'eventuels troubles statiques. Ceux-ci sont domines par le pied creux et surtout par les troubles statiques de l'avant pied. Ils sont a l'origine d'hyperpressions source d'hyperkeratose (durillon, cor). L'hyperkeratose fait le lit du mal perforant plantaire. L'osteoarthropathie diabetique est due a la neuropathie Le pied est indolore et deforme par les destructions osteo-articulaires. Le traitement des hyperkeratoses repose sur le port d'ortheses plantaires pour decharger les zones d'hyperpression.
La Tunisie médicale, 2012
Carpal tunnel syndrome (CTS) is the most frequent ductal syndrome. Few epidemiological studies in... more Carpal tunnel syndrome (CTS) is the most frequent ductal syndrome. Few epidemiological studies in Tunisia exist. To describe clinical, biological and electromyographic data of Tunisian patients with CTS METHODS: A retrospective study including 80 patients with CTS, during the period going from 2009 to 2010. A female predominance was observed with an average age of 52 years. Acroparesthesia was the main complaint, followed by night awakenings and muscular weakness. Physical examination showed a positive Tinel (91.2%) and Phalen (82.5%) tests, a decrease of tactile sensitivity (26.2%) and a thenar amyotrophy (10%). The Electromyography was abnormal in 85% cases. The most revealing lesions were demyelinating, sensitivo-motor predominance (66%) abnormalities. on Biology, hyperglycemia (12.5%), hyperuricemia (8.7%) and renal failure (7.5%) were the most observed. Medical treatment was drawn on analgesics and anti-inflammatory for 90% of our patients. Local steroid injections were indicat...
La Tunisie médicale, 2006
The study was aimed to evaluate the frequency and types of articular manifestations in a group of... more The study was aimed to evaluate the frequency and types of articular manifestations in a group of Crohn's disease patients, and to determine the risk factors. We included 68 Crohn's disease patients. All patients had a complete rheumatological examination. Radiographs of the sacroiliac joints and lumbar spine were performed. 40 men and 28 women with a mean age of 31 years were included. Articular manifestations were observed in 41 patients. Twenty two patients suffered of peripheral articular manifestations: arthralgias in 18 patients and arthritis in 10 cases. Peripheral articular manifestation were significatly associated to ileal location of intestinal disease. Their frequency was of 41.3% in ileal location group versus 13.6% in colic location group (p = 0.02). Axial manifestations were observed in 32 patients: ankylosing spondylitis was diagnosed in 11 cases, undifferentiated spondylarthropathy in 7 patients, sacroiliitis in 10 cases, inflammatory back pain in 3 patients...
Climacteric, 2015
Objectives Osteopenia is characterized by intermediate values of bone mineral density (BMD) as co... more Objectives Osteopenia is characterized by intermediate values of bone mineral density (BMD) as compared to normal and osteoporotic subjects. BMD, a surrogate phenotype for osteoporosis, is influenced in part by genetic factors. Among the genes associated with BMD, the vitamin D receptor (VDR) was the first gene studied as a potential candidate associated with BMD in adult and postmenopausal bone loss. However, results are controversial. Methods To determine whether VDR polymorphisms ApaI and TaqI are associated with BMD, osteopenia, osteoporosis and low-impact fracture risk in North Africans, these genotypes were analyzed in 566 postmenopausal Tunisian women. Results In postmenopausal Tunisian women, the GT ApaI genotype seems to be protective against osteoporosis development (p = 0.02; odds ratio = 0.54). Moreover, the presence of the combined GT/TT genotype of ApaI and TaqI polymorphisms is more frequent in normal BMD women than in osteoporotic women (p = 0.00; odds ratio = 0.41). Interestingly, the GG ApaI genotype is associated with osteopenia development (p = 0.02; odds ratio = 1.86) and also the TT TaqI polymorphism (p = 0.02; odds ratio = 1.53). The GG ApaI genotype is associated with a three times risk of vertebral fracture. Conclusions The ApaI polymorphism showed an association with osteopenia and low-impact vertebral fracture incidence but not with osteoporosis. The TaqI polymorphism is associated specifically with the osteopenia phenotype. The presence of the two polymorphisms increases the risk to develop osteopenia in postmenopausal Tunisian women. Osteopenia seems to be genetically determined. However, osteoporosis is the result of interaction between genetic and environmental factors.
Revue du Rhumatisme, 2008
Resume L’association de certaines connectivites, telles que la polyarthrite rhumatoide ou la poly... more Resume L’association de certaines connectivites, telles que la polyarthrite rhumatoide ou la polymyosite aux cancers, est connue. La survenue de neoplasie au cours de l’evolution d’une maladie de Behcet (MB) est en revanche rare. Nous rapportons une nouvelle observation d’un lymphome associe a une MB et nous discutons l’etiopathogenie d’une telle association. Un patient âge de 46 ans suivi depuis 14 ans pour une MB (criteres internationaux) avec des aphtes refractaires traites par dapsone, a presente en decembre 2003 un lymphome malin non Hodgkinien B de l’amygdale droite. Le patient a ete traite par trois cures de chimiotherapie associees a une radiotherapie (45 Gy) amenant une disparition totale de la tumeur. Il est actuellement en remission avec un recul de quatre ans.
Climacteric, Apr 28, 2017
Biotechnic and Histochemistry, 2009
The Notch family is involved in cell differentiation during embryogenesis. Osteoarthritic chondro... more The Notch family is involved in cell differentiation during embryogenesis. Osteoarthritic chondrocytes undergo morphological and biochemical changes leading to the de-differentiation process. In the study reported here, we were interested in the involvement of the Notch pathway in murine articular chondrocyte de-differentiation. Articular chondrocytes were subjected to several cell culture passages and treated with or without a Notch inhibitor, N-[N-(3,5-difl uorophenacetyl-L-alanyl)]-S-phenylglycine t-Butyl Ester (DAPT). Chondrocyte morphology was studied using optical microscopy. Immunocytochemistry and immunoblot were performed to study the expression of collagens and Notch family members. Without DAPT treatment, chondrocyte de-differentiation resulted in fi broblast-like morphology. This was confi rmed by immunocytochemical staining and immunoblot analysis, which showed an increase in collagen type I (col I) and a decrease in collagen type II (col II) expression. With DAPT treatment, de-differentiation was delayed. Immunocytochemistry and immunoblot analysis showed during the fi rst passages inhibition of col II expression, which then was re-instituted during the last passage, suggesting chondrocyte re-differentiation. In the study reported here, we showed that inhibition of the Notch receptor not only delayed the de-differentiation process, but also chondrocyte re-differentiation, which confi rms the involvement of the Notch pathway in chondrocyte de-differentiation.
PubMed, Dec 1, 2011
Background: Rheumatic manifestations of genetic hemochromatosis are frequent with axial or periph... more Background: Rheumatic manifestations of genetic hemochromatosis are frequent with axial or peripheral arthropathies (mono-, oligo- or polyarticular). These manifestations are characterized by articular damage and osteoporosis. Aim: To review the rheumatic manifestations of genetic hemochromatosis. Methods: A narrative review of literature. Results: The diagnosis should be brought to mind when we discover arthropathy resembling degenerative joint disease with involvement of unusual articular sites, almost identical to the arthropathy in calcium pyrophosphate dihydrate crystals deposition disease (chondrocalcinosis). Conclusion: There is a significant bone loss in HC that cannot solely be explained by hypogonadism or cirrhosis and must lead to measure bone mass density to each patient with HC.
Revue du Rhumatisme, Nov 1, 2006
PubMed, Feb 1, 2012
Background: Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often l... more Background: Diagnosing early rheumatoid arthritis is difficult and radiographic signs are often late. MRI detects erosions at an early stage and visualizes synovitis, bone edema and tenosynovitis. Aim: To assess the value of MRI for diagnosis of early forms of rheumatoid arthritis. Methods: Prospective study involving 20 patients who had non erosive rheumatoid arthritis lasting for less than 2 years. MRI of the hand was performed by sequences coronal and axial T1-weighted, T2 with saturated fat signal (FatSat) FatSat and T1 with gadolinium injection. Results: The median age of patients was 52 years and sex ratio M/F of 0.05. The median disease duration was 9 months. Ten patients had antibodies Anti-Cyclic citrullinated protein positive. The MRI was abnormal in 75% of patients. This review found 36 erosions which 50% were in carpal bones, 55 joints with synovitis mainly localized midcarpal and metacarpophalangeal. Bone edema was found mainly in carpal bones. Tenosynovitis affected most frequently the flexor tendons. Seventy percent of patients without anti-Cyclic citrullinated protein had a pathological MRI. Conclusion: MRI has an important role in detecting infraradiological lesions in early RA. This contributes to early diagnosis and initiation effective treatment.
Case Reports, Feb 2, 2011
BACKGROUND Sweet's syndrome (SS) is the most common neutrophilic dermatosis (ND). It is most ofte... more BACKGROUND Sweet's syndrome (SS) is the most common neutrophilic dermatosis (ND). It is most often idiopathic but may be associated with a wide range of diseases, especially malignant conditions, infectious diseases or infl ammatory diseases. CASE PRESENTATION We report the case of a 28-year-old woman with a 2-year history of seropositive and destructive rheumatoid arthritis (RA) associated with a secondary Sjögren's syndrome, who was treated by methotrexate (15 mg/week) and lowdose prednisone (5 mg/day). She presented with a widespread cutaneous eruption that involved the face, trunk and four limbs, associated with fever, arthralgia, bilateral conjunctivitis and deterioration of general condition. This symptomatology occurs 5 days after a nasopharyngitis. Clinical examination objectifi ed the fever at 38.5°C and demonstrated well-demarcated erythematous papules, with centrifugal extension involving the face, arm, back Unusual association of diseases/symptoms
Revue de Médecine Interne, Aug 1, 2007
Introduction.-L'arthrose est la maladie articulaire la plus commune dans le monde. Avec le vieill... more Introduction.-L'arthrose est la maladie articulaire la plus commune dans le monde. Avec le vieillissement progressif de la population, elle devient un problème majeur de santé publique. Il s'agit d'une affection dégénérative caractérisée par un ensemble de désordres aboutissant à un défaut structural et fonctionnel d'une ou de plusieurs articulations. Actualités et points forts.-Dans cette revue, nous nous intéressons aux principaux mécanismes inflammatoires touchant le cartilage articulaire au cours de l'arthrose primaire. Nous présentons aussi quelques facteurs de prédisposition dont l'implication dans la pathogenèse de cette maladie a été formellement établie tel que l'âge, la surcharge pondérale ou les facteurs génétiques. En effet, l'arthrose est le résultat d'un déséquilibre entre les processus de dégradation et les tentatives de réparation élaborées par le chondrocyte qui est le seul type cellulaire présent au niveau du cartilage. Les phénomènes de dégradation observés sont le résultat de l'action de plusieurs substances chimiques telles que des enzymes protéolytiques (les métalloprotéases) et des cytokines pro-inflammatoires essentiellement représentées par l'interleukine 1β. Face à ces processus de dégradation, le chondrocyte va entamer des tentatives de réparation en secrétant des facteurs de croissance (transforming growth factor et insulin growth factor) ou des cytokines à action anti-inflammatoire (interleukines 4 et 10) mais n'arrive pas à contrecarrer la réponse catabolique aboutissant aux modifications observées au niveau du cartilage arthrosique. Perspectives.-Une meilleure compréhension de la physiopathologie de l'arthrose permettra une meilleure prise en charge de cette maladie fréquente et invalidante.
La Tunisie médicale, 2013
The physical activity during adolescence seems to correlate with bone mass at the end of the grow... more The physical activity during adolescence seems to correlate with bone mass at the end of the growth period. aim : To determine the effect of handball regularly practiced by teenage girls on the anthropometric parameters and bone mineral density. Cross-sectional case-control, made in the rheumatology department of the Rabta hospital, has enrolled adolescent handball players of high level, which were compared to a control group matched by age and sex, but sedentary. We evaluated our two groups for anthropometric parameters and BMD. The lean mass (LM), fat mass (FM), the mean values of BMD at the lumbar spine and femur of our sports were significantly higher than that of sedentary controls. On bone mineral content (BMC), a statistically significant difference was observed between groups of sedentary and athletic teenagers. Positive and significant correlations were found between anthropometric parameters and measurements of BMD, BMC and of bone area. The regular practice of handball se...
La Tunisie médicale, 2003
Palmar fasciitis and arthritis was reported in association with several neoplasms and in particul... more Palmar fasciitis and arthritis was reported in association with several neoplasms and in particular with the cancers of the ovary. We report the case of a 37 year old patient who was hospitalized in our service for investigation of sever palmar fasciitis and to whom various investigations allowed to make the diagnosis of a light chains myeloma. Through the study of the various cases of the literature, we remind the various characteristics of this syndrome.
Bulletin de la Société de pathologie exotique (1990), 2002
It is a retrospective study, reviewing all cases of vertebral tuberculosis recorded between 1989 ... more It is a retrospective study, reviewing all cases of vertebral tuberculosis recorded between 1989 and 1999 in La Rabta Hospital (Tunis). 29 patients have been included whose average age was 49 years. The main symptoms which appeared within a average period of six months were vertebral pain, associated with fever in half of the cases. The diagnosis of infectious spondylitis was made according to the results of Computer tomography in 26 cases. The diagnosis of infection was confirmed by characteristic histological pattern and/or culture biopsy. 27 patients were cured without complications except for 2 of them who developed a spinal cord compression. This complication was quickly stemmed by steroid therapy.
Revue du Rhumatisme, 2006
La Tunisie médicale, 2010