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2010-2011年突尼斯变革：起因与现状

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阿拉伯世界研究 2012年第2期 51-63页

作者：伊美娜[突尼斯] 北京大学国际关系学院

2010年12月17日,突尼斯"茉莉花革命"爆发后,总统本.阿里带家人离境,飞抵沙特阿拉伯,结束了其长达23年的统治。随后,在突尼斯变革的"雪球效应"的影响下,埃及、利比亚、也门、叙利亚以及其他阿拉伯国家相继发生了反政府的变革。本文着重... 详细信息

2010年12月17日,突尼斯"茉莉花革命"爆发后,总统本.阿里带家人离境,飞抵沙特阿拉伯,结束了其长达23年的统治。随后,在突尼斯变革的"雪球效应"的影响下,埃及、利比亚、也门、叙利亚以及其他阿拉伯国家相继发生了反政府的变革。本文着重探讨导致2010～2011年突尼斯变革的内外原因,阐述变革后突尼斯的政局现状并展望其未来走向。

关键词：突尼斯变革政治腐败中东变局议会大选

Mature Teratoma Revealed by an Encysted Pleural Effusion

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Open Journal of Respiratory Diseases 2021年第2期11卷 84-89页

作者： Houda Gharsalli Monia Attia Sarra Zairi imen Sahnoun Aida Ayadi Henda Neji Sonia Maalej Leila Douik ElGharbi Department of Pulmonology Abderrahmane Mami Hospital Ariana Tunisia University of Tunis El Manar Tunis Tunisia Department of Radiology Abderrahmane Mami Hospital Ariana Tunisia Department of Thoracic and Cardiovascular Surgery Abderrahmane Mami Hospital Ariana Tunisia Department of Pathology Abderrahmane Mami Hospital Ariana Tunisia

A 32-year-old patient with no previous history was admitted for chest pain, dyspnea, appetite and weight loss. Chest X-ray revealed an opacity involving the lower two-thirds of the right hemithorax, suggestive of a pleural effusion. Because of the absence of fluid return even after ultrasound-guided thoracentesis, a Chest Computed tomography was required showing a heterogeneous anterior mediastinal mass with soft tissue, fat, fluid and calcifications associated with extensive encysted fluid collection in the right hemithorax. A video-assisted mini-thoracotomy revealed a mediastinal tumor firmly attached to the thymus with a cystic wall lined by squamous epithelium and sebaceous gland composed of respiratory tissue, adipose tissue, cartilage,

Vigilance Disorders in Permanent Night Workers: The Case of the Medical Staff

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Open Journal of Nursing 2017年第3期7卷 409-418页

作者： Aouatef Mahfoudh Kraiem Amira Omrane Asma Mahfoudh Boussaid imen Kacem Ridha Ben Cheik Taoufik Khalfallah Lamia Bouzgarrou Department of Occupational Medicine and Ergonomics Faculty of Medicine of Monastir University of Monastir Monastir Tunisia Department of Physiology Faculty of Pharmacy University of Monastir Tunisia Department of Physiology Faculty of Medicine of Monastir University of Monastir Monastir Tunisia

Purpose of the work: To assess the impact of fixed night shift on the vigilance of paramedical staff. Methods: The present study is an exhaustive cross-sectional survey which has been conducted at the University Hospital of Monastir, Tunisia, and it is about 92 care agents working permanently the night. The study of vigilance is based on Epworth scale and Super Lab program. Results: The average age was equal to 42.53 ± 9.45 years with a sex ratio of 1.72. Nurses accounted for 72%. The average score of alertness assessed with Epworth scale was equal to 14.5 ± 6. The use of the Super Lab software has objectified a tendency towards the increase in the average time of reaction of accomplishment of the simple task and the positive cueing task, which was evaluated while starting the shift, during the half time of the work and at the end of the shift. In addition, the average rate of errors evaluated at the beginning, half-time and at the end of the work has increased during 3 tests (simple task, positive and negative cueing tasks) without this difference being statistically significant. Conclusion: The alteration of vigilance with an ascent of the error rate among fixed night shift workers is a reality, which puts in question, not only the health of paramedical staff but also the care safety provided by these teams.

关键词： Impaired Alertness Fixed Night Work Healthcare Workers Epworth Scale

Clinical Characteristics and Follow-Up Data in a Series of Twenty Infective Endocarditis Complicated of Rheumatic Manifestations

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Open Journal of Clinical Diagnostics 2015年第2期5卷 58-62页

作者： Madiha Mahfoudhi imen Gorsane Hedia Bellali Amel Gaieb Battikh Sami Turki Fathi Ben Hamida Taieb Ben Abdallah Internal Medicine A Department Charles Nicolle HospitalTunisTunisia Research Unit of Kidney Diseases(LR00SP01) Charles Nicolle HospitalTunisTunisia Epidemiology and Statistics Department A Mami HospitalArianaTunisia

The infective endocarditis is a septicemia complicated of many systemic manifestations. Rheumatic manifestations can be revelatory, leading sometimes to a lateness diagnosis. The aim of this study is to determine the epidemiological, clinical, bacteriological profile and the follow up in patients affected of an infective endocarditis complicated of rheumatic manifestations. It’s a retrospective study concerning the period from January 1990 to December 2015. The analysis had implicated epidemiological, clinical, biological data, in association to immunological, bacteriological and radiological examinations. All the patients fulfilled the revised Duke’s criteria for the infective endocarditis. Articular and osseous radiographs, blood culture, transthoracic and/or transoesophageal echocardiography were performed in all patients. Twenty patients had rheumatic manifestations. The mean age was 37 years. There were arthralgia in 15 cases, myalgia in 5 cases and arthritis in 8 cases: 6 cases of mono-arthritis and 2 cases of oligo-arthritis. All patients had an inflammatory biological syndrome. The blood culture was positive in all the cases. Echocardiography revealed vegetations in all the patients: mitral in 10 cases, aortic in 4 cases, mitral and aortic in 4 cases, aortic and tricuspid in 1 case, tricuspid in 1 case. The radiological examination found 2 cases of spondylodiscitis and a case of saco-iliitis. The articular outcome was favorable in 17 cases. Three patients had died. The infective endocarditis should be considered in case of febrile arthritis. An early diagnosis and adapted treatment are guarantors of better prognosis.

关键词： Infective Endocarditis Blood Culture Vegetation Myalgia Arthritis

Stenosis of the Subglottic Trachea Revealing Relapsing Polychondritis of a Young Adult

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International Journal of Clinical Medicine 2015年第9期6卷 646-651页

作者： Mounira El Euch Madiha Mahfoudhi imen Gorsane Souha Hadded Wifek Bani Moez Karoui Sami Turki Taieb Ben Abdallah Department of Internal Medicine A Charles Nicolle Hospital Tunis Tunisia

Relapsing polychondritis is a rare inflammatory disease involving essentially cartilaginous structures. Other systemic manifestations can be encountered as the eye and ear disturbance. Aortic aneurysms affect few cases. If affection of airway cartilages occurs, prognosis may be worsened by eventual stenotic lesions. We report a 22-year-old woman with Relapsing polychondritis. When she was referred to our hospital 4 weeks after the onset of respiratory symptoms, she was having severe breathing difficulty. Immediate tracheostomy followed by steroid therapy improved her respiratory condition, although the treatment was complicated because of her diabetes. While airway involvement of Relapsing polychondritis can be life threatening, it is curable with steroid therapy. Clinicians should keep in mind that airway obstruction could be caused by this disease.

关键词： Relapsing Polychondritis Airway Narrowing Prognosis

Adult Onset Still’s Disease: Articular Manifestations in Twenty Cases

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Open Journal of Clinical Diagnostics 2015年第2期5卷 41-45页

作者： Madiha Mahfoudhi imen Gorsane Amel Gaieb Battikh Rafik Shimi Sami Turki Fathi Ben Hamida Taieb Ben Abdallah Internal medicine A department.Charles Nicolle Hospital TunisTunisia Research Unit of Kidney Diseases(LR00SP01) Charles Nicolle HospitalTunisTunisia

The adult onset Still’s disease is a rare inflammatory pathology of unknown pathogeny. The clinical features are variable. The diagnosis is difficult since exclusion of infectious, systemic and tumoral pathologies should be done. The articular complications are frequent and can be revelatory of this pathology. The articular prognosis depends on the diagnosis delay and the treatment efficiency. Our study aims to analyze different aspects of articular manifestations complicating adult onset Still’s disease to define epidemiological, clinical and evolving characteristics of these complications. It was a cross-sectional study concerning 20 cases of adult onset Still’s disease diagnosed from 1990 to 2015 in the internal medicine A department of Charles Nicolle Hospital in Tunis, meeting Yamaguchi criteria. We identified clinical, radiological, evolving and therapeutic profile of the articular manifestations occurred in these patients. There were 13 women and 7 men. The average age was 25 years. The arthralgias were reported in all cases;while, the arthritis interested fifteen patients. A hand deformation was found in four patients. A wrist ankylosis was noted in one case and a flexion elbow in one patient. The standard articular radiographs were normal in twelve cases. The treatment associated essentially non-steroidal anti-inflammatory and/or corticosteroids and/or methotrexate. Concerning the evolving profile, the monocyclic form was present in 25% of the cases, the intermittent form in 45% and the chronic articular form in 30% of our patients. The adult onset Still’s disease is rare and heterogeneous. The articular disturbances are frequent and have various outcomes.

关键词： Adult Onset Still’s Disease Arthritis Fever Corticosteroids Biotherapy Prognosis

Primary Thyroid Non-Hodgkin’s Lymphoma

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Open Journal of Pathology 2015年第4期5卷 114-116页

作者： Madiha Mahfoudhi Khaled Khammassi imen Gorsane Mounira El Euch Sami Turki Mamia Ben Salah Taieb Ben Abdallah Department of Internal Medicine Charles Nicolle Hospital Tunis Tunisia Department of Oto-Rhino-Laryngology Charles Nicolle Hospital Tunis Tunisia

Primary non-Hodgkin’s lymphoma of the thyroid gland was rarely described. We report the case of a 44-year-old man admitted for an anterior neck swelling, hoarseness and dyspnea. The chest radiograph showed a trachea deviation. He had no clinical, biological or radiological sign of other lymphoma locations. Ultrasound examination of the neck revealed a bilateral heterogeneous thyroid lesion. Cytology revealed lymphoid cells having high nuclear-cytoplasmic ratio with multiple and irregular nucleoli. An urgent thyroid surgery consisting of total thyroidectomy had been performed since the presence of compressive signs due to the tumor. The histopathological examination of a biopsy from the thyroid tissue confirmed a high-grade non-Hodgkin’s lymphoma. Then, L-thyroxin substitution therapy, chemotherapy and radiotherapy were initiated. A prolonged remission was noted.

关键词： Thyroid Gland Lymphoma Immunohistochemistry

Epidemiological, Clinical and Follow-Up Data in a Series of Thirteen Renal Insufficiencies Complicating Sarcoidosis

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Open Journal of Clinical Diagnostics 2015年第2期5卷 50-53页

作者： Madiha Mahfoudhi imen Gorsane Amel Gaieb Battikh Sami Turki Hayet Kaaroud Rym Goucha Fathi Ben Hamida Taieb Ben Abdallah Internal Medicine A Department Charles Nicolle HospitalTunisTunisia Research Unit of Kidney Diseases(LR00SP01) Charles Nicolle HospitalTunisTunisia

The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and the interest of considering sarcoidosis diagnosis in case of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 13 women with an average age of 41 years. Biological investigations showed an abnormal normocalcemia in 8 cases, a hypercalcemia in 5 cases, a hypercalciuria in 11 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 540 umol/L. The renal echography was normal in all patients. The kidney biopsy performed in all patients showed tubulo-interstitial nephritis. The extra-renal signs were: pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymphadenopathy in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 3 cases and a polyarthritis in 6 cases. Six patients benefited from hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis should be made rapidly in order to avoid end stage renal failure.

关键词： Sarcoidosis Acute Renal Failure Interstitial Nephritis Granuloma

Interstitial Lung Diseases Associated with Connective Tissue Pathologies: Radiologic Features

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Open Journal of Respiratory Diseases 2019年第4期9卷 112-122页

作者： Houda Gharsalli Monia Attia Sawssen Hantous-Zannad imen Sahnoun Sonia Maalej Leila Douik El Gharbi Henda Neji Khaoula Ben Miled-Mrad Department of Pulmonology Abderrahmane Mami Hospital Ariana Tunisia University of Tunis El Manar Tunis Tunisia Department of Radiology Abderrahmane Mami Hospital Ariana Tunisia

Introduction: The high resolution computed tomography (HRCT) is an important part in the diagnostic approach of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) by providing detailed information on the elementary lesion and the radiological pattern of ILD. Aim: to point out the role of HRCT in the diagnosis of ILD associated with CTD (ILD-CTD). Methods: A Retrospective descriptive study was conducted between 2008 and 2017. Data of 24 patients presenting ILD-CTD were collected. A review of HRCT was performed by a radiologist without knowledge of the CTD. Results: Predominant elementary lesion of ILD associated with dermatomyositis (9 cases) was ground glass opacity (n = 9) followed by consolidation (n = 6). Non Specific Interstitial Pneumonia (NSIP) was the most reported pattern (5 cases). Ground glass opacity was also the predominant elementary lesion for the 2 cases of scleroderma and in Sjögren’s syndrome (4 cases/5). NSIP was the predominant radiological presentation in these two CTD. Lymphoid interstitial pneumonia revealed Sjögren’s syndrome in one case. In rheumatoid arthritis (6 cases), the elementary HRCT lesions were irregular interlobular septal thickening (n = 4) and honeycombing (n = 4) consistent with Usual Interstitial Pneumonia (UIP) in 2 cases. Similarly UIP has been described for the 2 patients with lupus and mixed connective tissue disease. Conclusion: HRCT plays an important role in the management of ILD-CTD. Description of the HRCT elementary lesions and the radiological pattern of ILD can be helpful for CTD’s diagnosis.

关键词： Interstitial Lung Diseases Connective Tissue Diseases Computed Tomography Imaging Diagnosis