Publications (24) View all
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Article: Effects of a low-intensity dynamic-resistance training protocol using an isokinetic dynamometer on muscular strength and aerobic capacity after coronary artery bypass grafting.
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ABSTRACT: OBJECTIVE: Study the effect of muscle strength training on muscle strength, maximal oxygen uptake (VO(2)max), hemodynamic and anthropometric parameters as well as quality of life after coronary artery bypass grafting (CABG). METHODS: After CABG surgery, 32 patients were randomized into two groups. The first group was to perform aerobic-type training with a cycle ergometer (AT=16). The second group was to perform low-intensity muscle strength training of the quadriceps and hamstrings using an isokinetic dynamometer (i.e. 20 to 30% of peak torque) (ST=16). Before and after the strength training program we conducted a stress test, evaluation of isokinetic force production, 6-minute walking test, body impedance analysis (BIA) and SF-36 quality of life test. RESULTS: Compared to the AT group, the ST group showed better results with improved quadriceps strength (48.2% vs. 8.2%), VO(2)max (P<.001) and diastolic blood pressure at rest (P=0.01). Quality of life improved in both groups. CONCLUSION: The dynamic-resistance muscle strength training protocol using isokinetic dynamometer can safely (i.e. without clinical symptoms or changes to the ECG and arterial blood pressure) improve muscle strength and VO(2)max without any major risks in patients post-CABG. These findings should encourage additional studies to validate the relevance of these strength training modalities in rehabilitation centers.Annals of physical and rehabilitation medicine 12/2012; -
Article: The role of procalcitonin and N-terminal pro-B-type natriuretic peptide in predicting outcome after cardiac surgery.
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ABSTRACT: Objective(s): Determine the thresholds of procalcitonin (PCT) and N-terminal pro-B-type natriuretic peptide (Nt-pro-BNP) associated with poor prognosis after heart surgery with CPB. Design: Prospective observational study. Setting: Academic Medical Center Habib Bourguiba. Participants: Adult patients consecutively operated for coronary or valve surgery with CPB, elective or semi-urgent. Interventions: Serum concentrations of PCT and Nt-pro-BNP were determined before and after CPB, in the fourth postoperative hour (H4) and every day during the first 4 days. Receiver-operating characteristic curves and cut-off values were used to assess the ability of these markers to predict length of intensive care unit (ICU) stay >3 days. Measurements and Main RESULTS: Forty patients were included in the study. Systemic inflammatory response syndrome (SIRS) occurred in 35 (87.5%) patients. Seventeen of them (42.5%) showed severe SIRS. Significantly higher serum concentrations of Nt-pro-BNP and PCT were found in patients with severe SIRS. Receiver operating characteristic (ROC) analysis showed that the threshold of PCT was 0.737 ng/mL and that of Nt-pro-BNP was 1235 pg/mL on day 1 could predict an ICU stay of more than 3 days. The association of Nt-pro-BNP to procalcitonin (p=0.009) better predicted the ICU stay than PCT alone (p=0.02) or Nt-pro-BNP alone (p=0.03). The best combination is Nt-pro-BNP + PCT + C-reactive protein (CRP) (p=0.007). CONCLUSIONS: PCT and Nt-pro-BNP on day 1 may be associated with severe SIRS and predict the length of stay. A biomarker approach combining PCT, CRP and BNP is superior to a traditional single marker for predicting ICU stay.Perfusion 07/2012; · 0.92 Impact Factor -
Article: [Isolated abscess of the thoracic and abdominal wall: an exceptional form of tuberculosis].
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ABSTRACT: Isolated thoracic parietal involvement is a very rare form of tuberculosis and multifocal localization is exceptional. It often poses a diagnostic problem with parietal tumours requiring recourse to surgical biopsy. We report a case of tuberculous abscess localized to the anterior and superior part of the chest wall with a second abdominal localization but without any pulmonary involvement. The patient was a woman of 56 years presenting with a one-year history of a swelling to the right of the sternum accompanied after several months by a second swelling to the right side of the abdomen. The radiological and biological investigations revealed a parietal tumour in two separate areas. The diagnosis was confirmed by histological examination of a surgical biopsy and bacteriological examination of a percutaneous aspirate of the collection. Standard anti-tuberculosis treatment was given for nine months with good clinical and radiological resolution. In this case report, we study the anatomical and clinical features of this condition and discuss the diagnostic difficulties.Revue des Maladies Respiratoires 01/2010; 27(1):72-5. · 0.59 Impact Factor -
Article: [Rare cause of pulmonary embolism in a child].
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ABSTRACT: Cardiac hydaticyst is a rare condition and accounts for only 0.5 to 2% of all visceral locations of hydatid disease. The objective of this study was to point out the main clinical, radiological, and disease-course characteristics of this rare and serious pathology. We report a 13-year-old patient with a hydatid pulmonary embolism caused by a hydatid cyst of the interauricular septum. The diagnosis was established by transthoracic echocardiography, thoracic CT scan, and hydatid serology. Surgery was performed without delay and the outcome was good after 15 months of follow-up. This case underlines the need for rapid diagnosis and surgery before complications of cardiac hydatid cyst.Archives de Pédiatrie 09/2011; 18(9):987-9. · 0.30 Impact Factor -
Article: Does kidney transplantation with multiple arteries affect graft survival?
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ABSTRACT: We compared short- and long-term outcomes of renal transplants with single versus multiple arteries. We retrospectively analyzed data from kidney transplants from 208 living donors performed between 1994 and 2010. Renal grafts were divided into two groups: single renal artery (n = 164) versus multiple renal arteries (n = 44). The groups were compared regarding early and late vascular and urological complications. Patient and graft survivals were compared using Kaplan-Meier survivorship curves with comparisons using the log-rank test. Both groups were comparable regarding acute rejection episodes, posttransplant hypertension, postsurgery renal artery stenosis, and urologic complications. Only hemorrhagic complications and renal artery thrombosis were significantly higher in the multiple renal arteries group (P = .027 and .03, respectively). Warm ischemia time was significantly longer in the multiple renal arteries group without any influence on the incidence of acute tubular necrosis (P = .2). Mean creatinine clearance at 1 year was 65 versus 50 mL/min/1.73 m(2) (P = .5) and at 5 years, 60 versus 55 mL/min/1.73 m(2) (P = .1) for the single versus multiple renal arteries groups, respectively. Return to hemodialysis was necessary for 18.8% of the single and 16.1% of the multiple renal arteries group. The use of an allograft with multiple renal arteries is a safe, successful surgical procedure, that does not influence patient or graft survivals or increase surgical complication rates provided the surgical team is evolved with technical skill.Transplantation Proceedings 11/2011; 43(9):3423-5. · 1.00 Impact Factor
