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1. Workaholism in engineers: Prevalence and associated factors.

Author

Hrairi A, Dhouib F, Kotti N, Sellami I, Jmal Hammami K, Masmoudi ML, and Hajjaji M

Subjects
Humans, Young Adult, Adult, Cross-Sectional Studies, Prevalence, Surveys and Questionnaires, Job Satisfaction, Behavior, Addictive epidemiology
Abstract

Introduction: Workaholism is an emerging form of behavioural addiction encountered in the workplace. The present study aims to assess the prevalence and the associated factors of this phenomenon in engineers., Methods: A cross sectional survey was conducted for two months by means of an online questionnaire of engineers practising in Tunisia. The evaluation of workaholism was based on the WART questionnaire (Work Addiction Risk Test)., Results: A total of 107 engineers have answered the questionnaire. The mean age of participants was 29.2±4.4 years. Computer engineers represented 32.7% of our sample. Most of engineers worked more than 8hours per day (45.8%) and less than 6 days per week (63.6%). A high risk of workaholism was noted in 42.1% of cases. Statistical analysis showed that workaholism was not associated with socio-demographic characteristics. However, it was associated with smoking cigarettes, psychotropic drug consumption and poly-addiction and inversely associated with the presence of a leisure activity. With regard to occupational factors, workaholism was associated with agronomic engineering, working more than 8hours per day, working the whole week and a job satisfaction score under 5/10., Conclusion: Workaholism interested a significant proportion of this sample, and several professional factors could increase the likelihood of adopting this behaviour. The intervention of occupational doctors seems important in order to raise awareness about this form of addiction and to identify its early signs among employees., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Published
2023
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2. Does mindfulness reduce perceived stress in healthcare professionals?

Author

Kckaou A, Dhouib F, Kotti N, Sallemi I, Hammami KJ, Masmoudi ML, and Hajjaji M

Subjects
Humans, Stress, Psychological psychology, Cross-Sectional Studies, Health Personnel psychology, Delivery of Health Care, Mindfulness
Abstract

Background: Healthcare professionals (HCPs) are exposed to multiple psychosocial risks that may lead to high levels of stress and low levels of life satisfaction and well-being. Mindfulness, defined as the awareness that arises by intentionally paying attention in the present moment and in a non-judgmental way, seems to be a moderator in the causal association between life stressors and well-being., Aims: The aim of the present study was to test the model of relationships between self-reported mindfulness, perceived stress, well-being index and life satisfaction in a sample of Tunisian HCPs., Methods: We performed a correlational cross-sectional study on a sample of HCPs at Hedi Chaker University Hospital, Tunisia. We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), the World Health Organisation Well-Being Index (WHO-5) and the Satisfaction with Life Scale (SWLS). For data analysis, the SPSS version 23 program was used., Results: Participants (n=297) included staff nurses (49.2%), medical technicians (19.2%) and doctors (31.6%). The overall model revealed that reduced perceived stress (β=-0.30, P<0.000) and high levels of well-being (β=0.13, P=0.03) were associated with mindfulness, explaining 14% of the variance. Individually, perceived stress significantly predicted mindfulness explaining 13% of the variance., Conclusion: The study explores a variety of elements that can support the development of mindfulness interventions for stress prevention, staff well-being, and improvement of services as a whole., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Published
2023
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3. Role of chemical exposure in the incidence of vitiligo: a case-control study in Tunisia.

Author

Rmadi N, Kotti N, Bahloul E, Dhouib F, Sellami I, Sellami K, Jmal Hammami K, Masmoudi ML, Turki H, and Hajjaji M

Subjects
Humans, Case-Control Studies, Incidence, Tunisia epidemiology, Phenols, Vitiligo chemically induced, Vitiligo epidemiology, Vitiligo diagnosis
Abstract

Vitiligo is a multifactorial dermatosis with many etiological hypotheses that have been suggested for its occurrence. To our knowledge, few epidemiological studies are available on vitiligo induction factors and particularly on the role of exposure to chemicals in the onset of the disease has been found. Therefore, there is need to investigate the relationship between vitiligo and chemical exposures in order to understand this mysterious disease. We conducted a case-control study of patients with vitiligo whose diagnosis was made by a specialist in dermatology. The total study period was of 6 months extending from 1 July to 31 December 2019. The minimum sample size was determined as 46 cases and 92 controls. The control group was gender, age, and professional status matched to the vitiligo group. In the binary logistic regression model, household chemicals/colored toothpaste use, a history of a repeated antibiotic use, and an occupational exposure to phenol/catechol derivatives were significantly associated with vitiligo (three to fourfold increase). Our results suggest that chemical factors play a key role in the occurrence of vitiligo. Therefore, prevention of this dermatosis requires the identification of exposure to the incriminated chemicals in any patient followed for vitiligo. The earlier the diagnosis of 'chemical' or chemically aggravated vitiligo, the better the prognosis for this disease.

Published
2023
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4. Quality of weight loss during chemoradioherapy in patients with nasopharyngeal cancers.

Author

Fourati N, Trigui R, Dhouib F, Nouri O, Siala W, Khanfir A, Mnejja W, and Daoud J

Subjects
Humans, Prospective Studies, Weight Loss, Body Mass Index, Nutritional Status, Nasopharyngeal Neoplasms radiotherapy
Abstract

Purpose: Radiation therapy with chemotherapy (CCR) is currently the gold standard treatment for nasopharyngeal carcinoma (NPC). Anatomical changes are mainly due to weight loss. Our prospective study aimed to evaluate the nutritional status and the quality of weight loss in our patients to adapt the subsequent nutritional management of patients during treatment for NPC., Patients and Methods: A prospective, single-center study of 27 patients with non-metastatic NPC treated in our oncology radiotherapy department between August 2020 and March 2021. Data from interrogation, physical examination, and bioelectrical impedancemetry (weight [W], body mass index [BMI], fat index [GI], fat mass [FM], and fat-free mass (FFM]) were collected at the beginning, the mid, and the end of treatment., Results: Weight loss from mid to end of treatment (median=-4kg [-9.4; -0.9]) was greater than that from baseline to mid-treatment (median=-2.9kg [-8.8; 1.8]) (P=0.016). Weight loss during the entire treatment was -6.2kg [-15.6; -2.5] (8.4%). The losses of FM were identical between the beginning-mid treatment and the mid-end treatment; they were respectively -1.4kg [-8.5; 4.2] and -1.4kg [-8.2; 7.8] (P=0.4). FFM losses between the mid- and the end of treatment (-2.5kg [-27.8; 0.5]) were greater than those between baseline and mid-treatment (-1.1kg [-7.1; 4.7]) (P=0.014). Median FFM loss during treatment was -3.6kg [-28.1; 2.6])., Conclusion: The results of our study show that weight loss during CCR for NPC is complex and is not just about loss but about a disruption of body composition. Regular follow-ups by nutritionists are required to prevent denutrition during treatment., (Copyright © 2023 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Published
2023
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5. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS.

Author

Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, and Brahmi N

Published
2023

6. [Current management and perspectives for locally advanced nasopharyngeal carcinoma].

Author

Mnejja W, Nouri O, Fourati N, Dhouib F, Siala W, Charfeddine I, Khanfir A, Farhat L, and Daoud J

Subjects
Humans, Induction Chemotherapy, Nasopharyngeal Carcinoma pathology, Nasopharyngeal Carcinoma therapy, Neoplasm Staging, Carcinoma pathology, Nasopharyngeal Neoplasms pathology, Radiotherapy, Intensity-Modulated methods
Abstract

Nasopharyngeal carcinoma diagnosis is often made at a locally advanced stage (75 to 90% of cases) due to its deep localization. Concomitant radio-chemotherapy is the cornerstone of the treatment of locally advanced forms. The advent of intensity-modulated radiotherapy has improved oncological outcomes and reduced toxicity and is currently the gold standard for irradiation technique. For the locally advanced stage, the addition of induction chemotherapy has become the new standard care according to the latest international recommendations to reduce tumor volumes and act early on micro-metastases. Despite these therapeutic advances, the local and especially distant failure rate remains high. This article reviews current treatment strategies and discuss new approaches and perspectives of locoregional and systemic treatment to reduce treatment failures., (Copyright © 2022 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Published
2022
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7. Allergic contact dermatitis to isothiazolinones in a rubber factory: A case report.

Author

Hrairi A, Kotti N, Baklouti M, Bahloul E, Sellami I, Dhouib F, Hammami KJ, Masmoudi ML, Turki H, and Hajjaji M

Abstract

Isothiazolinones, used as preservative, are known to be skin sensitizers. Although cosmetics represent their main source, occupational exposure may be a significant origin of eczema. While allergic eczema related to these derivates have been reported in a number of professional sectors, their presence in the same workplace was not common., Competing Interests: All authors have nothing to declare. They know of no conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome., (© 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Published
2022
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8. Occupational exposure to coal and risk of multiple health outcomes: A case report.

Author

Hakim Z, Kotti N, Ben Younes K, Dhouib F, Jmal Hammami K, Masmoudi ML, Turki H, and Hajjaji M

Abstract

Occupational cutaneous squamous-cell carcinoma has an increased incidence, but rarely suspected. When located in an uncovered skin area, it is closely linked to polycyclic aromatic hydrocarbons exposure. However, single pulmonary anthracosis nodule is rarely described in the literature. The association of both diseases due to the same exposure remains uncommon., Competing Interests: None., (© 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Published
2022
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9. Subclinical left ventricle impairment following breast cancer radiotherapy: Is there an association between segmental doses and segmental strain dysfunction?

Author

Fourati N, Charfeddine S, Chaffai I, Dhouib F, Farhat L, Boukhris M, Abid L, Kammoun S, Mnejja W, and Daoud J

Subjects
Female, Heart, Heart Ventricles diagnostic imaging, Humans, Middle Aged, Prospective Studies, Ventricular Function, Left, Breast Neoplasms radiotherapy, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left epidemiology, Ventricular Dysfunction, Left etiology
Abstract

Background: Cardiotoxicity following breast cancer radiotherapy (RT) represents one of the most redoubtable toxicities. The Global longitudinal strain measurement (GLS) based on 2D speckle tracking imaging (STI) allows detection of left ventricular (LV) dysfunction at a subclinical stage. The aim of this prospective study was to detect patients at risk of cardiotoxicity using echocardiographic parameters and to determine the association between segmental RT doses and early cardiac toxicity., Material and Methods: The STI was performed prior to RT and at 3, 6 and 12 months after. The association between subclinical LV dysfunction, defined as a reduction of GLS more than 10% from the initial value, radiation doses to different LV segments and non-radiation factors were performed based on multivariate analyses., Results: From June 2017 to August 2018, a total of 103 female patients were included. Sixty patients had left sided RT. Seven patients (7.8%) developed a GSL impairment. The segmental alterations predominated in the anteroseptal and apical LV segments. The mean Dmean in altered segments was significantly higher than in non-altered segments (6.7 ± 8.8Gy-7.8 ± 8.9Gy vs 4.9 ± 7.9-5.4 ± 8.2Gy; p < 0.05). Age > 55 years and obesity were important confounding factors that should be considered during radiotherapy planning., Conclusion: The results of our study show that radiation dose is correlated with the subclinical LV segments' alteration. Global heart delineation seems to be insufficient during the breast radiotherapy planning. Segmental delineation of the LV may be an interesting alternative to limit segmental doses and to reduce the risk of subclinical alterations. A mean dose of 5Gy could be proposed in exposed heart segment., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Published
2021
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10. [Concomitant radiotherapy and trastuzumab: Rational and clinical implications].

Author

Fourati N, Trigui R, Charfeddine S, Dhouib F, Kridis WB, Abid L, Khanfir A, Mnejja W, and Daoud J

Subjects
Antineoplastic Agents, Immunological adverse effects, Breast Neoplasms metabolism, Breast Neoplasms pathology, Cardiotoxicity etiology, Cardiotoxicity prevention & control, Cell Proliferation, Combined Modality Therapy adverse effects, Combined Modality Therapy methods, Female, Heart drug effects, Heart radiation effects, Humans, Myocardium metabolism, Radiation Tolerance, Receptor, ErbB-2 metabolism, Trastuzumab adverse effects, Antineoplastic Agents, Immunological therapeutic use, Breast Neoplasms drug therapy, Breast Neoplasms radiotherapy, Receptor, ErbB-2 antagonists & inhibitors, Trastuzumab therapeutic use
Abstract

The HER2 receptor (Human Epidermal Growth Receptor 2) is a transmembrane receptor with tyrosine kinase activity that is over-expressed in 25-30 % of breast carcinomas. Its activation is associated with an exaggeration of cell proliferation with an increase in repair capacity resulting in increased radioresistance. On cardiac tissues, HER2 receptor activation plays a cardio-protective role. Trastuzumab, the first anti-HER2 drug used to treat patients with breast cancer overexpressing HER2 receptor , inhibits the cascade of reactions resulting in the proliferation of tumor cells, thus restoring cellular radiosensitivity. However, the combination of Trastuzumab with radiation therapy also removes HER2 receptor cardio-protective role on myocardial cells which increases the risk of cardiotoxicity. Thus, the concomitant association of these two modalities has long been a subject of controversy. Recent advances in radiation therapy technology and early detection of cardiac injury may limit the cardiotoxicity of this combination. Through this review, we developed the biological basis and the benefit-risk of concomitant combination of radiotherapy and Trastuzumab in adjuvant treatment of breast cancers overexpressing HER2 and we discuss the modalities of its optimization., (Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Published
2021
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11. Management of patients with cardiac implantable electronic devices (CIED) undergoing radiotherapy: A consensus document from the Tunisian Society of Oncology Radiotherapy and the Tunisian Society of Cardiology and Cardiovascular Surgery.

Author

Zarraa S, Dhouib F, Ben Halima A, Ouali S, Moujahed R, Tebra S, Jabbari Z, Yahyaoui J, Jbara W, Besbes M, Nasr C, Belaïd A, Daoued J, Zakhama L, and Kochbati L

Subjects
Consensus, Electronics, Humans, Cardiology, Pacemaker, Artificial, Radiation Oncology
Abstract

In patients with cardiac implantable electronic devices CIEDs, including cardiac pacemakers (PM) and implantable cardioverter-defibrillators (ICD), radiotherapy (RT) could compromise CIED function. Managing radiotherapy patients with CIED, has been a great practical and procedural challenge in radiotherapy and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, Radiation Oncologists and Medical physicists. It aims to propose recommendations on risk stratification, management approach before, during and after radiation treatment/course of patients with CIED.

Published
2021

12. Patterns of Failure in Patients With Head and Neck Squamous Cell Carcinomas of Unknown Primary Treated With Chemoradiotherapy.

Author

Dhouib F, Bertaut A, Maingon P, Siala W, Daoud J, Aubignac L, Lestrade L, Crehange G, and Vulquin N

Subjects
Adult, Aged, Aged, 80 and over, Female, Head and Neck Neoplasms pathology, Head and Neck Neoplasms therapy, Humans, Male, Middle Aged, Neck pathology, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Radiotherapy Planning, Computer-Assisted methods, Retrospective Studies, Treatment Outcome, Chemoradiotherapy methods, Neoplasm Recurrence, Local therapy, Neoplasms, Unknown Primary pathology, Neoplasms, Unknown Primary therapy, Radiotherapy Dosage standards, Squamous Cell Carcinoma of Head and Neck pathology, Squamous Cell Carcinoma of Head and Neck surgery, Tomography, X-Ray Computed methods
Abstract

Background: To evaluate the patterns of failure in patients treated for head and neck carcinoma of unknown primary and to discuss treatment practices concerning radiotherapy target volumes definition and dose prescription., Methods: Eleven patients presenting a locoregional recurrence after head and neck carcinoma of unknown primary treatment with curative-intent radiochemotherapy performed between 2007 and 2017 in the departments of radiation oncology of 2 French cancer institutes. Images of the computed tomography scan or the magnetic resonance imaging performed at the time of the recurrence were fused with those of the simulation computed tomography scan to delimit a volume corresponding to the recurrence and to define the area of relapse compared to the volumes treated., Results: Irradiation was unilateral in 6 cases and bilateral in 5 cases. The median time to onset of recurrence was 7.24 months (extreme 3-67.7 months). Six patients had only a neck node recurrence, 3 had a neck node and subsequent primary recurrence, and 1 had only a median subsequent primary recurrence. Only 1 patient had synchronous distance progression to local recurrence. All neck node recurrences were solitary and ipsilateral. The subsequent primary recurrences were in the oropharynx in 3 cases and in the contralateral oral cavity in one case. All neck node recurrences were into the irradiated volume. The subsequent primary recurrences were either within or in border of the irradiated volumes. The median of the mean dose, received by neck node recurrences, was 69.9 Gy and that of the mean dose, minimum dose, maximum dose, and dose received by 95% of the volume of recurrence was 66.7 Gy. For the primary relapses, the median of the mean dose was 52.1 Gy and that of the mean dose, minimum dose, maximum dose, and dose received by 95% of the volume of recurrence was 39.9 Gy., Conclusions: All local nodal recurrences occurred at sites that received high radiotherapy doses and doses received by sites of eventual failure did not vary significantly from sites that remain in control.

Published
2020
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14. [Post-traumatic carotido-jugular fistula: Case report and review of the literature].

Author

Dammak A, Ben Jmaà H, Hadhri S, Cheikhrouhou H, Dhouib F, Haddar S, Kammoun L, Ben Jmaà T, Hammami B, Masmoudi S, Elleuch N, Ben Jmaà M, and Frikha I

Subjects
Adult, Arteriovenous Fistula diagnostic imaging, Arteriovenous Fistula surgery, Carotid Artery Injuries diagnostic imaging, Carotid Artery Injuries surgery, Humans, Jugular Veins diagnostic imaging, Jugular Veins surgery, Male, Occupational Injuries diagnostic imaging, Occupational Injuries surgery, Arteriovenous Fistula etiology, Carotid Artery Injuries complications, Jugular Veins injuries, Occupational Injuries complications
Abstract

The neck, being not protected by skeleton, is vulnerable to external trauma and injury which can involve blood vessels, muscles, nerves, and trachea. Carotid injuries can be potentially life-threatening by hemorrhage and stroke. We present a case of a 26-year-old manual worker who presented a neck injury caused by a metallic projectile. The injury involved the right common carotid artery with an internal jugular vein fistula, and tracheal damage. The patient was managed with surgical repair of the tracheal lesion, reconstruction of the carotid section using a PTFE graft bypass, and ligation of the internal jugular vein. In the immediate postoperative period, the patient presented with no neurological deficits, but he did develop a pulmonary infection that resolved with antibiotic therapy. The follow-up is now 3months. The patient is doing well without any neurological disorder., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Published
2017
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15. Summaries of the papers of the 4th National Congress of the Tunisian Society of Medical Oncology attached to the 4th Maghreb Congress of Oncology.

Author

Abbes I, Abdelhak S, Abdelhedi C, Abid K, Abidi R, Acacha E, Achour S, Achour A, Adouni O, Afrit M, Ahlem A, Akik I, Akremi M, Aloui R, Aloulou S, Ammar N, Arem S, Athimni S, Attia L, Attia M, Ayadi M, Ayadi A, Ayadi K, Ayadi H, Ayadi L, Ayadi I, Ayari J, Azzouz H, Bacha D, Bahloul R, Bahri I, Bahri M, Bakir D, Balti M, Bargaoui H, Batti R, Bayar R, Bdioui Thabet A, Beji M, Bel Hadj Hassen S, Bel Haj Ali A, Belaid I, Belaid A, Beldjiilali Y, Belkacem O, Bellamlih O, Ben Abdallah W, Ben Abdallah M, Ben Abdellah H, Ben Abderrahmen S, Ben Ahmed S, Ben Ahmed K, Ben Ayache M, Ben Ayoub W, Ben Azaiz M, Ben Azouz M, Ben Daly A, Ben Dhia S, Ben Dhiab M, Ben Dhiab T, Ben Fatma L, Ben Ghachem D, Ben Hammadi S, Ben Hassen M, Ben Hassena R, Ben Hassouna J, Ben Kridis W, Ben Leila F, Ben Mahfoudh KH, Ben Mustapha N, Ben Nasr S, Ben Othman F, Ben Rejeb M, Ben Rekaya M, Ben Rhouma S, Ben Safta Z, Ben Safta I, Ben Said A, Ben Salah M, Ben Salah H, Ben Slama S, Ben Temime R, Ben Youssef Y, Ben Zid K, Benabdella H, Benasr S, Bengueddach A, Benna M, Benna F, Bergaoui H, Berrazaga Y, Besbes M, Bhiri H, Bibi M, Blel A, Bohli M, Bouali S, Bouaouina N, Bouassida K, Bouaziz H, Boubaker J, Boudaouara T, Boudaouara Z, Boudaouara O, Boughanmi F, Boughattas W, Boughizane S, Bouguila H, Bouhani M, Bouhlel B, Boujelbane N, Boujemaa M, Boulma R, Bouraoui S, Bouriga R, Bourmech M, Bousrih C, Boussen H, Boussen N, Bouzaien F, Bouzayene F, Brahem I, Briki R, Chaabene K, Chaabouni M, Chaari H, Chabchoub I, Chachia S, Chaker K, Chamlali M, Charfi L, Charfi M, Charfi S, Charradi H, Cheffai I, Chelly B, Chelly I, Chenguel A, Cherif A, Cherif O, Chiboub A, Chouchene A, Chraiet N, Daghfous A, Daldoul A, Daoud N, Daoud J, Daoud R, Daoud E, Debaibi M, Dhaouadi S, Dhief R, Dhouib F, Dimassi S, Djebbi A, Doghri R, Doghri Y, Doudech B, Dridi M, El Amine O, El Benna H, El Khal MC, Eladeb M, Elloumi M, Elmeddeb K, Enaceur F, Ennouri S, Essoussi M, Ezzairi F, Ezzine A, Faleh R, Fallah S, Faouzi N, Fathallah K, Fehri R, Feki J, Fekih M, Fendri S, Fessi Z, Fourati N, Fourati M, Frikha I, Frikha M, Gabsi A, Gadria S, Gamoudi A, Gargoura A, Gargouri W, Ghariani N, Ghazouani E, Ghorbal A, Ghorbel L, Ghorbel S, Ghozzi A, Glili A, Gmadh K, Goucha A, Gouiaa N, Gritli S, Guazzah K, Guebsi A, Guermazi Z, Guermazi F, Gueryani N, Guezguez M, Hacheni F, Hachicha M, Haddad A, Haddaoui A, Hadoussa M, Haj Mansour M, Hajjaji A, Hajji A, Hamdi A, Hamdi Y, Hammemi R, Haouet S, Hdiji A, Hechiche M, Hedfi M, Helali AJ, Henchiri H, Heni S, Hentati A, Herbegue K, Hidar S, Hlaf M, Hmida W, Hmida I, Hmida L, Hmila Ben Salem I, Hochlef M, Hsairi M, Jaffel H, Jaidane M, Jarraya H, Jebsi M, Jedidi M, Jlassi A, Jlassi H, Jmal H, Jmour O, Jouini M, Kabtni W, Kacem M, Kacem S, Kacem I, Kaid M, Kairi H, Kallel M, Kallel R, Kallel F, Kammoun H, Kamoun S, Kanoun Belajouza S, Karray W, Karrit S, Karrou M, Kchir N, Kdous S, Kehili H, Keskes H, Khairi H, Khalfallah MT, Khalifa MB, Khanfir A, Khanfir F, Khechine W, Khemiri S, Khiari H, Khlif A, Khouni H, Khrouf S, Kochbati L, Korbi I, Korbi A, Krir MW, Ksaier I, Ksantini R, Ksantini M, Ksantini F, Ktari K, Laabidi S, Laamouri B, Labidi A, Lahmar A, Lahouar R, Lamine O, Letaief F, Limaiem F, Limayem I, Limem S, Limem F, Loghmari A, M'ghirbi F, Maamouri F, Magherbi H, Mahjoub N, Mahjoub M, Mahjoubi K, Majdoub S, Makhlouf T, Makni A, Makni S, Mallat N, Manai MH, Mansouri H, Maoua M, Marghli I, Masmoudi T, Mathlouthi N, Meddeb K, Medini B, Mejri N, Merdessi A, Mesali C, Mezlini E, Mezlini A, Mezni E, Mghirbi F, Mhiri N, Mighri N, Mlika M, Mnejja W, Mnif H, Mokni M, Mokrani A, Mosbah F, Moujahed R, Mousli A, Moussa A, Mrad Dali K, Mrizak N, Msakni I, Mzabi S, Mzali R, Mzoughi Z, Naimi Z, Najjar S, Nakkouri R, Nasr C, Nasrallah D, Nasri M, Njim L, Noubigh GEF, Nouira Y, Nouri O, Omrani S, Osmane W, Ouanes Y, Ouanna N, Oubich F, Oumelreit Belamlih G, Rachdi H, Rafraf F, Rahal K, Raies H, Rammeh S, Rebaii N, Rekik W, Rekik H, Rhim MS, Rhim S, Rihab D, Rjiba R, Rziga T, Saad H, Saad A, Saadi M, Said N, Salah R, Sallemi N, Sassi A, Sassi K, Sassi Mahfoudh A, Sbika W, Sellami A, Serghini M, Sghaier S, Sh Zidi Y, Siala W, Slimane M, Slimani O, Soltani S, Souguir MK, Sridi A, Tabet Zatla A, Tajina D, Talbi G, Tbessi S, Tebra Mrad S, Temessek H, Tlili G, Toumi N, Toumi O, Toumia N, Tounsi H, Trigui E, Triki M, Triki A, Turki M, Werda I, Yahyaoui S, Yahyaoui Y, Yaich A, Yamouni M, Yazid D, Yousfi A, Zaghouani H, Zaied S, Zairi F, Zaraa S, Zehani A, Zenzri Y, Zidi A, Znaidi N, Zouari K, Zouari S, Zoukar O, and Zribi A

Published
2017

16. [Surgical and endoluminal management of the inflammatory aortitis: A Tunisian center experience].

Author

Ben Jmaà H, Karray R, Jmal H, Cherif T, Dhouib F, Souissi I, Karoui A, Bahloul Z, Masmoudi S, Elleuch N, and Frikha I

Subjects
Adult, Endovascular Procedures, Female, Humans, Male, Retrospective Studies, Tunisia, Young Adult, Aortitis surgery, Behcet Syndrome surgery, Giant Cell Arteritis surgery, Takayasu Arteritis surgery
Abstract

Non-infectious aortitis is usually due to giant-cell arteritis, Takayasu disease or Behçet disease. The main aortic lesions are stenoses, occlusions and aneurysms in the Takayasu disease and aneurysms in the Behçet disease and giant-cell arteritis. Treatment is based on corticosteroid therapy and surgery. Endoluminal management is now the rule. We report a retrospective descriptive study of 10 patients who underwent surgical or endoluminal management of inflammatory lesions of the aorta between January 2000 and December 2015. There were 4 cases of Takayasu disease and 6 cases of Behçet disease. The aortic lesions were aneurysmal in all of the patients with Behçet disease. In the patients with Takayasu disease, aortic occlusions predominated, associated with other arterial lesions. Four patients with Behçet disease were managed surgically, and 2 patients underwent endovascular repair. All of the patients with Takayasu disease underwent surgery. Two patients died in the postoperative period, and two patients died during long-term follow-up. Systematic screening, as well as regular monitoring of the entire aorta during the follow-up, is necessary due to the frequency of aortic aneurysms., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Published
2017
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17. [Role of postoperative chemoradiotherapy in the therapeutic management of adenocarcinomas of the stomach and oesogastric junction].

Author

Ben Salah H, Bahri M, Dhouib F, and Daoud J

Subjects
Adenocarcinoma surgery, Antineoplastic Agents therapeutic use, Clinical Trials as Topic, Combined Modality Therapy, Digestive System Surgical Procedures, Disease-Free Survival, Esophageal Neoplasms surgery, Humans, Lymph Node Excision, Meta-Analysis as Topic, Perioperative Care, Radiotherapy, Conformal, Stomach Neoplasms surgery, Adenocarcinoma therapy, Chemoradiotherapy, Esophageal Neoplasms therapy, Esophagogastric Junction, Stomach Neoplasms therapy
Abstract

The available data in the literature show that for gastric adenocarcinoma or gastroesophageal junction adenocarcinoma, postoperative chemoradiotherapy improves disease-free survival after surgery with D0 or D1 lymph node dissection (and perhaps D2) as well as in case of positive node or R1 resection. With the publications of perioperative chemotherapy trials, the role of postoperative radiotherapy in the therapeutic arsenal of gastric adenocarcinoma or gastroesophageal junction adenocarcinoma becomes difficult to define. Postoperative radiotherapy is indicated in case of R1 resection., (Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Published
2016
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18. [Popliteal artery pseudoaneurysm caused by femur exostosis: A pediatric case].

Author

Ben Jmaà H, Dhouib F, Jmal H, Ghorbel N, Bouassida A, Trigui M, Souissi I, Masmoudi S, Elleuch N, and Frikha I

Subjects
Adolescent, Anastomosis, Surgical, Aneurysm, False diagnostic imaging, Aneurysm, False surgery, Computed Tomography Angiography, Female, Humans, Saphenous Vein, Ultrasonography, Doppler, Aneurysm, False etiology, Femoral Neoplasms complications, Osteochondroma complications, Popliteal Artery diagnostic imaging, Popliteal Artery surgery
Abstract

Exostoses, or osteochondromas are benign bone tumors that have developed on the bone surface. These benign tumors can be asymptomatic or lead to complications, for instance arterial pseudoaneurysm. We report a case of a pseudoaneurysm of the popliteal artery treated surgically in a 17-year-old girl with a solitary exostosis of the right femur. Surgery was closure of the pseudoaneurysm and a bypass using a venous graft., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Published
2016
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21. [Splenic artery aneurysm rupture in late pregnancy: A case report].

Author

Benali M, Charrada H, Bouassida M, Bahloul A, Jmal K, Dhouib F, Saied MR, and Khaddar MK

Subjects
Adult, Aneurysm, Ruptured diagnostic imaging, Arteriovenous Fistula diagnostic imaging, Female, Humans, Pregnancy, Splenic Rupture diagnostic imaging, Ultrasonography, Aneurysm, Ruptured surgery, Arteriovenous Fistula surgery, Pregnancy Complications, Cardiovascular surgery, Splenic Artery diagnostic imaging, Splenic Rupture surgery
Published
2013
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22. [Foreign bodies in the hand].

Author

Ennouri K, Baccari S, Dhouib F, Daghfous M, Tarhouni L, and Bahri H

Subjects
Aged, Dissection methods, Foreign Bodies etiology, Humans, Male, Referral and Consultation statistics & numerical data, Foreign Bodies surgery, Hand innervation
Abstract

The strange body at the hand level is frequent consultation pattern. Its extraction seems easy, however it's not. The authors reported one observation of the hand which is penetrated by a ig strange body. It's ablation is performed in a surgical room under anaesthesia, respecting the tension lines at the hand level and avoiding the nerves ramification of the cubital nerve that was hung by the harpoon.

Published
2000

23. Mitral balloon valvuloplasty by Inoue technique without echocardiographic standby.

Author

Kiwan Y, Endrys J, Kasri R, Hayat N, Langar J, Dhouib F, Lilia B, and Bousnina A

Abstract

Mitral balloon valvuloplasty (MBV) by Inoue technique was performed in 85 patients with symptomatic rheumatic mitral stenosis (MS). Twenty-eight patients were male and 57 patients were female. The age range was nine to 59 years (mean 28). All patients were subjected to echocardiographic and Doppler examinations before and one day after the procedure. The first 57 patients were subjected to exercise tolerance tests (ETT) a few days before and a few days after the procedure. An echocardiographic score was measured regarding valve thickening, leaflet mobility, degree of calcification and the severity of involvement of subvalvular apparatus. The mitral valve area (MVA) increased from 0.9 +/- 0.2 cm2 to 1.9 +/- 0.45 cm2, (P<0.0001). The mitral gradient (MG) decreased from 20 +/- 5.8 mm/Hg to 5.05 +/-+ 3.2 mm/Hg (P<0.0001). Mean left atrial pressure (LAP) dropped from 25.85 +/- 8.4 mm/Hg to 11.05 +/- 5.4 mm/Hg (P<0.0001). Exercise tolerance test (ETT) increased from 5.59 +/- 1.3 to 11.75 +/- 1.48 min. (P<0.0001). Complications included severe mitral regurgitation (MR) in two patients (2.3%). In the first 57 patients, mild left-to-right shunt measured by green dye dilution technique had occurred in 40% of patients. In conclusion, MBV by Inoue balloon is a good alternative to surgical commissurotomy and echocardiographic standby is very helpful when it is available. However, MBV can be safely performed if echocardiography is inaccessible.

Published
1994
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24. [Contribution of transesophageal echography in auricular and mitral pathology].

Author

Béchraoui F, Kasri R, Langar J, Dhouib F, Ben Ammar K, Bouraoui L, and Bousnina A

Subjects
Adolescent, Adult, Aged, Female, Heart Atria, Heart Diseases complications, Heart Diseases physiopathology, Heart Septal Defects, Atrial complications, Heart Septal Defects, Atrial physiopathology, Hemodynamics, Humans, Male, Middle Aged, Mitral Valve Insufficiency complications, Mitral Valve Insufficiency physiopathology, Thrombosis complications, Thrombosis physiopathology, Echocardiography, Transesophageal, Heart Diseases diagnostic imaging, Heart Septal Defects, Atrial diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging, Thrombosis diagnostic imaging
Published
1993

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