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ABSTRACT: Background : The broncopulmonary cancer is a major problem of public health whose diagnosis is most of the time unfavorable. For a long time, strategies of management of cancer have not taken into consideration much the histological type and few authors have studied the implication of histological type of cancer on the future of patients having cancer. Aim: Taking into account the results of recent studies, we propose to review the recent epidemiological and biological aspects of bronchial cancers and then to study the impact on the therapeutic strategy. Methods: Review of literature Results: The scientific progress and the discovery of new mechanisms of carcinogenesis considerably enlarge the therapeutic potential targets and enable to adopt a more specific approach of the cancer cell. Conclusion: Despite the progress observed in thoracic cancerology, the benefits concerning survival remain modest. The oncoming of new molecules specifically targeting a stage of oncogenesis enables a better therapeutic selectivity and a lesser toxicity.
La Tunisie médicale 12/2012; 90(12):847-51.
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La Tunisie médicale 05/2012; 90(5):412-4.
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La Presse Médicale 12/2011; 41(7-8):755-9. · 0.67 Impact Factor
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La Tunisie médicale 10/2011; 89(10):802-3.
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ABSTRACT: Severe obesity sometimes leads to a chronic alveolar hypoventilation: obesity hypoventilation syndrome (OHS), (Pao2<70mmHG, Paco2>45mmHG and body mass index (BMI)>30Kg/m2). The association with an OSAS is frequent.
To assess predicting factors that lead to hypoventilation in a population of obese patients with SAS and to deduct the type of association between OHS and SAS.
We have study during 4 years, at pneumology service of Charles Nicolle hospital, 62 obese patients (BMI>30Kg /m2), 41men and 21 women and presenting an OSAS. We excluded those carriers of a bronchial obstruction (VEMS/CV <60%) and we have compared anthropométriques, functional, gazométriques and polysomographiques details of the groupe1 (G1): OHS=9 and of the groupe2 (G2): obesity without hypoventilation (n=53).
We didn't identified any significant difference between the two groups concerning (age, sex, the frequency of smokers, the frequency of the nasopharynx region abnormalities, apnea-hypopnea index (AHI), the SAS severity and the respiratory functional exploration). The obesity is significant more important in the G1, it is sever (BMI>40) in 77.8% of patients of the G1 with significant difference with the G2 (P=0.004). We noted that there is a positive interrelationship between BMI and Paco2. We identified severe gazométrique perturbation in G1 (Pao2 medium = 61± 9 mmHg,Paco2 medium=50 ± 7 mmHg), in the G2 we noted a moderate hypoxemia. Patients of the group1 make of the minimal desaturation of 63 ± 17% and a Sao2 average of 81 ± 20% what is meaningfully more important than in the G2.
The alveolar hypoventilation in SAS seems to be in correlation with the degree of obesity. The hypercapnie in the OHS is in relation neither with the SAOS nor with its severity. The OHSSAS association is usual but not synonym; the OHS is an autonomous disease.
La Tunisie médicale 09/2011; 89(8-9):668-71.
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La Tunisie médicale 06/2011; 89(6):578-9.
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La Tunisie médicale 06/2008; 86(5):513-5.
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ABSTRACT: The aim of this study was to determine the side effects of standard antituberculosis therapy with isoniazid, rifampicin, pyrazinamide and streptomycine in patients treated for tuberculosis. One hundred eighty nine patients with proven tuberculosis, who initially received standard antituberculosis therapy, were retrospectively studied. Begaud and coll's method of side effects drugs imputability elaborated in 1999 was used in our study. Side effects related to therapy were present in 31.7% of the studied population. Gastrointestinal side effect was the most common (13.2%), isoniazid, rifampicin and pyrazinamide were often incriminated. The significant risk factors of hepatotoxicity were female gender (OR : 10.59) and concomitant hepatotoxic drugs (OR 6). Chocleovestibular toxicity was associated significantly with female gender (OR : 8.03) and diabetes mellitus (OR : 6.13). Patients aged above 50, proved to be at risk for pyrazinomide intolerance and females for streptomycine. The study did not reveal any susceptibility to isoniazid and rifadine intolerance.
La Tunisie médicale 09/2006; 84(8):487-91.
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ABSTRACT: This article presents a literature review on the different methods of tobacco cessation that proved their efficiency through the recent meta-analyses. Smoking help cessation can consist in a systematic minimal advice that must be achieved physician or other professional of health throughout during their contact with their patients. This minimal intervention permits to get 5% of tobacco abstinence. The intensive clinical intervention is a very useful to higher dependent smokers or presenting anxiety and depressive disorders. It consists in a psychological combined approach by a behavioral and cognitive therapy and a pharmacological approach with two types of treatment: nicotine replacement therapy and the bupropion, the other "methods" not having proven their efficiency. The success rate of this intervention depends in the time of contact and the number of session. In order to promote tobacco cessation, it is necessary to widen the pharmacological product range and to educate health professionals in smoking cessation.
La Tunisie médicale 02/2004; 82(1):1-11.
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ABSTRACT: We estimate that more than 80% of tobacco-smokers hope that they will stop smoking one day. The major obstacle is the psychologic and pharmacologic dependence generated by the cigarette. Different weaning methods have been tried, but their rate of success remains low. The nicotinic sustitution by transdermic track (patch) will give good results providing it is prescribed within the framework of a medical help to wean away from smoking tobacco.
La Tunisie médicale 05/2002; 80(4):172-7.
