[Assessment of eating behavior after smoking cessation]

Background: Weight gain is very frequent after smoking cessation and constitutes an obstacle to the decision to quit smoking

Aim: To assess the impact of smoking cessation on the weight and eating behaviour

Methods: This was a prospective study that included thirty four smokers. A questionnaire allowing the assessment of the eating behaviour was given to all smokers at the first consultation and at one month of smoking cessation

Results: The mean age was 40.32 years. Thirty two smokers were males. The mean weight had increased by 1.7 kg at 1 month of smoking cessation [p=0.00]. The increase of weight was significativelly associated with the female gender, the age of smoking initiation and the consumption of cigarettes per day. The waist and hip circumferences had also increased [p=0.00]. The calories intake had increased from 3875.70 Calories to 4168.85 Calories [p=0.03]. Snacking had increased from de 73.5% to 82.4% [p= 0.263]. The intake of lipids and carbohydrates had not changed. The intake of protein had decreased from 14.57% to 13.5% [p= 0.041]. An increase of the intake of fiber [p= 0.033], zinc [p= 0.033], and vitB9 [p= 0.044] had been noted

Conclusion: The weight gain is an unwanted effect of smoking cessation which justifies a global care

[ Pollen-food olive-olive syndrome]

Background: The pollen-foods syndrome is rare and of difficult diagnosis. The aim is to report a rare case, it's the four case reported in the literature

Case report: A 48-year-old woman presenting with palatal itching and generalized urticaria following ingestion of olive fruit, 5 years after being diagnosed with olive pollinosis. She did not have a history of other food allergy or urticaria. The prick-test was positive in olive pollen.The olive pollen specific IgE was positive. The oral provocation test was positive for olives and negative for olive oil. The diagnosis of "pollen-food olive-olive syndrome" was accepted. Interestingly, in this rare case the patient developed olive fruit allergy in the presence of olive pollinosis, but did not experience allergic symptoms to fruits other than olive

Conclusion: In spite its rarity this syndrome should be evoke particularly in our country

[Pulmonary tuberculosis in immunocompetent: causes and consequenses]

Background: Despite scientific advances, extended forms of pulmonary tuberculosis are still relevant. The aim of our study was to determine clinical features and outcome of extended pulmonary tuberculosis in immunocompetent patients

Methods: Retrospective comparative study including 100 patients HIV negative, presenting pulmonary tuberculosis divided into 2 groups of 50 patients [group1: extended tuberculosis and group2: localized tuberculosis]. Tuberculosis was considered extended when reaching above one lobe

Results:The average age was comparable in the 2 groups [p = 0.138]. In group1, we noted a higher incidence of diabetes [p = 0.037] and malnutrition [p = 0.045]. Clinically, patients in group1 had more general signs [p=0.033] and dyspnoea [p=0.037]. Biologically, anemia [p<0.001], leukocytosis [p=0.05], elevated CRP [p=0.031], thrombocytosis [p=0.023], hyponatremia [p = 0.001] and liver disturbances [p = 0.001] were significantly more frequent in group1. Concerning the evolution, time to smear negativity was significantly longer [p=0.012]. Similarly, radiological sequelae were more frequent [p = 0.02] and more extensive [p = 0.012]. Positive predictive value of radiological extent in disease evolution was 62% with a confidence interval between 47.2% and 75%

Conclusions: The extent of pulmonary tuberculosis is an important factor in clinical and biological presentation and disease evolution. Indeed, patients with extended tuberculosis develop more severe presentation and are more likely to develop parenchymal sequelae

[Palliative chemotherapy of non small lung cancer in Tunisia. prospective study of the cost and impact on the quality of life]

Bronchopulmonary cancer is actually the first cancer in the world. In Tunisia, recent statistics are alarmous. The most bronchopulmonary cancer in tunisian series are diagnosis at metastatic states. To evaluate the cost of the global treatment by chemotherapy in patients with metastatic non small lung cancer and its impact over the quality of life in Tunisia. It's a prospective study lead between January 2006 and Juin 2007 to evaluate the quality of life for patients hading metastatic non small lung cancer treated by palliative chemotherapy in Ibn Nafiss department in Abderrahmen Mami hospital.The evaluation of the qualitt of life is inspired by the questionnary of EORTC: QLQC30 version 3 translated in en arab langage, filled before chemotherapy, after the le 3rdcycle, and at the end of the first ligne. The study of the cost is effectued for the 2 protocols whose the most used in first ligne: Cisplatin-Vinorelbine [P-V] and Cisplatin- Gemcitabine [P-G]. 30 patients had benefit from palliative chemotherapy based on P-V [18 cases] or P-G [12 cases]. All patients had responded for the questionnary in the opportunt moments. After 3 cycles of chemotherapy, we note an improve of the symtomatic, physical, activity, emotional and global health scales. In opposition, we note a deterioration of cognitive and social scales without any supplementary improvement[no significant difference] if we add other cycles in the twice protocols. At the same level of the benefit in term of quality of life and survival without supplementary toxicity, the choice is made by the less cost's protocol in other words P-V. Our results confirm the benefit from chemotherapy in term of survival and quality of life in our context, howewer, the important cost of the chemotherapy necessitate to rationnalize the indications and the le choice of the treatments in this palliative indication

[Lung cancer with venous thrombo-embolism: clinical characteristics]

Lung cancer is the most common malignancy diagnosed in patients with venous thrombo-embolism [VTE]. To investigate clinical, biological, radiological features and survival of lung cancer patients with VTE. Retrospective case-control study investigating biologic, clinical course and survival of 25 patients lung cancers with VTE [Group M] and 50 lung cancers without VTE [group T]. The frequency of the VTE was 5.88% with 2.58% pulmonary embolism [PE]. The mean age was 58 years +/- 9.8 in group M and 57.9 years +/- 9.6 in group T. No significant difference concerning medical or surgical history for both groups was found. The dyspnea and chest pain were at equal frequency [63.6%]. Regarding the clinical probability of the PE, it was no significant differences between the two groups. A rate of D-dimer > 0.7micro g/l was more frequent among group M [75% vs 20%; p = 0.054]. The most common histological type was nonsmall cell lung cancer [88%]. A stage IV was significantly more frequent in group M [86.4% vs. 52.3%; p = 0.007]. The mean period of survival in Group M was 10.6 +/- 1.2 month and 20.2 + 1.8 month in group T; p = 0.38. The VTE associated to lung cancer is under diagnosed. Prospective studies are needed to establish more adapted scores

[ value of tumor markers in pulmonary tuberculosis]

In thoracic oncology, no tumor marker has yet shown sufficient sensitivity nor specificity to be usefull for lung cancer diagnosis. However, in some cases, monitoring of tumor marker blood levels provides useful evaluation of response to specific treatment and assessment of infracfinical tumor progression. To determine the value of umor markers in pu1monar tuberculosis. A prospective study was conducte in our department during 2 years 2005 through 2007. We included 40 men who presented confirmed pulmonary tuberculosis. Before starting antituberculous chemotherapy, serum assays were practiced for the following tumor markers: NSE, CA 12.5, ACE and Cyfra 21.1. Mean age was 37, 12 years [17-81]. The levels of NSE were high in 91, 66%of cases with an average value of 29,22 micro g/l [2,24 X normal]. This highest sensitivity was superior to those of other tumor markers: 55, 55%for CA125, 28, 94%for ACE and 7,6%for Cyfra 21.1. Analysis of the levels of NSE according to age, tobacco consumption, delay of consultation, type of the pulmonary lesions and negativation delay in smear did not show any significas difference, whereas levels of CA 125 were higher in bilateral lesions [P=0, 05].The highest sensitivity of the NSE in pulmonary tuberculosis, with no neoplastic pathology could be interesting diagnosis of smear negative tuberculosis, with small amounts bacilli

[Benign schwannoma: a case report about a uncommon localization]

Schwannoma is a benign slow growing nerve sheath tumor which generally originates from cranial or spinal nerve roots. Peripheral nerve localisations are scarce. We report the case of a 76-year man who presented with a laterosternal chest wall mass located in the fourth intercostal space. Diagnosis of intercostal benign schwannoma was suggested by medical imaging and confirmed histologicolly upon surgical removal. Chest wall solitary schwannoma is exceptional. Our case is still more interesting by its peripheral localisation and late occurence following a chest trauma