[Predictive factors of the outcome of smoking cessation among Tunisian women]

Background: The spread of smoking among women in Tunisia has reached alarming proportions because of increasing smoker rate, the younger age of smoking initiation and therefore its duration

Aim: Identify predictors of success or failure of smoking cessation, Methods: we conducted a retrospective study [January 2008-June 2011], including 101 female smokers [19.8%] among 510 smokers of both sexes undergoing smoking cessation interventions. Univariate and multivariate analysis between groups of smokers who succeeded and who failed smoking cessation was performed

Results: Average age of our patients was 44 years. The overall success rate at 6 months and 1 year were respectively 24.7 and 18.8%. In univariate analysis, a statistically significant difference in terms of successful weaning was observed in smokers who had a late age of smoking onset [after 20 years] [p = 0.03], respiratory or cardiovascular comorbidities associated [p = 0.03] and good adhesion to the consultation [p = 0.02]. In multivariate analysis only the presence of a tobacco-related disease [OR: 4.43, 95% CI [1.29- 15.17], p = 0.01] and adherence to the consultation [OR 5.02 95% CI [1.29 -19.39], p = 0.01] were significantly associated with a good prognosis for successful weaning at 6 months and one year. A possible but not significantly associated with age of smoking initiation was observed [OR = 0.3 95% CI [0.08 - 1.07], p = 0.06]

Conclusion: Beyond validated smoking cessation and prolonged follow-up, a differential approach, taking into account women specificities, would increase the chances of quitting smoking

[Management of non small cell lung cancer]

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. 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. Review of literature. 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. 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

[Obesity hypoventilation syndrome and obstructive sleep apnes syndrome: what kint of association?]

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 anthropom‚triques, functional, gazom‚triques 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 gazom‚trique 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

[Risk Factors of side effects of antituberculosis drugs]

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 tuber-culosis. One hundred eighty nine patients with proven tuber-culosis, who initially received standard antituberculosis the-rapy, were retrospectively studied. Begaud and coil'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