Solid tumors after chronic lymphocytic leukemia patients: report of six cases and review of the literature

Introduction: Malignancies have been reported to occur with increased frequency in chronic lymphocytic Leukemia [CLL] patients. The aim of this study was to describe which second malignancies occur in patients with CLL, whether these malignancies are related to CLL, its treatment, or both. We also attempt to study factors predicting the development of other malignancies

Patients and methods: Between 1995 and 2009, six cases of CLL associated with solid tumor were diagnosed in Hematology Department of Military Hospital of Tunis. The diagnosis of CLL was made by immunophenotyping of peripheral blood circulating B cells, and the diagnosis of solid tumors was made by biopsy with anatomopathological exam and immunohistochemical study

Results: The mean age of patients was 71 years. Five patients were male. The CLL was classified Stage A in one case, Stage B in three cases and Stage C in two cases. Two patients had abnormal karyotype. Three patients have not received specific treatment for their CLL. Solid tumors were represented by skin cancer in three cases, lung cancer in two cases and breast cancer in one case. The median time between diagnosis of CLL and that of solid tumor was 53 months

Conclusion: Patients with CLL have an increased risk of developing a second cancer. Awareness of risk factors could permit early detection

Goals for oral health in Tunisia 2020

In 1981, the World Health Organization [WHO] together with the F‚d‚ration Dentaire Internationale [FDI] set global dental health goals for the year 2000 within the global strategy of health for all. In 1999, a team of experts drew up new goals to be achieved by 2020, which aimed to facilitate specific oral health policy development for each country. These goals are more general and have to be adapted to local circumstances. This paper aimed to adapt the WHO/FDI/IADR's Global goals for oral health 2020 to Tunisia and draw up new national goals and targets for Tunisia based on previous national oral health surveys

Pleural and lung complications of chickenpox in the immunocompetent adult

Varicella [chickenpox] is a common, contagious and usually benign infection in childhood nevertheless, in adulthood, it's uncommon, severe and usually associated to a high mortality rate. Varicella pneumonia is the most common and fatal complication of this infection in adults. However, pleural involvement is exceptional. We report the case of an immunocompetent adult patient presenting with fever, right chest pain, cough, shortness of breath and vesicular cutaneous disseminated rash, suggestive of varicella infection. Chest radiograph revealed interstitial left lung pneumonia associated with a total right pneumothorax. Serum sample varicella-zoster was positive to Ig G. A high dose venous acyclovir treatment with pleural drainage were effective, with improvement of clinical signs, healing of vesicular rash and reexpansion of the right lung. Varicella pneumothorax, contrarely to varicella pneumonia, is an extremely rare complication of chikenpox, and should be ruled out by chest x-ray examination if a patient with chickenpox develops a sudden chest pain or shortness of breath

Effect of 5 years of dental studies on the oral health of Tunisian dental students

This study is a follow- up of one made in 1998- 99 on first- year dental students in Monastir. Now in their fifth year, we assessed the effect of dental studies on students' oral health practices and dental health. Of the 155 students in the first study, 140 were still enrolled. Periodontal troubles, malocclusion and dental decay affected 84.3%, 80.0% and 43.0% of the students respectively. Compared with the previous study, students had achieved a better dental health status - tooth-brushing rate was much higher, prevalence of dental decay and periodontal pockets had decreased, and DMF index had improved. However, the prevalence of smoking, bleeding and calculus had not changed, and the frequency of malocclusion had increased

[Profile of first year dental students in Tunisia]

The aim of this study was to assess social conditions, school history, professional choices and oral health status of first-year dental students 1998/1999. We included 155 Tunisian students, 18-22 years old. There was a higher proportion of female students [58%] whose average age [18.9 years] was younger than the males. We found that 79% came from urban environments and 41% from middle socioeconomic background. Also 48% had parents who had a high level of education. Dental studies were the first choice for 50% of the students and they were looking for prestige and security. Concerning oral heath status, 88% of the students had periodontal problems and 70% had caries. More information for students about the options available to them at university and greater efforts from teachers to motivate students in oral hygiene are needed

School oral health survey in Kairouan, Tunisia

The aim of the oral health survey was to study oral disease prevalence in 600 schoolchildren [aged 6 years and 12 years] in Kairouan. World Health Organization methodology was used and the results were compared with the 1994 national survey findings. As well as oral examination, fluoride dosage in drinking water was assessed. Analysis showed that the findings were in agreement with the national survey except for dental caries prevalence, therapeutic index and dental fluorosis prevalence. Thus WHO recommendations made after the national survey remain valid in Kairouan

[Prevalence of dental caries in children with low birth weight]

Dental caries was evaluated in 58 children with low birth weight [750-2500 g] and in a control group of 58 children with birth weights greater than 2500 g. All children were examined for their caries experience using a standardized clinical examination. The results showed a higher prevalence of caries in the children with low birth weight [77.5%] than in the children with birth weights greater than 2500 g [44.8%], the difference being statistically significant [P < 0.001]. There was a negative correlation between birth weight groups and prevalence of caries [r = -0.34]. It was concluded that children with low birth weight have a greater risk of dental caries than others