[Crohn's disease: influence of age at diagnosis on clinical type of disease]

The aim of the study was to examine the influence of age at diagnosis of Crohn's disease on disease site and course in Tunisian patients

Methods: All hospital patients for Crohn's disease between 1993 and 2002 were included. They were segregated by age at diagnosis as follows: younger than 20 years, 20-39 years, and 40 years or older. And all patients were classified at the time of the latest visit into one of three subtypes of disease [non complicating, stricturing, and fistulizing] according Vienna's classification. Crohn's disease was devised also by site [ileum, ileocecal, colon and higher site]

Results: Sixty one patients [50,4%] were 20-39 years old and 43 patients [35,5%] were 40 years and older. Colonic involvement was significantly more common [46,5%] in the 40 years and older group compared with 20-39 years group [24,6%] [p=0,01]. The subtype without complication was significantly more common [58,1%] in the 40 years and older group compared with 20- 39 years group [39,3%] [p=0,05]. The frequency of the need for surgery for any indication for Crohn's disease didn't differ significantly according to age

Conclusion: In this study, Crohn's disease diagnosed in tunisian patients that were 40 years and older had often a colonic site and a less severe phenotype supporting the concept of genetic heterogeneity

[Epidemiologic profile of gastric carcinoma: study of 140 cases]

The authors make a retrospective study of a series of 140 patients aged 59 years in average, followed up from 1995 to 2002 for adenocarcinoma of the stomach. Surgical resection was performed in 79 percent of the patients with total gastrectomy in 15.4%, partial gastrectomy in 50.6%. Resection was considered as curative in 66%. Lymph node metastases were present in 42, 9 percent of the patients. Margins of resection were involved in 24, 5% of the specimens. The mean survival rate was 26.5 months, 13 months and 5 months after curative resection, palliative resection and without resection

[Importance of vaccination chronic hepatitis B]

Weak therapeutic responses and weak immune cytotoxic CD8 and CD4 response in chronic hepatitis B emphasize the necessity to find new therapeutic strategies especially as specific immunotherapy. Vaccination, whose principle was to widen immune repertoire, was used as a curative treatment of chronic hepatitis B. It would be the therapeutic procedure with the lowest cost and the potentially greatest benefit. Our purpose was to enhance the interest of therapeutic vaccination in chronic hepatitis B in order to debate later its usefulness in developing countries