[Predictive factors of recurrence in spontaneous pneumothorax]

Background: Spontaneous pneumothorax is usually a benign condition that most often affects young patients. Its most common complication is recurrence. This complication appears to be increased by some factors

Aim: To identify predictors of recurrence in spontaneous pneumothorax through a series of 204 cases. Methods: A retrospective study of 204 cases of patients hospitalized for spontaneous pneumothorax. 50 patients experienced at least one recurrence. The study of predictors of recurrence is based on the X2 test for the univariate analysis and logistic regression for the multivariate analysis

Results: The average age of our patients was 37 +/- 7.6 years. A male predominance was noted [97.6%]. 80.4% of patients were smokers. Pneumothorax is considered primary in 65.2% of cases. Fifty patients had at least one recurrence of their pneumothorax. Smoking and the pursuit of tobacco intoxication were the two risk factors for recurrence in our patients. Gender, age, side, importance of pneumothorax and therapeutic means of the first episode as well as the primary or secondary pneumothorax did not influence recurrence. In the multivariate analysis the pursuit of tobacco intoxication was the only predictor factor of recurrence

Conclusion: The recurrence is the most common complication of spontaneous pneumothorax. This risk appears to be increased by smoking and the pursuit of tobacco intoxication. Thus smoking cessation could be a simple and effective means to prevent recurrence

[Chemotherapy in advanced non small cell lung cancer]

Lung cancer is the worlds first cause of death by cancer. Locally advanced and metastatic non small cell cancers represent 2/3rd of cases at diagnosis and are of worst prognosis. We conducted a retrospective study of 202 patients to investigate the effect of chemotherapy on survival and quality of life. 95 patients received chemotherapy with VP16- CDDP [88%] or Gemcitabin-CDDP Improvement survival was observed in the chemotherapy group: 8 month IC 95% [6.6-9.3]4 month IC 95% [3.1-4.9] in the control group. Chemotherapy also had a good perfect on the quality of life with improvement of performance status symptoms and need of analgesic. However, although significant the role of chemotherapy in NSCLC remains modest and new therapeutic approaches are needed including prevention and early detection which are probably more effective and cheaper

Evolution de la fonction ventilatoire chez les BPCO. Etude analytique de 160 cas

The incidence of chronic obstructive pulmonary disease [COPD] is increasing particularly in developing countries. Their prognosis depend on several factors in particular the one second forced expiratory volume [FEV1] decline. To study FEV1 decline speed and factors affecting it, we carried out a retrospective study of 160 cases of COPD in stable state and heaving at least two FEV1 measures at 6 months of interval in the minimum and. The middle age was 63 +/- 12 yr, 52% was former smokers and 46% current smokers, with middle of 50 +/- 27pack-yr.The FEV1 decline was calculated by linear regression models. The decline average in FEV1 with time was 72 +/- 55 ml/yr. Absolute value was higher than 30 ml/yr therefore more accelerated than general population in 79% of cases. We confirmed by multivariate analysis that age and smoking habit and increased the FEV1 decline. However this last correlated with FEV1% predicted. We concluded that the decline of FEV1 is higher in COPD that in the general population and I slowing it needs smoking stop

Survie et facteurs pronostiques du carcinome bronchique non. a petites cellules: Revue analytique de 211 cas

Prognostic factors have a pivotal role in clinical oncology. They are helpful in the selection of treatment, provide insights into the disease process and the therapeutic response. The number of possibly useful prognostic factors in the lung cancer is large. This study attempts to observe the survival of non small cell lung cancer [NSCLC] and to find prognostic factors and other variables potentially associated with outcome of lung cancer. It's a retrospective study based on 211 patients with NSCLC. Median survival was 6 months with 95% confidence interval [4,2 - 7,8]. Overall 3 and 5 year survival were respectively 8,3% and 5,2%. Various Prognostic factors have been identified through univariate [Koplan-Meier] then multivariate [Cox] analyses. In addition to the clinical factors such as age, disease extent and performance status, other variables were found of significant prognostic value, like pre-therapeutic leukocyte level. Survival was significantly improved with surgery, radiation and also with chemotherapy, mainly in advanced. stage [IIIB and IV]

Fibrose pulmonaire revelatrice d'une drepanocytose

The lung is a target organ in sickle celle disease. The manifestations are the principal consequence of sickling of red blood cells leading to vascular thrombosis these manifestations can be dominated by the acute chest syndrome or be chronic with pulmonary hypertension or fibrosis. We report a case the originality of which is that the heterozygote sickle cell disease is an uncommon cause of pulmonary troubles. Moreover, pulmonary fibrosis is rarely reported in this disease, and finally the fibrosis has revealed the sickle cell anomaly. We recommend to include in the chronic pulmonary fibrosis etiologies the sickle cell disease, particularly those who are heterozygote

Les indications de la corticotherapie dans les B.P.C.O a l'etat stable

The efficacy of corbicollerapyis asthma is wonderfully bemonstrabed and its usefuluess. Well condified. But its bringing in the treatementsof COPD is covrovensed, particularyin the steady state. The aim of this prosective work was to evaluate the usefulness of this therapy in those diseases; 30 male patients with COPD in a steady state; all smokers were included. The mean age is 66 +/- 7 years. A clinical and functionnal respiratory evaluation was performed on obmission. Then a corticotherapy was instaured [10 mg/kg/day] and similar reevluations were contucted at time incremets until day 14. A clinical improvement [byspuea] was noticed in 87%. A significant respiratory functional improvement, based on FEVI was noticed in 10 patients. Thus 3% of our patients are responder. This percentage is similar to those of almost obben series the initial revensibility of the obstructive ventilatory trouble is the most predictive element for a positive response. It is allowed to conclude that steady state COPD response to corticosteroids is varying but could to positive in neanly third of cases, ye is so useful de perform a therapeutic test with corticosteroids in steady state COPD. Only responders would receive a long term oral corticotherapy. This attitude could be proposed until multicenti studies results on oral corticotherapy will be brought