[Allergic bronchopulmonary aspergillosis: a review of 3 cases]

Allergic bronchopulmonary aspergillosis [ABPA] is a rare affection, initially described in 1952. Its pathophysiology incriminate several mechanisms in relation with the organism of the patient and the bronchial colonisation by the fongic agent. To report three cases of ABPA. Three patients had been treated for ABPA in Ibn Nafiss department in Abderrahmen Mami hospital in Ariana. ABPA had been discovered in the three cases by a corticodependant asthma, refractory for different therapeutics. Positif diagnosis reposed in the 3 patients at 6 major and one minor criterion. Traitment was essentially based in corticotherapy. Positif diagnosis of ABPA is actually well established, however, its traitement, although based on corticotherapy, remind not clearly codified. Association of antifongic treatment may improve the prognosis

[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

[Adjuvant chemothgerapy in resected non small cell lung cancer: preliminary results about 8 cases]

Report the preliminary results of adjuvant chemotherapy in patients surgically treated for non small lung cancer. Its a prospective study about 12 patients surgically treated between January 2005 and December 2007.8 patients had benefit of adjuvant chemotherapy. The protocol had been based at 4 cycles of Cisplatine Our 8 men patients, aged for the mean of 59 years with a Performans Status at 1, had benefit of adjuvant chemotherapy after curative surgery. Six patients considered us II B stage, had benefit immediately for surgically treatment. Adjuvant chemotherapy protocol had been based of Cisplatin and Vinorelbine [5 patients] and Cisplatin and Gemcitabine [1 patient]. The 4 cycles can be administered without any limiting toxicity only for one patient who's received 2 cycles of Cisplatin and Gemcitabine in front of the severity of digestive side effects. Two patients considered us IIIB stage, had been surgically treated after neo adjuvant chemotherapy based at Cisplatin and Vinorelbine. Histological response was complete for twice of them. The same chemotherapy was stopped after 2 cycles us adjuvant, in front of haematological side effects. Two patients did at 4 and 15 months of neoplasic progression. The six other patients had been still on life with a move back of 33 months. Post operative adjuvant chemotherapy is the standard treatment for the II A and II B stages and probably for lB stage. For none immediately operative patients [IIIA and some III B], articulation of chemotherapy with surgery must be clarified

[Pulmonary metastases revealing choriocarcinoma]

Uterine choriocarcinoma is a trophoblastic tumour characterised by high metastasis potential. Pleuropulmonary metastasis can reveal rarely the neoplasm. Report a new case. We report the case of a 31 years- old woman, with no pathological antecedent, admitted in our department for thoracic pain and haemoptysis occurring two months after delivery of a dead child-birth. Chest X ray and thoracic CT scan showed several bilateral opacities. A diagnosis of metastatic choriocarcinoma was confirmed by plasmatic level of beta human chorionic gonadotrophin [beta HCG] superior to 4000 Ul/ml. Gynaecological exam revealed latero-uterine mass. Abdomino-pelvicn ultra sound and CT scan showed tissular latero uterine and hepatic masses. Brain CT scan had been normal. Patient did after 3 cures of chemotherapy because of acute respiratory failure caused by massive pulmonary embolism. Diagnosis of choriocarcinoma must be evocated in front of several pulmonary opacities occurring in genital activity women and necessities the dosage of level of betaHCG