[Active smoking: A major risk factor for human non-communicable diseases in a hospital survey]. / Le tabagisme actif : un facteur de risque majeur des maladies non transmissibles humaines dans une enquête hospitalière.

INTRODUCTION: Tobacco is the main preventable cause of death worldwide. Our study aimed to determine the role of tobacco in the occurrence of non-communicable diseases (NCDs). METHODS: We conducted a retrospective study including all NCDs patients during 2015-2016. NCDs include cardiovascular diseases (CVD), chronic respiratory diseases (CRD), cancers (CS) and diabetes mellitus (DM). RESULTS: We identified 3643 cases of NCDs (43%) among 8478 hospitalizations, all diseases combined. Active smoking was found in 1076 cases (29.5%). Among the NCDs groups, CVD was the most common (65%). Tobacco was significantly associated with CVD (P<0.001), CRD (P=0.002), bronchopulmonary CS (P<0.001), haematological malignancy (P=0.023), and DM (P<0.001). Multivariate analysis performing binary logistic regression revealed that tobacco was an independent factor associated with CVD (OR=2.6, P<0.001), CRD (OR=1.5, P<0.001), bronchopulmonary CS (OR=1.8, P=0.013) and DM (OR=3.6, P<0.001). CONCLUSION: Active smoking was a major risk factor in the occurrence of NCDs. Thus, smoking cessation represents the cornerstone for preventing the spread of these diseases, especially in countries with limited resources.

Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation.

CONTEXT: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. METHODS: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. RESULTS: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. CONCLUSION: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.

[Surgical and endoluminal management of the inflammatory aortitis: A Tunisian center experience]. / Traitement chirurgical et endovasculaire des atteintes aortiques inflammatoires : expérience d'un centre tunisien.

Non-infectious aortitis is usually due to giant-cell arteritis, Takayasu disease or Behçet disease. The main aortic lesions are stenoses, occlusions and aneurysms in the Takayasu disease and aneurysms in the Behçet disease and giant-cell arteritis. Treatment is based on corticosteroid therapy and surgery. Endoluminal management is now the rule. We report a retrospective descriptive study of 10 patients who underwent surgical or endoluminal management of inflammatory lesions of the aorta between January 2000 and December 2015. There were 4 cases of Takayasu disease and 6 cases of Behçet disease. The aortic lesions were aneurysmal in all of the patients with Behçet disease. In the patients with Takayasu disease, aortic occlusions predominated, associated with other arterial lesions. Four patients with Behçet disease were managed surgically, and 2 patients underwent endovascular repair. All of the patients with Takayasu disease underwent surgery. Two patients died in the postoperative period, and two patients died during long-term follow-up. Systematic screening, as well as regular monitoring of the entire aorta during the follow-up, is necessary due to the frequency of aortic aneurysms.

[Results of a protocol for etiologic diagnosis of pneumopathies on immunosuppressed children (author's transl)]. / Résultats d'un protocole d'enquête étiologique des pneumopathies chez les enfants immunodéprimés.

A protocol for etiologic diagnosis has been used on 40 immuno suppressed children with pulmonary infiltrate. The purpose of this protocol is to permit an early etiologic diagnosis, concomitant infections by several pathogen agents being frequently seen. An endobronchial brushing is first performed; the results being obtained between 24 to 48 hours. If the results are negative and the patient's condition worsens we propose an open lung biopsy. Thus pathogenic agent has been established in 24 cases, in 17 cases by endobronchial brushing, in 3 cases by open lung biopsy and in 2 cases by endobronchial brushing and open lung biopsy. In 3 cases several opportunistic organisms were responsible of the pneumopathy. Pneumocystis carinii is the most often established (19 cases); it was also present in one out of 6 post mortem examinations. In 14 cases the pneumopathy occured in children treated for acute leukemia; Pneumocystis was the organism responsible in 6 of them; the evolution was favorable in 13 of the 14 cases. One patient died from a pulmonary infection by the measles virus.

[Severity factors of poisoning in children admitted to intensive care units]. / Facteurs de gravite des intoxications chez les enfants admis dans les unites de soins intensifs.

From 1964 to 1976, 854 children were admitted with poisoning to three intensive care units in Paris. The severity of the condition has been assessed in terms of the patients received: 1. observation only (67%). 2. routine intensive care (27%). 3. very seriously ill (6%). At the time of discharge, 92% of children were normal, 3% had minor sequelae, 3% had major sequelae; 2% died. The outcome was closely related to the severity of the illness. The main factors affecting the severity were: 1. The nature of the ingested substance. Poisoning with Amanita phalloides was the most serious with a high mortality. Poisoning with domestic agricultural and industrial products were more often responsible for major sequelae, particularly affecting the oesophagus, than drugs. 2. The type of poisoning. This was related to the age of the child. Iatrogenic poisoning of infants and self poisoning by adolescents were more serious than accidental poisoning in toddlers. 3. The toxicity of the ingested dose. 4. The interval between ingestion and effective treatment. Although all the factors are interrelated, each factor has its own prognostic value.