[Nasopharyngeal perforation: an exceptional accident during digestive endoscopy]. / Perforation du cavum: un accident exceptionnel d'endoscopie digestive.

A case of an endoscopic nasopharynx perforation is reported. As we known, this accident has never been described. During introduction of a duodenal tube appeared a subcutaneous neck emphysema. Radios revealed pneumomediastinum, pneumoperitonitis and retropneumoperitonitis. Nasofibroscopy affirmed the diagnosis. The too fast death of this 92 years old patient didn't allow an adapted therapeutic.

[AIDS and myasthenia: an uncommon association]. / SIDA et myasthénie: une association exceptionnelle.

A 18 year-old soldier, heroin-addict, presented with the association of myasthenia gravis and HIV infection with a specific subacute encephalopathy. To our knowledge, it is the second reported case. This association may result from an immune dysregulation due to nonspecific thymic modifications, which has been reported in AIDS.

[Tropical diabetes mellitus, a new nutritional indicator?]. / Le diabète sucré tropical, un nouvel indicateur nutritionnel?

Studies on diabetes mellitus in tropical zones indicate that its traditional link with overnutrition depends not only on the economic level, but also on some ethnic, social and cultural factors. At present, we insist on the unexpected relationship between diabetes mellitus and undernutrition either in some major infantile forms (described in India and Nigeria) with calcareous pancreatitis, or some less severe forms observed in Africa. This tropical diabetes mellitus occurs in some patients with normal weight or inferior to normal; it is not very ketogenic, responding to glucagon stimulation, and seems more frequent in the chronic malnutrition areas. So, it is tempting to utilize diabetes mellitus as an indicator of nutritional disorder or of dietary toxic factors. However, we ought to consider it within a multifactor surroundings associating genetic determinism and the other factors of tropical aggressiveness.