[Tuberculosis prevention]. / Prévention de la tuberculose.

UNLABELLED: Tuberculosis prevention is classically based on early detection of potential contagious cases and their effective treatment. But due to new parameters such as migration flows around the world, the emergence of Mycobacterium tuberculosis resistant strains and the increase of the population at risk, screening should be more active and target those who are more vulnerable to developing the disease. Traditional screening methods such as chest X-ray and tuberculin skin test, due to their high sensitivity and low cost, remain valid especially in populations with a high prevalence of the disease. The interferon-gamma release assays (IGRAs) seem to be very useful in immunodeficient patients with prior BCG vaccination. The treatment of subjects at high risk of developing active tuberculosis with a daily isoniazid self-administrated dosage for a period of 9 months is a prevention measure not only at the individual level but also at the collective one. All prevention interventions should be part of a national program concordant with the guidelines of the WHO Stop TB program that recommend a universal access to quality diagnosis and treatment focused on the patient. OUTLOOK: New methods of detection based on gene amplification would better suit to detect tuberculosis in immunodeficient patients and identify treatment-resistant strains. The development of the third part of the Stop TB project would reduce the morbidity and mortality of this disease by 2025. CONCLUSION: The prevention of tuberculosis has been a major epidemiological challenge around the world and is continuously improving to adapt to the evolving disease.

[Family transmission of atopic organ manifestations and allergen sensitizing in 659 Tunisian families]. / Transmission familiale de l'atopie selon l'organe cible et de la sensibilisation allergénique: a propos de 659 familles Tunisiennes.

BACKGROUND: The atopic family transmission is the topic of many studies. In addition to the allergy total transmission, which is well established, it seems that atopic organ manifestations and their gravity are family transmitted. To our knowledge, very few authors studied the specific transmission of allergen sensitizing. AIM: The aim of this paper is to study the specific family transmission of atopic organ manifestations and allergen sensitizing, in Tunisian families. METHODS: 659 supposed allergic Tunisian families are studied, which include 1494 patients, 444 parents and 1050 children, consulting for rhinitis and/or asthma. All patients were submitted to a family investigation and had an allergologic check including skin prick test. RESULTS: We highlighted a transmission of the allergy according to the body between parents and their children. Asthma is more transmitted by the mother (p = 0.002) than by the father (p = 0.05). However, rhinitis is transmitted only by the father (p = 0.03). There is no significant concordance neither for asthma nor for rhinitis between children. Concerning the transmission of the allergenic sensitivity, our study doesn't show a statistically significant concordance between parents and children and between children. CONCLUSION: These results confirm the atopic family transmission of the symptoms especially between parents and children. It doesn't seem to exist of hereditary factor concerning the sensitizing allergen.

[Sub-pleural lipoma: apropos of a case]. / Le lipome sous-pleural: à propos d'un cas.

Lipomas are rarely observed in a subpleural localization. Clinical signs are uncommon and most are an incidental discovery at x-ray. We report a case of an incidentally discovered lipoma in the subpleural area observed in a 56-year-old patient. Physical examination showed normal respiratory function. An extrapulmonary intrathoracic opacity situated in the right axillary area was observed on standard chest x-ray. Computed tomography established the diagnosis of a subpleural fatty mass. This case draws attention to this uncommon localization of lipomas and illustrates the contribution of computed tomography for diagnosis. The CT pattern allowed us to avoid transmural or surgical biopsy.