[Thoracic hydatidosis. A review of 1619 cases]. / Les localisations thoraciques de l'hydatidose. A partir de 1619 observations.

We analyzed the cases of 1619 patients who underwent surgery for hydatidosis in a chest localization to present a review of this parasitosis, endemic in Southern Mediterranean countries. A lung localization was observed in 1527 patients (94.6%). Extrapulmonary localizations were less common (5.62%) and included 42 heart cysts, 21 primary pleural cysts, 13 diaphragm cysts, 8 mediastinum cysts and 8 ribs cysts. For pulmonary cysts the sex ratio was 1: 1 (51.46% men, 48.85% women). Mean age was 24 years. A context of hydatid exposure was present in 81.8% of cases. The diagnosis was established on the basis of associated functional signs and an opacity with regular borders on the chest x-ray. Surgical treatment was simple cystecomy in 85.9% of the cases and lung resection in 14. 1%. Operative mortality was 0.785%. Pleuropulmonary recurrence was observed in 21 patients. Thoracic and pulmonary hydatidosis is easily diagnosed and treatment is well defined. It remains however a major challenge for health care with an important social and economic impact. Prevention can only be achieved by carefully designed actions against parasite transmission.

[Epidemiology of chronic arteritis of the lower limbs: multicenter study: report of 531 cases]. / Epidemiologie de l'arterite chronique des membres inferieurs: etude multicentrique: à propos de 531 cas.

Arteritis is a local finding of a general disease: atherosclerosis. To define the risk factors of this disease in Tunisia, 531 patients were collected by a multicenter retrospective study between January 1998 and December 1999. Most of our patients were male with a mean age of 62 years. The most important risk factor was tobacco with an incidence of 90%. Lipids and diabetes were less common. The association of risk factors is particularly dangerous.

[Carotid stenosis: indications and therapeutic approach]. / La stenose carotidienne: indications et conduite therapeutique.

There has not been a peripheral vascular surgical procedure subject to as exquisite scruting as carotid endarterectomy. The last decade gave a new attitude after the analysis and conclusions of the North American Symptomatic Carotid Endarterectomy Symptomatic extracranial lesions were best managed with operative intervention rather than antiplatelet treatment alone. Now, in the first decade of the new millenium, we are embarking on yet another test of carotid endarterectmy--a comparison with percutaneous angioplasty and stenting, which is a most rigorous contest because endarterectomy must now withstand comparison with another "active treatment" rather than the more passive observational modality of antiplatelet therapy. The topic of the authors was to provide a panorama of the contemporay treatment of carotid disease at this pivotal point in the life cycle carotid endarterectomy.

[Brucella endocarditis of native valves. Report of 3 cases]. / Les endocardites brucelliennes sur valves natives. A propos de 3 cas.

Brucella endocarditis is a rare but a serious complication of human brucellosis. We report 3 cases, the diagnostic was suspected by the patient's history of systemic brucellosis in two cases and established by the culture of native valve material in the third. All the patients underwent surgery for non control of the infections, one patient died in immediately postoperative period by acute cardiac failure. For the other patients, there were no early or late mortality and no recurrence after a follow up of respectively 6 and 84 months. The diagnostic of brucella endocarditis needed a very high degree of clinical suspicion, it requires an early management valve replacement is in the majority of cases, followed by adequate and prolonged antibiotic treatment.