RESUMO
Rheumatoid arthritis (RA) is a heterogeneous disease in terms of presentation and evolution. In recent years, a change in the face of this disease has been noticed. RA appears to be less lethal than before, with a larger decline in cardiovascular mortality. Patient hospitalization and orthopedic surgery appear to be declining. Today's RA also seems less active and less destructive. These documented changes, especially over the last decade, are attributable not only to the emergence of biotherapies, but also to more rigorous management strategies by rheumatologists as well as increased patient awareness.
La polyarthrite rhumatoïde (PR) est une pathologie hétérogène dans sa présentation et son évolution. Au cours des dernières années, un changement du visage de cette maladie a été remarqué. Cette maladie semble être moins mortelle qu'avant, avec une baisse plus importante de la surmortalité cardiovasculaire. Le recours aux hospitalisations des patients et à la chirurgie orthopédique semble aussi en baisse. Les PR d'aujourd'hui paraissent aussi moins actives et moins destructrices. Ces changements, attestés surtout au cours de la dernière décennie, seraient attribuables non seulement à l'émergence des biothérapies, mais aussi à des stratégies de prise en charge des rhumatologues plus rigoureuses et une meilleure prise de conscience de la part des patients.
Assuntos
Artrite Reumatoide , Ortopedia , HumanosRESUMO
INTRODUCTION: Nasal cavity acinic carcinoma are exceptional and often of turbinal origin. We report a case of acinic carcinoma of septal origin and discuss this histological type rare in this site. OBSERVATION: A 47-year-old women, with no pathologic history, consulted for right nasal obstruction and hyposmia having evolved for a year. The clinical examination revealed a right nasal cavity lesion adhesive to the septum. Tomodensitometry showed a right nasal cavity and ethmoid opacity without bone destruction. The surgical treatment was endonasal tumor resection. The histological examination revealed a nasal fossa acinic carcinoma completely resected. A postoperative radiotherapy was initiated. The evolution was uneventful without recurrence after 4 years of follow-up. DISCUSSION: Acinic carcinoma is rarely located in the nasal cavity. Its septal origin is exceptional. It is usually located at the salivary gland level. Curative treatment is surgery associated or not to radiotherapy. The prognosis is related to tumor extension and quality of resection.
Assuntos
Carcinoma de Células Acinares/cirurgia , Septo Nasal/patologia , Neoplasias Nasais/cirurgia , Carcinoma de Células Acinares/patologia , Carcinoma de Células Acinares/radioterapia , Feminino , Humanos , Pessoa de Meia-Idade , Septo Nasal/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/radioterapia , Radioterapia Adjuvante , Tomografia Computadorizada por Raios XRESUMO
Inherited complement deficiency is a rare disease. It predisposes to autoimmune diseases, glomerulonephritis, angioedema, and meningococcal meningitis. A prospective study was conducted over five years. The goal was to evaluate the prevalence of deficiency in Tunisian patients presenting with community acquired purulent meningitis and identify the type of deficiency. We enrolled 122 patients, 15 of whom presented with a complement deficiency (12.3%). This prevalence was higher than the one observed in the global Tunisian population and in reported international data. The mean age of deficient patients (13 men and two women) was 24.7 years.