[Smoking prevalence in A Mami hospital of Ariana: prospective study about 700 health professionals]. / Prévalence du tabagisme à l'hôpital A Mami de l'Ariana : Etude prospective à propos de 700 professionnels de la santé.

BACKGROUND: smoking is one of the most serious threats to public health worldwide. Health structures are the cornerstone of each program against smoking , or some studies have shown a prevalence of smoking as high in hospitals than in the general population. Aim : To assess the prevalence of smoking, smoking behavior and attitudes of health professionals towards smoking within the A Mami Ariana Hospital METHODS: This is a cross-sectional survey conducted among 700 health professionals (doctors, nurses, workers, technicians and administrative staff) in the first quarter of 2010, based on a detailed questionnaire containing 15 closed-end items. RESULTS: The average age was 37 years and the sex ratio 0,5. Response rate to questionnaire was 81,4% and overall smoking prevalence 24,8%, five times higher in men (52,5% vs 9,8% p< 0,001). Smoking was greater among workers, night health professionals employees and employees of technical services, administration and intensive care services and only 13% among doctors. 50% of the surveyed have already tried at least once to quit, twice as many women than men. Former smokers accounted for 5,5% of all health professionals. CONCLUSION: Although our hospital has been declared non-smoking area since 2009, 75% of professionals continue to smoke at the scene of their work. Strengthening of existing measures against smoking as smoking bans in the hospital, and improving training of health professionals on the dangers of smoking and ways of weaning are needed now.

[Results of tuberculosis screening in children with household contact]. / Résultats du dépistage de la tuberculose chez les enfants contacts de parents tuberculeux.

INTRODUCTION: Tuberculosis screening in children is important to identify and treat latent tuberculosis infection and thus avoid progression to disease. METHODS: It is a prospective study realized in 83 children between November 2009 and January 2013 who consulted after a household contact for tuberculosis in the pediatric department B of Abderrahmen Mami hospital of Ariana. RESULTS: The mean age of the children was 4.8 years (3 months-15 years). A latent tuberculosis infection was diagnosed in 31.3% of children, 10.8% had tuberculosis and 57.8% were considered healthy. Fifty-seven children (68.7%) had a close daytime contact with the index and 57.8% slept in the same bedroom of the contaminator. The identified risk factors were the diagnosis delay of the index of more than 30 days (P=0.023), presence of cavitations on the chest X-ray of the index (P=0.029) and a close daytime contact (P=0.004). CONCLUSION: Our study showed a high rate of contamination in children with a household contact. Efforts are needed to shorten the time to diagnosis of adults' tuberculosis.

Primary mediastinal angiosarcoma: a rare observation in a patient with 8-year-survival.

BACKGROUND: Vascular tumours of the mediastinum are rare, accounting for 1-2% of all mediastinal tumours in this location. Angiosarcomas are most often encountered as sporadic lesions, typically in the scalp or face of elderly patients. However, they can occur in any anatomic site. Mediastinal angiosarcomas (MA) are very rare with less than 50 cases reported. CASE REPORT: The authors describe the case of a 38-year-old woman whose past medical history was consistent for a MA that was diagnosed in 2003. This tumour was treated by complete surgical resection followed by radiation therapy and chemotherapy. Diagnosis was based on histologic examination. In 2011, the patient presented a pleural localisation of the angiosarcoma and died one month after admission, 8 years after diagnosis of the MA. CONCLUSION: MA is a very rare tumour causing a diagnostic dilemma. Clinical and radiologic findings are non-specific, and final diagnosis is based on histologic examination. The case described is unusual considering the long period of survival, which may be explained by the treatment modalities associating complete surgical resection, chemotherapy and radiation therapy.

[Cardiac tamponade and myocarditis in Churg-Strauss syndrome]. / Tamponnade et myocardite aiguë au cours d'un syndrome de Churg-Strauss.

INTRODUCTION: The successive occurrence of pericardial tamponade and myocarditis during a Churg-Strauss syndrome is exceptionally described. We report a patient in whom pericardial tamponade and myocarditis were the presenting manifestation of a Churg-Strauss syndrome. CASE REPORT: A 58-year-old woman was admitted because of alteration of the clinical status with eosinophilia. One month ago, she was hospitalized for a pericardial tamponade treated by pericardial drainage. Acute myocarditis was diagnosed on chest pain during the second hospitalization. The etiologic inquiry ended in the diagnosis of Churg-Strauss complicated with a double cardiac involvement. A good response of clinical and biological anomalies was obtained after corticosteroid and immunosuppressive treatment. CONCLUSION: Isolated or multiple involvements of cardiac tunics should lead to make diagnosis of systemic vasculitis. A complete initial assessment and a close observation of the patients followed for Churg-Strauss syndrome is imperative to detect a cardiac achievement and set up an early treatment.