Specific sites of bone expansion depend on the level of volleyball practice in prepubescent boys.

The purpose of this study was to investigate the effect of 18 months of high and low levels of volleyball practice on bone acquisition. 130 prepubescent boys (mean age 11.4 ± 0.7) were divided into a high-level training group (HLG), low-level training group (LLG), and controls. Bone mineral content (BMC) and bone area at the whole body, lumbar spine L2-L4, femoral neck of the dominant leg, and right and left radius were measured using dual-photon X-ray absorptiometry. Enhanced BMC resulted from high-training volleyball activity in all measured sites except the third left and right distal radius, which is not modified by low-level training in prepubescent players but it was accompanied by a bone area expansion in radius and weight-bearing sites for the HLG, and in legs, whole right and left radius for the LLG. Significant improvement of skeletal tissues is associated with the intensity and duration of volleyball training.

[Arterial involvement in Behçet's disease]. / L'atteinte artérielle de la maladie de Behçet.

Ten cases of Behçet's disease with arterial lesions were observed in a series of 500 patients over a period of 12 years. The majority of patients were male (9/10) aged between 24 and 36 years with a mean of 30 +/- 5 years. The first group (3 cases) presented with thrombosis of the radial and superficial femoral arteries, the second group (4 cases) presented with aneurysm of the subclavian artery, common and external iliac arteries, brachiocephalic trunk and abdominal aorta and the third group (3 cases) had a combination of thrombosis and aneurysm of the pulmonary, external iliac and renal arteries.

[Characterization and evolution of blood cryoglobulin in visceral leishmaniasis]. / Caractérisation et évolution d'une cryoglobulinémie au cours d'une leishmaniose viscérale.

The evolution of immunological parameters in mediterranean visceral leishmaniasis reveal a type III mixed cryoglobulin with rhumatoid factor activity and antileishmania antibodies. This cryoglobulin follows the clinical signs of the disease and disappear under treatment. The authors insist on the transitory character of this cryoglobulin which is in relation with polyclonal stimulation of the immune system by parasitical infection.

[Cerebral miliary tuberculosis. Apropos of 5 cases and review of the literature]. / Miliaire tuberculeuse cérébrale. A propos de 5 cas et revue de la littérature.

The authors report 5 cases of cerebral miliary tuberculosis studied by computerized tomography and review 5 cases of the literature. Computerized tomography can see very small tuberculomas, of several millimeters. Chest miliary tuberculosis is found in all their cases, and 3 of the 5 cases of the other authors. Because of the discretion of neurological signs and the association with chest miliary, we suggest to make a computed tomography of brain of all patients who have chest miliary tuberculosis despite the absence of neurological signs and we think that we will find out other cases of brain miliary tuberculosis.

[Hepatitis and pregnancy in Tunis. 103 cases compared with 100 cases who were not pregnant (author's transl)]. / Hépatite et grossesse à Tunis. A propos de 103 cas comparés à 100 cas en dehors de la grossesse.

The authors have reviewed the notes of 103 pregnant women who contracted hepatitis during pregnancy and compared it with a controlled series of hepatitis occurring in 100 women who were not pregnant but were of reproductive age. The mortality rate in the pregnant group was considerably higher than in those who were not pregnant--27 deaths out of 103 cases as against 4 deaths in the control series of 100 cases. The fetal prognosis was very bad in the group of women who died. 3 out of 4 pregnancies resulted in loss of the fetus. It was less bad in those who had mild hepatitis--39.3% lost the fetus and one out of two pregnancies had a premature labour. Loss of consciousness was a very bad prognostic sign. The prognostic value of marked drop in prothrombin and raised white blood counts is emphasized in the cases who died. When the series of women who were pregnant and who survived is compared with those who survived in the control group, the authors found that judgment had to be used carefully in evaluating the prodromal signs in the pregnant women. They found in the two groups that the haemoglobin level and the serial levels of protein and albumen are comparable to those found in developed countries. They conclude that their maternal mortality due to hepatitis was comparable to that reported in underprivileged countries but that "malnutrition" in the broader sense of the term does not explain the serious state of affairs.

[Staphylococcal infection of the face. 52 cases]. / Infection staphylococcique de la face. 52 observations.

Severe staphylococcal infections, and notably those affecting the face, are frequent in Tunisia. We report 52 cases observed between December 1981 and September 1989. The epidemiological, clinical and therapeutic features of the disease are presented. New antibiotics have reduced the mortality rate to 4%. Lethal cases and sequelae are due to delayed treatment. This demonstrates the importance of an early treatment and, above all, of prevention by vigorous chemotherapy of even the mildest facial skin infections.

[Study of psychosocial factors in HIV infected patients in Tunisia]. / Etude des facteurs psychosociaux des patients infectés par le VIH en Tunisie.

We conducted a prospective study using an anonymous questionnaire and semistructured interviews on 60 patients with HIV to assess the psychological and socioenvironmental factors that may result in risk-taking behaviour. The patients were mainly young males (mean age 33.1 +/- 7.0 years) (sex ratio 2.3) deprived in both social and educational terms. Injecting drug use was the predominant risk factor and was characteristic of a first group of young men raised in large families shattered by rural-urban migration, with an antisocial personality. A second group consisted of women, mostly illiterate from traditional rural settings. They had been infected by their spouses who had worked abroad, whether drug users or not. Approaches for the prevention of HIV infection are proposed.

[Standard radiological characteristics of thoracic sites of tuberculosis in patients with AIDS in a Tunisian population]. / Particularités radiologiques standards des localisations thoraciques de la tuberculose chez des sidéens dans une population Tunisienne.

Aspects of tuberculosis on the standard chest X-ray in a population of 18 AIDS patients in Tunisia were examined. The diagnosis of pulmonary tuberculosis was confirmed in all cases with bacteriology tests. Diffuse lesions of the parenchyma predominated contrasting with the exceptional nature of cavernous formations. Localized infiltrations were infrequent and intrathoracic node enlagement was rare. Cases with no abnormal radiological signs were also seen in advanced HIV infection. Such atypical cases, in agreement with data in the literature, would be explained by immunoradiologic correlation. Thus it is necessary to search for the tuberculosis bacilli in all patients with HIV infection whatever the aspect on the standard chest X-ray.

PIP: The chest X-ray is a fundamental element in the diagnosis of pulmonary tuberculosis (TB). In the person co-infected with HIV and TB, radiological signs can be deceiving given the degree of immunodepression and the resulting clinical manifestations. TB is endemic in Tunisia with a prevalence of 120 people infected per 100,000 population. TB affects 42% of people with AIDS in Tunisia, the major opportunistic infection in that population. The authors report upon their examination of aspects of TB in the standard chest X-ray of 18 AIDS patients in Tunisia. The diagnosis of pulmonary TB was confirmed in all cases with bacteriology tests. Diffuse lesions of the parenchyma predominated contrasting with the exceptional nature of cavernous formations. Localized infiltrations were infrequent and intrathoracic node enlargement was rare. Cases with no abnormal radiological signs were also seen in advanced HIV infection. Such atypical cases, in agreement with data in the literature, could be explained by immunoradiologic correlation. The authors stress the need to search for the TB bacilli in all patients with HIV infection regardless of the aspect on the standard chest X-ray.

[Role of cryptosporidia and microsporidia in diarrhea in immunocompromised patients]. / Place des cryptosporidies et des microsporidies dans les diarrhees des immunodeprimes.

Cryptosporidium and Microsporidian play an important part in the diarrhoeic pathology of the immunocompromised patients. The study of 35 cases of cryptosporidiosis and 4 cases of intestinal microsporidiosis diagnosed in the parasitology laboratory of Rabta hospital of Tunis shows that cryptosporidiosis prevalence is 17.24% for AIDS patients, 3.45% for immunocompromised patients VIH (-), and microsporidiosis prevalence is 5.7% for patients with acquired immunodeficiency syndrome. Common points for these two parasitosis are: Clinical syndromes dominated by an acute diarrhea A diagnosis based on specific techniques showing the significance of the clinical orientation. Lack of an effective specific therapy.