[Pulmonary tuberculosis and diabetes. A retrospective study of 60 patients in Tunisia]. / La tuberculose pulmonaire provoque un déséquilibre du diabète Etude rétrospective de 60 malades en Tunisie.

BACKGROUND: Tuberculosis is a frequent infectious disease in Tunisia. The estimated case rate is 22.3 per 100,000 inhabitants. The risk of tuberculosis is 2 to 6 times greater in patients with diabetes. The purpose of this study was to analyze the particularities in the etiology, diagnosis and bacteriologic course of pulmonary tuberculosis in patients with diabetes and to evaluate the impact of tuberculosis on diabetes control. METHOD: This retrospective case-control study of 142 patients with confirmed pulmonary tuberculosis seen from 2000-2006 compared the 60 patients with diabetes with the 82 without diabetes. RESULTS: Diabetes was more frequent in older patients with tuberculosis and in women. 91.5% had type 2 diabetes. A history of contact with people with tuberculosis was significantly less frequent in the group with diabetes (13.3% vs 30.5%; p=0.01). Tuberculosis symptoms and their duration did not differ between the 2 groups. Basal lesions and cavitation occurred more frequently in the patients with diabetes, but this difference was not significant. The time for conversion to negative of sputum culture was longer in case patients (43+/-27 days) than in controls (28.2+/-20.5) (p=0.03). The proportion of patients with uncontrolled diabetes was elevated, and 50% required frequent insulin treatment. CONCLUSION: Tuberculosis is frequently associated with diabetes, usually due to reactivation of Mycobacterium tuberculosis. It is characterized by a longer time to culture conversion to negative and a risk of uncontrolled diabetes that requires frequent treatment adjustment and insulin use.

[Association of IGg multiple myeloma with pulmonary amyloidosis: about one case]. / Association myelome multiple à IG G--amylose pulmonaire: a propos d'un cas.

Pulmonary amyloidosis is a rather rare complication of multiple myeloma particularily the rare Ig D myeloma. It is often generalized and is seen in a late stage of the disease. We report a case of an Ig G myeloma complicated of a pulmonary amyloidosis in a 66-year-old man hospitalised for infectious pulmonary disease with a radiologic interstitial syndrome. Discovery of the multiple myeloma and of the amyloidosis was fortuitous.

[Lung cancer and chondromatous hamartoma: a case report]. / Association hamartochondrome pulmonaire et cancer bronchique, à propos d'un cas.

The association lung cancer with chondromatous hamartoma is frequent. We present a case of synchronous primary lung adenocarcinoma and chondromatous hamartoma. Although hamartoma is generally considered to be a benign tumor, there have been several reports of increased risk of lung cancer in patients with a chondromatous hamartoma. Therefore we recommend that patients with hamartoma should be submitted to a complete evaluation and to regular follow up, considering the risk of associated synchronous malignancy.

[Tracheobronchial foreign bodies. Diagnostic and therapeutic aspects in children]. / Corps étrangers trachéo-bronchiques de l'enfant. Aspects diagnostiques et thérapeutiques.

In this retrospective study, the authors reviewed 31 cases of tracheobronchial foreign body in children ranging in age from one to 15 years, recruited in Ariana hospital since 1987. 74% of the patients were male, and only 26% were less than 3 years old. The foreign body is mostly revealed by a radio-clinical presentation of a feverish bronchopneumonia (32%); children were referred to the hospital within 15.4 months. Although penetration syndrome was reported in 61% of patients, it represented the reason of consultation in only 19% of cases, and children were referred within 4.5 days. The main radiographic findings were atelectasis (32%) and non specific foci of pneumonia (19%). Air trapping was noted in just 10% of cases. 55% of foreign bodies were vegetable in nature, with sunflower seeds at the head of the list (16%). They have been lodged preferentially in the right bronchial tree (58%) and 51% of them were found in the mainstem bronchus. 71% were removed by endoscopic procedures; a surgical operation was performed in 6 cases (19%): one case of pneumotomy to extract a metallic foreign body from distal respiratory tract, and five cases of parenchymal excision, including four for bronchiectasis. 77% of patients had symptoms that lasted at least 2 weeks before diagnosis; the long delay in diagnosis (average of 7.6 months) explains the high-level of bronchiectasis in our study (22%). The authors emphasize the necessity to promote preventive measures by information parents and physicians on risks of foreign body aspiration, which early diagnosis can save much trouble in children.