[Predictive factors of recurrence in spontaneous pneumothorax]. / Facteurs prédictifs de récidive dans le pneumothorax spontané.

BACKGROUND: Spontaneous pneumothorax is usually a benign condition that most often affects young patients. Its most common complication is recurrence. This complication appears to be increased by some factors. AIM: To identify predictors of recurrence in spontaneous pneumothorax through a series of 204 cases. METHODS: A retrospective study of 204 cases of patients hospitalized for spontaneous pneumothorax. 50 patients experienced at least one recurrence. The study of predictors of recurrence is based on the X2 test for the univariate analysis and logistic regression for the multivariate analysis. RESULTS: The average age of our patients was 37 ± 7.6 years. A male predominance was noted (97.6 %). 80.4% of patients were smokers. Pneumothorax is considered primary in 65.2 % of cases. Fifty patients had at least one recurrence of their pneumothorax. Smoking and the pursuit of tobacco intoxication were the two risk factors for recurrence in our patients. Gender, age, side, importance of pneumothorax and therapeutic means of the first episode as well as the primary or secondary pneumothorax did not influence recurrence. In the multivariate analysis the pursuit of tobacco intoxication was the only predictor factor of recurrence. CONCLUSION: The recurrence is the most common complication of spontaneous pneumothorax. This risk appears to be increased by smoking and the pursuit of tobacco intoxication. Thus smoking cessation could be a simple and effective means to prevent recurrence.

[Obstructive sleep apnea syndrome. Analytical study of 63 cases]. / Syndrome d'apnees obstructives du sommeil (SAOS). Etude analytique de 63 cas.

Obstructive sleep apnoea (OSA) is a relatively common disorder, in developed country with prevalence estimated to lie between 2 and 4% in adult population. The diagnosis of this syndrome is made on the basis of characteristic clinical features and the results of nocturnal polysomnography. There is no data concerning the OSA in developing country. It is therefore of interest to determine the clinic and polysomnographic profile of this disease and to landmark factors correlated with severity in our country. This was achieved by studying a set of 63 OSA. The mean of age was 53 + 13 years with sex ratio 1. The means of Epworth sleepiness scale score, BMI and Apnoea/Hypopnoea index (AHI) were respectively 16 + 4, 38.8 + 7 kg/m2 and 51.7 + 28.6. 44% of patients have OSA severe with IAH > 50/h. Arousal index and desaturation index were respectively 36.4 + 21.7 and 49 + 26. Trial of continuous positive airway pressure (CPAP) therapy was proposed first to 40 patients, 17 were able to use CPAP.

[Survival and prognostic factors of non small cell lung cancer: analytic review of 211 cases]. / Survie et facteurs pronostiques du carcinome bronchique non a petities cellules: revue analytique de 211 cas.

Prognostic factors have a pivotal role in clinical oncology. They are helpful in the selection of treatment, provide insights into the disease process and the therapeutic response. The number of possibly useful prognostic factors in the lung cancer is large. This study attempts to observe the survival of non small cell lung cancer (NSCLC) and to find prognostic factors and other variables potentially associated with outcome of lung cancer. It's a retrospective study based on 211 patients with NSCLC. Median survival was 6 months with 95% confidence interval: [4.2 - 7.8]. Overall 3 and 5 year survival were respectively 8.3% and 5.2%. Various Prognostic factors have been identified through univariate (Kaplan-Meier) then multivariate (Cox) analyses. In addition to the clinical factors such as age, disease extent and performance status, other variables were found of significant prognostic value, like pretherapeutic leukocyte level. Survival was significantly improved with surgery, radiation and also with chemotherapy, mainly in advanced stage (IIIB and IV).

[Embolic pseudotumor diagnosed by surgery]. / Nodule pulmonaire pseudotumoral d'origine embolique de decouverte chirurgicale.

We report a case of pulmonary infarction in a 72-year-old woman who was hospitalised for hemoptysis, chest pain and weight and coin a lesion in the loss periphery of the left lower lobe. Camputed tomography of the chest demonstrated a sub pleural solitary nodule with spicular radiation. Video-assisted thoracoscopic surgery was performed to obtain a histological diagnosis. Thoracoscopic examination showed a lesion that evoked chronic abscess. Histological examination confirmed an ischemic infarction. This is the second case of pseudotumor due to pulmonary infarction that was diagnosed by video-assisted thoracoscopic resection.