Study of anxiety-depressive disorders among doctors at "Salah Azaïez" Cancer Institute in Tunis.

INTRODUCTION: Oncologists are often confronted with patients at the end of their lives who are suffering. This can lead to anxiety and depressive disorders (ADD), affecting the quality of the doctors's quality of life. AIM: To compare the level of ADD among doctors practicing at Salah Azaiez Institute (SAI) in Tunis with doctors who do not treat cancer patients, while identifying any factors associated with these disorders. METHODS: We conducted a comparative and analytical study of 141 physicians:53 oncologists practicing at the Salah Institut Azaiez and 91 at other hospital structures (Charles Nicolle's Hospital and Rabta's Hospital), matched by age and gender for a period of 2 months, started from 02 May to 30 June 2022. RESULTS: Our research showed that SAI's doctors were significantly more exposed to anxiety disorders (p= 0.016) compared with other doctors (47.2% vs. 37.5%), without being more exposed to depressive disorders. SAI's doctors reported more associated stress factors, notably exposure to body image-distorting tumors (p<0.001), exposure to the suffering of loved ones (p=0.006), lack of human resources (p=0.017), perceived unsuitability of premises (p=0.001) and overwork (p=0.013). These doctors consumed more alcohol (p=0.04). In addition, 58.5% of SAI's doctors felt that their profession significantly affected their quality of life, compared to 45% of doctors in other hospitals (p=0.04). CONCLUSIONS: All the doctors questioned, "all specialties combined", showed varying rates of anxiety and depressive disorders. However, anxiety disorders were significantly higher among SAI's doctors, for whom stress factors had a greater impact.

[Superior vena cava syndrome and internal mammary nodes in breast cancer: two cases]. / Syndrome cave superieur avec atteinte de la chaine mammaire interne au cours d'un cancer du sein: a propos de deux observations.

BACKGROUND: The association of superior vena cava syndrome with involvement of the internal mammary lymph nodes in breast cancer has not been reported in the literature. AIM: To report two cases of association of superior vena cava with involvement of the internal mammary lymph nodes in breast cancer. CASES REPORT: We report two observations in two patients 45 and 52 years with breast cancer classified T4N2M0 and T3N2M0 treated. Both patients had clinical features compatible with the diagnosis of superior vena cava confirmed by the initial clinical appearance (observation 1) and after treatment (observation 2) to the CT scan. CONCLUSION: The combination of superior vena cava with the achievement of the internal mammary chain in breast cancer worse prognosis.

Gestational trophoblastic neoplasia: experience at Salah Azaiez Institute.

Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. It includes benign trophoblastic disease (hydatidiform moles (HM)) and the malignant trophoblastic diseases or gestational trophoblastic neoplasia (GTN). The frequency of the GTD in Tunisia is one per 918 deliveries. The aim of this study is to analyze the clinical characteristics, treatment and outcomes of GTD at Salah Azaiez Institute (ISA). Medical records of women diagnosed with GTD at ISA from January 1st, 1981 to December 31st, 2012 were retrospectively reviewed. FIGO score was determined retrospectively for patients treated before 2002. One hundred and nine patients with GTN were included. Patients presented with metastases at 43% of cases. The most common metastatic sites were lung (30%) and vagina (13%). Fifty six (56 (51%) patients had low-risk and 21 (19%) cases had high-risk, the FIGO score was not assessed in 32 cases. After a median follow-up of 46 months, 21 patients were lost to follow-up, 12 patients died, 19 progressed and 8 relapsed. At 10 years, the OS rate was 85% and the PFS rate 79%. OS was significantly influenced by the presence of metastases at presentation (M0 100 % vs. Metastatic 62 %; p < 0.0001), FIGO stage (I-II 100% VS 61% and 65% for stage III and IV; p < 0.001), FIGO score (low-risk 99 % vs. high-risk 78 %; p < 0.001). GTN is a significant source of maternal morbidity with increased risk of mortality from complications if not detected early and treated promptly.

[Synchronous pulmonary and lachrymal glands involvement by MALT lymphoma]. / Atteinte synchrone pulmonaire et des glandes lacrymales par un lymphome de type MALT.

Primary lung lymphomas are rare tumors representing less than 1% of malignant tumors of the lung. The most frequent form is the mucosa-associated lymphoid tissue (MALT). Ocular involvement is also rare and it is mostly located in the lachrymal glands. We report the case of a patient with pulmonary MALT lymphoma associated with synchronous involvement of the lachrymal glands. This study illustrates the nonspecific clinical, radiological and evolutionary features of this disease.