Association between the -2518G/A polymorphism in the monocyte chemoattractant protein-1 (MCP-1) gene and myocardial infarction in Tunisian patients

BACKGROUND: Monocyte chemoattractant protein-1 (MCP-1; gene name CCL2) has been suggested to play an important role in the initiation of atherosclerosis by recruiting monocytes to sites of injured endothelium. Recently, single nucleotide polymorphisms (SNPs) in the MCP-1 regulatory region have been identified. Controversial results regarding the association of the -2518G/A polymorphism of the MCP-1 gene with coronary artery disease (CAD) have been reported. In the present study, we examined a possible association between the -2518G/A polymorphism of the MCP-1 gene and myocardial infarction (MI) in a sample of the Tunisian population. METHODS: A total of 319 Tunisian patients with MI and 467 healthy controls were included in the study. The SNP of the MCP-1 gene was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: Patients with MI had significantly higher frequency of the AG+GG genotypes compared to controls [42.9% vs. 35.8%; OR (95%CI), 1.34 (1.00-1.79); p=0.04]. The MI patient group showed a significant higher frequency of the G allele compared to the controls [0.242 vs. 0.195; OR (95%CI), 1.31(1.02-1.68), p=0.03]. The association between the -2518G/A polymorphism of the MCP-1 gene and MI was no longer significant after adjustment for other well-established risk factors. CONCLUSION: The present study showed a significant but not independent association between the -2518G/A polymorphism of the MCP-1 gene (presence of G allele) and MI in the Tunisian population.     

Congenital bilobar emphysema

Congenital bilobar emphysema is reported to be extremely rare. We describe 3 cases, and we review the diagnosis problems and treatment methods of this childhood respiratory tract pathologic condition.     

Recurrent dysosmia induced by pyrazinamide

Pyrazinamide can have adverse effects such as hepatic toxicity, hyperuricemia or digestive disorders. In rare cases, alterations in taste and smell function have been reported for pyrazinamide when combined with other drugs. We report a case of reversible olfactory disorder related to pyrazinamide in a woman, with a positive rechallenge. The patient presented every day a sensation of smelling something burning 15 min after drug intake. Dysosmia disappeared completely after pyrazinamide withdrawal and recurred after its rechallenge. The case was reported to the Tunisian Centre of Pharmacovigilance.     

Histopathological study of gastric polyps. A report of 65 cases

In a retrospective study of the specimens of gastric polypectomy, carried out between January 1992 and December 2002, we analysed the demographic and histological aspects of 65 polyps. This study revealed hyperplastic polyps in 66%, adenomatous lesions in 9.2%, Peutz-Jeghers polyps in 7.7%, inflammatory fibroid polyps in 6.15%, two cases of focal foveolar hyperplasia (3%), two cases of Brunner's gland heterotopia (3%), 1 pancreatic heterotopia (1.5%), 1 fundic gland polyp (1.5%) and 1 carcinoid tumor (1.5%). All adenomas and two Peutz-Jeghers polyps include intraepithelial neoplasia. Moreover, we identified a case of Brunner's gland heterotopia, which contain a focus of plane tubular adenoma with high-grade intraepithelial neoplasia. Other lesions were found within the polyps or into the surrounding gastric mucosa, such as intestinal metaplasia and Helicobacter Pylori gastritis. This work allowed us to recommend complete removal of gastric polyps and the realization of biopsies of the nonpolypoid gastric mucosa in the search of intraepithelial neoplasia or other lesions with malignant potential.     

Dermatofibrosarcoma protuberans of the breast

Dermatofibrosarcoma protuberans is a superficial mesenchymal cutaneous tumor of essentially local malinancy, located more often in the trunk and extremities. This tumor is usually diagnosed after multiple recurrences. We report two cases of rare mammary localisations of dermatofibrosarcoma protuberans in 2 patients aged 39 and 43 years respectively, the two lesions sized 35 x 45 mm were treated by wide excision and reconstruction with a dorsal flap; in the second case.     

Return to work after acute myocardial infarction

OBJECTIVES: The aim of this work was to study the professional repercussions of acute myocardial infarction and to analysis medical, social and occupational factors which could influence return to work. MATERIAL AND METHODS: Our study concerns 70 patients less than 66 years old, working before their hospitalization and having been admitted for acute myocardial infarction between January 1-st, 1999 and December 31, 2000 in the Department of Cardiac Resuscitation of hospital La Rabta of Tunis. Data were collected from retrospective review of folders and answers to a questionnaire for which the patients have been summoned in 2002. RESULTS: There were 70 patients almost exclusively men (n=69). The mean age was 49.0 +/- 6.8 years. The mean follow-up was 27.2 +/- 7.7 months. Sixty one patients (87.1%) have initially been back to work and eight of them lost it secondarily. The average delay of return to work has been 91+/- 111 days. The direct repercussions of myocardial infarction on the professional capacities was observed at the majority of patients. CONCLUSION: Despite an important professional repercussions of acute myocardial infarction, our study showed a high rate of return to work with relatively short delays.     

Premature ovarian insufficiency. Analysis of 30 cases

Premature menopause is a relatively rare disease but it has delicate consequences dominated by infertility problems. Most often, etiologic investigation is disappointing. Helped in some cases by the association to some auto-immune diseases or a previous treatment with chemotherapy or an irradiation may be useful to understand the origin of the premature ovarian failure. We analyse in this paper 30 cases of premature menopause to try to precise its etiologic factors, its diagnosis tools, the fertility prognostic and the therapeutic possibilities     

A child elbow calcific bursitis: no hasty surgical option. A case report

We report the elbow calcific bursitis case of an 11 years old child. The imaging let us notice a lateral peri-articular calcifying and we planned a surgical biopsy. But the tumour spontaneous resolutive development in the clinical aspect and its ray disappearance led to a therapeutic abstention. The set of clinical elements, the imaging and the development let us come to a calcific bursitis diagnosis, exception for a child. These calcifyings are located in the sinew bursa. virtual cavities in a normal state. They are related to a sinew chronic antagonism with an anatomic bony ground and they generally develop in a spontaneous resolution with a macrophagic resorption. However their rare occurrence for a child must lead us to be extremely cautious in the diagnostic of child bony tumours in general and extra-bony calcifyings in particular: the rule must be the imaging result and the biopsy.