Mona Mlika

Pulmonary Localization Revealing Wegener's Granulomatosis

Wegeners granulomatosis (WG) is the most frequent antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis. It affects mainly the upper airways, lungs, and kidneys. Two forms are identified: systemic and limited. We describe three cases of limited WG diagnosed during a 7-year period. Our aim is to report three localized forms of WG and to put emphasis on the necessity of differentiating localized from systemic forms because of their different prognoses and manner of management. Our study contained two men and one woman with a mean age of 43 years. All our patients were symptomatic and presented with nonspecific respiratory signs. The cANCA were positive in all patients. The imaging findings consisted of cavitary masses. The diagnosis was based on surgical lung biopsy in all cases. All patients were put on cyclophosphamide and prednisolone. Only one patient presented with renal complications after a 2-year follow-up period. The two other patients did not present complications after, respectively, 1 month and 1 year of follow-up. These case reports put emphasis on a rare form of WG, the limited form. The low number of patients, due to the rarity of this disease, does not allow us to delineate the characteristics and the differences between this form and the systemic form, but we highlight the necessity of future investigations in order to explore the pathogenesis, therapeutic, and prognosis differences between these two subsets.

Sleeve Right Lower Lobectomy: a Rarely Performed Extended Resection

Sleeve resection is a valid option in the surgical treatment of lung tumors, avoiding large resection. To ensure a good functional result and avoid post-operative complications like recent broncho-pleural fistulas and long-term stenosis, anastomosis between bronchi must be well performed. We report two cases of sleeve resection of the right lower lobe and show how we managed caliber discrepancy between the middle lobe bronchus and the truncus intermedius.

Evaluation of the Microvessel Density and the Expression of Metalloproteases 2 and 9 and Ttf1 in the Different Subtypes of Lung Adenocarcinoma in Tunisia: A Retrospective Study of 46 Cases

Despite the new available histologic classification of lung cancers, it remains difficult to assess the real prognostic relevance of the different subtypes of lung adenocarcinomas. Facing the prognostic relevance of microvessel density (MVD) and the expression of metalloproteases and thyroid tyrosine factor 1 (TTF1) in different cancers, we tried to compare these parameters in the different subtypes of lung adenocarcinomas. We conducted a retrospective study of 46 adenocarcinomas surgically resected. An immunohistochemical study using the cluster of differentiation 34 (CD34), TTF1, metalloproteases 2 (MMP2), and metalloproteases 9 (MMP9) antibodies was performed on all samples while MVD was evaluated using CD34 antibody. The analyzed cases included 19 acinar, 7 papillary, 1 lepidic, and 19 solid predominant American Thoracic Classification of lung adenocarcinomas (ASK). The higher MVD levels were observed in papillary and acinar subtypes types and a statically significant difference in the MVD was observed in the different subtypes (p< 0,001). This study didn’t show significant statistical results concerning MMP and TTF1 expression but it revealed a tendency to an equal expression of these antibodies in the different subtypes. The difference in the MVD between the different subtypes of adenocarcinoma puts emphasis on their prognostic relevance.

Organizational Ostracism: A Potential Framework in Order to Deal with It

Background Organizational ostracism is defined as a violation of norms that we are suggested to acknowledge at the workplace. It results in the exclusion of one person or multiple persons, and causes damage to our innate need to belong. This kind of behaviorism can be engaged through a hierarchical or nonhierarchical relationship. Three elements interact in the framework of organizational ostracism: the actor, the target, and the institution. Our aim was to describe the different factors interacting with every element in order to produce recommendations targeting to prevent the occurrence of such behaviorism in an institution and to help targets of such a violence in order to handle this situation and go forward. As psychological impact of ostracism has frequently been studied in the literature, we focused on its impact on professional tasks. Methods We performed a questionnaire-based study about organizational ostracism. This questionnaire was established through an online platform (https://www.sondageonline.com) and made available through the following link: https://goo.gl/forms/KrkVXe3bMEc79cau2. A keyword was sent to all participants. We created a 23-interrogation questionnaire with open and short questions. Nonwritten consent was obtained from all participants. Results The actor of ostracism engaged in ostracism, in most of the cases, with other persons without a real purpose. The actor of ostracism had an antecedent of problematic relationship at work in 82.9% of the cases. Of the participants, 58.5% were of the view that ostracism aimed to cause hurt and isolate them. Professional isolation was observed in 58.5% of the cases; 51.2% of the participants tried to improve their work potential and explained their reaction by an intrinsic motivation. The organization atmosphere was judged to be bad in most of the cases. Conclusion Our study showed that ostracism was mainly observed in public practice.

Cytological smears and cell blocks on endobronchial aspirates complement each other and allow a higher diagnostic yield.

The accurate diagnosis of lung carcinoma has become compulsory especially after the introduction of new target therapies. Most of the patients are non operable. This fact points out the diagnostic importance of the cytology specimen. Our target was to assess the diagnostic efficacy of bronchial smears and cell blocks by comparing their results with those of the final diagnoses made on biopsies. We conducted a prospective study of 55 bronchial aspirates. It showed a sensitivity of 100% and a specificity of 100% when coupling both techniques. These results put emphasis on the diagnostic efficacy of both bronchial smears and cell blocks in diagnosing bronchial carcinoma.