Hela Kamoun

Background: Venous thromboembolism (VTE) is a common and potentially fatal complication in patients with lung cancer. This study aimed to develop and validate a risk score for early prediction of VTE in these patients. Methods: Four hundred and one patients with lung cancer from three pulmonology departments hospitalized between January 2011 and December 2021 were retrospectively assessed. The population was divided into two groups: a Development Group (182 patients) and a validation group (199 patients). In the development group, the risk score system was developed, via univariate and multivariate analyses, based on demographic and clinicopathological variables; it was then validated in the validation group. Results: The incidence of VTE was 26.8% in the development group. It was 25.8%, and 27.6% in the internal and external validation groups, respectively. Hemoglobin level <10g/l, metastasis, histological type poorly or undifferentiated non-small cell carcinoma, and active smoking were the items of the risk score system. This score allowed proper stratification of patients with either high or low risk of VTE in the development group (c statistic =0.703). The patients in the development group were classified into 3 risk groups: low risk (scores 0-1), moderate risk (scores 2-3), and high risk (scores 4-5). When validated in the validation group, there was a moderate loss of predictive power of the score (c statistic=0.641), but the categorization of the patients by the score remained clinically useful. Conclusions: This risk score requires prospective validation studies on a nationwide scale in order to use it as a valid tool for the prevention of VTE in lung cancer.

Pulmonary squamous cell carcinoma (SCC) is a common subtype of non-small cell lung cancer, often associated with metastatic spread at diagnosis. We report the case of a 61-year-old male with a history of renal stones who presented with a four-month history of progressive exertional dyspnea, dry cough, and declining visual acuity in the right eye. Imaging revealed a left hilar tumor with carcinomatous consolidation, bilateral parenchymal nodules, and left pleural effusion. Ophthalmologic evaluation showed choroidal lesions in the right eye, confirmed by orbital MRI as a subretinal intraocular lesion. Biopsies confirmed pulmonary SCC. The patient received six cycles of cisplatin and gemcitabine chemotherapy alongside choroidal radiotherapy. After four cycles, choroidal metastases regressed, and visual acuity improved. Post-treatment imaging showed complete resolution of the intraocular lesion and a 34% reduction in tumor burden per RECIST 1.1. This case underscores the efficacy of combined systemic and localized therapies in managing advanced metastatic pulmonary SCC.

Hydatid disease is a significant public health concern in endemic regions. The liver and lungs are the primary sites of infection, and mediastinal localization is extremely rare. We report the case of a 34-year-old patient with no significant medical history, who presented with right basithoracic pain and exertional dyspnea. Chest radiography revealed mediastinal widening, and further imaging with chest CT and magnetic resonance imaging (MRI) identified a right anterosuperior multivesicular mediastinal hydatid cyst adjacent to the pericardium. The patient underwent surgery with favorable postoperative outcomes.

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Background: Venous thromboembolism (VTE) is a common and potentially fatal complication in patients with lung cancer. This study aimed to develop and validate a risk score for early prediction of VTE in these patients. Methods: Four hundred and one patients with lung cancer from three pulmonology departments hospitalized between January 2011 and December 2021 were retrospectively assessed. The population was divided into two groups: a Development Group (182 patients) and a validation group (199 patients). In the development group, the risk score system was developed, via univariate and multivariate analyses, based on demographic and clinicopathological variables; it was then validated in the validation group. Results: The incidence of VTE was 26.8% in the development group. It was 25.8%, and 27.6% in the internal and external validation groups, respectively. Hemoglobin level <10g/l, metastasis, histological type poorly or undifferentiated non-small cell carcinoma, and active smoking were the items of the risk score system. This score allowed proper stratification of patients with either high or low risk of VTE in the development group (c statistic =0.703). The patients in the development group were classified into 3 risk groups: low risk (scores 0-1), moderate risk (scores 2-3), and high risk (scores 4-5). When validated in the validation group, there was a moderate loss of predictive power of the score (c statistic=0.641), but the categorization of the patients by the score remained clinically useful. Conclusions: This risk score requires prospective validation studies on a nationwide scale in order to use it as a valid tool for the prevention of VTE in lung cancer.

Introduction. - Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercorticism. It is caused by ectopic secretion of ACTH by a non-pituitary endocrine tumor. The aetiological biological and radiological data are often inconclusive, which creates a problem of differential diagnosis with Cushing's disease. In addition, these tumors are often small and their location is extremely variable. As a result, the difficulties of localization require the use of specific imaging techniques.Observation. - We report the observation of a 44-year-old man suffering from diabetes and high blood pressure, presenting a severe and rapidly progressive Cushing syndrome, in connection with a hypercorticism caused by an ectopic ACTH secretion. The thoracic computed tomography performed within the framework of a search for a neoplastic origin objectified a 15 mm nodule isolated at the level of the middle lobe, the scintigraphy with octreotide marked with indium-111 found a significant fixation at the level of the lung nodule. The patient had a middle lobe lobectomy. The outcome was favorable with regression of Cushing's syndrome. Pathological examination was in favor of a typical carcinoid tumor, and the immunohistochemical complement showed tumor cell positivity for ACTH, CD56, chromogranin, and synaptophysin.Conclusion. - This observation illustrates the dilemma between the need to locate an ectopic ACTH secretion and the control of aggressive and threatening Cushing's syndrome. Early use of the octreotide scintigraphy should be considered if a topographic diagnosis of the causative tumor cannot be done through conventional imaging techniques.

Introduction: Pulmonary tuberculosis still raises many problems. The delay in care can affect respiratory functional prognosis. We were interested to difficulties in management of tuberculosis sequelae. Patients and Methods: A retrospective study including patients treated for pulmonary tuberculosis between January 2012 and January 2014. We selected patients with pulmonary sequelae. Results: Sixty-five cases have been collected. 81.5 % were male and 18.5% female. The mean age was 55.6 years ± 13. Seventy seven percent of these patients were smokers. The mean time to the onset of respiratory symptoms related to pulmonary sequelae was 15.6 ± 8 years. The clinical symptoms were dominated by a chronic sputum (74%), dyspnea (68%) and hemoptysis (34%). The thoracic imaging showed: a destroyed lung (46%), bronchiectasis (31%), aspergilloma (14%), emphysema (12.3%), pulmonary fibrosis (7.7%), residual cavity (6.2%) and lung cancer (1.5%). Functional respiratory explorations found a restrictive ventilatory defect in 78% of cases, chronic respiratory failure in 24% of cases. Treatment was essentially medical consisting in ininhaled corticosteroids, theophyllin and long acting beta agonist. Long term oxygen therapy was indicated for 8 patients. Surgery was indicated for only 5 patients whose, 3 of them had symptomatic aspergilloma. During the period of study the average number of hospitalization per year for all patients was 1.68 ± 2. Conclusion: The prevention of tuberculosis sequelae requires both early diagnosis and available treatment of the disease. These lesions increase morbidity and a preventable mortality.