Suicide Among Adolescents in Center Tunisia: An 18-Year Autopsy Study

Background: Suicide and suicide attempts are more common among adolescents. Many factors are known to influence suicide in particular: region and culture. Adolescent suicide has been widely studied in many countries, but there are, currently, no data relating to adolescent suicide in Tunisia. Aim: The aims of this study were to describe epidemiological aspects of death related to adolescent suicide in Sousse, a city in central Tunisia. Methods: Data of forensic autopsies from 1998 to 2015 related to suicide of adolescents were retrospectively examined considering age, gender, method of death, year and risk factor. Results: 70 cases were reported with female predominance (62, 8%). The age range was from 10 to 19 and most of the suicides occurred in the 15-to-19 age group (75, 7%). Most victims were from rural zones (70%). Self-poisoning was the most used method (47, 1 %) followed by hanging (35, 7%). Hanging was the most common method used by males (17/26) and self-poisoning by females (29/44). Self-poisoning was related to pesticides in the vast majority of cases (29 cases among 33). The identified precipitating factors were chronic family problems in 51.4%, sentimental deception in 8.6%. Conclusion: This retrospective study raises concerns regarding the use of pesticides and the urgent need to provide rural areas with structures and medical equipment. This will ensure adequate suicide prevention in the region

Male breast cancer: a report of 127 cases at a Moroccan institution

Background: Male breast cancer (MBC) is a rare disease representing less than 1% of all malignancies in men and only 1% of all incident breast cancers. Our study details clinico-pathological features, treatments and prognostic factors in a large Moroccan cohort. Findings: One hundred and twenty-seven patients were collected from 1985 to 2007 at the National Institute of Oncology in Rabat, Morocco. Median age was 62 years and median time for consultation 28 months. The main clinical complaint was a mass beneath the areola in 93, 5% of the cases. Most patients have an advanced disease. Ninety-one percent of tumors were ductal carcinomas. Management consisted especially of radical mastectomy; followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. The median of follow-up was 30 months. The evolution has been characterized by local recurrence; in twenty two cases (17% of all patients). Metastasis occurred in 41 cases (32% of all patients). The site of metastasis was the bone in twenty cases; lung in twelve cases; liver in seven case; liver and skin in one case and pleura and skin in one case. Conclusion: Male breast cancer has many similarities to breast cancer in women, but there are distinct features that should be appreciated. Future research for better understanding of this disease at national or international level are needed to improve the management and prognosis of male patients

Phenotypic features and genetic characterization of male breast cancer families: identification of two recurrent BRCA2 mutations in north-east of Italy

BACKGROUND: Breast cancer in men is an infrequent occurrence, accounting for ~1% of all breast tumors with an incidence of about 1:100,000. The relative rarity of male breast cancer (MBC) limits our understanding of the epidemiologic, genetic and clinical features of this tumor. METHODS: From 1997 to 2003, 10 MBC patients were referred to our Institute for genetic counselling and BRCA1/2 testing. Here we report on the genetic and phenotypic characterization of 10 families with MBC from the North East of Italy. In particular, we wished to assess the occurrence of specific cancer types in relatives of MBC probands in families with and without BRCA2 predisposing mutations. Moreover, families with recurrent BRCA2 mutations were also characterized by haplotype analysis using 5 BRCA2-linked dinucleotide repeat markers and 8 intragenic BRCA2 polymorphisms. RESULTS: Two pathogenic mutations in the BRCA2 gene were observed: the 9106C>T (Q2960X) and the IVS16-2A>G (splicing) mutations, each in 2 cases. A BRCA1 mutation of uncertain significance 4590C>G (P1491A) was also observed. In families with BRCA2 mutations, female breast cancer was more frequent in the first and second-degree relatives compared to the families with wild type BRCA1/2 (31.9% vs. 8.0% p = 0.001). Reconstruction of the chromosome phasing in three families and the analysis of three isolated cases with the IVS16-2A>G BRCA2 mutation identified the same haplotype associated with MBC, supporting the possibility that this founder mutation previously detected in Slovenian families is also present in the North East of our Country. Moreover, analysis of one family with the 9106C>T BRCA2 mutation allowed the identification of common haplotypes for both microsatellite and intragenic polymorphisms segregating with the mutation. Three isolated cases with the same mutation shared the same intragenic polymorphisms and three 5' microsatellite markers, but showed a different haplotype for 3' markers, which were common to all three cases. CONCLUSION: The 9106C>T and the IVS16-2A>G mutations constitute recurrent BRCA2 mutations in MBC cases from the North-East of Italy and may be associated with a founder effect. Knowledge of these two recurrent BRCA2 mutations predisposing to MBC may facilitate the analyses aimed at the identification of mutation carriers in our geographic area

Isolated double chambered right ventricle as a rare cause of sudden death in infancy

Isolated double-chambered right ventricle (DCRV) is a rare form of congenital heart disorder in which the right ventricle is divided into a high-pressure inlet portion and a low-pressure outlet portion by an anomalous muscle bundle. Rarely, autopsy cases describing this congenital heart disease have been reported in the world literature. We report the case of a 50-day-old male who died seven days after been suffering from fever and dyspnea. The autopsy revealed essentially an isolated double-chambered right ventricle (DCRV) and an important pulmonary edema. In this paper, we present the first reported case of sudden unanticipated death in infancy due to isolated double-chambered right ventricle