Plantar nodular melanoma: a case report

Jean-Luc Kambire1, Souleymane Ouedraogo1, Fagnima Traore2, Salam Ouedraogo1, Tioulé Mamadou Traore3 Published in the journal : September 2017 Category : Dermatology

While cutaneous melanoma is rare in Africa, it is most often of nodular or acral lentiginous histology, with plantar location. Its diagnosis is late and its prognosis poor. Improving the survival rate in case of melanoma requires promoting an early diagnosis. We here report the case of a 30-year-old female patient suffering from an ulcerated-budding tumor of the heel that had evolved for 2 and a half years, reaching 4 cm at the time of diagnosis. Histological examination of the resection specimen revealed a Clark’s level V nodular melanoma.

Key Words

Nodular melanoma, diagnosis, treatment

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Mehdi Bsilat ¹, Daniel Leonard ², Sandy Van Nieuwenhove ³, Catherine Lambert ⁴ Published in the journal : September 2017 Category : Hematology/Oncology

We here present a case of diverticulitis complicated by a pylephlebitis of the portal and superior mesenteric vein, requiring treatment with heparin and antibiotics. The patient subsequently developed a splenic vein thrombosis and suffering bowels. A large resection of the small bowel was performed, with subsequent ileostomy and parenteral nutrition. Following anticoagulation therapy initiation, a thrombocytopenia was observed, and the patient was found to have developed heparin-induced thrombocytopenia (HIT), as evidenced by high levels of anti-heparin/PF4 antibodies. Furthermore, he had a contributory family history of thrombophilia, and molecular tests confirmed that he was carrying a thrombophilic G20210A factor II mutation. To our knowledge, this is the first case report of a bowel ischemia in a context of pylephlebitis treated with heparin, leading to another rare thrombophilic syndrome: heparin-induced thrombocytopenia and thrombophilia (HITT).

This article illustrates how a rare complication of a common disease and its treatment can aggravate the primary condition. We discussed the pylephlebitis and the HITT as the explanation for such a rare consequence on the bowel in the context of inherited thrombophilia.

Key Words

Pylephlebitis, heparin-induced thrombocytopenia, surgery, bowel ischemia, prothrombin mutation

Note: Full text in english

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Two clinical cases of chronic intestinal pseudo-obstruction in a geriatric care unit: a rare and complex situation

Henrianne Levie, Itziar Clement Corral, Anne Van de Vyvere, Christophe Dumont Published in the journal : September 2017 Category : Geriatry

The article describes two cases of chronic intestinal pseudo-obstruction (CIPO). This rare intestinal motility disease is associated with high morbidity and mortality. The obstruction is functional, without any radiologically or surgically detectable obstacle, in contrast to volvulus that is a purely mechanical obstruction. Symptoms are recurrent and evolve over several months or years. Based on a literature review, we here present a coherent pluridisciplinary approach used to optimize the diagnosis and treatment necessary to help an elderly multimorbid and often polymedicated population. Since CIPO is an incurable disease, the main therapeutic objectives are the control of symptoms and ionic disorders, enteral nutrition, and maintenance of mobility.

Key Words

Chronic intestinal pseudo-obstruction (CIPO), volvulus, chronic constipation, elderly

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Management of fever in splenectomized adults: case report and theoretical reminder

Halil Yildiz, Lucie Wartique, Jean-Cyr Yombi Published in the journal : September 2017 Category : Internal Medicine

In asplenic patients, fever should never be trivialized. The clinical presentation of a severe infection can be unspecific (fever, chills, sore throat, diarrhea, vomiting, and muscle aches). If an antibiotherapy is not given rapidly, the evolution can be abrupt, and patients can develop a disseminated intravascular coagulation. We here describe the case of a 77-year-old splenectomized female patient. Given the unspecific clinical presentation, the diagnosis of acute gastro-enteritis was made; however, the patient developed a severe pneumococcal infection. With this case report, we would like to remind the adequate management of fever in asplenic patients in order to avoid severe, potentially life-threatening, complications

Key Words

Fever, splenectomy, antibiotherapy, vaccination, education

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Epidemiological particularities of Kawasaki disease in Luxembourg over the past decade: focus on infants under 12 months

Fanny Kubat, Armand Biver, Kerstin Wagner, Isabel De La Fuente Garcia Published in the journal : September 2017 Category : Cardiologie pédiatrique

Kawasaki disease is the leading cause of acquired heart disease in children. Its incidence is underestimated in infants aged less than 1 year. In this population, clinical manifestations are atypical. The diagnosis should therefore be suspected in infants with persistent fever, even if not all clinical signs are present, in order to avoid delaying the diagnosis and treatment and prevent harmful cardiovascular consequences. Echocardiography is a helpful diagnostic tool and should be performed promptly in case of Kawasaki disease suspicion.

Key Words

Kawasaki disease, incidence, infant, coronary arteries, intravenous immunoglobulin

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Screening and prevention of Alzheimer's disease before memory loss: news and perspectives

Bernard Hanseeuw Published in the journal : September 2017 Category : Prix Simonart 2017

Over the past few years, clinical research dedicated to preclinical Alzheimer’s disease has considerably intensified. In vivo markers of Alzheimer’s disease paved the way for (1) studies investigating the association between pathology and cognitive decline and (2) the launch of the very first preventive trials. Besides brain autopsy, cerebrospinal fluid analyses along with amyloid- and tau-specific radiotracers are now used to detect Alzheimer’s disease. Further advances are expected in coming years, with an improved specificity of tau tracers, novel therapeutic targets, and a continuing increase in our understanding of Alzheimer’s biological processes.

Key Words

Alzheimer’s disease, PET-scan, Amyloid, Tau, Aging

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Treatment of global cardiovascular risk with fixed-dose ASCOT combination: atorvastatin, perindopril, and amlodipine

Olivier S. Descamps Published in the journal : September 2017 Category : Actualité thérapeutique

A fixed combination product, composed of atorvastatin, perindopril and amlodipine, such as that used in the ASCOT study, has just been marketed by the Servier company under the trade name LIPERTANCE®. This provides us the opportunity to recall the usefulness of this double approach targeting both high blood pressure and high cholesterol levels in cardiovascular prevention. The ASCOT study has definitely proven the remarkable cardiovascular benefit of this combination in primary prevention for hypertensive patients with moderately-high cholesterol levels. Key Words cardiovascular disease, cardiovascular prevention, hypercholesterolemia, high blood pressure, LDL cholesterol, atherosclerosis

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Facial decoding in schizophrenia is underpinned by basic visual processing impairments

Published in the journal : June 2017 Category : Mémoires de Recherche Clinique

Schizophrenia is associated with a strong deficit in the decoding of emotional facial expression (EFE).

Key words

Schizophrenia, faces, emotion, cognition, face recognition

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Guillain-Barré syndrome : a retrospective study of patients admitted to the University hospitals St-Luc between 1978 and 2013

Nikola Tomagová., MD; Peter Van den Bergh, MD, PhD Published in the journal : June 2017 Category : Mémoires de Recherche Clinique

Guillain-Barré syndrome (GBS) and its clinical variants (paraparetic variant, Miller Fisher syndrome, bifacial weakness with paresthesias) are rather well-known medical afflictions nowadays.

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Arthur Van Gehuchten’s work about neurosyphilis, more than an historical treasure, a work still relevant?

Claire Ledouble, Anne Jeanjean, MD, PhD. Published in the journal : June 2017 Category : Mémoires de Recherche Clinique

The purpose of this historical master thesis is to rediscover the medical semiology of the neurosyphilis during the XIXth and XXth centuries and to see its evolution up to the present day.

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