Félix Kwizera (1), Stéphanie Hublet (1), Antoine Bufkens (1), Jean-Pierre Chami (2), Stéphane Rysselinck (1)Published in the journal : January 2017Category : Urology
Genito-urinary tuberculosis (GUTB) is a severe form of extra-pulmonary tuberculosis (EPTB). The most commonly affected organs are the epididymis and testis. GUTB diagnosis may prove difficult and is often delayed given that symptoms are non-specific. We have here reported the case of a patient with no history of pulmonary TB, who presented with acute right scrotal pain mimicking an epididymo-orchitis. After failure of antibacterial therapy, we completed the patient's work-up by means of a CT scan that showed progressive retro-peritoneal lymph nodes. Correct diagnosis was made using laparoscopic lymphadenectomy (histology: granulomatous necrotizing lymphadenitis, culture: M. Turberculosis). A tuberculosis treatment was initiated after diagnosis.
Depression is a major public health concern, with an increasing proportion of the population under antidepressants. Depending on depression severity, different drug regimens are proposed. Among them, monoamine oxidase inhibitors are indicated in the event of resistance to other treatments. We report a case of drug-induced subfulminant hepatitis occurring 2 months after the first use of phenelzine.
Marie Liégeois(*), Eric Constant(**)Published in the journal : January 2017Category : Psychiatrie
Based on the observations made during hospital care of a victim of sexual violence in South Kivu and suffering from PTSD, the authors stress the relevance of considering cultural and socio-political aspects, as well as the nature of the violence experienced for a better understanding of the situation. Given that in this very context, patients with PTSD only partially respond to the reference treatment, it is primordial to install a management that is adapted to the specificities of patient's situation. Based on the concepts of dehumanization and resilience, the authors emphasize the necessity of respecting the expression mode of suffering in PTSD patients and of setting up a network for the short- and long-term support to resilience.
Charlotte d’Odémont (1), Michel Henry (2), Pascale Grandjean (1)Published in the journal : January 2017Category : Cardiology
Peripartum cardiomyopathy (PPCM) is defined as a non-familial form of peripartum heart failure and described as an “idiopathic cardiomyopathy presenting with heart failure secondary to left-ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery”. We have here reported the case of a young woman suffering from peripartum cardiomyopathy 2 months after delivery. This case provided us the opportunity to review etiology, diagnosis, and treatment of this little-known medical condition with occasionally serious outcome.
Yves Pirson¹, Thien-Anh Ho¹, Nathalie Demoulin¹, Nathalie Godefroid², Valérie Dekeuleneer³, Kenou van Rijckevorsel⁴, Marie-Cécile Nassogne⁵, Riëm El Tahry⁴, Yves Sznajer⁶Published in the journal : January 2017Category : Rare Diseases
Tuberous sclerosis complex (TSC) is a genetic disease characterized by the development of hamartomas in several organs, including the brain, kidney, and skin.
Shortly after the discovery of the different so-called monogenic genes (one gene = one disease), the medical and scientific community became excited by the prospects of development and implementation of clinical trials in gene therapy aimed at correcting failing genetic activity. Following the death of a patient with severe combined X-linked immunodeficiency, widely reported in the scientific community, it was obvious that there was still much progress to be made in the 2000s for recognized gene therapies to be implemented. However, new vectors derived from lentiviruses and adenoviral vectors are currently in development, which promise to be more efficient and safer, with positive outcomes in several clinical trials on hemophilia, adrenoleukodystrophy, Leber's amaurosis, or cancer.
Gestational diabetes refers to first-onset glucose intolerance occurring during pregnancy. The prevalence of this pathology was shown to vary widely, whilst currently increasing worldwide in relation to obesity and diabetes outbreak. The pathophysiology of gestational diabetes is similar to that of Type 2 diabetes, as characterized by increased insulin resistance and subsequent pancreatic beta-cell dysfunction. Even though complications of gestational diabetes are well-known, there is no universal consensus with respect to screening criteria. The cornerstone of treatment is diet, which may be followed by insulin therapy, if necessary. Post-partum follow-up appears essential, considering the high risk of diabetes in the patient's future.
Mobile devices, tablets, and smart-phones have become essential tools in today's society, and they are also entering the healthcare field. We are slowly, but surely, approaching the e-medicine domain, inhabited by the e-patient, with all its advantages in terms of accessibility, yet also its complications, along with the need to rethink the current health care system.
The patient's return to his own home following heart surgery constitutes a significant moment in time, reflecting his return to daily normal-life activities. Once the peri-operative phase overcome, and following the period of convalescence, the patient must very abruptly continue to life "without any medical environment". The role of the information provided to the patient during his hospital stay, as well as the cooperation between the physician, cardiologist, and surgeon, are all paramount to facilitate the patient's return to his own home.
The general practitioner is commonly faced with patients coming home after having undergone coronary intervention. Given this context, the specific items that must be followed-up include potential vascular complications, administered medications for preventing stent thrombosis (antiplatelet agents), as well as the management of recurrent chest pain. General measures to prevent atherothrombosis should be applied and monitored as well.