The splenic complications of acute malaria include two different prognostic and treatment entities: splenic infarction and splenic rupture. This is the first case of splenic infarction during an ...acute malaria due to Plasmodium ovale in a 34-year-old man. As in the majority other described cases of splenic infarction, the course was spontaneously favourable, suggesting that this complication was relatively benign compared to splenic rupture, which is life-threatening and usually necessitating surgery.
Pulmonary arterial hypertension (PAH) is a rare complication of systemic lupus erythematosus (SLE).
We identified all patients with SLE and PAH (SLE-PAH) who were enrolled in the French Pulmonary ...Hypertension Registry with a diagnosis confirmed by right heart catheterization (RHC). A control group of 101 patients with SLE without known PAH was selected from SLE expert centers participating in the Pulmonary Hypertension Registry. Survival was estimated by the Kaplan-Meier method. Hazard ratios associated with potential predictors of death were estimated using Cox proportional hazard models.
Of the 69 patients with SLE-PAH identified in the French Pulmonary Hypertension Registry, 51 were included in the study. They did not differ from the control group regarding age, sex, or duration of SLE at the time of the analysis but had a higher frequency of anti-SSA and anti-SSB antibodies. The delay between SLE diagnosis and PAH diagnosis was 4.9 years (range, 2.8-12.9) years. The 3- and 5-year overall survival rates were 89.4% (95% CI, 76.2%-96.5%) and 83.9% (95% CI, 68.8%-92.1%), respectively. The survival rate was significantly better in patients with anti-U1-RNP antibodies (P = .04).
Patients with SLE-PAH have an overall 5-year survival rate of 83.9% after the PAH diagnosis. Anti-SSA/SSB antibodies may be a risk factor for PAH, and the presence of anti-U1-RNP antibodies appears to be a protective factor regarding survival.
IntroductionIntra-articular (IA) and peri-articular glucocorticoid (GC) injections are common in sports medicine. However, from 1 January 2022, all injectable GC routes (including IA administration) ...will be prohibited in-competition by World Anti-Doping Agency (WADA). Owing to these rules, an IA GC treatment out-of-competition could result in an adverse analytical finding in-competition if the washout period is not clearly defined. The aim of this study is to determine the urinary excretion profile of triamcinolone acetonide following IA injection to strengthen the definition of the washout periods.Methods and analysisThis is a prospective multicentre trial to include 20 subjects who practice sports for at least 4 hours/week and present a knee disorder requiring IA injection of triamcinolone acetonide for therapeutic purposes. To determine the excretion profile of triamcinolone acetonide in both urine and blood following IA injection of the drug, We will perform 20 urinary tests and 20 dried blood spot tests, two prior to GC injection (baseline) and the last one at 35 days. Analyses will be performed by the French antidoping agency laboratory in accordance with WADA standards and regulations.Ethics and disseminationThe study protocol was approved by the French ethics committee (CPP Sud Est III—Lyon—2020-070B on 06 October 2020). All subjects will provide written informed consent. The results of this study will be accessible in peer-reviewed publication and be presented at academic conference.Trial registration numberNCT04574232.
The Legouest military training hospital is one of the eight hospitals of the armed forces health service. Situated in the Grand-Est region, one of the regions most affected by the COVID-19 epidemic ...in spring, it had to reorganise itself within a few days with its regional and national partners. While continuing to support forces sent abroad, to overseas territories or located in the East of France, the armed forces hospital had three major missions: the support of other military hospital facilities, the continued care of non-COVID patients and the care of patients affected by COVID-19 requiring non-intensive hospital care.
This worldwide health crisis forced hospitals to adapt their activities to this new confinement environment. Innovation was required to maintain a social bound between cohorting service's patients ...and their families, to guarantee a dedicated listening time and prevent as much as possible from the isolation due to this COVID-19 unusual situation. With that aim, the army training hospital Legouest created an information and support listening cell dedicated to COVID-19 hospitalized patients' families. It also provided several tablets for creating a patient and family digital gate.
Despite the recent emergence of COVID-19 and the absence of a specific cure, the hospital treatment of patients affected by this virus is well established. It is based on symptomatic treatments ...including oxygen therapy, physiotherapy and anticoagulation therapy. The treatment plan and potential therapeutic limitations must be well defined and adapted to the severity, predisposition and wishes of the patient.
The SARS-Cov-2 pandemic took health care players across the world by surprise, including caregivers, managers and logisticians. In the absence of a vaccine or a specific therapy, detecting the ...disease at an early stage and isolating confirmed cases from the rest of the healthy population was soon considered to be essential. The RT-PCR technique was the gold standard method for testing for infection with the virus. It has high specificity but moderate sensitivity. It was difficult to access it during the first weeks of the pandemic. On the basis of the observations of the Chinese and Italian scientific community in particular, the recommendation was to combine use of the RT-PCR with a low-dose thoracic CT scan. In the absence of easy access to the RT-PCR, the use of the lung CT scan for a rapid triage of patients within emergency departments proved effective.
Anthrax is an acute bacterial infection caused by Bacillus anthracis. The infection is cutaneous in about 95% of human cases and respiratory in about 5%. Approximately 2000 cases of cutaneous anthrax ...are reported annually worldwide. This disease became exceptional in Europe thanks to strict veterinarian monitoring. The last human cases of anthrax indicated in France were in 1997. We report 3 new related cases of naturally acquired cutaneous anthrax that occurred in France in 2008. The unique features of these cases include the atypical clinical presentation and the contribution of the rapid and specific diagnosis techniques by polymerase chain reaction.In cutaneous forms of anthrax, although the local course is not influenced by the treatment, antibiotic therapy is necessary to control any bacterial distribution. A case of exposure similar to that of a confirmed human case or an exposure identified by epidemiologic inquiry should usually result in chemoprophylaxis. Chemoprophylaxis for the close relations of a patient or for health workers is unnecessary since person-to-person transmission has not been reported.
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