Revue De Medecine Interne最新文献

{"title":"Issue Contents","authors":"","doi":"10.1016/S0248-8663(24)01259-1","DOIUrl":"10.1016/S0248-8663(24)01259-1","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages e21-e22"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Une aspergillose cutanée invasive au cours d’une granulomatose avec polyangéite","authors":"Amir Agade ,&nbsp;Cyril Habougit ,&nbsp;Cédric Chol ,&nbsp;Jean-Baptiste Gaultier ,&nbsp;Caroline Mahinc ,&nbsp;Lucile Grange ,&nbsp;Martin Killian ,&nbsp;Baptiste Gramont","doi":"10.1016/j.revmed.2024.09.005","DOIUrl":"10.1016/j.revmed.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Aspergillosis is an opportunistic infection that can complicate any situation of immunosuppression. The primary manifestations are pulmonary, and more rarely, in cases of severe immunosuppression, the infection can become invasive with extra-pulmonary involvement.</div></div><div><h3>Observation</h3><div>We report the case of a 76-year-old female patient, experiencing a relapse of granulomatosis with polyangiitis treated with corticosteroids, rituximab and cyclophosphamide, who presented with diffuse erythematous nodular skin lesions. A biopsy with histological analysis confirmed a diagnosis of invasive cutaneous aspergillosis. Treatment with voriconazole led to a favorable outcome.</div></div><div><h3>Conclusion</h3><div>The appearance of skin lesions in an inflammatory context in a patient receiving immunosuppressive therapy should prompt a comprehensive microbiological assessment for opportunistic pathogens, as well as a skin biopsy to investigate for invasive cutaneous aspergillosis.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 726-730"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rôle des médecins hospitalo-universitaires de médecine interne dans la formation aux métiers de la santé et au sein des institutions en France : enquête du Collège National des Enseignants de Médecine Interne (CEMI)","authors":"Odile Rauzy ,&nbsp;Laurence Bouillet ,&nbsp;Kevin Chevalier ,&nbsp;Fleur Cohen-Aubart ,&nbsp;Isabelle Delacroix ,&nbsp;Thomas Hanslik ,&nbsp;Gilles Kaplanski ,&nbsp;Estibaliz Lazaro ,&nbsp;Emmanuelle Le Moigne ,&nbsp;Pierre Pottier ,&nbsp;Etienne Riviere ,&nbsp;Luc Mouthon","doi":"10.1016/j.revmed.2024.07.003","DOIUrl":"10.1016/j.revmed.2024.07.003","url":null,"abstract":"<div><h3>Rationale</h3><div>On the occasion of the General stage meeting of Internal Medicine, the National College of Internal Medicine Teachers (CEMI) conducted a survey on teaching activity among all French university hospital (HU) internal medicine specialists.</div></div><div><h3>Method</h3><div>The survey was carried out in September 2023 by sending an email to 101 hospital practitioners university professors (PU–PH) and 18 hospital practitioners assistant professors (MCU–PH) of internal medicine in subsection 53-01 of the National council of universities (CNU), as well as to the 11 HU internists working in immunology (subsection 47-01) or therapeutics (subsection 48-04).</div></div><div><h3>Results</h3><div>Seventy-three HUs (56.1%) responded to the survey, including 65 PU–PH, 7 MCU–PH and 1 university hospital practitioner (PHU). Internal medicine HUs participate in faculty teaching: 80% are responsible for teaching, 30% are responsible for the year or cycle or lead committees and 40% have had or have an elected mandate at the faculty or at university. Internal medicine HU are involved in the teaching of semiology during the first cycle of medical studies, but also in pharmaceutical sciences, dentistry, midwifery and in paramedical training. They are very invested in the implementation of the second cycle reform and 80% are involved in the preparation of Objective Structured Clinical Examinations (ECOS), mainly as examiners (90%). They also participate in teaching using simulation (60%), teaching advanced practice nurses (IPA) (25%), and writing CEMI books (75%). For ECOS, 90% participate as examiners, 60% participate in teaching using simulation, 25% are involved in teaching advanced practice nurses (IPA), 75% participated in the writing of CEMI works. Eight (12%) internal medicine HUs co-facilitate training with patients and 26 (38%) participate in master's courses at the Faculty of Sciences. Finally, 94% are affiliated with a research unit and 48% supervise university theses students.</div></div><div><h3>Conclusion</h3><div>Internal medicine universities teachers have a strong educational commitment, particularly in semiology and in the reform of the second cycle of medical studies with ECOS and simulation.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 678-686"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hémophilie acquise : quoi de neuf en 2024 ?","authors":"Hervé Lévesque ,&nbsp;Benoit Guillet ,&nbsp;Roseline d’Oiron ,&nbsp;Ygal Benhamou","doi":"10.1016/j.revmed.2024.06.005","DOIUrl":"10.1016/j.revmed.2024.06.005","url":null,"abstract":"<div><div>Acquired hemophilia A (AHA) is a rare autoimmune disorder due to autoantibodies against factor VIII, with a high mortality risk. It should be suspected in subjects with abnormal bleedings, especially subcutaneous bleed associated with prolonged activated partial thromboplastin time (aPTT). AHA is often idiopathic but is associated with autoimmune diseases, malignancies, pregnancy and postpartum period or drugs. Treatment is based on haemostatic agents as by-passants agents such as factor VIIa and activated prothrombine concentrate complex or recombinant porcine factor VIII for severe bleeding. Eradication of inhibitor should be established as soon as the diagnosis is confirmed with steroid alone often associated with cytotoxic agents or rituximab, depending on FVIII activity and inhibitor titer. The purpose of this review is to summarize the epidemiology, etiopathogenesis, diagnosis, treatment of AHA and discuss current recommendations.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 710-725"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évolution du choix de la médecine interne (et immunologie clinique) à l’issue des épreuves classantes nationales depuis 2010","authors":"Kevin Chevalier ,&nbsp;Raphaël Lee ,&nbsp;Loris Azoyan ,&nbsp;Anaïs Roeser ,&nbsp;Camille Mettler ,&nbsp;Lucile Grange ,&nbsp;Pascal Sève ,&nbsp;Odile Rauzy ,&nbsp;Luc Mouthon","doi":"10.1016/j.revmed.2024.08.004","DOIUrl":"10.1016/j.revmed.2024.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The 2017 reform of the third cycle of medical studies (R3C) was accompanied by modifications in the formats and number of specialty diplomas. The aim of this study was to investigate the evolution of the choice of the internal medicine and clinical immunology specialty before and after 2017.</div></div><div><h3>Methods</h3><div>We used the median ranking and its evolution, as well as incoming and outgoing remorse rights, as markers of attractiveness. Data on the number of position offered, rankings and affectation were collected from decrees published in the French “Journal Officiel” each year. A survey conducted by the “Amicale des Jeunes Internistes” investigated the reasons for the outgoing or incoming rights to remorse.</div></div><div><h3>Results</h3><div>Before 2017, internal medicine was accessible to 52% of students on average, with a median rank of 1118 [339–2640]. From 2017 onwards, the internal medicine specialty was accessible to an average of 76.6% of students, with a median rank of 2772 [1039–5155]. The balance of incoming and outgoing remorse rights was –4.7% before 2017 and varied between –4.1 and –12.4% from 2017.</div></div><div><h3>Conclusion</h3><div>Since 2017, the median and cut-off ranks of students choosing internal medicine specialty have increased, and balance of incoming and outgoing remorse rights was increasingly negative. A reflection on the attractiveness of the internal medicine specialty is undertaken by the National College of Internal Medicine Teachers in order to make the richness of the specialty and its different modes of practice known to future residents.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 687-695"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La médecine interne française est à un tournant de son histoire. Synthèse de la Journée nationale de médecine interne 2024","authors":"P. Sève ,&nbsp;B. Ranque ,&nbsp;A. Bourgarit ,&nbsp;E. Oziol ,&nbsp;O. Rauzy ,&nbsp;K. Chevalier ,&nbsp;B. Godeau ,&nbsp;L. Mouthon","doi":"10.1016/j.revmed.2024.10.453","DOIUrl":"10.1016/j.revmed.2024.10.453","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 673-677"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un œdème pulmonaire inattendu","authors":"Charlotte Dumas,&nbsp;Prunelle Getten,&nbsp;Edouard Flamarion","doi":"10.1016/j.revmed.2024.08.007","DOIUrl":"10.1016/j.revmed.2024.08.007","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 731-733"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La glomérulonéphrite fibrillaire","authors":"C. Dumas De La Roque ,&nbsp;I. Brocheriou ,&nbsp;A. Mirouse ,&nbsp;P. Cacoub ,&nbsp;A. Le Joncour","doi":"10.1016/j.revmed.2024.05.005","DOIUrl":"10.1016/j.revmed.2024.05.005","url":null,"abstract":"<div><div>Fibrillary glomerulonephritis (FGN) is a glomerular disease described since 1977, with a prevalence in renal biopsies of less than 1%. It presents as renal failure, proteinuria, haematuria and hypertension in middle-aged adults. It is defined histologically, using light microscopy, which reveals organised deposits of fibrils measuring around 20<!--> <!-->nm, which are negative for Congo red staining. Electron microscopy, the first gold standard for diagnosis, has now been superseded by immunohistochemistry using the anti-DNAJB9 antibody. The discovery of this molecule has revolutionised the diagnosis of GNF, thanks to its excellent sensitivity and specificity (98% and 99% respectively). The association of GNF with hepatitis C virus, autoimmune diseases, neoplasia or haemopathy is debated. Renal prognosis is guarded, with 50% of patients progressing to end-stage renal failure within 2 to 4<!--> <!-->years of diagnosis. In the absence of randomised controlled trials, the recommended treatment is based on nephroprotective measures, corticosteroid therapy and possibly a second-line immunosuppressant such as rituximab. After renal transplantation, recovery or recurrence is possible. The pathophysiology of the disease is still poorly understood, and further studies are needed.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 703-709"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141052019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Système 1 et système 2 : enjeux pédagogiques à la croisée du raisonnement clinique et du raisonnement en intelligence artificielle","authors":"Alexis Bourgeois ,&nbsp;Pierre Fourneret ,&nbsp;Michel Cermolacce ,&nbsp;Christophe Gauld","doi":"10.1016/j.revmed.2024.10.008","DOIUrl":"10.1016/j.revmed.2024.10.008","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 737-738"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’anémie invraisemblable de Karl","authors":"E. Chauvel ,&nbsp;R. Deshayes ,&nbsp;V. Genin ,&nbsp;T. Le Scornet ,&nbsp;R. Collot ,&nbsp;A. Renaud ,&nbsp;A. Auféril ,&nbsp;L. Drouart ,&nbsp;L. Leghima ,&nbsp;M. Nicolič","doi":"10.1016/j.revmed.2024.06.003","DOIUrl":"10.1016/j.revmed.2024.06.003","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"45 11","pages":"Pages 734-736"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}