Revue De Medecine Interne最新文献

{"title":"Issue Contents","authors":"","doi":"10.1016/S0248-8663(25)00063-3","DOIUrl":"10.1016/S0248-8663(25)00063-3","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 3","pages":"Pages e5-e6"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529048","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":"Chez les sujets hospitalisés avec bactériémie, un traitement antibiotique de 7 jours est-il non inférieur à un traitement de 14 jours en termes d’impact sur la mortalité ?","authors":"Luc Lanthier , Alex Carignan , Alexandre Mutchmore , Marc-Émile Plourde , Michel Cauchon","doi":"10.1016/j.revmed.2025.01.007","DOIUrl":"10.1016/j.revmed.2025.01.007","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 3","pages":"Pages 183-184"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412127","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":"Syndromes auto-inflammatoires VEXAS-like : à propos de 2 cas","authors":"Mathilde Devaux , Vincent Jachiet , Pierre Hirsch , Sophie Georgin-Lavialle , Arsene Mekinian , Geraldine Salmeron , Sonnthida Sep-Hieng , Pascale Flandrin-Gresta , Andrea Chretiennot , Lilia Ghit , Helene Masson , Zoe Le Lostec , Catherine Veyssier-Belot","doi":"10.1016/j.revmed.2024.12.003","DOIUrl":"10.1016/j.revmed.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Le syndrome VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic), dû à une mutation somatique du gène <em>UBA1</em> et souvent associé à une hémopathie, est caractérisé par des symptômes systémiques proches de ceux décrits dans la maladie de Still ou la polychondrite atrophiante. Certains patients atteints d’hémopathies, présentent des symptômes inflammatoires rappelant ceux du syndrome VEXAS mais sans mutation canonique du gène <em>UBA1</em>.</div></div><div><h3>Cas/Discussion</h3><div>Deux patients de sexe masculin consultaient pour des signes généraux, des symptômes dermatologiques, des arthralgies, des chondrites et des thromboses veineuses, similaires à ceux décrits dans la cohorte française VEXAS. Le myélogramme retrouvait des vacuoles dans les précurseurs myéloïdes et érythroïdes, avec un diagnostic de leucémie myélomonocytaire chronique pour l’un et de syndrome myélodysplasique pour l’autre. La recherche d’une mutation du gène <em>UBA1</em> par la technique sanger, l’analyse par <em>next-generation sequencing</em> (NGS) d’un panel myéloïde et le séquençage complet étaient négatifs, ne permettant pas de retenir le diagnostic de syndrome VEXAS. Il existait d’autres mutations somatiques, signant une hématopoïèse clonale associée à ce tableau systémique inflammatoire. La corticothérapie initiale était efficace mais, une corticodépendance nécessitait un traitement d’épargne par agent hypométhylant ou inhibiteurs de Janus Kinase.</div></div><div><h3>Conclusion</h3><div>Le rôle des mutations somatiques dans la physiopathologie des maladies auto-inflammatoires associées aux hémopathies doit être mieux compris afin de mieux les caractériser et de développer des traitements ciblés.</div></div><div><h3>Introduction</h3><div>VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic), recently described, due to a somatic mutation of the <em>UBA1</em> gene and often associated with hemopathy, is characterized by systemic symptoms close to those described in Still's disease or relapsing polychondritis. There are also patients with hemopathy, presenting inflammatory symptoms reminiscent of those of VEXAS syndrome but without mutation of the <em>UBA1</em> gene.</div></div><div><h3>Case/Discussion</h3><div>Two male patients consulted for general signs, dermatological symptoms, arthralgia, chondritis and venous thrombosis, like patients in the French cohort suffering from VEXAS syndrome. The myelogram found vacuoles in the myeloid and erythroid precursors, with a diagnosis of chronic myelomonocytic leukemia for one and myelodysplastic syndrome for the other. The search for a mutation of the <em>UBA1</em> gene by the sanger technique, the next-generation sequencing (NGS) analysis of a myeloid panel and the complete sequencing was negative, not allowing the diagnosis of VEXAS syndrome to be retained. There were other somatic mutations, indicating clonal hematopoiesis associated with this systemic infla","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 3","pages":"Pages 139-145"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901507","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":"Acidose lactique liée à la metformine : expérience du centre hospitalier de Saint-Denis","authors":"Sarah Diakité ,&nbsp;Martin Mathurin ,&nbsp;François Lhote ,&nbsp;Stéphanie Ngo ,&nbsp;Elisa Pasqualoni ,&nbsp;Edouard Versini","doi":"10.1016/j.revmed.2024.11.014","DOIUrl":"10.1016/j.revmed.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Metformin is a first line treatment for type II diabetes. Cases of metformin-associated lactic acidosis are regularly reported. A direct causal link between metformin overdose and lactic acidosis is not clearly established. The aim of this study is to describe cases of metformin-associated lactic acidosis, to assess their vital et renal prognosis, and to analyze the correlations between metforminemia, lactacidemia, pH and death.</div></div><div><h3>Methods</h3><div>Cases of metformin-associated lactic acidosis from a single hospital center in Saint-Denis, France, between 2010 and 2022 were analyzed. Inclusion criteria were patients aged 18 or older, treated with metformin, metabolic acidosis with a pH inferior to 7.35 and lactacidemia superior to 5<!--> <!-->mmol/l.</div></div><div><h3>Results</h3><div>Twenty-eight patients were included. Median age was 65 years old. Voluntary intoxication was present in 17% of cases. Metformin was contraindicated in 39% of cases. All patients presented with acute kidney injury at admission. Mortality rate was 7%. No factor was associated with death in the univariate analysis. Correlation between pH, lactacidemia, creatininemia and glycated hemoglobin was found. There was no correlation between metforminemia and lactacidemia.</div></div><div><h3>Conclusion</h3><div>Metformin-associated lactic acidosis is a rare complication. Its prognosis is inconstant, varying with the presence or absence of a severe disease causing the overdose. No association was found between clinical data, biological data and death.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 68-73"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960742","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":"Une dyspnée révélant un syndrome de platypnée-orthodéoxie chez une patiente insuffisante cardiaque","authors":"Muriel Gauthier ,&nbsp;Nicolas-Charles Roche ,&nbsp;Thomas Audoual ,&nbsp;Philippe Aldebert ,&nbsp;Pierre-Laurent Massoure","doi":"10.1016/j.revmed.2024.11.013","DOIUrl":"10.1016/j.revmed.2024.11.013","url":null,"abstract":"<div><h3>Introduction</h3><div>The platypnea orthodeoxia syndrome is a rare clinical entity combining positional dyspnea and arterial oxygen desaturation during the transition to orthostatism, reversible on return to decubitus. The most frequent etiology of this syndrome is the presence of a patent foramen ovale (PFO) responsible for a right-to-left intracardiac shunt, the severity of which results in significant functional disability and a risk of death from hypoxia.</div></div><div><h3>Case report</h3><div>We report the case of a 93-year old patient on long-term oxygen, initially hospitalized for acute heart failure following a community-acquired urinary tract infection. The onset of recurrent positional dyspnea with desaturation on raising revealed a platypnea orthodeoxia syndrome. Transesophageal echocardiogram with bubble test revealed a large right-to-left shunt through a PFO, percutaneous closure of which led to complete resolution of symptoms and discontinuation of oxygen therapy.</div></div><div><h3>Discussion and conclusion</h3><div>The platypnea orthodeoxia syndrome associated with a patent foramen ovale often suffers from delayed diagnosis. Advanced age and co-morbidities should not prevent patients from undergoing percutaneous PFO closure, as the clinical benefit is important.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 116-119"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796675","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":"Chez les personnes avec obésité et apnée du sommeil obstructive modérée à sévère, est-ce que le tirzépatide est efficace pour diminuer l’indice d’apnée-hypopnée comparativement au placebo tout en étant sécuritaire ?","authors":"Alexandre Mutchmore ,&nbsp;Michel Cauchon ,&nbsp;Marc-Émile Plourde ,&nbsp;Luc Lanthier","doi":"10.1016/j.revmed.2024.12.002","DOIUrl":"10.1016/j.revmed.2024.12.002","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 124-125"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857322","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":"JAK inhibitors (JAKi): Mechanisms of action and perspectives in systemic and autoimmune diseases","authors":"Liticia Chikhoune ,&nbsp;Claire Poggi ,&nbsp;Julie Moreau ,&nbsp;Sylvain Dubucquoi ,&nbsp;Eric Hachulla ,&nbsp;Aurore Collet ,&nbsp;David Launay","doi":"10.1016/j.revmed.2024.10.452","DOIUrl":"10.1016/j.revmed.2024.10.452","url":null,"abstract":"<div><div>Janus kinase (JAK) molecules are involved in important cellular activation pathways. Over the past decade, many targeted therapies have emerged, including the increasingly promising role of JAK inhibitors (JAKi) in the treatment of inflammatory and autoimmune diseases. The spectrum of use of these small molecules is increasingly broader. JAKi have been approved in several autoimmune diseases. Currently, four molecules (tofacitinib, baricitinib, upadacitinib and filgotinib) have been labeled for moderate to severe rheumatoid arthritis (RA) with failure or poor tolerance of one or more conventional disease-modifying antirheumatic drug (csDMARDS), or biologics (bDMARDS). JAKi are now also commonly used in other diseases such as psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis. They have also shown promising results in clinical trials for the treatment of other autoimmune conditions. We present here their mechanisms of action, and the main data about JAKi use on systemic and autoimmune diseases.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 89-106"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645331","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":"Issue Contents","authors":"","doi":"10.1016/S0248-8663(25)00031-1","DOIUrl":"10.1016/S0248-8663(25)00031-1","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages e3-e4"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386992","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 pic électrophorétique transitoire","authors":"Quentin Gomes de Pinho ,&nbsp;Xavier Heim ,&nbsp;Gabriel Dejeans ,&nbsp;Audrey Benyamine ,&nbsp;Brigitte Granel","doi":"10.1016/j.revmed.2024.11.003","DOIUrl":"10.1016/j.revmed.2024.11.003","url":null,"abstract":"","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 122-123"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386994","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":"Quel bilan proposer après une grossesse compliquée de pathologie vasculo-placentaire ?","authors":"Claire de Moreuil ,&nbsp;Annabelle Remoué ,&nbsp;Jordan Pozzi ,&nbsp;Christophe Trémouilhac ,&nbsp;François Anouilh ,&nbsp;Karine Morcel ,&nbsp;Pascale Marcorelles","doi":"10.1016/j.revmed.2024.09.001","DOIUrl":"10.1016/j.revmed.2024.09.001","url":null,"abstract":"<div><div>Vasculo-placental disorders include pregnancy complications resulting from placental dysfunction of vascular origin, i.e. pre-eclampsia, HELLP syndrome, intrauterine growth retardation (IUGR), placental abruption and stillbirth of vascular origin. Pre-eclampsia should be investigated for antiphospholipid syndrome (APS) in case of severe pre-eclampsia and premature delivery before 34 weeks of gestation. In addition to testing for APS, pathological report of the placenta can identify some anatomical predispositions to placental vascular malperfusion, as well as chronic placental inflammatory lesions and excess fibrin deposits. The latter two are associated with IUGR and recurrent stillbirth, reflecting a dysimmune process of maternal origin. The internal medicine and obstetrics consultation, organized two months after delivery, combines the postnatal visit with an assessment of the causes of vasculo-placental disorders, and enables to inform patients about the management of future pregnancies and their cardiovascular health.</div></div>","PeriodicalId":54458,"journal":{"name":"Revue De Medecine Interne","volume":"46 2","pages":"Pages 107-115"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305076","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}