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[Artificial intelligence in healthcare: A survival guide for internists]. [医疗保健中的人工智能：内科医生的生存指南]。
La Revue de medecine interne Pub Date : 2025-02-20 DOI: 10.1016/j.revmed.2025.02.002
Thomas Barba, Marie Robert, Arnaud Hot
{"title":"[Artificial intelligence in healthcare: A survival guide for internists].","authors":"Thomas Barba, Marie Robert, Arnaud Hot","doi":"10.1016/j.revmed.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.revmed.2025.02.002","url":null,"abstract":"<p><p>Artificial intelligence (AI) is experiencing considerable growth in medicine, driven by the explosion of available biomedical data and the emergence of new algorithmic architectures. Applications are rapidly multiplying, from diagnostic assistance to disease progression prediction, paving the way for more personalized medicine. The recent advent of large language models, such as ChatGPT, has particularly interested the medical community, thanks to their ease of use, but also raised questions about their reliability in medical contexts. This review presents the fundamental concepts of medical AI, specifically distinguishing traditional discriminative approaches from new generative models. We detail the different exploitable data sources and methodological pitfalls to avoid during the development of these tools. Finally, we address the practical and ethical implications of this technological revolution, emphasizing the importance of the medical community's appropriation of these tools.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Between the normal and the pathological: The concept of pre-disease applied to systemic autoimmune rheumatic diseases]. [正常与病理之间：应用于系统性自身免疫性风湿病的病前概念]。
La Revue de medecine interne Pub Date : 2024-11-25 DOI: 10.1016/j.revmed.2024.11.009
L Chiche, M-E Truchetet, D Cornec, C Immediato Daien
{"title":"[Between the normal and the pathological: The concept of pre-disease applied to systemic autoimmune rheumatic diseases].","authors":"L Chiche, M-E Truchetet, D Cornec, C Immediato Daien","doi":"10.1016/j.revmed.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.11.009","url":null,"abstract":"<p><p>The incidence of systemic autoimmune diseases is constantly rising. They are chronic diseases requiring prolonged treatment, with considerable psychosocial impact. While attention to the promising results obtained with CAR-T cells in refractory patients is justified, it seems important not to overlook the opportunities for prevention based on the identification of a pre-disease state. After clarifying the various stages that make up this pre-disease state, using the prototypical example of systemic lupus erythematosus, we will apply a transdisciplinary and transpathological approach to describe comparatively recent data obtained for other systemic autoimmune diseases (rheumatoid arthritis, Sjögren's syndrome and systemic scleroderma). We will then discuss the practical implications of this new paradigm in the typical consultation of a potentially \"pre-sick\" individual, and on the prospects opened up by this new paradigm in care and research.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Atypical and/or systemic dermatologic disorders related to immune checkpoint inhibitors: A review]. [与免疫检查点抑制剂有关的非典型和/或系统性皮肤病：综述]。
La Revue de medecine interne Pub Date : 2024-11-22 DOI: 10.1016/j.revmed.2024.11.011
Valérian Rivet, Vincent Sibaud, Jérémie Dion, Salomé Duteurtre, Mélanie Biteau, Cécile Pages, Andréa Pastissier, Karen Delavigne, Pierre Cougoul, Odile Rauzy, Thibault Comont
{"title":"[Atypical and/or systemic dermatologic disorders related to immune checkpoint inhibitors: A review].","authors":"Valérian Rivet, Vincent Sibaud, Jérémie Dion, Salomé Duteurtre, Mélanie Biteau, Cécile Pages, Andréa Pastissier, Karen Delavigne, Pierre Cougoul, Odile Rauzy, Thibault Comont","doi":"10.1016/j.revmed.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.11.011","url":null,"abstract":"<p><p>Immunological checkpoint inhibitors are now part of the oncological therapeutic arsenal in many solid cancers and malignant blood diseases, at the cost of immuno-mediated toxicities, of which dermatological disorders are among the most frequent. The most common, following treatment with anti-PD1 or anti-CTLA4, are maculopapular erythema, pruritus, vitiligo, or lichenoid lesions, but other more atypical conditions may lead to the internist being called upon. Here, we present a case series of these less common dermatological manifestations including fasciitis, dermatomyositis, scleroderma, granulomatosis and immune-induced vasculitis. Some manifestations appear similar to the primary forms or seem to correspond to paraneoplastic syndromes, but some diagnostic and therapeutic particularities are specific to ICI toxicity that the internist must be aware of.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Management of congenital thrombotic thrombocytopenic purpura in the era of recombinant ADAMTS13 protein: Recommendations from the Reference Center for Thrombotic Microangiopathies (CNR-MAT)]. [重组 ADAMTS13 蛋白时代的先天性血栓性血小板减少性紫癜管理：血栓性微血管病参考中心（CNR-MAT）的建议]。
La Revue de medecine interne Pub Date : 2024-11-21 DOI: 10.1016/j.revmed.2024.11.004
Bérangère S Joly, Adrien Joseph, Claire Dossier, Theresa Kwon, Nathalie Gouge-Biebuyck, Olivia Boyer, Vassilis Tsatsaris, Agnès Veyradier, Paul Coppo
{"title":"[Management of congenital thrombotic thrombocytopenic purpura in the era of recombinant ADAMTS13 protein: Recommendations from the Reference Center for Thrombotic Microangiopathies (CNR-MAT)].","authors":"Bérangère S Joly, Adrien Joseph, Claire Dossier, Theresa Kwon, Nathalie Gouge-Biebuyck, Olivia Boyer, Vassilis Tsatsaris, Agnès Veyradier, Paul Coppo","doi":"10.1016/j.revmed.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.11.004","url":null,"abstract":"<p><p>Thrombotic Thrombocytopenic Purpura (TTP) is a rare disease characterized by a severe deficiency of ADAMTS13, the specific protease that cleaves von Willebrand factor. The congenital form of TTP (cTTP) results from pathogenic variants of the ADAMTS13 gene. cTTP has two peaks of incidence: one in childhood and the other in adulthood, mainly in an obstetric context. The treatment of cTTP relies on ADAMTS13 replacement therapy for prophylaxis or on-demand, depending on the evolving nature of the disease, along with the management of cardiovascular risk factors. The historical treatment for cTTP has been substitution plasma therapy. Since 2017, a recombinant human ADAMTS13 protein (rhADAMTS13) has been evaluated in cTTP in international clinical trials. The rhADAMTS13 protein, intravenous infusion used for prophylaxis or on-demand, has been granted early access or compassionate use in cTTP in France in 2024. The objective of this document is to establish academic recommendations for the use of rhADAMTS13 in cTTP.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Fibrillary glomerulonephritis]. [纤维性肾小球肾炎]。
La Revue de medecine interne Pub Date : 2024-11-01 Epub Date: 2024-05-15 DOI: 10.1016/j.revmed.2024.05.005
C Dumas De La Roque, I Brocheriou, A Mirouse, P Cacoub, A Le Joncour
{"title":"[Fibrillary glomerulonephritis].","authors":"C Dumas De La Roque, I Brocheriou, A Mirouse, P Cacoub, A Le Joncour","doi":"10.1016/j.revmed.2024.05.005","DOIUrl":"10.1016/j.revmed.2024.05.005","url":null,"abstract":"<p><p>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 20nm, 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 4years 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.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":"703-709"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Q fever revealed by an anti-phospholipid syndrome: A case report. 由抗磷脂综合征引发的急性 Q 热：病例报告
La Revue de medecine interne Pub Date : 2024-07-01 Epub Date: 2024-05-17 DOI: 10.1016/j.revmed.2024.05.006
K Balasoupramanien, J-B Roseau, N Cazes, C Surcouf, E Le Dault
{"title":"Acute Q fever revealed by an anti-phospholipid syndrome: A case report.","authors":"K Balasoupramanien, J-B Roseau, N Cazes, C Surcouf, E Le Dault","doi":"10.1016/j.revmed.2024.05.006","DOIUrl":"10.1016/j.revmed.2024.05.006","url":null,"abstract":"<p><strong>Introduction: </strong>Q fever is a zoonosis caused by Coxiella burnetii. Acute infection is mainly asymptomatic. In other cases it mainly causes a flu-like illness, a pneumonia, or an hepatitis. We present an atypical case of an acute Q fever revealed by a massive pleural effusion.</p><p><strong>Case report: </strong>We report the case of a 43-year-old man referred to our hospital for an acute respiratory distress. Further analyses showed an exudative eosinophilic pleural effusion, associated with a pulmonary embolism and a deep femoral vein thrombosis. Aetiologic explorations revealed an acute Q fever (IgM and IgG against C. burnetii phase II antigens) associated with anti-phospholipids. The outcome was favorable with vitamin K antagonists, doxycycline, and hydroxychloroquine, till the negativation of the anti-phospholipid antibodies.</p><p><strong>Discussion and conclusion: </strong>During acute C. burnetii infections, anti-phospholipid antibodies are highly prevalent but thrombotic complications are rare. The 2023 ACR/EULAR APS criteria restricts the diagnosis of APS, as in our case of acute severe infection. In front of an atypical pneumonia and/or thrombotic events, screening of C. burnetii and anti-phospholipid antibodies could be useful. Given its low level of evidence, prolongated treatment by doxycycline, hydroxychloroquine ± anticoagulant for C. burnetii's associated anti-phospholipid syndrome is discussed, but succeeded in our case.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":"444-446"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Portrait of Claire Le Jeunne, professor and former head of the internal medicine department at Hôpital Cochin, Paris]. [巴黎科钦医院内科教授和前主任克莱尔-勒让纳的肖像]。
La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.05.004
G. Martin de Frémont, K. Chevalier, A. Roeser
{"title":"[Portrait of Claire Le Jeunne, professor and former head of the internal medicine department at Hôpital Cochin, Paris].","authors":"G. Martin de Frémont, K. Chevalier, A. Roeser","doi":"10.1016/j.revmed.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.05.004","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141026080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Among patients with metabolic dysfunction associated steatohepatitis (MASH), is resmetirom 80 or 100mg superior to placebo in reversing MASH and/or fibrosis on liver biopsy, and is it safe?] [在代谢功能障碍相关性脂肪性肝炎（MASH）患者中，瑞美替罗 80 毫克或 100 毫克在逆转 MASH 和/或肝活检纤维化方面是否优于安慰剂？］
La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.05.007
L. Lanthier, D. Grbic, Marc-Émile Plourde, M. Cauchon
{"title":"[Among patients with metabolic dysfunction associated steatohepatitis (MASH), is resmetirom 80 or 100mg superior to placebo in reversing MASH and/or fibrosis on liver biopsy, and is it safe?]","authors":"L. Lanthier, D. Grbic, Marc-Émile Plourde, M. Cauchon","doi":"10.1016/j.revmed.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.05.007","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":"49 S3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Atypical alveolar echinococcosis with systemic involvement in a patient treated with dupilumab]. [一名接受杜匹单抗治疗的患者患上全身受累的非典型肺泡棘球蚴病]。
La Revue de medecine interne Pub Date : 2024-05-01 DOI: 10.1016/j.revmed.2024.04.002
L. Jacquel, B. Hoellinger, G. Marzolf, A. Stab, A. Guffroy
{"title":"[Atypical alveolar echinococcosis with systemic involvement in a patient treated with dupilumab].","authors":"L. Jacquel, B. Hoellinger, G. Marzolf, A. Stab, A. Guffroy","doi":"10.1016/j.revmed.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.revmed.2024.04.002","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Autologous peripheral stem cell transplantation in systemic sclerosis: An important step forward, but we must temper our enthusiasm!] 自体外周干细胞移植治疗系统性硬化症:向前迈出了重要一步，但我们必须缓和我们的热情!］
La Revue de medecine interne Pub Date : 2023-12-05 DOI: 10.1016/j.revmed.2023.11.010
L Mouthon
{"title":"[Autologous peripheral stem cell transplantation in systemic sclerosis: An important step forward, but we must temper our enthusiasm!]","authors":"L Mouthon","doi":"10.1016/j.revmed.2023.11.010","DOIUrl":"https://doi.org/10.1016/j.revmed.2023.11.010","url":null,"abstract":"<p><p>Three prospective randomized studies have demonstrated the efficacy of autologous hematopoietic stem cell (HSC) transplantation in systemic sclerosis (SSc) on survival. These results encourage us to offer this therapy to patients who have a rapidly progressive disease and who have early symptoms but no advanced visceral involvement. HSC autograft can thus be discussed in patients with diffuse cutaneous SSc with a duration of the disease since the first visceral manifestations (cutaneous, cardiac, digestive, pulmonary, or renal) excluding Raynaud's phenomenon of less than 5 years. However, the indications for HSC autograft in SSc validated at European level and in the national diagnostic and care protocol (PNDS) are broader and some of these indications are debatable, in particular in patients with worsening diffuse interstitial lung disease. These indications are discussed in a reasoned way, taking into account the level of evidence and the toxicity of the HSC autograft.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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