La Revue de medecine interne最新文献

{"title":"[Organized pneumonia].","authors":"Robin Deshayes, Stéphanie Dirou, Renan Liberge, Christine Sagan, Christian Agard","doi":"10.1016/j.revmed.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.09.002","url":null,"abstract":"<p><p>Organizing pneumonia is a condition first described in 1941. Its symptoms are nonspecific (fever, arthromyalgia, etc.), and its diagnosis relies primarily on histology, when this is not feasible, it is based on a combination of clinical, laboratory, and radiological findings, in the absence of a differential diagnosis particularly active infections. It is a rare condition that may be secondary to another condition or primary and referred to as cryptogenic. Numerous causes of organized pneumonia have been described: post-infectious, associated with connective tissue diseases, drug-induced, etc. It affects all age groups, with the idiopathic form predominantly occurring between the ages of 50 and 60. A non-contrast chest CT scan may be suggestive but remains nonspecific and must rule out infection. Bronchoalveolar lavage can help rule out active infectious causes and provide diagnostic clues; however, the gold standard remains histological examination, which reveals endoalveolar buds, an inflammatory infiltrate of the alveolar walls, and thickening of the alveolar walls. Treatment is usually based on corticosteroid therapy for the cryptogenic form but must be tailored to the underlying condition when the disease is secondary. The prognosis is generally favorable in the cryptogenic form and depends on the cause in the secondary form.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027302","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}

{"title":"[Recurrent fever and severe anemia after return from Senegal].","authors":"Mathilde Schmitt, Aurore Bousquet, Weniko Caré, Dinaherisoa Andriamanantena, Pierre-Louis Conan","doi":"10.1016/j.revmed.2026.09.003","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.09.003","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003196","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}

{"title":"Management of pregnancy with minor thrombophilia: Thrombophilia testing, anticoagulant prophylaxis. A survey of French practice.","authors":"V Montillet, J Carré, A Brossard Violeau, C Thollot Karolewicz, O Souchaud Debouverie, L Macchi","doi":"10.1016/j.revmed.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.09.001","url":null,"abstract":"<p><strong>Objectives: </strong>To assess current French practices regarding the prescription of genetic thrombophilia screening and anticoagulant prophylaxis in the antepartum and postpartum periods for pregnancies associated with minor thrombophilia, specifically the heterozygous factor V Leiden (HFVL) mutation.</p><p><strong>Methods: </strong>Three clinical cases, presented as questionnaires, were submitted to practitioners involved in the management of pregnancies at risk of thrombosis, with or without thrombophilia.</p><p><strong>Results: </strong>Three hundred fifty-four questionnaires were analyzed, with a predominance of responses from vascular physicians (n=228). Thrombophilia screening was prescribed in 37% of cases with a second-degree family history of deep vein thrombosis (DVT) but no first-degree family or personal history of DVT, and in 77% of cases with a personal history of DVT. The presence of an HFVL mutation influenced antepartum and postpartum thromboprophylaxis, regardless of the patient's personal or family history of DVT. The timing of thromboprophylaxis initiation and the duration of postpartum treatment also depended on whether this minor thrombophilia was present or absent.</p><p><strong>Conclusion: </strong>This practice survey clearly demonstrates the heterogeneity in the management of pregnant patients with minor thrombophilia. These management approaches are not always consistent with the various national and/or international guidelines. Standardization and improved dissemination of recommendations are necessary.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993216","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}

{"title":"[Structured training of physicians in clinical reasoning and decision-making has a positive impact on the quality of care].","authors":"Etienne Rivière","doi":"10.1016/j.revmed.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.014","url":null,"abstract":"<p><p>Explicit training in clinical reasoning and rational decision-making improves the quality of diagnostic judgments, patient safety, and the ethical dimension of decisions by strengthening metacognition, enriching illness scripts built from clinical practice, and incorporating patients' values. To be effective, it should rely on a longitudinal curriculum, active strategies (deliberate practice, SNAPPS+, one-minute preceptor, test-enhanced learning), and a climate of cognitive safety. The challenge is to structure such teaching within clinical environments under heavy time pressure, workload and patient turn-over, with unpredictable teaching opportunities, limited institutional recognition, and large, heterogeneous groups of learners.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984469","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}

{"title":"[Translation into French and republication of: \"French recommendations for the use of Imaging in Giant Cell Arteritis\"].","authors":"Olivier Espitia, Hubert de Boysson, Emmanuel Heron, Christine Rodriguez-Regent, Sandrine Jousse, François Xavier Lapebie, Marie-Pierre Gobin-Metteil, Marie Morard, Florent L Besson, Bastien Jamet, Xavier Puechal, Laurent Sailler, Alban Redheuil, Christian Agard, Jean-Michel Serfaty, Quentin Gomes de Pinho, Raphaèle Seror, Yann Nguyen, Catherine Vignal-Clermont, Simon Parreau, Valérie Devauchelle-Pensec, Augustin Lecler, David Saadoun, Maxime Samson, Alexis Regent","doi":"10.1016/j.revmed.2026.08.017","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.017","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed at developing French recommendations for the use of imaging modalities in Giant Cell Arteritis (GCA).</p><p><strong>Methods: </strong>A systematic literature review was conducted to identify evidence regarding the use of Doppler ultrasound (DUS), magnetic resonance imaging (MRI), computed tomography (CT) angiography and [¹⁸F]-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) for diagnosing, monitoring, and predicting the outcome of GCA. The task force, composed of 23 physicians, proposed the recommendations through an iterative process based on evidence and expert opinion, with consensus determined by anonymous voting.</p><p><strong>Results: </strong>The task force recommends an early imaging test for patients with suspected GCA. The recommendations propose DUS as the first-line imaging test for all patients with suspected GCA. FDG-PET, cranial MRI, aortic MRI and CT-scan can be used as alternative methods to assess the cranial and/or extracranial arteries, providing imaging evidence of vasculitis. Imaging of large vessels is also useful for determining prognosis and follow-up procedures. In patients with suspected visual GCA, ophtalmoscopic fundus examination, optical coherence tomography (OCT) and retinal angiography should be performed in emergency. Although imaging is not routinely recommended for follow-up, it may be used to assess a persistent vascular inflammatory process in patients suspected of relapse, especially when inflammatory biomarkers are unreliable. In this situation, vascular activity scores are recommended for follow-up. Imaging may be used to monitor long-term structural damage, particularly in areas where vascular inflammation has previously been detected.</p><p><strong>Conclusions: </strong>The recommendations offer guidance on the use of imaging for diagnosing and evaluating patients with GCA.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984385","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}

{"title":"[In patients with previously treated metastatic pancreatic adenocarcinoma, does daraxonrasib improve overall survival and progression-free survival compared with standard chemotherapy, while being safe?]","authors":"Luc Lanthier, Giulia Pool, Alexandre Mutchmore, Marc-Émile Plourde, Michel Cauchon","doi":"10.1016/j.revmed.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.016","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957778","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}

{"title":"[Multilevel fat accumulation].","authors":"Valentin Lacombe, Fabrice Gahungu, Maria Cecilia Pestana Ferreira de Mello","doi":"10.1016/j.revmed.2026.08.012","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.012","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946450","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}

{"title":"[\"It's just another mouth ulcer\": Is it, really?]","authors":"Aïcha Kante, David Saadoun, Etienne Rivière","doi":"10.1016/j.revmed.2026.08.011","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.011","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922192","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}

{"title":"[Asthenia, weight loss in a pregnant 37-year old woman].","authors":"Nicolas Duhamel, Marie Ottavi, Hervé Hyvernat, Julie Merindol, Noémie Abrisror","doi":"10.1016/j.revmed.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.005","url":null,"abstract":"","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889789","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}

{"title":"[Functional cognitive disorders: How to diagnose and manage them? Discussion based on a clinical case].","authors":"Inas Al Chare, Elsa Mhanna, Juliette Palisson, Béatrice Garcin","doi":"10.1016/j.revmed.2026.08.009","DOIUrl":"https://doi.org/10.1016/j.revmed.2026.08.009","url":null,"abstract":"<p><p>Functional cognitive disorder (FCD) is a frequent and underrecognized cause of cognitive complaints. Long regarded as a diagnosis of exclusion, conceptual advances have allowed this condition to be integrated within the nosological framework of functional neurological disorders, and to be approached through a positive definition based on the identification of internal inconsistency signs. Nevertheless, establishing a diagnosis of FCD can prove challenging in clinical practice, particularly due to overlapping features with the main differential diagnoses. Through the illustration of a typical clinical case, this article aims to support the positive diagnostic criteria for FCD, and to highlight the key arguments allowing FCD to be distinguished from its main differential diagnoses: cognitive symptoms related to depressive disorder, neurodegenerative diseases at the prodromal stage, and malingering. Diagnosing FCD requires a comprehensive patient evaluation, integrating a qualitative analysis of the interview and the patient's conversational profile alongside the assessment of symptoms, physical examination, and neuropsychological testing.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889917","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}