La Revue de medecine interne最新文献_第3页

Morbi-mortality of obese patients with systemic sclerosis: A comparative study. 肥胖患者合并系统性硬化症的发病-死亡率：一项比较研究。

La Revue de medecine interne Pub Date : 2025-05-06 DOI: 10.1016/j.revmed.2025.04.026

Lucile Grange, Benjamin Chaigne, Marion Casadevall, Pascal Cohen, Bertrand Dunogue, Alexis Régent, Luc Mouthon

{"title":"Morbi-mortality of obese patients with systemic sclerosis: A comparative study.","authors":"Lucile Grange, Benjamin Chaigne, Marion Casadevall, Pascal Cohen, Bertrand Dunogue, Alexis Régent, Luc Mouthon","doi":"10.1016/j.revmed.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.revmed.2025.04.026","url":null,"abstract":"Introduction: The prevalence of systemic sclerosis (SSc), as well as obesity, has significantly increased in recent decades. To address the lack of data on obese SSc patients, we conducted a retrospective comparative study to assess the prevalence, clinical characteristics, and long-term consequences of obesity in SSc patients.Methods: We conducted a retrospective comparative study at the Cochin University Hospital's Department of Internal Medicine (Paris) from 2000 to 2019.Results: Of the 911 SSc patients included, 90 (9.9%) were obese, comprising 79 females and 11 males. The median weight for obese patients was 90 [82-98] kg, compared to 60 [53-67] kg for non-obese patients, corresponding to a median body mass index of 33 [31-37] kg/m2 and 23 [20-25] kg/m2, respectively. Obese patients exhibited a higher prevalence of cardiovascular risk factors. The median modified Rodnan skin score was significantly higher in non-obese patients than in obese patients (6 [2-16] vs 3 [2-7]; P<0.05). Organ involvement did not differ significantly between obese and non-obese patients. We observed a lower number of deaths in obese SSc patients compared to non-obese SSc patients (6 [11%] vs. 26 deaths [25%], P=0.06). Analysis of 30-year Kaplan Meier survival curves did not show significant survival difference between obese and non-obese SSc patients.Conclusions: This study of obese ScS patients reveals that they have a higher prevalence of cardiovascular risk factors, lower mRSS, less calcinosis, and similar rates of organ damage and mortality compared to non-obese ScS patients.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045437","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

[Internal medicine: A core discipline in healthcare establishments for the care of complex patients]. [内科：医疗机构中治疗复杂病人的核心学科]。

La Revue de medecine interne Pub Date : 2025-05-06 DOI: 10.1016/j.revmed.2025.04.024

Quitterie Reynaud, Mathias Gernez, Natacha Grienay-Poletto, Pascal Sève, Arnaud Hot, Mael Richard, Yoann Roubertou, Yvan Jamilloux, Thomas Barba, Céline Piegay, Isabelle Durieu

{"title":"[Internal medicine: A core discipline in healthcare establishments for the care of complex patients].","authors":"Quitterie Reynaud, Mathias Gernez, Natacha Grienay-Poletto, Pascal Sève, Arnaud Hot, Mael Richard, Yoann Roubertou, Yvan Jamilloux, Thomas Barba, Céline Piegay, Isabelle Durieu","doi":"10.1016/j.revmed.2025.04.024","DOIUrl":"https://doi.org/10.1016/j.revmed.2025.04.024","url":null,"abstract":"Introduction: The role of internal medicine departments in the management of chronic diseases in older patients with more comorbidities is a topical issue.Methods: For each internal medicine department of the Lyon University Hospital (North, Centre and South Hospices Civils de Lyon Hospital Group), Programme de médicalisation des systèmes d'information (PMSI) activity report data were used, with the number of medical unit summary (RUM) and standardised discharge summary (RSS) stays for 4 consecutive years from 2018 to 2022.Results: Activity increased in the three internal medicine departments in outpatient day hospital activity, the rest of the activity remained stable. The rate of admissions via emergency units was multiplied by 3, with an increase in discharges to rehabilitation services. The death rate doubled. The average age increased to 68, with an increase in the Charlson score comorbidity index to 2, independently of age, and in the percentage of stays with severity 3 and 4.Conclusion: Analysis of data on conventional inpatient care in internal medicine at Lyon University Hospital shows a major qualitative change, with older patients with more comorbidities and higher severity stay profiles, leading to an increase in the number of inpatient deaths, and greater use of rehabilitation units.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063746","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

[Non-pharmacological interventions: A new paradigm and opportunities for internists]. [非药物干预：内科医生的新范式和机遇]。

La Revue de medecine interne Pub Date : 2025-04-26 DOI: 10.1016/j.revmed.2025.04.004

Grégory Ninot, Mathilde Minet, Jérôme Larché, Jean Ribstein, Laurent Chiche

{"title":"[Non-pharmacological interventions: A new paradigm and opportunities for internists].","authors":"Grégory Ninot, Mathilde Minet, Jérôme Larché, Jean Ribstein, Laurent Chiche","doi":"10.1016/j.revmed.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.revmed.2025.04.004","url":null,"abstract":"The notion of non-pharmacological interventions (NPI) has been used by healthcare researchers since 1975, and is cited in numerous reports by French, European and international healthcare authorities, such as the WHO since 2003 and the HAS since 2011. However, it was only recently that a collaborative initiative of consensus was launched to address the lack of consensus on how to define and evaluate these health practices, amplified by the media controversy surrounding these practices during the COVID-19 episode. Indeed, in 2021, the launch of a collaborative and open research program responding to international scientific expectations in the healthcare field and to the specificities of these immaterial, personalized and targeted healthcare solutions has finally been initiated. The first part of this article, intended for specialists in internal medicine, describes the consensus-building work carried out under the guidance of a multidisciplinary committee, with the support of Inserm and the logistics of the international Non-Pharmacological Intervention Society (NPIS). Over a period of three years, this work, involving more than 1000 participants, established a definition, a characterization and an evaluative framework including 77 ethical and methodological recommendations for these practices. This NPIS Model framework has received the support of 30 French scientific and medical societies, two European societies and three French health authorities. The second part of the article presents the collaborative tools that have emerged from this work. Finally, the third part of the article looks at the implications of NPI for research and practice in the field of internal medicine.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063748","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 febrile neutropenia]. [发热性中性粒细胞减少症的处理]。

La Revue de medecine interne Pub Date : 2025-04-24 DOI: 10.1016/j.revmed.2025.04.005

Xavier Jannot, Jean-Édouard Terrade, Manuel Méndez-Bailón, María Belén Alonso-Ortiz, Emmanuel Andrès, Noel Lorenzo-Villalba

引用次数: 0

[Erdheim-Chester disease associated with Langerhans cell histiocytosis: A case of a mixed form]. [Erdheim-Chester病合并朗格汉斯细胞组织细胞增多症：混合型1例]。

La Revue de medecine interne Pub Date : 2025-04-03 DOI: 10.1016/j.revmed.2025.02.012

Houria Sahel, Billel Merrouche, Souad Bellaifa, Nacima Djennane, Zine Charef Amir, Abdelkrim Talbi, Ammar Maireche, Radhia Ait Chalal, Amine Habouchi

{"title":"[Erdheim-Chester disease associated with Langerhans cell histiocytosis: A case of a mixed form].","authors":"Houria Sahel, Billel Merrouche, Souad Bellaifa, Nacima Djennane, Zine Charef Amir, Abdelkrim Talbi, Ammar Maireche, Radhia Ait Chalal, Amine Habouchi","doi":"10.1016/j.revmed.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.revmed.2025.02.012","url":null,"abstract":"Introduction: Langerhans cell histiocytosis and Erdheim-Chester disease are rare inflammatory myeloid neoplasms. They present characteristic clinical, histological and radiological signs. Their association is exceptional. We report a new observation.Observation: A 47-year-old man presented with lesions of seborrheic dermatitis-like, intracranial hypertension, paralysis of the sixth cranial nerve, and central diabetes insipidus. The skin biopsy concluded that there was Langerhans cell histiocytosis. The bone scan showed metaphyseal-diaphyseal osteosclerotic lesions of the femur, tibia and humerus. The thoraco-abdomino-pelvic CT scan showed an aortic sheathing, suggesting Erdheim-Chester disease. The search for the BRAFV600E mutation was negative. The patient was treated with oral corticosteroid therapy then with cladribine which allowed a good evolution.Conclusion: We report an observation of a mixed form of histiocytosis associating Langerhans cell histiocytosis and Erdheim-Chester disease, with a diagnostic delay of ten years, and having responded well to treatment with cladribine.","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797528","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

[Atrial fibrillation in 2025: Diagnosis and treatment]. [2025年心房颤动：诊断与治疗]。

La Revue de medecine interne Pub Date : 2025-03-12 DOI: 10.1016/j.revmed.2025.02.010

Jean-Marc Sellal, Néfissa Hammache, Mathieu Echivard

引用次数: 0

[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

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":"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.","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":"Introduction: 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.Case report: 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.Discussion and conclusion: 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.","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

引用次数: 0