This study has focused on the specificity of twins’ attachment, along with its impact on their development. To this end, adult twins were invited to revisit the experience of their relationship. When analyzing these testimonies, differences in the process and rhythm of twin empowerment compared to the singular child became apparent. Based on these findings, new practical recommendations pertaining to educating twins can be outlined. One can, thus, challenge the widely held assertion that it is crucial to "untwin" the twins at any price.
Ha Mo Linh Lê (1), Patrick Gohy (1), Aude Schillaci (2), Didier Deltour (2), Andoni Laka (3), Patricia Schatt (4), Philippe Machiels (1)Published in the journal : December 2017Category : Maladies infectieuses
The diagnosis of peritoneal tuberculosis is often delayed, given that this clinical condition has become rare in developed countries, while its presentation often proves to be indolent, with non-specific clinical features. In addition, the tests used to diagnose peritoneal tuberculosis do not enable us to distinguish this pathology from other abdominal diseases. Ziehl-Neelsen staining and polymerase chain reaction (PCR) analysis are not always sensitive. Culture growth can take up to 2 months before yielding results. While quick alternative non-invasive tests, such as plasmatic adenosine deaminase levels, may prove useful for diagnosis, laparoscopy remains the gold standard for peritoneal tuberculosis, allowing for both direct examination and tissue sampling in view of culture and histologic analysis.
Melina Terrana, Laurence Faugeras, Anne-Caroline Courtois, Lionel D’Hondt (1)Published in the journal : December 2017Category : Maladies infectieuses
Spontaneous bacterial peritonitis affects approximately 30% of hospitalized cirrhotic patients (1). Similar cases have been reported in patients suffering from carcinomatous ascites or receiving peritoneal dialysis (2). The most common pathogens are E. coli, Klebsiella pneumonia, Streptococci spp, and Enterobacteriaceae spp (3). In a minority of cases (<5%), other microorganisms are found, such as Candida, anaerobic bacteria, and Listeria (3). Only 108 cases of PSB Listeria have been reported in the scientific literature since 1977 (4). Identifying these cases proves paramount, because they are mainly resistant to cefotaxime (5).
Caroline Fobe (1), Etienne Marbaix (2), Thierry Gustin (3), Etienne Delgrange (4)Published in the journal : December 2017Category : Endocrinology
Galactorrhea associated with a sellar mass results in a large differential diagnosis. We discuss the case of a female patient harboring an invasive macroadenoma upon MRI, clinically associated with galactorrhea and mild hyperprolactinemia. The discrepancy between the large tumor size and mild prolactinemia, as well as the rapid normalization of prolactinemia under cabergoline without associated tumor volume reduction were considered arguments pleading against the lactotroph tumor diagnosis. Despite the lack of hypercortisolism-related clinical symptoms, with normal free urinary cortisol levels and normal cortisol suppression under dexamethasone, a silent corticotroph adenoma was suspected preoperatively, owing to the mildly-elevated ACTH levels in contrast with normal cortisol levels.
Stéphanie Olivier, Diane Declaye, Jean-Marie Lachapelle, Marie Baeck, Dominique Tennstedt (1)Published in the journal : December 2017Category : Dermatology
The PEAU’se Dermatology meeting held on March 21, 2016 focused on the understanding of dermatology in the past, present, and future, or, in other words, how the dermatology of the past has shaped the dermatology of today and will further shape the dermatology of tomorrow. Professor Emeritus Jean-Marie Lachapelle shared his experience on controversial pathologies, such as interstitial granulomatous dermatitis, nummular eczema, and Paederus dermatitis. Thereafter, the dermatology team from Cliniques universitaires Saint-Luc provided a series of "tips and tricks" to be remembered in daily dermatology practice.
Virginie Faucon, Mona Momeni(1), Patrice Forget(2)Published in the journal : December 2017Category : Anesthesiology
Jehovah witnesses refuse transfusion of labile blood products. This is the reason why blood conserving procedures must be implemented when high bleeding risk surgery is required. Management of these patients consists in a multidisciplinary approach involving the anesthesiologist, intensivist, surgeon, and general practitioner. The procedures have to be initiated as soon as possible and be pursued during the entire hospitalization, while following a specific legal framework. This article provides a series of rules enabling doctors to properly care for their patients.
Marie-Bénédicte Benats, MD, Anne-Catherine Pouleur, MD, PhD, Agnès Pasquet, MD, PhD (1)Published in the journal : December 2017Category : Cardiology
Right ventricular dysfunction is a strong predictor of mortality in patients with heart failure. Due to the configuration right ventricle, assessing the function of the right ventricle proves complex. Cardiac RMN is actually considered the gold standard to evaluate right volumes and right heart dysfunction. There is limited information available to date on the optimal management of right ventricular dysfunction, except in arterial pulmonary hypertension cases (Group 1). Future research is needed to determine specific treatments, improve prognosis, and increase quality of life of patients with right-sided heart failure.
Canelle Koutny (1), Vincent Potmans (2)Published in the journal : November 2017Category : Pneumology
This case report describes a metastatic small cell neuroendocrine carcinoma (SCNC) of the right maxillary sinus, which first manifested as atypical low back pain. Due to the rarity of this localization, specific therapeutic recommendations for SCNC of paranasal sinuses are still lacking. Current treatment modalities are extrapolated based on similar tumors of pulmonary origin. This contribution comprises a case description, along with a review of clinical presentations, imaging characteristics, and treatments available to date. This article will eventually end with a series of practical recommendations.
Key Words
Small cell neuroendrocrine carcinoma, paranasal sinus, extra-pulmonary, metastatic
Jeremy Marchal(1), Zaynab Ouadi(1), Benjamin Alexandre(2), Aude Schillaci(1), Didier Deltour(1)Published in the journal : November 2017Category : Gastroenterology
GIST are rare mesenchymal tumors, and their pre-operative diagnosis may prove challenging. This can be accounted for by less accessible anatomical localizations, and particularly the duodenum and angle of Treitz, in addition to the fact that the biopsies obtained may turn out to be poorly contributory. Surgical intervention that usually allows for a formal diagnosis remains the cornerstone of treatment. When a GIST is suspected, surgery must be encouraged and this, even in the absence of histologically confirmed disease.
Nurcan Yilmaz (1), Daniel Leonard (1), Nora Abbes Orabi (1), Christophe Remue (1), Laurence Annet (2), Cristina Dragean (2), Andrea Penaloza (3), Alexandros Raptis (4), Alex Kartheuser (1)Published in the journal : November 2017Category : Chirurgie digestive
A 39-year-old man presented with a history of fever and acute peri-umbilical pain. A computed tomographic scan of the abdomen revealed inflammation of Meckel’s diverticulum. The treatment was a laparotomic diverticulectomy. A perforation was observed during the procedure. There is no consensus yet on the radiological imaging technology considered to be the gold standard for diagnosis. The treatment is at all times surgical. Moreover, there is no agreement yet on the optimal surgical technique, be it a diverticulectomy or a resection of the segment containing the diverticulum. Although there is still uncertainty about the best approach, laparotomy versus laparoscopy, using the less invasive approach appears preferable.
Key Words
Meckel’s diverticulum, intestinal perforation, surgery