La Revue de médecine interne
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We report a 54-year-old man who presented bilateral, symmetric depressions on the anterior aspect of his thighs corresponding to lipoatrophia semicircularis. The origin of this distinctive variant of lipoatrophy is unknown. ⋯ Recently, as many recently affected subjects shared a status of administrative employee, the role of electromagnetic fields generated by computers and their wirings has been discussed. Prevention proposal includes adapting work environment related to the use of computerized devices.
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Bariatric surgery (gastric banding, gastric bypass, sleeve gastrectomy, bilio-pancreatic diversion) is the most efficient long-term treatment concerning weight loss, comorbidities and quality of life improvement, and mortality reduction for massive obesity and complicated obesity. These benefits need to be compared to immediate and late adverse events. ⋯ This review describes the various surgical techniques and their complications. Then, it discusses the modalities to prepare, follow-up and take care of these surgical patients to improve the results and avoid the complications.
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Human immunodeficiency virus (HIV) infection represents a risk factor for thrombotic microangiopathy. HIV-associated thrombotic microangiopathies encompass two entities with distinct pathophysiology, clinical presentation, treatment and prognosis. Thrombotic thrombocytopenic purpura associated with human immunodeficiency virus is typically characterized by a sudden onset in a patient with a moderate immune deficiency and a few events of opportunistic diseases, and a profound acquired deficiency in the von Willebrand factor cleaving protease ADAMTS13. ⋯ On the opposite, HIV-associated thrombotic microangiopathy with a progressive onset that occurs in profoundly immunocompromised patients with past history of multiple opportunistic diseases usually have a detectable ADAMTS13 activity and a worse prognosis. Usual treatment is poorly efficient. Forthcoming studies should assess the role of immunomodulatory drugs such as rituximab in the setting of HIV-associated thrombotic microangiopathy, and identify possible risk factors associated with the occurrence of these diseases.