La Revue de médecine interne
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Therapeutic erythrocytapheresis is a selective red cell-depletion aphaeresis technique. ⋯ Therapeutic erythrocytapheresis is a more modern and more effective method than the classic patient-bleeding. It has to be preferred in the early treatment of patients with polycythemia vera and hereditary hemochromatosis.
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Clostridium difficile is an anaerobic gram positive, spore-forming bacterium which is responsible for 15-25% of antibiotic-associated diarrhea and for more than 95% of pseudomembranous colitis (PMC). This paper will review the main knowledge on C. difficile-associated infections and their recent evolution. ⋯ A systematic reporting of C. difficile incidence by health facilities should enable a better assessment of this pathology in France.
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Typhlitis is a rare condition, characterized by necrotizing inflammation of the colon. It occurs mainly in neutropenic patients receiving chemotherapy for leukemia. ⋯ The pathological mechanisms of typhlitis remain unclear in neutropenic patients. The role of cytotoxic drugs as well as both bacterial overgrowth and translocation has been postulated. In our patient, asymptomatic reactivation of cytomegalovirus infection may have increased chemotherapeutic-agents-digestive toxicity.
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We review the current knowledge about fibromyalgia, adding to the clinical aspects, the nosology, epidemiology and pathogenesis. The therapeutic and social management of these suffering patients are discussed. ⋯ Fibromyalgia is a clinical autonomous entity. Physiopathology knowledge is improving, but must be confirmed by new research. Patients will take profit of multimodal individualized treatment programs, including explanations about the diagnosis. In most cases, fibromyalgia is compatible with the maintenance of a professional activity, possibly adapted to the patient. Recognized disability requiring compensation is infrequent.
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Case Reports
[Should we care about pregabalin for elderly patients with a history of cardiac dysrhythmia?].
Pregabalin is similar in structure to gamma-aminobutyric acid. It is used for neuropathic pain, generalized anxiety disorders and as an adjunct therapy for partial seizures. Tachycardia is a rare side-effect. ⋯ She developed a sinusal tachycardia followed by atrial fibrillation and congestive heart failure 15 h after a first dose of pregabalin. The imputation was considered as plausible. Even though the mechanism remains unclear, pregabalin might induce tachycardia in predisposed old patients.