La Revue de médecine interne
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Sleep-wake rhythm disturbances observed in Alzheimer's disease are correlated with the severity of cognitive impairment and often result in institutionalization. These disturbances are also a major cause of psychotropic medication misuse. We report age-related physiologic and disease related pathologic changes in sleep-wake rhythms and propose chronobiological treatment approaches in patients with Alzheimer's disease. ⋯ In Alzheimer patients, controlling sleep-wake disturbances with sedative drugs often increases both sleep disturbance and cognitive dysfunction. A chronobiological approach with bright-light therapy, melatonin administration, restricted time in bed, and diurnal activity may be an interesting therapeutic alternative in the management of sleep-wake disorders in Alzheimer patients. The aim of these therapeutics is to improve sleep and diurnal activity and consequently to increase the quality of life in Alzheimer patients.
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Cutaneous metastatic Crohn's disease is a granulomatous inflammation of the skin that is noncontiguous to the gastrointestinal tract. ⋯ During Crohn's disease, biopsy should be considered for every undiagnosed skin lesion as the characteristics of cutaneous metastatic Crohn's disease are not specific. The presence of a non caseous granulomatous dermal infiltration suggests the diagnosis and should make consider the initiation of corticosteroid and the discontinuation of others inappropriate therapeutics (i.e. surgical treatment, antibiotics).
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The aim of the study was to assess the place of cardiac Magnetic Resonance Imaging (MRI) in patients with sarcoidosis with or without cardiac involvement. ⋯ Cardiac MRI is a useful non-invasive method for the early diagnosis and follow-up of cardiac sarcoidosis.
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Central nervous system (CNS) tuberculosis remains a public health problem, particularly in developing countries. The aim of this study is to characterize neuroradiologic findings of various intracranial lesions. ⋯ Central nervous system tuberculosis has different appearences, mostly hydrocephalus and tuberculomas. MR with contrast is necessary for diagnosis and for follow-up during treatment.
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The responsibility of cannabis in juvenile thromboangeitis has been suggested for few years. We describe four new cases. ⋯ Search for cannabis use is important because interruption may improve prognosis.