Presse Med
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SPHINCTER TEARS: Vaginal delivery can lead to tears in the anal sphincters. Total perineal distension following expulsion concerns less than 1% of all deliveries. Initially, sphincter tears generally go unnoticed although echographically detectable defects can be found in one-third of all primiparturients. The inner or outer sphincter may be involved alone or in combination as is seen in half of the cases.
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EARLY BONE LOSS: Bone loss is greatest in patients given supra-physiological doses of corticosteroids during the first months of treatment. The rate of loss then tapers off but persists throughout the duration of the treatment because of depressed osteoblast activity.
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PROTEIN CAUSES: Although cardiogenic emboli, arterial dissection, and to a lesser extent, arteriosclerosis are the major underlying causes, clinicians should keep in mind the wide spectrum of possible etiologies. UNCOMMON CONDITIONS: Rigorous history taking (toxic risk, family history), systematic search for skin or skeletal anomalies, and an ophthalmologic examination can help orient the diagnosis and lead to the appropriate complementary explorations. DIAGNOSTIC STRATEGY: The need for a precise etiologic diagnosis is obvious as many vascular conditions are amenable to specific treatments or require particular monitoring or preventive measures. A family survey many be indicated.
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Case Reports Comparative Study
[Recurrent Mollaret's meningitis of herpetic origin].
Benign recurrent meningitis, or Mollaret's meningitis, is an uncommon disease whose viral origin was long unidentified. Since 1991, about twenty cases have been reported in patients with herpes infection. ⋯ HSV2 infection is one of the known causes of Mollaret's meningitis. Long-term antiviral therapy appears to prevent recurrence as was observed in our patient.
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MANAGEMENT STRATEGIES: Management of papillary and follicular cancer of the thyroid varies somewhat between centers because of the generally good prognosis and the absence of well-controlled therapeutic trials. The internationally recognized TNM system is widely used to modulate treatment and follow-up to the individual situation.