Presse Med
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Post-partum haemorrhage is one of the major worldwide causes of maternal mortality. Better knowledge of risk factors should limit its incidence and short term hazards. In case of excessive bleeding, classical therapeutic means continue to be of major importance. If unsuccessful, modern methods including injections of prostaglandins, vascular ligations, and arterial embolization, should be employed, preserving future fertility.
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Acute myocardial infarction with spontaneous coronary dissection was fatal in a 33-years-old man. Autopsy and family history revealed type IV Ehlers-Danlos syndrome. In this disease, conjunctive tissue is fragilized due to a deficit in type III collagen which leads to spontaneous ruptures in large and medium sized arteries. ⋯ This disease should be entertained in young people with no atherogenous risk factor and an acute coronary disorder since peripheral skin and joint syndromes may be discreet or missing. Treatment is difficult in case of spontaneous coronary dissection. Thrombolysis is not possible and diagnosis may require angiography which is in itself dangerous due to the fragility of the coronary vessels.
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Spondylodiscitis is rarely caused by anaerobic germs and occurs mainly in patients weakened by another infection. We report a case of Fusobacterium nucleatum spondylodiscitis in a 63-year-old man. This is the third such report and the second in a non-immunodepressed patient. ⋯ Magnetic resonance imaging is the most useful diagnostic tool for spondylodiscitis. The germ is isolated from a discal puncture aspirate in 66% of the cases but can also be obtained from blood cultures. Anaerobic germs are usually sensitive to penicillin or cephalosporins.
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Hyperthyroidism can be associated with various haematological disorders related to several mechanisms. These disorders might be related to the reduced life-span of whole blood components and/or to an autoimmune mechanism. Only one case of pancytopenia has yet been reported. ⋯ All haematological disorders disappeared when patients became euthyroid. In all cases, the haematological abnormalities were quite mild and might have gone unnoticed. Thus, it can be suggested that the frequency of pancytopenia in hyperthyroidism is underestimated.