La Revue du praticien
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Ekbom syndrome or delusional parasitosis is mainly described in presenile women who are unmarried or living alone. The presenting dermatological symptom is persistent pruritus, and the patients take medical advice in several practitioners one after another. ⋯ The Ekbon syndrome is defined as the most contagious of psychiatric syndromes. Beyond psychotherapy, pimozide is the drug of choice in such a syndrome.
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Malignant pleural effusions are the major cause of pleural effusions in patients older than 40. Their treatment is essentially palliative but recently improved with new efficient chemotherapy. The most frequent causes of malignant pleural effusions are pleural metastatic adenocarcinomas arising from lung in both sex, or from breast in women, and malignant mesothelioma. ⋯ Prophylactic irradiation has been proved to be efficient in the prevention of parietal seeding along the thoracocentesis and drainage channels. PET imaging could be of major interest in the diagnosis of mesothelioma and prognosis evaluation. Mesothelioma prognosis has recently been modified by the association of cisplatin with pemetrexed, a new antimetabolite agent, but mesothelioma remains seldom curable.
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La Revue du praticien · Feb 2007
Review Case Reports[Lesions of ligaments and menisci of the knee and the ankle].
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La Revue du praticien · Feb 2007
Review Comparative Study[Management of localized germ-cell tumours of the testis].
Stage 1 is currently the most frequent pattern at diagnosis of germ-cell tumours. Prognosis is excellent and different options are available after orchidectomy. ⋯ In case of pure seminoma, prophylactic radiotherapy directed to the retroperitoneal lymph nodes, chemotherapy by single-agent carboplatin and surveillance with differed treatment at relapse are the three currently available attitudes. In non-seminomatous germ cell tumours three options should also be considered: surveillance (watchful waiting), chemotherapy by two cycles of BEP, or retroperitoneal lymph node dissection.
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The postdural puncture headache is a frequent iatrogenic complication due to an excessive leakage of cerebrospinal fluid. The leak through the dural perforation mainly depends on the size and design of the needle. ⋯ Symptoms resolve spontaneously within 1 week or within 48 hours after autologous epidural blood patch. Prevention is based on using small-gauge pencil-point needles whereas the duration of bed rest has no effect on the incidence of postlumbar puncture headache.