Revue médicale de Bruxelles
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Case Reports
[Fecal microbiota transplant in the treatment of recurrent Clostridium difficile infection: A case report].
Clostridium difficile infection is a major cause of nosocomial diarrhea. Its incidence has increased in the past 20 years and is associated with a significant morbidity and mortality. Relapsing is frequent after treatment and the management of these recurrent Clostridium difficile infections is challenging. ⋯ Fecal microbiota transplantion is now part of the European recommendations in the treatment of recurrent Clostridium difficile infections. However, standard procedures are needed to define indications, donor's selection criteria, preparation of the stool sample and its administration as well as the patients follow up. Illustration by a case report.
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Low back pain (LBP) has become one of the greatest public health problems. The differentiation between specific and non-specific low back pain is mandatory. In the specific low back pain are classified all diseases whose etiology is well defined, quick and accurate diagnosis is required for specific treatment. ⋯ Chronicity factors are multiple, mainly psycho-social and professional. The chronic low back pain treatment goals are the reduction of pain and better activity/participation to achieve the prevention of disability and maintaining work ability. Multidisciplinary treatment programs including personalized and guided physical therapy, cognitive behavioral therapy and short-term training programs will help to improve, restore and maintain the function in chronic low back pain.
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Membranous nephropathy (MN) is the most common cause for nephrotic syndrome in adults and occurs as an idiopathic (primary) or secondary disease. Since the early 2000's, substantial advances have been made in the understanding of the molecular bases of MN. The neutral endopeptidase (NEP) and the receptor for secretory phospholipase A2 (PLA2R) have been identified as target antigens for circulating and deposited antibodies in allo-immune neonatal and adult " idiopathic " MN, respectively. ⋯ Newly developed diagnostic tests detecting circulating anti-PLA2R antibody and PLA2R antigen in glomerular deposits have induced a change in paradigm in the diagnostic approach of idiopathic MN. Measurement of circulating anti-PLA2R antibody is also very useful for the monitoring of MN activity. However, the mechanisms responsible for the formation of anti-PLA2R antibodies as well as those involved in the progression of MN to end-stage renal disease remain to be defined.
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Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. ⋯ In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).