Carcinoïd tumor revealing pernicious anemia

Endocrine tumors (ET) of the digestive tract are rare. Gastric carcinoid was the most common form of gastrointestinal ET's. It is a rare complication of pernicious anemia but may reveal the disease. We report the case of a 57-year- old women, wich is referred for exploration of epigastric pain with persistent dyspepsia. Gastroscopy found polypoids lesions (A) and gastric mucosae was enlarged, on histological study, by a well-circumscribed neoplastic proliferation covered by intact surface epithelium (B et C). Tumor cells have central, uniform nuclei, a low mitotic rate and co-express cytokeratine and chromogranine A, concluding to well-differentiated neuroendocrine tumor. Pallor on examination led us to perform NFS showing aregenrative anemia (hemoglobin at 7.2 g/dl) with high mean corpuscular volume and megaloblastosis in myelogram. Serum vitamine B 12 level is 60 pg /l and homocysteine level is 57 µmol/l. Vitamin replacement treatment is given as well as endoscopic resection of polyps since assessment of extension is negative. The onset of pernicious anemia is difficult to establish because of its insidious presentation. This slow progression of vitamine B 12 deficiency, resulting from advanced autoimmune atrophic gastritis, explains the adaptation to anemic syndrome that does not represent the main complaint in this patient. This case confirm the importance of endoscopic evaluation at the diagnosis of pernicious anemia

A Context-Aware Framework to Provide Personalized Mobile Assessment

In mobile learning environment, context-aware systems refer to applications that employs contextual information to provide appropriate services to the leaners or other applications to perform a specific task. An important challenge in such applications is context modeling, using ontologies to model context information and to reason about context at a semantic level has attracted a lot of interest in the research community. Semantic Web technologies have been applied in recent years with different purposes in education. But, their applications for generating useful personalized mobile assessment resources have not been researched enough so far.In this paper, we introduce a context-aware approach that makes use of Semantic Web technologies to support personalized assessment in mobile environments. We propose a Service-based framework for bringing assessment techniques to mobile environment. We provide a formal description for our mobile assessment framework and detail the functionalities of its various layers. We have carried out also an experiment with computer science university students to evaluate our mobile assessment framework

A case of primary biliary cirrhosis associated with pernicious anemia: a case report

Primary biliary cirrhosis is often associated with autoimmune diseases. However, its association with pernicious anemia has rarely been reported

A Context-aware Approach for Personalized Mobile Self-Assessment

Abstract: With the increasing development of mobile technologies, the learning environment is currently undergoing a major shift. Access to contextual information in a mobile learning environment aims to meet the needs of learning and assessment personalization according to various learners' profiles and a range of learning contexts. Semantic Web technologies have been applied in recent years with different purposes in education. But, their applications for generating useful personalized mobile assessment resources have not been researched enough so far. In this paper, an approach making use of semantic Web technologies to support personalized self-assessment in mobile environments is described. Assessment techniques are formalized with First Order Logic rules which allow to personalize assessment activities. We also propose an algorithm for semantic assessment resources retrieval. Finally, a Mobile Semantic Web Assessment Personalization system is presented. The qualitative and quantitative evaluation of the proposed system is also provided

A Context-aware Approach for Personalized Mobile Self-Assessment

With the increasing development of mobile technologies, the learning environment is currently undergoing a major shift. Access to contextual information in a mobile learning environment aims to meet the needs of learning and assessment personalization according to various learners' profiles and a range of learning contexts. Semantic Web technologies have been applied in recent years with different purposes in education. But, their applications for generating useful personalized mobile assessment resources have not been researched enough so far. In this paper, an approach making use of semantic Web technologies to support personalized self-assessment in mobile environments is described. Assessment techniques are formalized with First Order Logic rules which allow to personalize assessment activities. We also propose an algorithm for semantic assessment resources retrieval. Finally, a Mobile Semantic Web Assessment Personalization system is presented. The qualitative and quantitative evaluation of the proposed system is also provided

Granulocytic sarcoma of the rectum: Report of one case that presented with rectal bleeding

Granulocytic sarcoma is an uncommon and localized extramedullary tumor composed of immature granulocytic cells. It may present in association with acute myeloid leukaemia, myelodysplastic syndrome and chronic myelogenous leukaemia. Granulocytic sarcoma may occur in any anatomical site but involvement of the gastrointestinal tract is rare, especially in the rectum. We report on the case of a 17 year old female who presented with rectal bleeding, abdominal pain and weight loss one mo prior to admission. Rectosigmoidoscopy revealed a rectal polypoid and ulcerated mass. The histological examination of the mass showed granulocytic sarcoma. Bone marrow examination was compatible with acute promyelocytic leukaemia (FAB type M3). This case report is a reminder of this peculiar sign of tumoral syndrome in acute myeloid leukaemia. We also discuss diagnostic methods and analyze the disease course

Multi-Organ Involvement of Immunoglobulin G4-Related Disease

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition of unknown etiology, with presumed autoimmune mechanisms. It is characterized by high levels of IgG4 and variable clinical manifestations. It can involve one or multiple organs. Herein, we reported the case of a 62-year-old man with three organs involvement. He initially presented with recurrent jaundice. Laboratory analysis revealed cholestasis, high gamma-globulin levels, renal failure, and proteinuria. Abdominal Magnetic Resonance Imaging (MRI) showed segmental strictures of the left intrahepatic bile ducts and the wirsung duct with an increased volume of the pancreas and diffuse bilateral enlargement of the kidneys. Laboratory tests revealed high IgG4 levels (770 mg/dL). Based on the biological and radiological findings, we have suggested the diagnosis of systemic IgG4-related disease involving bile ducts, the pancreas, and probably the kidneys. Renal biopsy revealed lymphoplasmacytic infiltrate and fibrosis, but no IgG4-positive cell. The patient received corticosteroid therapy with a complete resolution of all symptoms and a rapid normalization of all blood tests. The present case underlines the complexity of IgG4-RD because of its variable clinical presentation. The diagnosis is challenging and should be carefully assessed for possible multi-organ involvement