Coping with the problems of diagnosis of acute colitis

AbstractAcute colitis is an acute condition of the colon. For the radiologist, it is mainly diagnosed during differential diagnosis of acute abdominal conditions. There are many causes of colitis and the degree of its severity varies. A CT scan is the best imaging examination for diagnosing it and also for analysing and characterising colitis. The topography, type of lesion and associated factors can often suggest a precise diagnosis but it is nevertheless essential to integrate these findings into the clinical context and take laboratory values into account. The use of endoscopy is still the rule where a doubt remains, or to obtain necessary histological evidence

Fatigue in teriflunomide-treated patients with relapsing remitting multiple sclerosis in the real-world Teri-FAST study

BACKGROUND: Fatigue is a frequent and disabling symptom of multiple sclerosis (MS) often associated with impaired quality of life (QoL) in patients. Teriflunomide is a once-daily oral immunomodulator used for the treatment of relapsing remitting forms of MS. However, its effect on fatigue is not well known in real life practice. We evaluated the impact of teriflunomide on fatigue in patients with relapsing remitting MS (RRMS) after 2 years of treatment in the real-world Teri-FAST study. METHODS: Teri-FAST was a 2-year, prospective, observational study conducted in France in RRMS patients treated with teriflunomide 14 mg. Fatigue was assessed using the French version of the modified fatigue impact scale (EMIF-SEP). The primary endpoint was the change from baseline in EMIF-SEP score after 2 years of treatment. Secondary endpoints included evaluation of depression (Beck Depression Inventory [BDI]), health-related QoL (Two-Life Scale TLS-QoL 10), self-reported physical activity, and adverse events. RESULTS: 210 eligible patients were included in the study with a mean age of 45.4 years and a mean ± SD Expanded Disability Status Scale score of 1.76 ± 1.43 at baseline. About half (52.4%) of patients had no previous treatment for MS. In the 163 patients who completed at least 1 follow-up visit, the mean change in EMIF-SEP score at Year 2 was -1.54 (95% CI: -4.02, 0.94) indicating that fatigue remained stable. Similarly, there were no changes in depression level and QoL after 2 years of treatment. Physical activity slightly improved with 57% of patients reporting being physically active after 2 years as compared to 46% at baseline. The safety profile of teriflunomide was consistent with that seen during clinical development, and compliance with treatment was high. CONCLUSION: Fatigue scores remained stable in RRMS patients treated with teriflunomide 14 mg over 2 years in real-life setting. Teriflunomide did not negatively impact depression or QoL

Pathogenesis, diagnosis and management of pneumorrhachis

Pneumorrhachis (PR), the presence of intraspinal air, is an exceptional but eminent radiographic finding, accompanied by different aetiologies and possible pathways of air entry into the spinal canal. By reviewing the literature and analysing a personal case of traumatic cervical PR after head injury, we present current data regarding the pathoanatomy, clinical and radiological presentation, diagnosis and differential diagnosis and treatment modalities of patients with PR and associated pathologies to highlight this uncommon phenomenon and outline aetiology-based guidelines for the practical management of PR. Air within the spinal canal can be divided into primary and secondary PR, descriptively classified into extra- or intradural PR and aetiologically subsumed into iatrogenic, traumatic and nontraumatic PR. Intraspinal air is usually found isolated not only in the cervical, thoracic and, less frequently, the lumbosacral regions but can also be located in the entire spinal canal. PR is almost exceptional associated with further air distributions in the body. The pathogenesis and aetiologies of PR are multifold and can be a diagnostic challenge. The diagnostic procedure should include spinal CT, the imaging tool of choice. PR has to be differentiated from free intraspinal gas collections and the coexistence of air and gas within the spinal canal has to be considered differential diagnostically. PR usually represents an asymptomatic epiphenomenon but can also be symptomatic by itself as well as by its underlying pathology. The latter, although often severe, might be concealed and has to be examined carefully to enable adequate patient treatment. The management of PR has to be individualized and frequently requires a multidisciplinary regime

Ab Initio Study of Azomethine Derivative Cancer Drug on Boron Nitride and Graphene Nanoflakes

International audienceOne of the main steps to realize targeted treatment is to build up effective target drug delivery nanosystems. Herein we present theoretical results, based on density functional theory, which demon-strate the potentiality of functionalization of perfect 2D nanomaterials (i.e., graphene and boron nitride nanoflakes) with anticancer mole-cule. Our first observations have confirmed that a perfect nanoflake blocked any chemical reaction onto them and could only transport physically active drug. Moreover, on defective surface, the resulting chemical attachment of an azomethine plus subsequent drug (like an anticancer Pt(IV) complex as cisplatin molecule) onto these ma-terials via a cycloaddition process show the formation of a five mem-bered ring. Moreover, the electronic activity and the structure of the drug are conserved in the most stable configuration, which means that the drug could delivered through this platform according to a supplementary target ligand

A new rapid and non-destructive method to detect tephra layers and cryptotephras: applying in the first distal tephrostratigraphic record of the chaîne des Puys volcanic field (France)

International audienc

[Portal vein thrombosis after cyanoacrylate injection therapy in bleeding gastric varices]

National audienc

Alveolar echinococcosis in the 21st century: An opportunistic infection?

National audienceIncreased susceptibility of experimental animals with immune suppression to alveolar echinococcosis (AE), due to Echinococcus multilocularis infection, has been known for more than 30 years, as well as the fast progression of residual AE lesions in patients with liver transplantation. However, occurrence of AE in patients with acquired immune suppression has been published as isolated cases only from the beginning of the 21st century. Based on the French Registry of Alveolar Echinococcosis cases (FrancEchino), a systematic study of AE cases in immunosuppressed patients, patients with AIDS, with cancer and malignant hematological disorders, with chronic inflammatory diseases, and with organ transplantations, has been performed. This study has confirmed the significant increase of AE cases in patients with immune suppression since 2000, compared to previous years, and of the percentage of such cases among all French AE patients, thus giving AE the status of 'opportunistic infection'. AE is most often an incidental finding in patients with a follow-up for the underlying disease. AE diagnosis is generally delayed and the treatment often erroneous because of misleading diagnostic findings, especially in patients with cancer. When the patients are symptomatic, unusual acute symptoms that simulate a liver abscess may be seen; these presenting symptoms, as well as more frequent negative serology and unusual imaging findings than in patients without immune suppression contribute to delayed diagnosis. Usual therapeutic strategy nevertheless applies to AE in immunosuppressed patients, with complete surgical resection of AE lesions whenever possible, anatomically and in the context of the underlying disease, and long-term administration of albendazole in non-operable patients. In such cases, albendazole efficacy is often excellent and fast; however, adverse effects of albendazole seem more frequent than in other patients. Complementary studies are necessary to understand whether AE occurrence in immunosuppressed patients is due to newly acquired infection or to the reactivation of dormant microscopic lesions