La Revue du praticien
-
Red eye in children is a common consultation purpose. Mostly benign, this sign may also cause visual impairment. We differentiate three kinds of red eye: localised, diffused and perikeratic injection. ⋯ Diagnosis must be sure and treatment has to be efficient to not pertubate childrens visual development. Unfortunately, physical examination on children is not always easy. Consultation with an ophthalmologist is justified if a doubt remains, in case of chronic pathology or resistance to first intention treatment.
-
Interstitial lung disease (ILD) may occur in the connective tissue diseases, with a negative impact on survival. The diagnosis of ILD is established by crackles of the lung bases at auscultation, and high resolution computed tomography of the chest demonstrating diffuse opacities predominating in the bases (ground glass opacities, reticular opacities, honeycombing, and traction bronchiectases). Bronchoalveolar lavage mostly contributes to the differential diagnosis. ⋯ ILD of various presentations may occur in Sjögren syndrome, possibly associated with thin-walled cysts; pulmonary lymphoma must be ruled out. Little information is available regarding treatment of ILD in connective tissue disease. Clinically modest short-term efficacy of cyclophosphamide treatment has been shown in systemic sclerosis, but was not maintained at 2 years.
-
La Revue du praticien · Sep 2007
Review[Prevalence and comorbidity of sleep disorders in general population].
Sleep disorders can be expressed in different ways. The International Classification of Sleep Disorders lists more than 80 different sleep disorder diagnoses. In general population, although the insomnia complaint is reported by nearly the third of the population, it is translated into a diagnosis of insomnia for only 6% to 15% of the population. ⋯ Among those more extensively studied, sleep paralysis is found for approximately 6% of the general population. Nocturnal terrors, the confusional arousals and nightmares have been observed with prevalences ranging from 2.2% to 5%. Despite their high frequency, sleep disorders remain poorly identified; less than 20% of individuals with sleep disorders are correctly diagnosed and treated.
-
Epidermal necrolysis (Stevens-Johnson syndrome, toxic epidermal necrolysis) is an acute and severe skin disease, induced by "(drug allergy" and characterized by the destruction of the epithelium of the skin and mucous membranes. It is extremely rare: about 2 cases per million per year. It is a life-threatening emergency. ⋯ A dozen "high risk" medications account for 50% of cases. Symptomatic management in specialized units is urgent. The mortality rate is high (20-25%) and about one half of survivors will have sequelae, especially on the eyes.
-
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.