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This case report concerns a 57-year-old man who developed an exanthem-like rash, digestive symptoms and an inflammatory syndrome after taking allopurinol. The patient was admitted to the general medical ward, where a number of hypotheses, including infectious, digestive and cardiac, were considered and then ruled out. After empirical antibiotic treatment, the medical team raised the possibility of DRESS syndrome, a serious and potentially fatal hypersensitivity reaction to drugs, leading to the patient’s transfer to a specialist department. This clinical case highlighted the frequency and diversity of manifestations of DRESS syndrome, which can present cutaneous and digestive symptoms and affect several organs such as the liver, kidneys, lungs, heart and pancreas. Despite the delay in diagnosis, the patient did not develop any serious complications associated with DRESS syndrome. This case study highlights the importance of prompt and appropriate management to improve the prognosis of patients suffering from this potentially fatal condition. [ABSTRACT FROM AUTHOR]

Chronic heart failure is a growing problem. Despite progress in its management, many patients become refractory to therapies including diuretic resistance, major congestion, and worsening renal function. The only alternative to get rid of excess water and sodium is ultrafiltration, which can be achieved via hemodialysis or peritoneal dialysis (PD). The majority of studies have shown multiple benefits of PD as an improvement in functional class, a reduction in hospitalization leading to increased quality of life, and even a reduction in mortality. Being a home dialysis technique, it is more favorably accepted by patients. It remains necessary to confirm these potential positive outcomes and to identify patients who would benefit the most from this treatment in the era of new therapies available to date.

Atrial myxoma is a rare and benign clinical entity. It remains common in women and mainly affects the left atrium. Its clinical picture is polymorphic. We report the case of a 53-year-old woman who consulted for dyspnea with cardiac failure's picture. The diagnosis of myxoma of the left atrium was made on echocardiography which also objectified the existence of mitral stenosis. The patient underwent surgical excision and mitral valve replacement with good postoperative outcomes., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêt., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: L’insuffisance cardiaque chronique est une maladie cachectisante amenant à une perte de poids fréquente, progressive et le plus souvent irréversible. La cachexie cardiaque est définie comme une perte de poids supérieure à 6 % par rapport au poids pré-morbide, non volontaire, en l’absence d’œdème. Elle s’accompagne d’une hypotrophie des muscles squelettiques et d’une hypotrophie myocardique. L’anorexie n’est impliquée que dans 10 à 20 % des cachexies cardiaques. La plupart du temps, les ingesta sont maintenus. Cependant ils ne permettent pas de couvrir l’augmentation des besoins secondaires à un hypermétabolisme de repos. Les autres mécanismes de cachexie cardiaque sont la malabsorption et l’entéropathie exsudative par hypoperfusion splanchnique/stase veineuse splanchnique, le déséquilibre neuro-endocrinien et immunologique associé à une hyperactivation de facteurs cataboliques (catécholamines, cortisol, TNF alpha) et une diminution ou résistance aux facteurs anaboliques (GH, IGF-1, insuline, DHEA, activité physique). Une évaluation alimentaire est nécessaire pour identifier les restrictions ou évictions instaurées dans le cadre d’une prévention cardiovasculaire et qui ne se justifient plus au stade de la cachexie cardiaque. L’enrichissement et le fractionnement de l’alimentation sont les premières interventions visant à couvrir les besoins énergétiques et protéiques. En cas d’échec, la nutrition entérale par sonde naso-gastrique est à envisager. La nutrition parentérale est à réserver aux cas d’intolérance ou d’échec de la nutrition entérale. [ABSTRACT FROM AUTHOR]

Résumé: La cardiomyopathie du péripartum se manifeste, chez une femme sans dysfonction cardiaque préexistante, par un tableau d’insuffisance cardiaque gauche. Elle survient à la fin de la grossesse ou dans les mois qui suivent l’accouchement. Rare en Europe, elle est mal connue des obstétriciens. Le pronostic peut être bon avec une restitution ad integrum de la fonction cardiaque mais son évolution peut être dramatique et conduire au décès de la patiente comme l’illustre ce cas clinique. [ABSTRACT FROM AUTHOR]

Home hemodialysis (HHD) is closely associated with the development of in-center hemodialysis (HD), being introduced gradually as the survival of dialysis patients increased with the progress of technology and scientific research. It peaked fifty years ago and then gradually declined. Nowadays there is a revival of HHD highlighting the clinical and quality of life benefits attributed to it. The practice is already solid in several countries internationally and in France the trend is growing up. However, in-center HD remains largely majority and several obstacles to the development of HHD are reported. In this article we address in particular the complex clinical context (heart failure, central venous catheter) of situations that may arise in daily practice that may call into question a HHD project. © 2022 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved., (Copyright © 2022 Société francophone de néphrologie, dialyse et transplantation. Publié par Elsevier Masson SAS. Tous droits réservés.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Anorexia nervosa is a serious syndrome that can kill patients due to malnutrition complications by muscular weakness, especially cardiac and/or diaphragmatic failure, and infections. Clinical gravity criteria, linked to body mass index and visceral impairment symptoms must be known. Major biological gravity criteria are severe and symptomatic hypokaliemia, hypophosphoremia and hypoglycaemia. Renutrition must absolutely be careful to prevent the refeeding syndrome, the major risk of severe anorexia that can cause multivisceral organ failure. [Copyright &y& Elsevier]

Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Anesthesie--Reanimation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Spontaneous subarachnoidal haemorrhage can be associated with neurogenic pulmonary oedema and cardiogenic shock. The presentation is an ischemic myocardial dysfunction associated with normal coronary arteries. Hypoxaemia associated with arterial hypotension on patients with brain injury can worsen neurological outcome. The administration of norepinephrine associated with fluid expansion could be deleterious on cardiac function. We report the case of a patient with acute pulmonary oedema associated with post-aneurysmal subarachnoid haemorrhage managed with transoesophageal Doppler monitoring. [Copyright &y& Elsevier]

Cardiologists and emergency-wards physicians are used to check natriuretic peptides serum level, mainly B-type natriuretic peptide and N-terminal pro-Brain natriuretic peptide for acute cardiac failure diagnosis. Due to their accumulation in chronic kidney disease and their elimination by dialysis, natriuretic peptides sampling remains debatable in chronic kidney disease patients. In dialysis patients, high natriuretic peptides values are associated with mortality, left ventricular hypertrophy and cardiac failure. However, a single value cannot provide a reliable diagnosis. Our clinical practice is as follows: First, we prefer B-type natriuretic peptide to N-terminal pro-Brain natriuretic peptide because of its shorter half-life, with less impact of renal function and dialysis, making its interpretation easier in case of advanced chronic kidney disease or in dialysis patients; second, we define a reference value of B-type natriuretic peptide at dry weight from serial measurements; third, the B-type natriuretic peptide changes are interpreted according to extracellular fluid and cardiac status, but also from the arteriovenous fistula blood flow. In stable dialysis patients, B-type natriuretic peptide is sampled monthly and weekly in unstable patients. We illustrate our experience using clinical cases of overhydration, new cardiac disease onset, hypovolemia and arteriovenous fistula with high blood flow. Longitudinal follow-up of B-type natriuretic peptide is an important advance in dialysis patients in order to detect and treat extracellular fluid variations and cardiac disease status early, both important factors associated with hard outcomes., (Copyright © 2020 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)

Résumé L’hypertension artérielle est fréquente chez les patients avec une insuffisance rénale chronique notamment d’origine diabétique. Elle est parfois résistante au traitement pharmacologique. Les antagonistes du récepteur minéralo-corticoïde ont leur place dans cette indication. Ils sont l’un des traitements clés (Classe 1, Niveau A) de l’insuffisance cardiaque à fraction d’éjection altérée. Le risque de développer une hyperkaliémie ou une altération de la fonction rénale, m’altère cependant pas le bénéfice clinique. Une surveillance biologique adaptée est nécessaire, ainsi qu’une possible adaptation posologique. Le syndrome cardio-rénal au cours de l’insuffisance cardiaque congestive aggrave considérablement son pronostic. Le recours à l’ultrafiltration peut être efficace en cas d’échec des traitements conventionnels. Sa place en première ligne nécessite d’être évaluée. Hypertension is common in patients with chronic renal disease particularly those with diabetes. It is sometimes resistant to the pharmacological treatment. The mineralocorticoid receptor antagonist spironolactone may be indicated here. The mineralocorticoid receptor antagonists have a Class 1, Level A indication for the treatment of heart failure with reduced ejection fraction. There is an associated risk of worsening renal function and of hyperkalemia which does not hinder their clinical benefit. However, an appropriate biological monitoring is warranted, along with potential dose adaptations. Cardiorenal syndrome significantly worses the prognosis of congestive heart failure. The use of ultrafiltration can be effective when conventional treatments failed. Its place in the front line needs to be evaluated. [ABSTRACT FROM AUTHOR]

In the past decade, a significant improvement has been done in the management of pulmonary arterial hypertension, a devastating disease. Beside the aging population, one of the next challenges is to develop a specific management of a pulmonary hypertension's suspicion, in the aged patients. In fact, recent data have shown that if pulmonary hypertension were mostly related to chronic heart or lung failure, or pulmonary embolism, some elderly may in fact develop a real pulmonary arterial hypertension. Because of the potential therapies which may be proposed, the evaluation of a pulmonary hypertension's suspicion in the elderly needs a stringent evaluation by trained physicians, in collaboration with geriatricians.