Acute myopericarditis and left shoulder capsulitis following second dose of mRNA SARS-CoV-2 Moderna vaccination.

Vaccination against mRNA SARS-CoV-2 has been administered on a very large scale and various side effects have been described. The increased risk of myopericarditis is known, and only a few cases of shoulder capsulitis have been reported after vaccination. These two pathologies have never been reported in the same patient after vaccination.

Going toe-to-toe with a rare case of a complex regional pain syndrome limited to the hallux.

We report the first case of a complex regional pain syndrome (CRPS) limited to the hallux using the Budapest criteria. Limited forms of CRPS are scarce in the literature and probably overlooked. There is currently no consensus to define these forms.

Cranial neuropathies in granulomatosis with polyangiitis (Wegener's): a case-based review.

The purpose of this case-based review is to highlight cranial nerve involvement in granulomatosis with polyangiitis (Wegener's). In this disease, cranial nerve involvement may be less frequent than other neurological manifestations, but often goes unrecognized by physicians as a sign of the disease, and its prevalence and importance is likely underestimated. Awareness of this aspect of the disease is necessary to make the proper diagnosis rapidly, as it can be a major feature of a patient's presentation.

A controlled trial of the benefits of ultrasound-guided steroid injection for shoulder pain.

Objectives: We studied the value of ultrasound (US) to define shoulder pathology and guide local steroid injection in comparison with a standard injection in the management of the acute painful shoulder.

Methods: Seventy consecutive patients with acute shoulder pain were assessed clinically and by US. Patients were randomized to receive either a standard subacromial infiltration of 7 mg of betamethasone or a US-guided injection according to the US diagnosis.

B cell depletion may be more effective than switching to an alternative anti-tumor necrosis factor agent in rheumatoid arthritis patients with inadequate response to anti-tumor necrosis factor agents.

Objective: Patients with rheumatoid arthritis (RA) in whom the response to anti-tumor necrosis factor (anti-TNF) therapy is inadequate have several therapeutic options, such as switching to an alternative anti-TNF agent or initiating B cell-depleting therapy with rituximab (RTX). Although both therapeutic options have been proven effective in trials, no head-to-head comparisons are available. The aim of this study was to compare the effectiveness of RTX with that of an alternative anti-TNF agent in the management of patients with RA who had an inadequate response to anti-TNF therapy.

A pilot study of IL-1 inhibition by anakinra in acute gout.

Monosodium urate crystals stimulate monocytes and macrophages to release IL-1beta through the NALP3 component of the inflammasome. The effectiveness of IL-1 inhibition in hereditary autoinflammatory syndromes with mutations in the NALP3 protein suggested that IL-1 inhibition might also be effective in relieving the inflammatory manifestations of acute gout. The effectiveness of IL-1 inhibition was first evaluated in a mouse model of monosodium urate crystal-induced inflammation.

Fever and musculoskeletal symptoms in an adult: differential diagnosis and management.

Fever in the context of a patient with musculoskeletal symptoms is a sign of systemic inflammation. Initial management should be targeted at the identification of the organ systems affected and the search for a precise diagnosis. The main challenge is to differentiate between an infectious aetiology from an immune-inflammatory cause.

[Reactive arthritis].

Reactive arthritis is a disease closely related to the presence of the HLA-B27 antigen and characterized by sterile joint inflammation secondary to infection. Arthritis is only one of the clinical manifestations of this systemic disease. Its diagnosis rests on history, clinical examination and various serologies.

Management of acute pharyngitis in adults: reliability of rapid streptococcal tests and clinical findings.

Background: How to use clinical score, the rapid streptococcal antigen test (RSAT), and culture results is uncertain for efficient management of acute pharyngitis in adults.

Methods: This prospective cohort study included 372 adult patients with pharyngitis treated at a Swiss university-based primary care clinic. In eligible patients with 2 to 4 clinical symptoms and signs (temperature >or=38 degrees C, tonsillar exudate, tender cervical adenopathy, and no cough or rhinitis), we performed an RSAT and obtained a throat culture.

Leg pain due to bilateral focal recurrent myositis in a hemodialysis patient.

Leg pain is a common symptom in dialysis patients. In most cases, the cause is easily identified, but some rare causes have been recognized. We describe a case of focal myositis as the source of recurrent leg pain in a hemodialysis patient.

Evaluation of drug prescription at the Geneva prison's outpatient service in comparison to an urban outpatient medical service.

Purpose: To analyse non-psychotropic drug prescription in a prison outpatient clinic in comparison with an urban medical outpatient service.

Methods: Comparative study during 3 weeks at Geneva: prison outpatient service and medical policlinic (MP) of the University Hospital.

Results: The most often prescribed non-psychotropic drugs at the Geneva prison were systemic analgesics (mostly non-steroidal anti-inflammatory drugs (NSAID) and paracetamol), dermatologicals, systemic anti-infectives and drugs for the gastrointestinal system.

Prescription of hypnotics and tranquilisers at the Geneva prison's outpatient service in comparison to an urban outpatient medical service.

Objectives: Examine whether an overconsumption of tranquillizers exists in prison and discuss possible reasons.

Methods: Comparative study during three weeks at Geneva: prison outpatient service and Medical Policlinic (MP) of the University Hospital.

Results: When comparing the 113 (prison) and 151 (MP) male patients younger than 39 years, we found important differences concerning the quality and quantity of prescriptions of psychoactive drugs: ten times more prison patients than patients from the MP were treated with benzodiazepines (BZD).