[High pressure trap].

Pheochromocytoma is a rare tumor potentially life-threatening and associated with non specific and diverse symptomatology. Cardiac symptoms may mislead diagnosis; they could manifest as myocardial sideration concomitant to a hypertensive peak or supraventricular arythmia. We report a case of pheochromocytoma associated with hypokaliemia revealed by a myocardial ischemia with acute cardiac failure and severe left ventricular depression and complete reversal after surgery.

[Partial anomalous pulmonary venous return in a 64-year-old woman].

Partial anomalous pulmonary venous return (PAPVR) represents 3 % of the congenital cardiopathies. Diagnosis in adults is challenging as clinical symptomatology is non-specific and echocardiographic signs are discrete and misleading potentially confusing with idiopathic pulmonary hypertension. We report the case of a 64-year-old woman in whom we diagnosed PAPVR associated with sinus venosus atrial septal defect.

[Biomarkers of vascular calcifications: what are analytical limits to apply "research-grade" diagnostic kits into daily practice?].

A better knowledge of physiopathologic mechanisms responsible for vascular calcification leads to emerging biological markers of calcifications. The use of these biomarkers in daily practice requires both clinical and analytical validation. This latter point is of particular importance to implement "research-grade" diagnostic kits into daily practice.

[Urinary biomarkers of kidney dysfunction].

The early diagnosis of chronic kidney disease (CKD) is based on the detection of markers of renal damage in urine collection. These urinary bio-markers are measurable before the appearance of functional defect, which is diagnosed with a decrease of glomerular filtration rate. Albuminuria, preferentially expressed as urinary albumin/creatinin ratio, is one of the marker of CKD.

MEN1 disease occurring before 21 years old: a 160-patient cohort study from the Groupe d'étude des Tumeurs Endocrines.

Context: Multiple endocrine neoplasia Type-1 (MEN1) in young patients is only described by case reports.

Objective: To improve the knowledge of MEN1 natural history before 21 years old.

Methods: Obtain a description of the first symptoms occurring before 21 years old (clinical symptoms, biological or imaging abnormalities), surgical outcomes related to MEN1 Neuro Endocrine Tumors (NETs) occurring in a group of 160 patients extracted from the "Groupe d'étude des Tumeurs Endocrines" MEN1 cohort.

[Screening and management of cardiovascular risk factors in systemic lupus erythematosus: Recommendations for clinical practice based on the literature and expert opinion].

Purpose: To develop French recommendations about screening and management of cardiovascular risk factors in systemic lupus erythematosus (SLE).

Methods: Thirty-nine experts qualified in internal medicine, rheumatology and nephrology have selected recommendations from a list developed based on evidence from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified.

Safety and efficacy of rituximab in adult immune thrombocytopenia: results from a prospective registry including 248 patients.

We conducted a prospective multicenter registry of 248 adult patients with immune thrombocytopenia (ITP) treated with rituximab to assess safety. We also assessed response and predictive factors of sustained response. In total, 173 patients received 4 infusions of 375 mg/m(2) and 72 received 2 fixed 1-g infusions 2 weeks apart.

[Univentricular heart in a 50 year-old woman complicated with infective endocarditis with favorable evolution].

Univentricular heart is a complex cyanotic congenital heart malformation classically repaired during early childhood. Despite correction, a residual risk of infective endocarditis still persists and may be associated with a severe prognosis. We report the case of a 50 year-old woman with a known partially corrected univentricular heart in whom we diagnosed an infective endocarditis with a favorable evolution under antibiotics.

[Uselessness of high-sensitivity cardiac troponins to improve diagnostic accuracy of dobutamine stress echocardiography in high-risk diabetic patients].

Background And Aim: Dobutamine stress echocardiography (DSE) is a well-established noninvasive stress modality for the detection and evaluation of coronary artery disease in diabetic patients. High-sensitivity cardiac troponin T recently emerged as a highly sensitive dosage for the detection of ischemia. The aim of the study was to examine whether high-sensitivity cardiac troponin T may improve the diagnostic accuracy of silent ischemia by DSE in high-risk diabetic patients.

[Large aneurysm of the left sinus of Valsalva in a 54-year-old man successfully treated with surgery].

Sinus of Valsalva aneurysms are very rare and are often asymptomatic. Clinical manifestations depend on associated complications, most commonly rupture or dissection. We describe the case of a 54-year-old male presenting with exercise-related angina and dyspnea and in whom we found a large unruptured aneurysm of the left sinus of Valsalva.

Compliance with recommendations of clinical practice in the management of venous thromboembolism in cancer: the CARMEN study.

Unlabelled: Cancer is associated with venous thromboembolism in 20% of patients. In such patients, thrombosis is difficult to treat, associated with bleeding, recurrence, and death. Specific treatments for venous thromboembolism in cancer are recommended.

[Totally asymptomatic coronary left main artery critical stenosis: when non-invasive tests are falsely reassuring].

Left main coronary artery severe stenosis is frequently very symptomatic and is considered as a classical contraindication for non-invasive ischemia testing. When performed, those tests usually yield a large area of ischemia associated with a rich symptomatology. We report the case of a 69-year-old completely asymptomatic man in whom both treadmill effort testing and dobutamine stress echocardiography were falsely reassuring as they eliminated significant ischemia despite the presence of a critical stenosis of distal left main artery ultimately confirmed by angiography.

[Coronary artery spasm during dobutamine stress echocardiography: prevalence, clinical and echocardiographic characteristics and prognosis].

Objectives: To assess the prevalence of coronary artery spasm during dobutamine stress chocardiography (DSE), to describe clinical and echocardiographic characteristics and prognosis.

Patients And Methods: We evaluated all the patients with known or suspected coronary artery disease (CAD) referred to our echocardiography laboratory for dobutamine stress test between January 2004 and June 2012, (10013 exams). Those with abnormal DSE underwent coronary angiograms with a systematic methylergometrine intracoronary injection in case of absence of significant coronary stenosis or spontaneous occlusive coronary spasm.

[Serous central chorioretinopathy and tadalafil: a case report].

We report a case of central serous chorioretinopathy in a 46-year-old man with no risk factors except for erectile dysfunction agent use: Tadalafil (Cialis(®)). An association between tadalafil and central serous chorioretinopathy could involve phosphodiesterase type 5 inhibitors and be a risk factor of central serous chorioretinopathy.

Clinical outcome in children with chronic recurrent multifocal osteomyelitis.

Objective: To determine the clinical outcome of children with chronic recurrent multifocal osteomyelitis (CRMO).

Methods: We retrospectively reviewed clinical, biological and radiological data of children with CRMO at five French paediatric centres. Outcome data were obtained through review of hospital charts and questionnaires sent to all patients to assess disease activity and educational and vocational achievement.

[Femoral venous catheter: an unusual complication].

We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

[A difficult dilemma to resolve: aged patients refused for treatment by iterative hemodialysis. Ethical problem or medical choice? Reflections apropos of a questionnaire-inquiry].

An inquiry has been conducted amongst 185 french nephrologists so as to try to determine upon which criteria therapeutic choices for aged patients with chronic renal failure are made: conservative treatment or chronic dialysis? The fear of sharing the responsibility of an injustice towards some patients already handicapped by the disease or by their poor opportunity of social or family rehabilitation, the obsession of passive euthanasia and the refusal of taking into account the economic consequences of their choices, seem to conduct some nephrologists to accept anybody for a dialysis treatment. However, the quality of life enabled by the treatment, the possibility for the patient to enjoy a satisfactory social or family life, the environment of the patient, his degree of autonomy as well as, in some cases, the poor prognosis due to associated diseases, actually constitute the most determining factors of decision. The answer to this inquiry have moreover pointed out the necessity to provide right now for structures fitting the treatment by dialysis of an increasing number of elderly patients.