[Miliary cerebral carcinomatosis secondary to EGFR mutation-positive lung adenocarcinoma]. / Miliaire cérébrale carcinomateuse secondaire a un adénocarcinome pulmonaire muté EGFR.

INTRODUCTION: Miliary brain metastases are a rare form of brain metastatic lesions. CASE REPORT: We report the case of a 58-year-old patient with lung adenocarcinoma and an EGFR mutation, who had metastatic lesions in the bones, pleura and pericardia at the time of diagnosis. The patient was treated with tyrosine kinase inhibitor. A few months later, he presented with progressive neuropsychiatric symptoms, which were attributed to miliary brain metastases based on the radiological pattern (micronodules, some of which were calcified) and the elimination of alternative possible diagnoses. Despite tumour stability in the thorax and metastatic sites other than the brain, his neurological condition deteriorated, even after cerebral radiotherapy, leading to his death eight months after the diagnosis of lung cancer. CONCLUSION: Miliary brain metastases are a rare form of brain metastases with unusual clinical presentation. The diagnosis is based on the radiological pattern of cerebral miliary dissemination, with sometimes calcified tumor nodules. Despite its rarity, several cases have been reported in lung adenocarcinoma in the presence of EGFR mutations.

Diagnosis and treatment of pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: An overview.

Hereditary hemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is an autosomic dominant disorder, which is characterized by the development of multiple arteriovenous malformations in either the skin, mucous membranes, and/or visceral organs. Pulmonary arteriovenous malformations (PAVMs) may either rupture, and lead to life-threatening hemoptysis/hemothorax or be responsible for a right-to-left shunting leading to paradoxical embolism, causing stroke or cerebral abscess. PAVMs patients should systematically be screened as the spontaneous complication rate is high, by reaching almost 50%. Neurological complications rate is considerably higher in patients presenting with diffuse pulmonary involvement. PAVM diagnosis is mainly based upon transthoracic contrast echocardiography and CT scanner examination. The latter also allows the planification of treatments to adopt, which consists of percutaneous embolization, having replaced surgery in most of the cases. The anchor technique consists of percutaneous coil embolization of the afferent pulmonary arteries of the PAVM, by firstly placing a coil into a small afferent arterial branch closely upstream the PAVM. Enhanced contrast CT scanner is the key follow-up examination that depicts the PAVM enlargement, indicating the various mechanisms of PAVM reperfusion. When performed by experienced operators as the prime treatment, percutaneous embolization of PAVMs, is a safe, efficient and sustained therapy in the great majority of HHT patients.

[Evaluation and utilization of home visual aids prescribed to the satisfaction of the patients for age-related macular degeneration]. / Evaluation de l'utilisation à domicile des aides visuelles prescrites et de la satisfaction du patient, en cas de dégénérescence maculaire liée à l'âge.

We evaluated the subjective advantage given by optical visual aids to patients affected by Age Related Macular Degeneration (ARMD). A total of 51 patients with ARMD having magnifying visual aids were retrospectively analysed. The 51 patients have been splitted up in 2 groups according to the final macular aspect and 7 subgroups according to their treatment, and have been questioned about the subjective advantage of their optical aids. Out of the 51 patients, 71% were satisfied, 5% were moderately satisfied and 24% were unsatisfied. The group with the lowest visual acuity at 5 meters has a satisfaction percentage only slightly lower (71%) than that with a higher visual acuity (75%). From the patients with a visual acuity superior to 3/10, 58% were affected with a persistence of macular edema. Seventy six percent of the patients with edema and 65% of the patients with a dry macular scar use their low vision aid every day. In summary, an important percentage of the patients are satisfied with their visual aids, independently of the fact that the retina is exsudative or dry, or that the visual acuity is good or bad. It seems useful to propose these optical aids to any patient suffering from ARMD who complains about reading-difficulties.

Presence of antibodies reacting with a ribonucleoprotein from Mycobacterium tuberculosis in sera from leprous patients.

Antibodies reacting with a ribonucleoprotein isolated from M. tuberculosis could be found in sera of leprous patients (lepromatous type of disease). The antibody titers are very high. There is a highly significant difference between the titers of leprous patient and tuberculosis patients. This renders our finding important for diagnostic purpose.