Music therapy, a review of the potential therapeutic benefits for the critically ill.

Intensive care units are a stressful milieu for patients, particularly when under mechanical ventilation which they refer to as inhumane and anxiety producing. Anxiety can impose harmful effects on the course of recovery and overall well-being of the patient. Resulting adverse effects may prolong weaning and recovery time. Music listening, widely used for stress release in all areas of medicine, tends to be a reliable and efficacious treatment for those critically ill patients. It can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication. This relaxation response can lower cardiac workload and oxygen consumption resulting in more effective ventilation. Music may also improve sleep quality and reduce patient's pain with a subsequent decrease in sedative exposure leading to an accelerated ventilator weaning process and a speedier recovery.

[Lactococcus lactis: an opportunistic bacterium?]. / Lactococcus lactis: un pathogène opportuniste?

Lactic bacteria have been used for centuries to ferment food and thus, to better preserve them. Considered as inoffensive for man, its use has largely spread in food industry. Some species are even being considered for the treatment of human diseases. Indeed, the development of new cellular biology technologies opens opportunities for the use of these bacteria as biotherapeutic agents. These species would produce heterogeneous proteins such as enzymes (lipase, lactase, esterase), chemical mediators (hormones and interleukins), and molecules able to stimulate local immune responses. However, rare cases of human infection, sometimes severe, were reported recently. They generally occured in patients with comorbidities with consumption of unpasteurized dairy products reported for some. The scarcity of these cases and their favorable outcome should not hinder the industrial and medical use of these bacteria.

Pneumococcal cellulitis in an HIV-infected adult.

Streptococcus pneumoniae is an uncommon cause of cellulitis. In almost all of the reported cases, the infection occurred in immunosuppressed patients, especially in those with connective tissue diseases. We report a case of cervical cellulitis associated with septicemia which occurred in an HIV-infected adult.

Group B streptococcus meningitis in an HIV-positive adult: case report and review.

We report a new case of meningitis due to group B streptococci (S. agalactiae) in an HIV-positive patient. Only three other cases have been reported so far, and common features are discussed.

Pancreatic pseudocyst located in the liver: a case report and literature review.

Pancreatic pseudocyst in the liver is a rare complication of acute or chronic pancreatitis. However, its frequency seems to be increasing with modem imaging procedures. The authors report a case of pancreatic pseudocyst involving the left lobe of the liver that occurred in a patient who never showed clinical evidence of pancreatitis or pancreatic injury. Complete screening led to the discovery of alcoholic chronic pancreatitis. The pseudocyst was treated successfully by radiologic drainage. The pancreatic pseudocyst location and therapeutic approaches are discussed. A literature review uncovered 26 cases of hepatic pancreatic pseudocysts. Clinical presentation, imaging characteristics, and treatment of these cases are analyzed.

Blindness following gastrointestinal haemorrhage.

Loss of vision is a rare but well known complication of distant and recurrent haemorrhage. It shares a poor prognosis, with only 10-14% of cases likely to make a complete recovery. Visual symptoms, due to ischaemic anterior optic neuropathy, vary from blurred vision to complete loss of vision in one or both eyes. The pathogenesis of such ischaemia remains unclear. Gastrointestinal bleeding seems to be the leading cause of loss of vision secondary to haemorrhage. However, complete and permanent blindness following gastrointestinal bleeding has rarely been reported. We report the case of a 51 -year-old woman who complained of complete blindness following blood loss, secondary to peptic ulcer, and discuss the pathogenesis of such a complication.

Spontaneous Escherichia coli meningitis in an adult.

Spontaneous meningitis due to gram-negative bacilli (excluding Hemophilus influenzae) is an infrequent infection in adult patients. It usually occurs in patients with underlying immunosuppressive conditions. Most of the cases are due to Escherichia coli and represent a complication of bacteraemia. The infection has a high mortality rate which may be as high as 90%, especially if associated with septicaemia. We report the case of a 53-y-old man with spontaneous, community-acquired Escherichia coli meningitis who was admitted with an unusual presentation. Blood and urine cultures were negative.

[Papillary solid tumor of the pancreas in a child: a case report]. / Tumeur papillaire solide du pancréas chez un enfant.

We present a case of a papillary solid neoplasm of the head of the pancreas incidentally diagnosed after an abdominal trauma in a thirteen year old boy. Imaging features (US, CT) of the lesion were not specific enough to permit a precise diagnosis with certainty. Preoperative percutaneous needle biopsy can give presumptive evidence which may guide the treatment. Prognosis is fairly better than other pancreatic neoplasms in children (particularly pancreatoblastoma). Treatment relies only on surgery.