[Amelanotic spitzoid melanoma of the digit: a case report]

Melanomas of digit is rare, accounting for 1% of all cutaneous melanomas. We report a new case. Our purpose is to discuss the clinicopathological characteristics and the difficulties encountred in establishing diagnosis of this rare tumor. We report the case of a 25 years old woman, who consulted for nodular and ulcerated lesion of the right index, located in the external face of the metacrapo-phalangial joint. The nodule was biopsied and histopathologic exam concluded to spitzoid melanoma. The surgical margins were involved. The patient refused surgical recovery. She consulted 3 years later with axillary lymph nodes. A wide excision of the tumor with lymph node biopsy were made. Histological study concluded to a tumoral residu incompletely excided with lymph node metastases. Amputation of the second digit with dissection of the axillary lymph nodes was made. The surgical margins were tumor free. Lung metastases appeared with a follow up of two months. The patient died early after starting chemotherapy with Deticen. In our report, clinical presentation was misleading causing a diagnosis and therapeutic delay. Pathologically, all the histological types of melanoma were described in the digit except spitzoid melanoma

Medically assisted reproduction and viral infections

During the past ten years Assisted Reproduction has been facing a new demand from patients requiring ART [Assisted Reproductive Techniques]: couples at risk of partner to partner, and mother to child transmission of viral infections, mainly Human immunodeficiency virus [HIV], hepatitis B virus [HBV] and hepatitis C virus [HCV]. The desire to have children is not easy to realize for serodiscordant couples, if we consider that, in order to avoid HIV virus transmission, it is necessary to use the condom in vaginal contacts. On the other hand infertile discordant HCV couples need to be included in protocols of controlled assisted reproduction procedures to avoid any risk of HCV transmission to the partner. In this paper, we review current literature about assisted reproductive techniques [ART] recommendations and results in the context of Human immunodeficiency virus [HIV], hepatitis B virus [HBV] and hepatitis C virus [HCV]

Embolie pulmonaire hydatique compliquant un kyste hydatique du coeur. A propos d'un cas

Hydatic pulmonary embolism complication of a cardiac hydatic cyst:a case report Hydatic cardiac cyst is a rare condition and represents only 0.5 to 2% oF all visceral localisations of the hydatid disease. We reported a 28 year old patient with a multiple hydatic pulmonary embolism caused by the rupture of a hydatic cyst of the interventricular septum. The diagnosis was established by transthoracic echocardio-graphy and CT Scan. Surgery was performed without delay and the outcome was good after a five month follow-up This case illustrates the diagnostic value of the non invasive imaging means in hydatic cyst of the heart and underlines the importance of surgery realized before complications occur

[Biventricular resynchronization in the management of the chronic heart failure]

Heart failure is a major problem of public health, it represents a frequent status among patients with heart disease, and its implications in term of mortality and cost are high. Non Pharmacological treatment of heart failure most commonly designed as cardiac resynchronization therapy [CRT] has demonstrate efficacy to improve functional class, exertion capacity, left ventricular ejection fraction, reduction of mitral regurgitation, and probably mortality at midterm. The most recent studies emphasize on the role of implantable cardioverter defibrillat or [ICD] combined with CRT to reduce mortality. More trials are needed to valid this concept