[Clinical and endoscopic prognostic factors in peptic ulcer bleeding]

Bleeding ulcer represent the most common cause of upper gastrointestinal hemorrhage. This study aims to evaluate the prognostic factors of recurrent bleeding and mortality in patients presenting with high risk of peptic ulcer bleeding. A cohort study with 88 patients was designed to investigate prognostic factors to the occurrence of new episodes of bleeding. Endoscopic hemostasis was performed in 32 cases [36%]. Recurrent bleeding and death occurred in 30 [34, 1%] and 3 cases [3, 4%] respectively. The predictors factors of rebleeding were hypovolemia at admission and the localization of the ulcer in bulb. The only predictor factor of death was the anticoagulant therapy. The identification of patients with risk of death by bleeding peptic ulcer remains as a challenge, once few factors are capable of predicting the severity of the evolution. The identification of such factors will allow the choice of the better therapeutic conduct improving the diagnosis and decreasing the rate of rebleeding and the mortality

[Intrahepatic cholestasis of pregnancy]

Intrahepatic cholestasis of pregnancy is a pregnancy specific hepatic disorder. It occurs mainly in the third trimester of pregnancy by pruritus and elevated serum levels of aminotransferases and total bile acid which completly regresses few days or weeks after delivery. Intrahepatic cholestasis of pregnancy is regarded as a benign disease with meaningful consequences to the mother but associated to increased perinatal risk with increased rates of preterm birth and perinatal mortality. The pathogenesis of disease is unclear yet but likely involves a genetic hypersensitivity to estrogen or progesteron metabolites. Treatment is focused on reducing symptoms in mother and to provide an adequate obstetric management in order to prevent fetal distress. Currently, only ursodeoxycholic acid treatment has been proven to be useful and safe and should be the first choice treatment

[Massive lower intestinal bleeding from colonic tuberculosis case report]

Colonic tuberculosis is an uncommon presentation of gastro intestinal tuberculosis. We describe a 46-year-old patient who presented with massive rectal bleeding. The patient had required a surgical resection following which the patient died to complications. This case emphasizes the need to include colonic tuberculosis in the diagnosis of lower intestinal bleeding

[Chronic HBS antigen carriers casually discovered - evolutionary aspects about 221 adults]

Hepatitis B virus infection constitutes a health public problem notably in our country where the frequency of chronic HBs antigen carriage is about 5%. Most of these patients are asymptomatic and so underestimated. Study epidemiological characters and clinical, biological and virological profile of chronic HBs Ag carriers whose discovery was fortuitous. retrospective study of 221 patient's files where HBs Ag was casually discovered: blood donors [128], pregnant women [40], exposition to risk factor [24], familial inquiry [23] and prenuptial examination [6]. average age was 31 years with a male predominance. Among the hepatitis risk factors found: high frequency of multiple syringes use and scarifications. All patients were asymptomatic with a normal physical exam. Prevalence of anti-HCV antibodies was 0,28% and that of anti-HDV 9,3%. A moderate cytolysis was noted in 14 patients [6,3%] and about 2/3 of them had positive markers of viral replication [HBe Ag+ and/or DNA+]. HBe antigen was positive in 12,7% of cases. Average duration of follow-up was 20,7 months. Three patients made spontaneous conversion HBe Ag/anti-HBe, and one conversion HBs Ag/anti-HBs. Hepatic biopsy was practised in 8 patients with cytolysis and showed 3 cirrhosis and 5 chronic hepatitis. Conclusion : despite favorable evolution of these patients, a clinical and biological supervision is necessary to search cytolysis and/or viral replication requiring then more agressive management

[Sternal osteomyelitis: an exceptional osteo-articular lesion in inflammatory bowel disease: a case study]

Primary sternal osteomyelitis is a rare condition. It's association with ulcerative colitis is exceptional. We report a case of a 34 years old woman with multiple extra-intestinal manifestations presenting sternal osteomyelitis successfully treated with combined surgical intervention and intravenous antibiotics