Bare metal stent thrombosis 13 years after implantation

There has been a great deal of recent controversy regarding the risk of very late stent thrombosis with drug eluting stents, especially in the context of antiplatelet therapy cessation. We report a case of very late stent thrombosis of a bare metal stent initially implanted for treatment of a myocardial infarction. The patient presented thirteen years later with a recurrent myocardial infarction three days after discontinuing aspirin. Angiography demonstrated thrombotic occlusion and severe underlying restenosis of the stent. To our knowledge, this is the latest bare metal stent thrombosis described in the world medical literature.     

Prevalence of psychopathology in patients suffering from breast and gastrointestinal cancer

Prevalence of psychopathology in 107 in- and outpatients suffering from cancer was assessed by means of self-rating inventory (Symptom Check List (SCL-90)) and an interview. There were 86 women with breast cancer and 21 patients with gastrointestinal cancer (9 women and 12 men). Inventory was administered once after surgery. Psychopathology exceeding so called mean borderline values derived from control samples ranged from 2% to 33% of the patients in particular dimensions of the inventory. Maximal mean values of the psychopathology were found in the dimensions of somatisation, depression, anxiety, phobic anxiety, hostility and of items not included, reflecting mostly sleep and eating distortions. Mean values of the psychopathology were insignificantly lower in patients after mastectomy, compared with gastrointestinal cancer patients. No significant differencies between initial (I and II) and advanced (III and IV) stages of the illness were achieved in the patients from both investigated samples. Screened patients are suitable for psychiatric or psychologic therapeutic intervention.     

Accoutumance orale rapide à la rifampicine en suspension

Allergic reaction to antituberculosis drugs is difficult to manage, notably since the advent of multiresistant tuberculosis. In patients with immediate-type allergic reactions to antituberculosis drugs, a rapid desensitization procedure may represent an interesting alternative. A 29-years-old man, not immunocompromised, hospitalized for a disseminated tuberculosis, has presented a severe immediate systematic reaction due to rifampicine allergy. We performed a rapid desensitization with a rifampicine syrup, while the patient was under corticosteroids and anti-histamines coverage. Desensitization and further treatment with a full dose of rifampycin induced no reaction. Thus, we show that the use of rifampicine syrup for rapid desensitization represents an efficient procedure that allows deferring the use of products in powder, which require meticulous dosages.