La prise en charge des lésions anopérinéales de la maladie de Crohn: revue de la littérature

The anoperineal Crohn??s disease lesions pose a several problems in diagnostic and therapeutic steps. The frequency of these lesions was around 21 to 23% in the literature [1]. The data in the literature are still insufficient in the absence of studies devoted to this location particularly debilitating. The purpose of this literature review is to highlight the current diagnostic and therapeutic modalities and new recommendations.     

Le dépistage ciblé de la pré-éclampsie au premier trimestre de la grossesse au CHU de Toulouse

GoalsPreeclampsia (PE) is a leading cause of maternal and neonatal morbidity and mortality. Early treatment by aspirin has been shown to significantly reduce PE risk before 37 weeks supporting the implementation of first-trimester screening.Subjects and methodsA targeted screening was recently implemented at Toulouse University Hospital for women in their first pregnancy or those with personal or familial history of PE. It uses Fetal Medicine Foundation (FMF) algorithm that combines maternal characteristics, clinical, biophysical and biochemical (PAPP-A, Pregnancy Associated Plasma Protein-A, and PlGF, Placental Growth Factor) data. We describe this first population of pregnant women and compare our results with those of a mini-test that excludes PlGF and biophysical data.ResultsBetween October 2016 and September 2017, 500 women have benefited from this screening. In such targeted population, we identified 3,6 % (n = 18) of women at high risk to develop PE before 34 weeks and 9,6 % (n = 48) of women at high risk to develop PE between 34 and 37 weeks. When we recalculated the risk using the mini-test, only 10 women (56 %) were identified at high risk of early PE.ConclusionFor the first time in France, we report the result of a targeted screening of PE during the first trimester using the FMF algorithm. We describe the screened population and show that it is more efficient than the mini-test.