Actinomycose secondaire du psoas : une complication du dispositif intra-utérin

Genital-pelvic actinomycosis is an uncommon disease which often arises on women with long term use of intrauterine device. Its diagnostic remains difficult. Even if different clinical locations has been reported, location to the psoas muscle is exceptional. We report such a case, diagnosed on a 53 years old woman. Both a tumoral and a severe infectious syndrome appeared three months after an intra-uterine device removal. The septic syndrome led to a laparotomic approach. Unusual clinical presentation, delay between device removal and septic syndrome and lack of genital infection explain the issues to reach the final diagnosis.     

Reconstruction mammaire après cancer du sein : les motifs du refus

The implementation of mammographic screening and neo-adjuvant therapeutics has profoundly modified breast cancer surgery, making it less aggressive. Despite these progresses, mastectomies must be performed in more than 20% of breast cancer cases. Psychological disorders following mastectomy are numerous and lead to various alterations of self-esteem, femininity and sexuality. Reconstructive breast surgery proves to be beneficial to improve these psychological disorders in about 20% of women, who accept breast mourning and appropriate their reconstructed breast. However, 80% of the patients refuse reconstructive breast surgery. Our review aims at analysing different motivations explaining reconstructive breast surgery refusal and different ways of “reconstructing psychologically” after mastectomy.