Hereditary hemorrhagic telangiectasia in a sudanese patient: A case report

(HHT) is a rare disorder affecting the skin and body''s internal organs with a tendency for bleeding. We report a case of Sudanese 42‐year‐old with family history of HHT presented with recurrent epistaxis and telangiectasias.     

Penetrating thorn in the heart complicated by infective endocarditis

A 3‐year‐old child presented with recurrent chest pain for 3 months, echocardiography showed a thorn inside the left ventricle, the patient was diagnosed with foreign body complicated with infective endocarditis and received proper treatment, and operation was performed after inflammatory reaction subsided.     

Ureteric complications in recipients of kidneys from donation after circulatory death donors

A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants (DCD n=494, live donor [LD] n=273, donation after brain death [DBD] n=305) performed during 2008‐2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend toward higher incidence of UCs in DCD (n=22, 4.5%) compared to LD (n=10, 3.7%) and DBD (n=5, 1.6%) kidney transplants, donor type was not a significant risk factor for UCs in multivariate analysis (DCD vs DBD HR: 2.33, 95% CI: 0.77‐7.03, P=.13). There was no association between the incidence of UCs and donor, recipient, or transplant‐related characteristics. Management involved surgical reconstruction in the majority of cases, with restenosis in 2.7% requiring re‐operation. No grafts were lost secondary to UCs. Despite a significant increase in the number of kidney transplants from DCD donors, the incidence of UCs remains low. When ureteric complications do occur, they can be treated successfully with surgical reconstruction with no adverse effect on graft or patient survival.     

The Double-Line Sign: A False Positive Finding on the Focused Assessment with Sonography for Trauma (FAST) Examination

Background: Emergency physicians commonly perform Focused Assessment with Sonography for Trauma (FAST) examinations to evaluate for free intraperitoneal fluid. Many ultrasound findings can be misinterpreted as free fluid, resulting in false-positive FAST examinations. Objectives: To describe a previously unreported ultrasound finding that can be misinterpreted as free intraperitoneal fluid. Case Report: A 32-year-old man was stabbed in the left upper abdomen. A FAST examination was performed and a right perinephric fat pad was interpreted as showing free fluid in Morison's pouch. After transfer to a trauma center, a repeat FAST examination revealed no signs of intraperitoneal free fluid. Wound exploration showed no signs of penetration into the peritoneal cavity. Conclusions: When performing a FAST examination, a wedge-shaped hypoechoic area in Morison's pouch that is bounded on both sides by echogenic lines (the “FAST Double-Line Sign”) is likely to represent perinephric fat and may result in a false-positive FAST examination.     

Evaluation of tourists’ UV exposure in Paris

Background Ultraviolet (UV) exposure is one of the most important risk factor for skin cancers. If UV hazard has been evaluated in tropical countries or in some population – children, outdoor activities – little information is available about UV hazard in high latitude towns like Paris, considered as the most ‘charismatic city’ in the world. Objective To evaluate UV exposure in Paris in spring, in sun and shade, in real life conditions. Methods We evaluated erythemal UV exposure, during four sunny days in May‐June in eight Paris touristic sites during peak hours (2 days), and during two walks in touristic downtown of Paris. Measures were performed in sun and shade. UV radiation exposure was evaluated with UV index performed with a ‘Solarmeter ultraviolet index (UVI)’ and UV dose with ‘standard erythema dose’ (SED) and ‘minimal erythema dose’ (MED) calculations. Results Despite ‘average’ UVI in sunny conditions, a 4‐h sun exposure reaches 13–20 SED and 3–10 MED according to phototype. Clouds were inefficient to protect against UV. Shade of places reduces moderately UVI (50–60%) in forecourts. Exposure during 1‐h walk reach at least one MED in real life conditions for skin phototypes I–IV. Conclusions UV risk for tourist is quite high in spring in Paris. UVI remains high despite high cloud fraction. Shade reduces UVI, but UV protection factor is only 2–3 in large places such as Place Notre Dame and Place Charles de Gaulle. So sun protection campaigns should be proposed, and sun protective strategies could be integrated in urban planning.