Thrombotic thrombocytopenic purpura (TTP) leading to pseudotumour's autoimmune pancreatitis (AIP): A case report

International audience; Introduction: Autoimmune pancreatitis is an idiopathic inflammatory disease that produces pancreatic masses and ductal strictures. This benign disease can be associated with extrapancreatic manifestations including cholangitis, sialadenitis, inflammatory bowel disease or retroperitoneal fibrosis, mediastinal adenopathy, interstitial nephritis mainly due to immunoglobulin G4 (Ig G4), and occasional association with other auto-immune diseases. Observation: We report a 57-year-old woman who developed thrombotic thrombocytopenic purpura (UP) and pseudo-tumour's seronegative autoimmune pancreatitis (ATP) type 1. The patient was initially treated with pulse corticosteroids…

Experience of medical students mentoring in an acute geriatric unit: Use of evidence-based medicine

International audience; n a retrospective study, we studied the learning experience of second and third year undergraduate medical students in the acute geriatric unit of a University Hospital.Students who did not receive Evidence based medicine (EBM) classes had lower grades than those who did in the final theoretical and practical evaluations (p < .01).Our experience suggested that the implementation of EBM in the curriculum through small, structured semiology courses tailored to the specificities of the elderly improved Evidence based practices for undergraduate medical students. EBM should improve instruction and mentoring during undergraduate students' clinical rotation.

Argumentative reasoning and taxonomic analysis for the identification of medical errors

Telemedicine consists of the use of information and communication technologies (ICTs) in the practice of medicine. The massive digitalisation of the society is changing the behaviour of ordinary people even in medical sectors. The impact of digitisation is also having impacts on teleexpertise, where a medical professional can remotely ask some advices through the use of ICTs to provide treatment to a patient in critical conditions in remote environment. However, sometimes the outcome of such advice obtained remotely can lead to medical errors. In these situations, it is important to determine whether the causes of the errors could have been avoidable or not for the purposes of establishing …

Knowledge-based modelling applied to synucleinopathies

International audience; The adoption of telemedicine technologies has enabled collaborative programs involving a variety of links among distributed medical structures and health officials and professionals. The use for telemedicine for transmission of medical data and the possibility for several distant physicians to share their knowledge on given medical cases provides clear benefits, but also raises several unsolved conceptual and technical challenges. The seamless exchange and access of medical information between medical structures, health professionals, and patients is a prerequisite for the harmonious development of this new medical practice. This paper proposes a new approach of sema…

Adverse drug reactions in some African herbal medicine: literature review and stakeholders’ interview

International audience; Background: In view of the large consumption of herbal medicine in Africa countries, it is likely that many adverse drugs reactions go unrecorded with either patients failing to present to health services, or no pharmacovigilance analysis being made, or the analysis not being reported centrally. This problem is of interest especially for those who are working in the general area of adverse drug reactions or stakeholders in the domain of herbal medicine for considering safety issues. Methods: We are particularly interested in the way that the use of very wellknown and highly valued plants is linked to the observation of adverse drug reactions in African countries. We …

Telemedicine and mobile health with integrative medicine in developing countries

International audience; African Home-based Care (AHC) and African Traditional Medicine (ATM) provide a number of self-sustainable primary health care workers in a rural region with the appreciation of ancestral knowledge and its contextual management. Even though most urban residents are able to afford and use conventional medicine to large extent, the implementations of modern medicine in rural areas and in poor peri-urban areas are limited. Our proposal is on how telemedicine solutions could enhance AHC and ATM practices and facilitate simultaneous delivery of both modern and traditional healthcare with evident added value to the recipients. This is indeed a fresh angle, as information an…

Verifying a medical protocol with temporal graphs: the case of a nosocomial disease.

Abstract Objective Our contribution focuses on the implementation of a formal verification approach for medical protocols with graphical temporal reasoning paths to facilitate the understanding of verification steps. Materials and methods Formal medical guideline specifications and background knowledge are represented through conceptual graphs, and reasoning is based on graph homomorphism. These materials explain the underlying principles or rationale that guide the functioning of verifications. Results An illustration of this proposal is made using a medical protocol defining guidelines for the monitoring and prevention of nosocomial infections. Such infections, which are acquired in the h…

Rare case of catastrophic diffuse hemorrhage complicating sepsis and meningitis due to Pasteurella stomatis in an elderly woman mimicking hemorrhagic septicemia

International audience; Cases of hemorrhagic septicemia because of Pasteurella were mainly in fallow deer, pigs, cattle, or horses generally in a tropical area where it is endemic. The infected animals present high fever, significant asthenia, diffuse hemorrhage, subcutaneous edema, hypersalivation, and diarrhea; sometimes, the disease can cause sudden death.2 The diagnosis of hemorrhagic septicemia does not refer to human beings.

Conceptual graph operations for formal visual reasoning in the medical domain

International audience; Objective - Conceptual graphs (CGs) are used to represent clinical guidelines because they support visual reasoning with a logical background, making them a potentially valuable representation for guidelines.Materials and methods - Conceptual graph formalism has an essential and basic component: a formal vocabulary that drives all of the other mechanisms, notably specialization and projection. The graph's theoretical operations, such as projection, rules, derivation, constraints, probabilities and uncertainty, support diagrammatic reasoning.Results - A conceptual graph's graphical user interface includes a multilingual vocabulary management, some query and decision-m…

Neurodegeneration in tauopathies and synucleinopathies.

International audience; While increasing life expectancy is a major achievement, the global aging of societies raises a number of medical issues, such as the development of age-related disorders, including neurodegenerative diseases. The three main disease groups constituting the majority of neurodegenerative diseases are tauopathies, alpha-synucleinopathies and diseases due to repetitions of glutamine (including Huntington's disease). In each neurodegenerative disease, the accumulation of one or more aggregated proteins has been identified as the molecular signature of the disease (as seen, for example, in Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, amyotrophic lat…

Olfactory sensitivity in elderly with Parkinson's disease

Could telemedicine enhance traditional medicine practices?

International audience; In developing countries, telemedicine and mobile health tools promise to enhance access to high-quality healthcare, to support communication of medical information and to assist pharmacovigilance processes. In this article, we provide some arguments on the potential of telemedicine and mobile health (mHealth) applications to improve the delivery of health care in rural African regions. Specifically, the development of mobile telemedicine could help to lay the foundations of a healthcare approach integrating modern medical knowledge with ancient medical practices on the African continent. Access to information and communication technology (ICT), technical devices or p…

Argumentation graphs with constraint-based reasoning for collaborative expertise

International audience; Collaborative processes are very important in telemedicine domain since they allow for making right decisions in complex situations with multidisciplinary staff. When modelling these collaborative processes, some inconsistencies can appear. In semantic modelling (conceptual graphs), these inconsistencies are verified using constraints. In this work, collaborative processes are represented using an argumentation system modelled in a conceptual graph formalism where inconsistencies could be particular bad attack relation between arguments. To overcome these inconsistencies, two solutions are proposed. The first one is to weight the arguments evolving in the argumentati…