Wandering spleen is a rare condition defined as a mobile spleen only attached with its pedicle. It can be complicated by a volvulus, which is a surgical abdominal emergency. Preventing infarction is the aim of a prompt surgery that can preserve the spleen and then proceed to splenopexy. We report a rare case of torsion of a wandering spleen associated with a dolichosigmoïd.

ABSTRACT

Intra-hospital mortality in cirrhotic patients is variable depending on the studies reported in literature. Several studies have demonstrated independent predictors of mortality. The aim of this work is indeed to identify these predictors. Patients and Methods: We conducted a retrospective study of 1080 cirrhotic patients hospitalized in our department of gastroenterology and hepatology between January 2001 and August 2010. A descriptive study of the study population was performed, and a univariate analysis looking for an association between intra-hospital mortality, and clinical, biological, etiological and socio-demographic characteristics of our patients. Results: The average age of our patients was 54 years, with an equal number of men and women. 41.1% of patients had cirrhosis secondary to hepatitis C and 18.5% had cirrhosis secondary to hepatitis B. 26.1% of our patients were CHILD C. Intra-hospital mortality was 8.7% (97 deaths) with a mean of 23.4 ± 35.8 months. Univariate analysis showed that the intra-hospital mortality was significantly associated with higher age (p = 0.049) as well as the reasons for admissions like hepatic encephalopathy, and hematemesis (p < 0.0001), melena, jaundice and ascites (p = 0.001). Among the biological parameters analyzed in univariate analysis, significant associations with mortality were objectified for high white blood cell count (p = 0.035), and high serum bilirubin and creatinine (p < 0.0001); low rate of prothrombin time (PT) (p < 0.0001), of albumin (p = 0.0001) and of serum sodium (p < 0.0001). Among the complications analyzed, significant associations with mortality were objectified for jaundice, ascites (p = 0.001), hemorrhagic decompensation, hepatic encephalopathy, and spontaneous bacterial peritonitis (p < 0.001). Univariate analysis of the etiology of cirrhosis objectified significant associations for cirrhosis secondary to hepatitis B (p = 0.001) and hepatitis C (p = 0.022). Multivariate analysis objectified four independent predictors of mortality: hepatic encephalopathy, infection (hyper leukocytosis ≥ 10,000/mm 3 ), renal failure (serum creatinine ≥ 15 mg/l) and hyponatremia. Conclusion: In our series, we identified four independent predictors of intra-hospital mortality in cirrhotic patients: hepatic encephalopathy, infection, renal failure and hyponatremia.

Purpose PIK3CA pathogenic variants in the PIK3CA-related overgrowth spectrum (PROS) activate phosphoinositide 3-kinase signaling, providing a rationale for targeted therapy, but no drug has proven efficacy and safety in this population. Our aim was to establish the six-month tolerability and efficacy of low-dose taselisib, a selective class I PI3K inhibitor, in PROS patients. Methods Patients over 16 years with PROS and PIK3CA pathogenic variants were included in a phase IB/IIA multicenter, open-label single-arm trial (six patients at 1 mg/day of taselisib, then 24 at 2 mg/day). The primary outcome was the occurrence of dose limiting toxicity (DLT). Efficacy outcomes were the relative changes after treatment of (1) tissue volume at affected and unaffected sites, both clinically and on imaging; (2) cutaneous vascular outcomes when relevant; (3) biologic parameters; (4) quality of life; and (5) patient-reported outcomes. Results Among 19 enrolled patients, 2 experienced a DLT (enteritis and pachymeningitis) leading to early trial termination (17 treated, 10 completed the study). No serious adverse reaction occurred in the 1 mg cohort (n = 6). No significant reduction in affected tissue volume was observed (mean −4.2%; p = 0.81; SD 14.01). Thirteen (76.4%) participants reported clinical improvement (pain reduction, chronic bleeding resolution, functional improvement). Conclusion Despite functional improvement, the safety profile of low-dose taselisib precludes its long-term use.

Active und passive dispersal of Lymantria dispar (L.) (Lep., Lymantriidae) in cork‐oak stands in Morocco Gypsy moth, Lymantria dispar, a serious insect pest of cork‐oak in Morocco, exhibits several dispersal modes. Sessile forms, especially eggs, are transported by man; neonate larva may be dropped by wind; older caterpillars move by crowling, in search of better food‐ or resting places; the male butterflies fly in search of a female; female imago is unable to fly. Authors review the modalities and conditions of these dispersal movements, by examining their possible effects on population dynamics. Attempts to control the insect by perturbating its movements were not successful. Many important questions concerning dispersal behaviour of the Gypsy moth remain to be answered. Résumé Des types divers de dispersion s'observent chez Lymantria dispar, ravageur du Chêne‐liège. Les formes immobiles, les oeufs notamment, sont transportés par l'Homme; les chenilles nouveau‐nées peuvent se laisser emorter par le vent; les chenilles plus âgées se déplacent surtout en rampant, à la recherche de meilleures conditions: les papillons mâles volent en quête d'une femelle; cette dernière est incapable de voler. Les auteurs passent en revue les modalités et les conditions de ces divers déplacements, en examinant leurs conséquences possibles sur le devenir des populations. Les tentatives faites pour lutter contre le ravageur en perturbant certains de ses déplacements n'ont pas été couronnées de succès. De graves lacunes subsistent dans notre connaissance de ces aspects de la bioécologie du ravageur. Zusammenfassung Über die aktive und passive Verbreitung des Schwammspinners Lymantria dispar (L.) (Lep., Lymantriidae) in den Korkeichenwäldern des atlantischen Marokko Die Verbreitung des Korkeneichenschädlings Lymantria dispar erfolgt auf verschiedene Weise. Immobile Stadien, vor allem die Eier, werden von Menschen verschleppt. Junglarven lassen sich vom Wind transportieren, ältere Raupen verbreiten sich kriechend selbst. Männliche Falter fliegen auf der Suche nach Weibchen, während letztere nicht flugfähig sind. Die Autoren beschreiben die verschiedenen Modalitäten und Bedeutungen der Verbreitung und die möglichen Konsequenzen daraus für die Bildung einer Population. Versuche, durch Störung der Entwicklung eine Bekämpfung zu erreichen, schlugen bisher fehl. Große Lücken bestehen in unserer Kenntnis dieses Aspektes der Bioökologie des Schädlings.