Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; 95% CI [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35–3.40]; p = 0.001 and HR 1.78; 95% CI [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.

The Ottawa score (OS) for predicting the risk of recurrent venous thromboembolism (VTE) in cancer patients with VTE may help to guide anticoagulant treatment decisions that will optimize benefit-risk ratios. However, data on its reliability are conflicting. We applied the OS to all cancer patients with VTE enrolled in the prospective multicenter TROPIQUE study who received low-molecular-weight heparin over a 6-month period. Of 409 patients, 171 (41.8%) had a high-risk OS. The 6-month cumulative incidence of recurrent VTE was 7.8% (95%CI 4.2–14.8) in the high-risk OS group versus 4.8% (95%CI 2.6–8.9) in the low-risk OS group (SHR 1.47; 95%CI 0.24–8.55). The Area Under the Receiver Operating Characteristic curve (AUROC) of the OS in identifying patients who developed recurrent VTE was 0.53 (95%CI 0.38–0.65), and its accuracy was 57.9%. Among individual variables included in the OS, only prior VTE was significantly associated with the 6-month risk of recurrent VTE (SHR 4.39; 95% CI 1.13–17.04). When pooling data from all studies evaluating this score for predicting VTE recurrence in cancer patients (7 studies, 3413 patients), the OS estimated pooled AUROC was 0.59 (95%CI 0.56–0.62), and its accuracy was 55.7%. The present findings do not support the use of the OS to assess the risk of recurrent VTE in cancer patients.

PAD is a frequent and growing pathology in recent years. Knowledge of PAD in women compared to men is surprisingly low compared to literature data concerning other cardiovascular diseases and general illnesses. For example, studies comparing endovascular or surgical revascularization in men versus women have reported conflicting results. In this retrospective cohort study based on medical records, we included adult patients (men and women) who had been hospitalized in the vascular surgery department of Nantes University Hospital Center for PAD revascularization by angioplasty with or without stent. The primary outcome was a composite of revascularization failures, collected intraoperatively, at one month (M1) and at one year (A1). Secondary outcome included various risk factors for PAD. A total of 447 patients including 315 men and 132 women were enrolled in the trial. The prevalence of tobacco was different between the two groups with 245 men (78.0%) who were smoking or had quit smoking, while only 13 women (9.8%) were smoking and 30 (22.7%) had quit smoking. Post-surgical anticoagulant, calcium channel blocker, beta-blocker and antiplatelet drugs were similarly prescribed in men and women. Differences were found for treatment with a renin-angiotensin system inhibitor, prescribed in 48.5% in women and in 60.2% in men (P=0.028). Similarly, statin treatment was prescribed in 59.1% of women and 76.4% of men (P<0.001). The 1-month incidence of the primary-outcome was higher in women than in men (27.8% vs. 19.3%), with a risk ratio of 1.43 (95% confidence interval [CI], 0.99 to 2.06; P=0.071). At one year, we found a risk ratio of 1.13 (95% confidence interval [CI], 0.94 to 1.37; P=0.20). In multivariable regression model, the adjusted odds ratio for primary outcome was 1.65 for women/men (95% confidence interval [CI], 0.95 to 2.86; P=0.075). Finally, there were significantly more cardiovascular deaths in women than in men at one month (P=0.003) and one year (P=0.005). Women are more at risk of failure after lower extremity surgery, especially in the first month. After a year of hindsight, women have more cardiovascular mortality than men. This can be explained by management at a later stage, a higher age or more distal damage, but also by differences in optimal medical treatment in men and women.

Aim: Upper Extremity Digital ischemia (UEDI) is a rare heterogeneous condition with digital upper limb ischemia occurring forty times less frequently than toe ischemia. Using the largest cohort ever published, the aim of this study was to evaluate etiologies, treatments, prognosis and long-term clinical outcomes of DI. Method: Patients included had UEDI with or without cutaneous necrosis. They were followed in a university hospital setting between January 2000 to December 2016. Etiologies, recurrence of UEDI, digital amputation and overall survival were analyzed retrospectively. Results: DI due to cardio-embolic disease (DICE) was the highest occurring etiology with 59 patients (18.3%), followed by UEDI due to Systemic Sclerosis (SSc) (16.1%), idiopathic causes (11.7%), Thromoboangitis obliterans (TAO) (9.3%), iatrogenic causes (9.3%) and cancer (6.2%). DICE patients tended to fall into an older age bracket and featured a greater numbers of cases with hypertension whereas TAO patients smoked more tobacco and cannabis. DICE presented a greater number of cases with paleness and neuropathic and nociceptive pain whereas SSc patients presented more cases with necrotic pathophysiology. Long-term follow-up of this study showed recurrences were significantly more frequent in SSc than in all others tested groups (p <0.0001 vs idiopathic and DICE, p=0.003 vs TAO) and that TAO patients had significantly more recurrences than DICE (p = 0.005). Global survival was significantly lesser in DICE than in SSc (p<0.0001), idiopathic (p=0.0093) and TAO (p =0.0007). Conclusion: The main etiologies of UEDI were CE, SSc and idiopathic. This study highlighted an increase of iatrogenic UEDI cases compared to previous studies. UEDI associated with SSc had a poor local prognosis and DICE presented poor general prognosis. UEDI with SSc and TAO presented with greater recurrence.