La Revue de médecine interne
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Beta-blockers (BB) are an heterogenous set of molecules actively blocking β adrenergic receptors. Their pharmacological properties depend on their various effects on the adrenergic signalling. Although they are no longer a first-choice treatment in hypertensive patients, they remain a cornerstone of pharmacological strategy in several cardiovascular diseases such as stable angina, heart failure, arrythmia and aortic related connective diseases. ⋯ Potential BB therapeutic repurposing is being investigated in COPD and cancer patients. This narrative review first encompasses the basic pharmacological knowledge that may be useful for the clinician. Then it will detail BB main indications before exploring new therapeutic fields.
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Observational Study
[Post-acute and rehabilitation care in young patients with multiple comorbidities: An observational study].
A unique structure devoted to post-acute and rehabilitation care for patients under 75 with multiple comorbidities has been created within the Department of Internal Medicine, Bichat Hospital, Paris. We aim to report on demographic factors, clinical characteristics and outcomes of patients hospitalized in this pilot structure. ⋯ The structure served a high percentage of patients with major and complex health needs but limited access to care due to individual disabilities, low-income and underinsured status. However, despite major health disorders, functional limitations, and vulnerability, admission improved patient outcomes and reduced excess hospital readmissions in most cases.
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Tryptase is the most abundant endopeptidase released by mast cells degranulation, involved in many pro and anti-inflammatory processes. Normal serum tryptase range is 0-11.4 μg/L. Tryptase is a useful diagnostic tool for anaphylaxis, systemic mastocytosis (SM) and mast cell activation syndrome (MCAS), where specific threshold values must be used. ⋯ A clonal mast cell disorder is a central question in anaphylaxis and appropriate explorations should be conducted in these patients. Triggers for anaphylactic reactions vary significantly in the general population and in patients with MS or MCAS. Finally, physicians must be aware of the many pathological and physiological situations that affect tryptase levels.