Presse Med
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Review Comparative Study
[Therapeutic management of primary pulmonary hypertension].
SEVERITY AND TREATMENT: The management of primitive pulmonary hypertension starts by the evaluation of its severity, based on the New York Heart Association's (NYHA) functional classification and right cardiac catheterization data. Hemodynamic criteria of poor prognosis are: an increase in right atrial pressure > 10 mm Hg, a decrease in cardiac output (cardiac index < 2.2 l/min/m2), an increase in pulmonary vascular resistance > to 20 mm Hg/l/min/m2, and saturation of the oxygen content in venous blood < 63%. These prognostic data will condition treatment. ⋯ Continuous intravenous infusion of epoprostenol has considerably improved the prognosis of PPH and related pulmonary hypertension (PH). Despite the constraints, such treatment should be proposed to NYHA functional class III and IV patients not responding to carbon monoxide tests, until new, equally efficient products have been launched on the market. If epoprostenol fails or provokes severe side effects, pulmonary or cardio-pulmonary transplantation should be envisaged.
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FOUR CATEGORIES OF LASERS ARE USED IN DERMATOLOGY: These are vascular, depigmentation, depilatory or resurfacing or vaporization lasers. Today, there are more potential or suggested indications than good methodological studies that confirm these indications. Nevertheless, there are indisputable indications for these lasers.