Revue médicale suisse
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Revue médicale suisse · Nov 2013
[Granulomatous lymphocytic interstitial lung disease in common variable immunodeficiency].
Common variable immunodeficiency (CVID) is the most frequent primary immune deficiency. Recurrent infections are classical consequences of CVID, but their impact has been largely reduced by immunoglobulin replacement. ⋯ GLILD currently constitutes an important cause of morbidity and mortality in these patients. It is distinct from bronchiectasis secondary to recurrent infections, and presents similarities but also striking differences with sarcoidosis.
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Obstructive sleep apnea (OSA) tends to worsen on the supine posture due to the effect of gravity on tongue position. In some cases, OSA is present exclusively on the supine posture (exclusive postural OSA). These patients may benefit from positional therapy (PT), which aim is to prevent sleep in the supine posture using different types of devices. ⋯ Because the efficacy of PT is inferior to continuous positive airway pressure (CPAP), the latter treatment remains the first line of therapy. Also, the discomfort of the existing devices appears to limit the long term use of PT. Further studies assessing the long term effects of PT on metabolic and neurocognitive outcomes are needed.
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Revue médicale suisse · Nov 2013
[Neutrophil gelatinase-associated lipocalin as a new diagnostic tool for acute kidney injury].
Diagnosing acute kidney injury (AKI) may be a challenging situation in the daily practice. Generally, only serum creatinine has been used as a biomarker. ⋯ Recent discovery of neutrophil gelatinase-associated lipocalin (NGAL) as structural marker heralds an important step in diagnostic of AKI. The early diagnostic of AKI made possible with detection of urinary or plasmatic NGAL allows early appropriate intervention, which is crucial to short and long-term clinical outcome.