Revue médicale suisse
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Revue médicale suisse · May 2013
[Adults with congenital heart diseases: a growing population, a multidisciplinary approach].
Untill recently, congenital heart disease was considered as a childhood's disease. With improvement in pediatric survival, adults with a congenital heart disease (ACHD) represent an emerging group of patients who need specialized medical care. In 2010, the ESC published newguidelines on global and specific management of adults with congenital heart disease. ACHD centers organize appropriate medical care for these patients, promote specialist training and national scientific research in collaboration with other national ACHD centers.
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Revue médicale suisse · May 2013
[Pulmonary hypertension in left heart disease: how to define it and how to manage it in 2013?].
Pulmonary hypertension is a frequent complication of left heart disease arising from a wide range of cardiac disorders and is associated with poor prognosis. Its pathophysiology is complex with both passive mechanisms of elevated filling pressures in left cavities and occasionally reactive mechanisms of arterial vasoconstriction and remodelling to interplay. This stage, called
pulmonary hypertension, further worsens the heart failure patients' prognosis but is still a matter of debate concerning the criteria to apply for its diagnosis and concerning the best way to manage it. This article gives an overview of the importance and pathophysiology of pulmonary hypertension associated with left heart disease, and discusses the challenges associated with its diagnosis and treatment. -
Antibody-drug conjugates (ADCs) are therapeutic agents combining the specificity of a monoclonal antibody for a target antigen with the delivery of a highly potent cytotoxic drug. Their development has been hampered by numerous problems, which are now better identified and partially solved. ⋯ Over 20 other ADCs are being investigated, with two of them (inotuzumab ozogamicin and gemtuzumab ozogamicin) in late stage of clinical evaluation. In the near future, ADCs may provide a powerful and selective treatment option for cancer patient.