Revue médicale suisse
-
As a result of advances in oncologic treatment, a growing number of women diagnosed with cancer may envisage cure. Young women diagnosed with cancer often have a desire to fall pregnant in the future or may even be diagnosed with cancer in the process of family planning. ⋯ Currently, ovarian stimulation with cryopreservation of oocytes or fertilized oocytes is the treatment of choice. However, other options such as in vitro maturation or ovarian tissue cryopreservation should be discussed if ovarian stimulation is contraindicated.
-
Plasma D-dimer measurement is the first diagnostic test performed in patients with a non-high or an unlikely clinical probability of pulmonary embolism (PE) but its clinical usefulness is limited in elderly patients due to a low specificity in this subgroup. PE can be excluded based on D-dimers and clinical probability only in about 5% of patients over 80 years when using the conventional cut-off. ⋯ Using the age-adjusted D-dimer cut-off markedly reduces the need for further diagnostic studies such as computed tomography pulmonary angiography (CTPA). The age-adjusted cut-off has been widely validated in retrospective cohorts, and more recently in a prospective management study.
-
Revue médicale suisse · Oct 2014
Review[Extrapulmonary manifestations of community acquired pneumonia].
The key diagnostic features of community acquired pneumonia are sometimes mixed with extrapulmonary clinical manifestations which are important to recognize. Indeed, when present, these clinical clues can help tailor the diagnostic and therapeutic approach in a more specific way. ⋯ Extrapulmonary manifestations are sometimes difficult to distinguish from septic complications of the pneumonia, but can sometimes warrant a specific treatment. The goal of this review is to remind the reader of the broad spectrum of these manifestations and their association with specific pathogens, most often the "atypical" ones.