Revue médicale suisse
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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.
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Allergy to radiographic contrast media Hypersensitivity reactions to radio-contrast media are common in the daily practice. These products are responsible for immediate (< or = 1 hour after administration) and non immediate (> 1 hour after administration) hypersensitivity reactions. ⋯ Practical recommendations are presented in this article. For gadolinium-based contrast agents, data in the literature is not sufficient for suggesting guidelines.
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Although most delayed drug hypersensitivity reactions are mild and show rapid improvement after drug discontinuation, there are severe systemic and/or cutaneous drug reactions which may be life-threatening. These entities are discussed here, namely DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms), acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). Early detection of warning signs and symptoms may help to take appropriate measures precociously.
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Revue médicale suisse · Apr 2013
[Impact of red blood cells transfusion on upper gastrointestinal bleeding].
Upper gastrointestinal bleeding is a major digestive emergency. The compensation of hypovolemia represents the cornerstone of the initial treatment, according to international recommendations. ⋯ The real impact of blood transfusions on the rate of rebleeding and mortality is still unknown. However, several studies suggest that transfusion may have a deleterious effect in patients with hemodynamically stable condition during upper gastrointestinal bleeding, promoting recurrent bleeding.