Revue médicale suisse
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Revue médicale suisse · Jun 2011
[Transcatheter aortic valve implantations in 2011: the interventional cardiologist].
Since the first transcatheter aortic valve implantation 9 years ago, constant technological progress and simplification of the procedure have been observed. For two devices in particular (Edwards SAPIEN valve and CoreValve), considerable clinical experience has been gained, with over 17,000 implantations each. ⋯ Consequently, the end of 2010 saw the TAVI (Transcatheter aortic valve implantation) become the standard-of-care for selected patients deemed inoperable on the basis of age or co-morbidities and now is an acceptable alternative to surgery in selected high-risk operable patients. However, the selection of patients and the technique used (trans-arterial or trans-apical) require a multidisciplinary approach which remains essential for procedural success.
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Meningoccocal meningitis is still a severe disease. In Switzerland the predominant serotypes are serotype B and C, but this could change as other groups predominate elsewhere. ⋯ New quadrivalent vaccines conjugated with a protein and efficient against serogroup ACWY will soon be available in our country. They show a number of advantages in term of type of protection and should simplify the current vaccination schedule while giving a better coverage against various serogroups, especially for travellers, but also for children at risk for complications.
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Urinary tract infections are commonly seen by general practitioners. Quinolones are frequently prescribed in this setting. The emergence of resistance to these antibiotics has led to new guidelines for the management of uncomplicated UTI, based on the use of fosfomycin and furadantine. This article reviews the epidemiology, pathogenesis, diagnostic and treatment of urinary tract infections in adults.
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Revue médicale suisse · Apr 2011
[Varicella during pregnancy: consequences for the mother and the newborn].
In our area, varicella is a frequent and essentially benign childhood disease. In contrast, the disease course is likely to be more severe or complicated in the adult, particularly so in the pregnant woman. ⋯ In case of chickenpox occurring at the very end of pregnancy, transplacental transfer of the virus may result in a perinatal varicella disease. We propose a approach of each of these different situations.