La Revue du praticien
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Pulmonary arterial hypertension (PAH) is a rare condition characterised by elevated pulmonary arterial resistance leading to right heart failure. PAH can be sporadic (idiopathic PAH, or primary pulmonary hypertension), familial (caused by germline BMPR2 mutations, a type II member of the TGFbeta receptor superfamily), or related to other conditions including connective tissue disease, congenital heart disease, human immunodeficiency virus infection, portal hypertension, appetite suppressant exposure... Idiopathic PAH has a prevalence of 2 per million per year in France. ⋯ Recent advances in the management of PAH including continuous intravenous prostacyclin infusion and endothelin receptor antagonists have improved markedly the patients' prognosis. Novel treatments such as inhaled iloprost and type 5 phosphodiesterase inhibitors have to be further evaluated in this setting. Lung transplantation is the last option for patients deteriorating despite medical treatment.
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Faced with equivalent treatments in terms of control of localised prostate cancer, by treatments as different as radical prostectomy and radiotherapy, the analysis of the physical and psychosocial consequences of each treatment is indispensable in determining the therapeutic options proposed to a patient. Current information on the quality of life after treatment of localised and metastatic prostate cancer show effects after treatment that are specific to this pathology (urinary, sexual and digestive problems) and general (physical state and functional capacity, capacity to accomplish all forms of work, capacity to maintain social relations...). These effects nevertheless differ depending of the stage of the disease and the type of treatment.