Revue medicale suisse最新文献

The year 2024 was rich in developments in the field of hepatology, gastroenterology, and interventional endoscopy. New molecules have been developed for the treatment of metabolic steatohepatitis, primary biliary cirrhosis, and inflammatory bowel diseases. Technological progress now makes it possible to perform screening measurements for portal hypertension directly under echo-endoscopic guidance and to extend the use of intraluminal stents to surgically modified anatomies. Several new recommendations have also been issued, including some for the nutritional management of inflammatory diseases, the management of polypoid lesions, and intraductal papillary mucinous neoplasms.

The use of psychoactive substances affects more men than women, with a prevalence that is 1.3 to 2 times higher, except for the use of sedatives. Men are also more affected by accidents, injuries, and acts of violence. As for women, they are more vulnerable to the consequences of substance use for metabolic, hormonal, and cerebral reasons. At the same time, they suffer more psychological problems, somatic complications, and exposure to violence. Sociocultural representations may prevent them from expressing their difficulties and delay their entry into care. It is essential to understand these gender differences in order to take action to reduce the prevalence of substance use among men and to facilitate early detection and treatment among women, particularly around the time of pregnancy.

This article reports on new findings on integrative and complementary medicine published in 2024. The implementation of guidelines for the management of pain in cancer patients is discussed. Then, a literature review is presented, that aims to clarify the role of complementary approaches in the management of chemotherapy-induced nausea and vomiting and provides a concrete example of how recommendations are established. Finally, a meta-analysis focusing on the efficacy of Echinacea in the treatment of upper respiratory tract infections is summarized. These articles illustrate the complexity of the path from science to practice and underscore the importance of identifiable centers of reference to support the dissemination of knowledge to health care professionals and promote broad patient access to well-coordinated therapies.

In 2024, several important innovations have enriched the management of respiratory diseases, including pulmonary hypertension, tuberculosis, COPD, and obstructive sleep apnea syndrome (OSAS). Notable advancements include the introduction of sotatercept in Switzerland for pulmonary arterial hypertension and mediastinal cryobiopsies, reflecting a shift toward more personalized medicine. Meanwhile, biologic therapies for COPD offer promising perspectives, and a potential path is emerging for shortening the treatment of certain forms of tuberculosis. These developments open the door to new therapeutic options, with the hope of enhancing care and delivering meaningful clinical benefits to patients.

Pregnancy leads to a progressive adaptation of the maternal vascular and cardiac systems. Blood pressure is an imperfect indicator of this adaptation, as it reflects cardiac output, vascular resistance, and circulatory volume. Increasingly, studies show that poor hemodynamic adaptation can predict or accompany maternal and/or foetal complications. During pregnancy follow-up, assessing hemodynamic parameters could help identify patients at-risk and personalize their care. In obstetric emergencies, understanding the maternal hemodynamic status can improve clinical management.

In recent years, studies have focused on the in vitro diagnosis of immediate drug reactions, with new recommendations concerning the use of the basophil activation test. Air pollution, particularly fine particles with a diameter of less than or equal to 2.5 m (PM2.5) and less than or equal to 10 m (PM10), is contributing to an increase in emergency room visits and hospital admissions for asthma exacerbations. Skin tests and specific immunoglobulin E assays have highly variable sensitivity and specificity depending on the type of food. Finally, new collaborations between allergists and oncologists have led to the adoption of joint positions, highlighting the possible protective effect of atopy on the development of gliomas.

Neurocognitive disorders are a major public health challenge, affecting 55 million people, and are projected to triple by 2050. This year's research highlights pathological mechanisms such as mitochondrial dysfunction and brain inflammation. Modifiable risk factors, such as vision loss, underscore the importance of early prevention. A Swiss study reveals a high prevalence of inappropriate drug prescriptions in the elderly. Anti-amyloid treatments, such as lecanemab and donanemab, show promising results. Lastly, anticoagulation for atrial fibrillation may reduce the risk of dementia. An integrated approach is essential to alleviate the burden of neurocognitive disorders.