Revue medicale suisse最新文献

In 2024, therapeutic and diagnostic advancements are shaping the field of neurology. Three new drugs show promise for treating myasthenia gravis and chronic inflammatory demyelinating polyneuropathy. A new classification for Parkinson's disease has been proposed, while a neuroprosthesis is improving gait in advanced stages. Revised criteria for inclusion body myositis and multiple sclerosis are refining diagnoses, and blood biomarkers are enabling early detection of Alzheimer's disease. The effectiveness of early thrombolysis in stroke has been confirmed, and new treatments are being explored for cerebral hemorrhages. In epilepsy, surgery reduces mortality by 30% in drug-resistant patients. Finally, new treatments targeting PACAP and CGRP are reducing refractory migraines with good tolerability.

The 2023-2024 updates on teratovigilance, with a focus on antiseizure medications, highlight several key points. American medical societies have revised their recommendations: maintaining effective seizure control is essential for both maternal and fetal health; lamotrigine, levetiracetam, and oxcarbazepine are preferred first-line treatments, whereas valproic acid and topiramate should be avoided if possible. In March 2024, an update on topiramate indicated an increased risk of neurodevelopmental disorders with prenatal exposure. For autism spectrum disorders specifically, a recent study did not find evidence linking topiramate to autism spectrum disorder. Lastly, a potential risk of neurodevelopmental disorders in children with fathers who used valproic acid has been suggested, but remains unconfirmed.

The year 2024 saw many advances in HIV care, both in terms of treatment and prevention. The cure of a patient from Geneva made headlines and helped in understanding the complex immunology of the HIV virus. Long-acting injectable treatments improve the quality of life of peoplewith HIV (PWHIV) and area promising option for pre-exposure prophylaxis (PreP). Primary cardiovascular prevention in PLWHIV is improving, and therapeutic options have increased for pregnant and breastfeeding women living with HIV. Those advances must encourage us to insist on open discussions with our patients regarding their risk of acquiring HIV and their eligibility for PreP, and on the importance of early testing and treatment in case of infection.

The epidemiology of femoral fractures is changing, with more femoral shaft fractures linked to high-risk physical exercise by an older population. Vitamin D given during pregnancy for the mother's health could benefit the child. Zoledronic acid is the most effective bisphosphonate. It should be given during hospitalization to people suffering from hip fractures. Denosumab should not be used in patients with severe renal failure. When denosumab is discontinued, management of the rebound effect requires bone resorption markers to be kept at very low levels to maintain the bone mass gained as much as possible. Finally, progress continues to be made in the treatment of rare bone diseases.

Emergency medicine plays a crucial vital role as the gateway to the Swiss healthcare system. Although it has not yet been officially recognized with a specialist title, unlike most European countries - emergency medicine in Switzerland is characterized by robust research activity. This scientific article demonstrates a dynamic and rigorous evolution. In this edition, we present six articles authored by Swiss emergency physicians, each examining different aspects of our field. Topics include gender stereotypes, prehospital cardiac arrest, the unique needs of the older patients in emergency department, the administration of antifibrinolytics in trauma cases, and a predictive model for infectious endocarditis.

From immunoglobulin A nephropathy to primary focal segmental glomerulosclerosis, sparsentan expands its indications. Complement inhibitors offer new hope for patients with certain poor-prognosis glomerulonephritides. Semaglutide enjoys great success, promising nephro- and cardioprotection for type 2 diabetics. The renal safety of proton pump inhibitors is questioned. Quality of life benefits of hemodiafiltration are confirmed. Vadadustat represents an oral alternative for the treatment of renal anemia. Xenotransplantation offers a glimpse of a future without organ shortages.

In 2024, urology continues to evolve with remarkable innovations. The Da Vinci SP surgical robot simplifies procedures by reducing surgical trauma and accelerating patient recovery. Regarding oncological conditions, new therapies have significantly improved the management of urological cancers, leading to increased survival rates. Additionally, for non-cancerous conditions, innovations like the Optilume balloon for urethral stricture treatment offer a minimally invasive and effective solution with few complications. These advances reflect the successful adoption of innovative technologies and targeted treatments to optimize urological care.

The journal Lancet Psychiatry is launching a Commission for Youth Mental Health, in response to the widely reported finding in the media of a significant deterioration in the health of young people worldwide in recent years. The aim of this commission is to gain a better understanding of the factors that have led to this situation, and to offer care adapted to the needs of this segment of the population. In Lausanne, following the publication of a manual on psychotherapy for psychosis, a training course has been set up to promote this type of care, which is all too often denied to patients suffering from psychosis.

The major clinical studies in 2024 reviewed in this manuscript will focus on blood pressure measurement, the effect of coffee on the latter, its follow-up in the postpartum period, blood pressure targets for patients at high cardiovascular risk, particularly those with diabetes, and the late onset of primary aldosteronism after a negative initial confirmation test.