New data about lipoprotein(a): A curious molecule or a causal cardiovascular risk factor? [Données nouvelles sur la lipoprotéine(a): Une curiosité biochimique ou un facteur de risque cardiovasculaire important?]
De Brouckere V.,Service de Medecine Interne |
Lienart F.,Service de Medecine Interne |
Ducobu J.,Medecine Interne |
Ducobu J.,University of Mons
Revue Medicale de Bruxelles | Year: 2010
Lipoprotein(a) is of interest to both basic researchers as well as to clinicians who are involved in the contribution of Lp(a) to cardiovascular risk profiles. The Lp(a) particle is a hybrid molecule consisting of a half part indistinguable from circulating LDL linked to the unique glycoprotein component apolipoprotein(a). Many epidemiological data indicate that elevated Lp(a) levels are an independent risk factor for vascular disease. Apo(a) is highly homologous to the fibrinolytic plasminogen containing many repeated kringle motifs similar to several of those found in the plasminogen molecule. The size of the kringle domain in apo(a) gives rise to Lp(a) isoforms heterogeneity which is a hallmark of this lipoprotein. The similarity between Lp(a) and plasminogen led to speculation of a bridging role for Lp(a) in atherosclerosis and thrombosis mechanisms based on the double structure of this lipoprotein. Moreover, there are specific properties that apo(a) confers to Lp(a) : this include the ability of Lp(a) to affect platelet function and to contribute to endothelial dysfunction. Recently, new data have revealed a potential role for Lp(a) in the elimination of oxidized phospholipids. Future areas of development in this field Include the role of apo(a) isoform size as a risk factor, the possible physiological roles of Lp(a), as well as recommendations for the best treatment of elevated Lp(a) in clinical practice.
Bradykinin mediated angioedema with ACE inhibitor in combination with immunosupressive agents [Angio-œdème bradykinique lors de l'association d'un inhibiteur de l'enzyme de conversion et d'un traitement immunosuppresseur]
Grandeau E.,Unite de Pharmacie Clinique Oncologique |
Turbelin A.,Reanimation Polyvalente |
Schmidt J.,Medecine Interne |
Gras-Champel V.,Center Regional Of Pharmacovigilance |
Chourbagi C.,Unite de Pharmacie Clinique Oncologique
Therapie | Year: 2014
We present a serious case of bradykinin mediated angioedema with upper airway disorders resulting from drug interaction between angiotensin-converting enzyme inhibitors and immunosuppressant agents. © 2014 Socié té Française de Pharmacologie et de Thérapeutique.
Morisset M.,Medecine Interne
Revue Francaise d'Allergologie | Year: 2011
The recent increase in the number of clinical trials demonstrates progress in the treatment of food allergies and confirms the value of oral immunotherapy. This article aims to review recent advances in understanding the subject. © 2011 Elsevier Masson SAS.
Tremolieres F.,Medecine Interne
Medecine/Sciences | Year: 2010
Antibiotics have been a true miracle. Would it end in a nightmare? Possibly. Since 1941, the antibiotic treatment of bacterial infections has been a revolution. The golden age lasted half a century, a period during which infectious diseases were considered definitely defeated. And \although from the beginning some kind of bacterial resistance was observed, a strong long-lasting belief was that continuous innovation and invention of new molecules would keep providing a step ahead in the war waged between the human and microbes. For twenty years the resistances became each year a greater concern. Having first hit the hospital, they now affect the community. New effective antibiotics are scarce, and innovation once thought endless, stopped. Today, to escape the nightmare of a return to the pre-antibiotic era, we must find a way to curb the spread of resistant bacteria, change radically our irresponsible squander of antibiotics, and give ways to new treatments effective against future resistant pathogens. These topics are developed in the present paper dealing with the real risk that these 20th century wonder of the medical science, become an object of memory.
Khalifa P.,Medecine Interne |
Therapie | Year: 2013
Unfractionated heparin (UFH) and low-molecular-weight heparins (LMWH) are broadly used for the thromboprophylaxis during pregnancy. Long-term heparin therapy has raised concern about the risk of bone loss and osteoporotic fractures while pregnancy by itself favors osteoporosis. Experimental studies show a comparable effect of UFH and LMWH on bone formation while UFH has a more marked effect on bone resorption. Available clinical studies do not provide evidence of a difference between UFH and LMWH or among different LMWH on the bone risk. However, clinical studies show that bone loss observed with LMWH is not different from the physiological loss related to pregnancy, and osteoporotic fractures are associated with comorbiditiesor osteoporosis risk factors. LMWH represent the preferred alternative for thromboprophylaxis during pregnancy. © Société Française de Pharmacologie et de Thérapeutique.