Genève, Switzerland
Genève, Switzerland

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Tsetsou S.,Service de Neurologie | Michel P.,Service de Neurologie | Ribi C.,Service dImmunonologie et Allergie | Hirt L.,Service de Neurologie | And 10 more authors.
Revue Medicale Suisse | Year: 2015

Giant cell arteritis (GCA) is a subacute/chronic vasculitis and represents the most common form of systemic vasculitis in people over the age of 50 years. The absence of clear and specific diagnostic criteria with the highly variable clinical presentation is a diagnostic challenge requesting a multidisciplinary approach. Yet, GCA is an emergency and the treatment must be initiated very rapidly due to the risk of blindness. This article presents a review of GCA as well as the diagnostic and therapeutic institutional guidelines of the University Hospital of Lausanne. © 2015, Editions Medecine et Hygiene. All rights reserved.

Grandjean A.-P.,Services de Medecine Interne Generale | Dettwiler S.,Service de Pathologie Clinique | Saudan P.,Service de Nephrologie
Revue Medicale Suisse | Year: 2010

Paraproteinaemia is frequent in the population above 50 years of age. It is commonly associated in patients with multiple myeloma with diverse renal involvements, such as cast nephropathy, light chain deposition disease, amyloidosis and Fanconi syndrome. A rapid diagnosis is necessary to implement a specific and aggressive treatment in order to prevent development of end-stage renal disease. Plasma exchanges or daily dialysis with high-cut off filter associated with chemotherapy may decrease the plasmatic concentration and production of monoclonal light chains. Bortezomib, thalidomide and lenalidomide are promising therapeutic agents, whose effects in patients with myeloma-associated renal diseases should be more thoroughly studied. Autologous hematopoietic cell transplantation remains the standard of care treatment for eligible patients.

Bourquin V.,Service de nephrologie | Zellweger M.,Service de nephrologie | Levy M.,Service de nephrologie | Ponte B.,Service de nephrologie | Moll S.,Service de pathologie clinique
Revue Medicale Suisse | Year: 2013

The glomerulonephritis (GN) are responsible for a significant amount of end stage renal disease. They may be secondary to another disease or idiopathic. When a secondary etiology has been excluded, it is called primary glomerulonephritis (PGN). Glomerular damage may have different presentations and there are many way to classify them. It is thus difficult for the non-specialist to understand the terminology used. This article is a summary of the most frequently encountered PGN such as : IgA nephropathy, membranous GN, idiopathic nephrotic syndrome, extracapillary and membranoproliferative GN. A brief description is given for each one of the PGN including epidemiology, semiology, histology and a pathophysiology explanation. © Médecine et Hygiène 2010.

Idiopathic interstitial pneumonias represent a group of complex lung diseases among which the most frequent types are idiopathic pulmonary fibrosis (IPF), idiopathic non-specific interstitial pneumonia (idiopathic NSIP), and cryptogenic organizing pneumonia (COP). Clinicians may rely on a precise classification of these diseases from an America-European consensus that has been published in 2002. However it appears that diagnosis should always be confirmed by a multidisciplinary team discussion with experience in the field. There are generally tremendous prognostic and therapeutic implications for the patient.

Koessler T.,Service doncologie | Bichard P.,Service de gastroenterologie | Lepilliez V.,Service de gastroenterologie | Puppa G.,Service de pathologie clinique | And 2 more authors.
Revue Medicale Suisse | Year: 2016

Colorectal polyps are frequent in the general population. The diagnostic is made by endoscopy. Polyp's characteristics determine the technic to be used to remove them. Transanal endoscopic microsurgery offers an alternative to radical surgery for large rectal polyps or rectal tumors with low risk of node invasion. One peace resection is necessary to evaluate the resection margins. Lymphatic invasion, = 1 mm submucosae invasion, tumor budding and poorly differentiated tumor are the four main risk factors for node invasion. In case of high risk of lymph node invasion a radical surgery is recommended. Surveillance must be adapted to the polyp type, their number, size, presence of a carcinomatous component as well as age and clinical status of the patient.

Genevay M.,Service de Pathologie Clinique | Benusiglio P.R.,Service dOncologie | Hutter P.,Laboratoire dOncologie Moleculaire | Chappuis P.O.,Institute Central des Hopitaux Valaisans
Revue Medicale Suisse | Year: 2011

Lynch syndrome is an autosomal dominant disease associated with an important risk of cancer, mainly endometrial and colorectal-cancer. This risk can be efficiently lessen by an appropriate screening as far as the mutations carriers are identified. As current clini copathological recommendations lack sensitivity, a systematic pre-screening of every patient with a colorectal or endometrial cancer can be proposed. Oncogenetic units of the HUG in Geneva and ICHV in Valais have set up a population-based study to evaluate the efficacy of such a strategy. Whatever the approach, the pathologist is directly implicated as Lynch syndrome harbors specific histological aspects that can help to its identification, but also as pre-screening tests are directly realized on tumor-tissue.

Burdet L.L.,Center Neuchatelois Of Psychiatrie | Epiney M.,Service dObstetrique | Bornand A.,Service de Pathologie Clinique | Pechere-Bertschi A.,Unite dHypertension | Ditisheim A.,Center Neuchatelois Of Psychiatrie
Revue Medicale Suisse | Year: 2016

The placenta has generated many beliefs over centuries and in all ethnicities. Considered in our society as a surgical waste, it is elsewhere contemplated for its mysterious protective powers, viewed as the seat of the soul, disposed of, burnt or even buried. However, once time is taken for its examination, the placenta tells a story. Of interest is the similarity observed between placental vascular disease in hypertensive pregnancy and atherosclerosis in coronary artery disease for example. Hypertension in pregnancy is frequent and associated with increased adverse obstetrical outcomes, and long-term risk of cardiovascular and kidney disease. This article will discuss the role of placental histopathology in hypertensive pregnancies, its indicative value for longterm cardiovascular risk in mothers and for subsequent pregnancy.

Pusztaszeri M.,Service de Pathologie Clinique | Girardin M.,Service de Gastro enterologie et dHepatologie | Hadengue A.,Service de Gastro enterologie et dHepatologie | Rubbia-Brandt L.,Service de Pathologie Clinique | Genevay M.,Service de Pathologie Clinique
Revue Medicale Suisse | Year: 2010

Many drugs are known to have adverse effects on the gastrointestinal tract. The consequences can range from asymptomatic histological lesions in the gastrointestinal mucosa to fatal complications such as haemorrhage or perforation. On the biopsies (or on surgical specimens), there is a limited number of injury pattern that should suggest drug-induced pathology. They are mostly non specific (ex: ulcer). However, some drugs may induce pathognomonic histological lesions. For this reason, the diagnosis of a drug-induced gastrointestinal pathology depends on a clinicopathological correlation and implies a good communication between the pathologist and the clinician. In this review, we focus on the most common and well-described drug-related clinico-pathological conditions of the gastrointestinal tract using an organ and lesion based approach.

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