Abrahamsenclemons6451

Traditional right ventricular pacing has been pursued for decades. As the deleterious effects of long-term right ventricular pacing have become evident, there is growing interest in a more physiological type of pacing like His bundle pacing. NSC 683864 As it engages conduction over the His-Purkinje system, His bundle pacing results in normal electrical activation of the ventricles and avoids dyssynchrony (and its negative effects on left ventricular function) in the long term. This pacing technique has become a routine procedure at the University Hospital of Geneva. This article overviews our experience with His bundle pacing and aims to familiarize the reader with this novel pacing technique that will be increasingly used in their patients.Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome, myocardial infarction and sudden cardiac death, among young patient with little/no traditional cardiovascular risk factors. Historically SCAD was considered as a rare pathology, associated primarily with pregnancy and the peripartum period. In recent years, SCAD diagnosis improved thanks to data derived from large registries, thanks to the increased use of diagnostic coronary angiography and the availability of intracoronary imaging. To date there are no randomized trials dedicated to SCAD. However, thanks to global efforts to build national SCAD registries, knowledge of SCAD has tremendously increased during the last years, demonstrating that SCAD is a distinct pathophysiological entity, and presents key differences in management and outcomes compared to ACS of atherosclerotic aetiology.The gene SCN5A encodes the cardiac sodium channel which, through the conduction of Na+ current into the cell, generates the fast upstroke of the action potential of cardiomyocytes. Pathogenic variants of SCN5A have been causally associated to several hereditary cardiac diseases including, among others, Brugada syndrome, congenital long QT syndrome and sinus node dysfunction. Recently, overlap syndromes have been described that are characterized by the simultaneous expression of mixed clinical phenotypes among two or more hereditary cardiac diseases associated to the gene SCN5A (HCD-SCN5A). For this reason, it is time to rethink about HCD-SCN5A as different expressions of the same complex spectrum encompassing multiple clinical phenotypes with pronounced overlaps instead of as distinct clinical entities.The decision to perform coronary revascularization in the setting of chronic coronary syndrome is based on the detection of myocardial ischemia through non-invasive or invasive tests, according to the cardiovascular risk of each patient. This latter will also determine the benefit to be expected with revascularization. The present article is a brief summary of the latest evidence in this domain.Myocarditis is an inflammatory disease of the myocardium caused by various etiologies with a dominance of viral infections and potential post-infectious autoimmunity. The clinical presentation ranges from chest pain to severe complications including cardiogenic shock, ventricular arrhythmias, and progression to dilated cardiomyopathy. The diagnostic approach is challenging and includes several investigations, such as an ECG, an echocardiography, troponin testing and the exclusion of coronary artery disease. Although endomyocardial biopsy remains the gold standard, cardiovascular magnetic resonance is now the most valuable tool to accurately characterize myocardial tissue inflammation. The management is mainly symptomatic and consists in early detection and treatment of complications including heart failure and arrhythmias.Before the advent of chemotherapy in the 1940s, cancer treatment was dominated by surgery and radiation therapy. The developments of targeted anti-cancer therapies in the 2000s followed by immunotherapy have largely changed the treatment landscape in particular in the metastatic setting. Here we provide a history of these advances.A therapeutic target can be defined as the biochemical entity by which a drug exerts its beneficial effects. Historically, most drugs have been used without a precise knowledge of their mechanism of action. The rational drug design for a predefined target has been progressively implemented during the second half of the 20th century. Recent advances in genomics have accelerated the discovery of several targets involved in many pathologies. During the recent period, there has also been a diversification of the types of targets used in therapy. Generally, the proteins modulated by drugs belonged mainly to the families of membrane receptors (receptors coupled to G proteins, ion channels, etc.), nuclear receptors or enzymes. Technological advances in the field of therapeutic antibodies and biotechnologies enabled curative agents to reach previously undruggable targets. In this article, we review these trends and illustrate them by various examples, notably in the field of anticancer drugs, lipid-lowering drugs, gene therapy or antisense therapy.Manual or automated immunoassays are largely used in clinical chemistry laboratories for measuring various compounds like steroid or peptide hormones. However, these methods can lack sensibility and specificity. Hence, during this last decade, tandem-mess spectrometry coupled with liquid chromatography (LC-MS/MS) have emerged as a technique of choice to precisely quantify those molecules. However, these instruments remain quite expensive and need highly trained people.An increasing number of adult patients are seeking orthodontic treatment and several surgical and non-surgical methods have been developed to reduce the overall treatment time. Two randomized controlled clinical trials, performed in our University Hospital, demonstrated that the piezocision surgery - minimally invasive corticotomies - decreased the overall orthodontic treatment time by 43 % - effect during 4 to 6 months after the surgery - without any further clinical and radiological adverse effects. In addition, the use of a custom-made orthodontic system - brackets and arches - optimized the acceleration in the fine-tuning phase of orthodontic treatment. Finally, the combination of the two techniques is therefore relevant to maximize the reduction of the orthodontic treatment time. Fundamentally, our preclinical studies in rats have highlighted the biological phenomena underlying piezocision with an important bone demineralization and osteoclast recruitment associated with a predominant expression of the RANKL-OPG duo.