[Prophylaxis with proton pump inhibitors in case of corticosteroid therapy: "less is more"].

It is common to routinely prescribe gastric ulcer prophylaxis with proton pump inhibitors (PPIs) when administering high-dose glucocorticoids (GC) (> 30 mg/day of prednisone equivalent) or during prolonged time (> 15 days). This routine is due to a risk profile considered safe for PPIs in comparison to the possible severe consequences of developing a gastric ulcer. Given the numerous adverse effects associated with PPIs, it is preferable to question the risk-benefit balance when prescribing them.

[False positive on macrotroponin].

The determination of I and T subunits of cardiac troponin isoforms are the biochemical gold standard for the detection of myocardial distress. The advent of so-called highly sensitive measurements has optimized the diagnosis of acute coronary syndromes at the cost of making the diagnostic approach more complex and increasing sensitivity to analytical interference. This article presents a case of macrotroponinemia, characterized by circulating IgG-troponin T immunocomplexes, in order to raise prescribers' awareness of the critical interpretation of high and persistent cardiac troponin values.

[Bradyarrythmias in acute coronary syndromes].

In up to 30-40% of the cases acute coronary syndrome (ACS) is complicated by cardiac arrhythmias. The latter can be benign or malignant and mainly occur during the first 24 hours after myocardial infarction. Ischemia time being the key factor, arrythmias decreased dramatically since the implementation of accelerated reperfusion strategies.

[COVID-19: Do not put the cart before the horse].

The SARS-CoV-2 pandemic has led to the study of a multitude of drugs to alleviate the epidemic burden. Among them, only corticotherapy (dexamethasone) and more recently concomitant anti-inflammatory therapy with IL-6 antagonists have shown benefit on mortality and mechanic ventilation requirement in patients requiring oxygen support. The management of patients with COVID-19 relies mainly on established therapeutic principles : adequate oxygen therapy, protective mechanic ventilation, prophylactic anticoagulation and targeted antibiotic therapy in case of secondary infection.