Severe hypercholesterolaemia: therapeutic goals and eligibility criteria for LDL apheresis in Europe.

Purpose Of Review: Despite the use of currently available lipid-lowering therapies, a significant proportion of patients with severe hypercholesterolaemia do not reach treatment goals and consequently remain at increased risk for cardiovascular disease (CVD). On the basis of clinical experience, these patients tend to have the most severe forms of familial hypercholesterolaemia or markedly elevated LDL cholesterol (LDL-C) levels but are unable to tolerate statin therapy.

Recent Findings: LDL apheresis is currently the best treatment option (or treatment rescue) to bring these patients closer to therapeutic LDL objectives, and has been shown to reduce the risk of CVD along with LDL-C levels.

Low-density lipoprotein apheresis in children with familial hypercholesterolemia: follow-up to 21 years.

Twenty-seven patients (14 girls, 13 boys) affected by familial hypercholesterolemia who had begun low-density lipoprotein (LDL) apheresis treatment before the age of 15 were studied. The median age at diagnosis was 4 years and the blood LDL cholesterol level was 704 +/- 163 mg/dL. Screening was performed for homozygous or double heterozygous mutations of the LDL cholesterol receptor gene and mutations were found in 24 of the patients.

[Treatments of idiopathic sudden sensorineural hearing loss: retrospective study of 144 cases].

In this report of a retrospective study of 144 cases of idiopathic sudden hearing loss, two important prognostic indicators appear: the elapsed time since the onset of symptoms and the degree of hearing loss. According to these indicators, the authors define three group of patients with a recovery rate of 65%: patients with a threshold hearing level of less than 40 dB, treated within two months of the onset of their hearing loss, patients with a threshold hearing level between 40 and 70 dB treated within one month and patients with a threshold hearing level of more than 70 dB treated within 7 days. Patients with a threshold hearing level of more than 70 dB, treated between 7 and 30 days, have only a partial recovery in 40%.

Serum sickness after wasp venom immunotherapy: clinical and biological study.

We describe a case of a man who developed serum sickness during wasp venom immunotherapy. Remarkable features were unusually severe neurological symptoms, multiple relapses in the absence of rechallenge, parallel course between clinical symptoms, serum levels of specific reagins and their antibodies, and a dramatic response to plasma exchange therapy. Desensitization is widely used and can cause a wide range of adverse effects; however, systemic vasculitis is a very rare complication and we are not aware of any case similar to ours, with serum sickness after injection of highly purified hymenoptera antigen.

[Normovolemic hemodilution: application to the treatment of refractory cutaneous ulcers. Transfusion Techniques and Therapeutics Group].

Resistant cutaneous leg ulcers have a long evolution and are not easily cured by traditional therapeutics. Normovolemic haemodilution was proposed in 1984 by Guenneguez and Ouvry, who studied a small number of patients with good results, by using a local protocol, and a manual procedure. Recent data about physiopathology of cutaneous leg ulcers seem to confirm the benefit that Normovolemic Haemodilution should bring to the treatment of this pathology.