[Health care services and regional development, a medicometric approach]. / Services de santé et développement régional: une approche médicométrique.

Health care services and regional development, a medicometric approach. If regional development is defined in terms of job creation and increased quality of life, health services can be seen as an investment contributing to employment and local structural changes. Spendings to increase health services, especially in peripherical regions, increase the level of economic development. Through case studies in Switzerland we open four perspectives for the future and propose a global view of health care systems in a regional context.

[Primary pulmonary hypertension arterial and Basedow disease]. / Hypertension artérielle pulmonaire primitive et maladie de Basedow.

We report a case of a fifty year old woman with Graves' disease with positive AntiTPO antibodies and positive AntiTSH receptor antibodies, who was hospitalized with a right cardiac failure. A pulmonary hypertension was discovered on echocardiography. After adequate antithyroid therapy, the right cardiac failure regressed rapidly and pulmonary pressure normalised. An autoimmune process has often been proposed to explain the association between pulmonary hypertension and hyperthyroidism. We report the arguments supporting this autoimmune etiopathogenesis. We also discuss an other hypothesis based on a direct effect of thyroid hormones on the pulmonary circulation and the effects of high cardiac output associated with hyperthyroidism.