[Remote management of pacemakers and implantable cardioverter defibrillators: an application of telemedicine]. / La télécardiologie pour les stimulateurs cardiaques et les défibrillateurs implantables.

Remote monitoring and follow-up of pacemakers and implantable cardioverter-defibrillator consists of automatic transmission of the data to the cardiologist on a secure website. Many clinical studies have demonstrated the safety of this process and the improvement of patient satisfaction. This strategy allows a reduction in the number of in-office visits, and results in a shorter delay to diagnosis of arrhythmias. A number of studies are ongoing to evaluate the effectiveness of remote monitoring in improving patient outcome.

Neurological and pulmonary adverse effects of subcutaneous methotrexate therapy.

We report the case of a patient receiving subcutaneous methotrexate (MTX) treatment for rheumatoid arthritis (RA) who developed a complex pattern of neurological and pulmonary symptoms. Fluctuant dysarthria, magnetic gait, weakness and dysmetria of the lower limbs, as well as symptoms and signs consistent with a diagnosis of pneumonitis started within 6 weeks of initiating MTX treatment and slowly resolved after its discontinuation. This case highlights the fact that even the relatively low doses of MTX in the therapy of RA can produce neurotoxicity, which can become manifest in a broad range of symptoms.