Revue médicale suisse
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Revue médicale suisse · Mar 2005
Review[Utility of procalcitonin for the diagnosis and the follow-up of infections in febrile neutropenic patients].
Procalcitonin is a marker of severe bacterial infections in non-neutropenic patients. The goal of this review is to assess its utility in the management of neutropenic patients. ⋯ Present knowledge suggests that procalcitonin may contribute to identify patients in whom 1) antibiotics could be stopped in the absence of bacterial infection, 2) investigations and adjustments of the antimicrobial therapy for persistent fever are needed. The use of procalcitonin for the management of febrile neutropenic patients should be studied prospectively.
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In febrile children and adults, it is frequently difficult, based on the sole clinical examination, to differentiate a bacterial illness from systemic inflammatory syndromes or severe viral infections. However, the positive and rapid diagnosis of a severe bacterial infection or a sepsis is essential to initiate lifesaving therapies. ⋯ Plasma levels below 0.5 microg/l usually rule out a severe bacterial disease, whereas values above 2 microg/l are strongly indicative of a bacterial sepsis. The usefulness and the limitations of the measurement of procalcitonin as a diagnostic and a prognostic tool during severe bacterial infections are discussed in this paper.
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Revue médicale suisse · Mar 2005
Review[Pharmacological treatment of female sexual disfunction: chimera or reality?].
Sexual dysfunction is defined as a disturbance in the sexual response cycle or as a pain with sexual intercourse. The prevalence of sexual dysfunctions is approximately 40% in the female population. ⋯ Whereas recent studies have demonstrated clear influences of hormones on sexual dysfunctions, no pharmacological treatment has been approved for that indication. We will review here several pharmacological treatment strategies proposed in case of sexual dysfunction, underlying the fact that they are effective only to treat specific cases of sexual disorders but cannot replace the sex therapies.
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Revue médicale suisse · Mar 2005
Review[What do we actually know about out-of-hospital cardiac arrest?].
Each year at least 300,000 people in the United States and 8000 to 10,000 people in Switzerland suffer from out-of-hospital cardiac arrest, mostly due to ventricular fibrillation. Early defibrillation provides definitive treatment for most of cardiac arrest victims. Semi-automatic external defibrillators are easy to handle devices allowing to deliver an early electric shock and can be successfully used by lay people following minimal training. Newer strategies of defibrillation designed to respond faster to out-of-hospital cardiac arrest, including public access defibrillation, as well as improvement of each link of the chain of survival appears as the best strategy for the management of out-of-hospital cardiac arrest.