Revue médicale suisse
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Revue médicale suisse · Oct 2011
[Use of glucocorticoids in low back pain due to disc herniation with radicular involvement].
Although systemic glucocorticoids are frequently used for the treatment of radicular pain due to disc herniation, there are only few studies available. No trial has successfully demonstrated the superiority of systemic glucocorticoids compared to placebo. ⋯ It might be offered when pain treatments according to the WHO steps have failed. Because rare but serious adverse events have been reported, transforaminal periradicular injections should only be used after thorough analysis of risks and benefits with the patient.
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Revue médicale suisse · Oct 2011
[Adult severe community-acquired pneumonia: from diagnosis to intensive care].
Severe community-acquired pneumonia is defined as a pneumonia acquired in an extra-hospital setting requiring intensive care. Clinical scores such as the ATS modified rule can help the clinician to recognize quickly the patients needing ICU. Evidence based interventions decreasing mortality consist of rapid administration of antibiotics, by probably privileging an association containing a macrolide, as well as fast and specialized care of shock and respiratory failure. Severe community-acquired pneumonia is burdened by a short and long-term important mortality.
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Revue médicale suisse · Oct 2011
[Carotidynia and Eagle syndrome: two neck pain syndromes to be rediscovered].
Two classical syndromes of upper cervical pain in the carotid region are discussed: carotidynia and Eagle syndrome. In both cases, after an initial period of enthusiasm, poorly defined diagnostic criteria led to frequent wrong diagnosis and poor treatment responses. ⋯ New radiologic diagnostic criteria have emerged and should allow for a more precise diagnosis. With the correct diagnosis, medical and surgical treatments should be better tailored and more efficient.