Revue médicale suisse
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Revue médicale suisse · Aug 2011
Comparative Study[Level of satisfaction in the emergency department. What about the residents?].
Emergency medicine is evolving within medical departments that are or will be experiencing major restructuring. The interdisciplinary organization of the emergency department (ED) is the result of a long reflexion from hospital managers or health professionals facing a real challenge: find an answer to the population's needs while providing a good and safe health system. ⋯ Hence, there is no official assessment method allowing residents to give a feedback of their work in the ED. With this survey, we wanted to have the opinion and the feeling of young doctors that worked in such an interdisciplinary model.
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Revue médicale suisse · Aug 2011
[The unresolved issue of false-positive D-dimer results in the diagnostic workup of pulmonary embolism].
The unresolved issue of false-positive D-dimer results in the diagnostic workup of pulmonary embolism Pulmonary embolism (PE) remains a difficult diagnosis as it lacks specific symptoms and clinical signs. After the determination of the pretest PE probability by a validated clinical score, D-dimers (DD) is the initial blood test in the majority of patients whose probability is low or intermediate. ⋯ Its safety has been confirmed in US emergency departments, but retrospective European studies showed that it would lead to 5-7% of undiagnosed PE. Alternative strategies are needed to reduce the proportion of false-positive DD results.
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Knee extensor mechanism is composed of the quadriceps and its tendon, patella and patellar tendon. Rupture of either the quadriceps or patellar tendon, or of the patella itself, lead to a disruption of the knee extensor mechanism. ⋯ Echography and MRI confirm the diagnosis and may reveal associated injuries. In case of knee extensor mechanism rupture, early surgical reconstruction of quadriceps or patellar tendon, or patella osteosynthesis, are mandatory to achieve early functional recovery.