Revue médicale suisse
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Revue médicale suisse · Apr 2014
[Inter-hospital CHUV-HUG medical consensus of back pain management. Its application in care pathways within CHUV of Lausanne].
Back pain is a considerable economical burden in industrialised countries. Its management varies widely across countries, including Switzerland. Thus, the University Hospital and University of Lausanne (CHUV) recently improved intern processes of back pain care. ⋯ This inter-hospital consensus produced three decisional algorithms that bear on recent concepts of back pain found in literature. Eventually, a fast track was created at CHUV, to which extern physicians will have an organised and rapid access. This fast track aims to reduce chronic back pain conditions and provides specialised education for general practitioners-in-training.
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In medicine, vital blue dyes are mainly used for the evaluation of sentinel lymph nodes in oncologic surgery. Perioperative anaphylaxis to blue dyes is a rare but significant complication. ⋯ The diagnosis of hypersensitivity to vital blue dyes can be established by skin test. We illustrate this topic with three clinical cases.
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Zostavax, a live attenuated vaccine against shingles (herpes zoster) has been available in Switzerland since 2008. In a population aged 60 and over, evidence suggests the vaccine effectively reduces the incidence of shingles and some of its corresponding complications. ⋯ Despite being part of the vaccination programmes in the United States and several European countries, the vaccine is not yet part of the Swiss vaccination programme. Should Switzerland follow suit by incorporating Zostavax into their vaccination policy?
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Multiple new cancer drugs have been marketed during the last decade, and among those many molecularly targeted agents. Their impact on clinical outcomes population-wide remains hard to measure. Are we merely seeing the development of expensive and toxic drugs that benefit a minority of patients, or are battles actually won in the war on cancer? Both epidemiologic trends and clinical trial data show that a patient's outcome today is significantly better than 10 or 20 years ago, in terms of cure rates and survival time for advanced disease.