Revue médicale suisse
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Revue médicale suisse · Jun 2014
[Lung volume reduction (LVR) in severe emphysema: a multidisciplinary approach].
Most cases of emphysema are managed conservatively. However, in severe symptomatic emphysema associated with hyperinflation, lung volume reduction (LVR) may be proposed to improve dyspnea, exercice capacity, pulmonary functions, walk distance and to decrease long-term mortality. ⋯ Currently, the optimal approach is discussed in a multidisciplinary setting. The latter permits a personalized evaluation the patient's clinical status and allows the best possible therapeutic intervention to be proposed to the patient.
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Revue médicale suisse · Jun 2014
[Enhanced Recovery After Surgery--optimal management of the surgical patient].
Enhanced Recovery After Surgery (ERAS) is a multimodal, standardized and evidence-based perioperative care pathway. With ERAS, postoperative complications are significantly lowered, and, as a secondary effect, length of hospital stay and health cost are reduced. ⋯ ERAS can be safely applied to any patient by a tailored approach. The general practitioner plays an essential role in ERAS by assuring the continuity of the information and the follow-up of the patient.
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Revue médicale suisse · Jun 2014
Review[Adolescents with chronic pain: practical assessment and management].
More than 20% of adolescents in the general population suffer of chronic pain mainly headaches, abdominal or musculoskeletal pain. Often, these complaints are self limited without impact on adolescent development but the cause of emergency consultations, unnecessary costs or inappropriate prescriptions. ⋯ Primary care phyisicians play a crucial role (private practice, adolescent clinic...). Efforts should be made to increase access to modern approaches of chronic pain taking into account family, development as well as aspects related to pain in itself.