Revue médicale suisse
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Testicular torsion is a true urologic emergency with a bimodal age presentation : the perinatal testicular torsion presenting with a hard, tender or non-tender scrotal mass usually with underlying dark discoloration of the skin and the peripubertal testicular torsion presenting with severe acute testicular pain, vomiting and frequently pain irradiation in the inguinal area, a high riding-horizontally positioned testis and absence of the cremasteric reflex. Obtaining a US Doppler must not add unnecessary delay to the urgent surgical treatment which entails detorsion and bilateral orchidopexy. We do not recommend manual detorsion as around 30 % of testis rotate externally. Up to 50 % of patients presenting with a testicular torsion suffered beforehand from intermittent testicular pain episodes.
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Revue médicale suisse · Feb 2017
[« Doctor, I would like to stay at home » About the partnership between a specialized palliative home care team and general practitioners].
During home care, general practitioners are faced with complex end-of-life situations. This leads to difficulties in taking care of the patient alone, and may require support from a multi-professional specialized palliative home care team. ⋯ The palliative care teams' activity is based on mentoring, anticipating possible future difficulties and managing crises. In order to have a real working partnership between the home palliative care teams and the GPs it is essential to have a mutual understanding of how each entity works and what kind of help they can provide.