Revue médicale suisse
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Revue médicale suisse · Sep 2015
Biography Historical Article[Oliver Sacks (1933-2015). An English physician who was able to explain neurology to the entire world].
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Revue médicale suisse · Aug 2015
[Gliptins, cardiovascular safety and congestive heart failure: state of the art after TECOS].
The cardiovascular safety of dipeptidyl peptidase-4 inhibitors (gliptins) has been well studied. Favourable effects of these oral antidiabetic agents have been reported in meta-analyses of phase II-III randomised controlled trials. ⋯ The suspected increase in the rate of hospitalisation due to congestive heart failure reported in SAVOR-TIMI 53 was neither found in EXAMINE nor recently confirmed in TECOS. Direct comparative trials, evaluating not only safety but also efficacy, with other oral antidiabetic medications would be of major interest.
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Before the development of non invasive ventilation (NIV), endotracheal intubation was the only ventilatory therapy available in case of severe respiratory distress and acute respiratory failure. NIV used to be employed in intensive care settings only. ⋯ Cardiogenic pulmonary edema and acute exacerbation of COPD are indications of choice, since NIV improves mortality. The efficiency of the therapy depends on early treatment; however, endotracheal intubation should not be delayed when it becomes necessary.
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Revue médicale suisse · Aug 2015
[Normobaric oxygen therapy in acute medical care: myths versus reality].
Oxygen adiministration for both medical and traumatic emergencies is regarded as an essential component of resuscitation. However, many recent studies suggest that the use of oxygen should be more restrictive. ⋯ In other pathologies, such as stroke or hemorragic shock, the situation is still unclear, and further studies are needed to clarify the situation. Generally speaking, oxygen therapy should from now on be goal-directed, and early monitoring of both pulse oximetry and arterial blood gases is advised.
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Revue médicale suisse · Aug 2015
[Acute dyspnea in the emergency room: from pathophysiology to ultrasonography].
Acute dyspnea is one of the leading clinical symptoms encountered in the emergency room. Its differential diagnosis is wide, ranging from noisy panic attacks to threatening acute heart failure. History taking and physical examination, even when exhaustive are of limited diagnostic value. ⋯ Its integration into the emergency physician's armamentarium considerably changed clinical management. Fast and accurate, ultrasonography has become the modern era stethoscope. This review discusses acute dyspnea through the main elements useful to diagnosis.