Revue médicale suisse
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The neurogenic shock is a common complication of spinal cord injury, especially when localized at the cervical level. Characterized by a vasoplegia (hypotension) and bradycardia, the neurogenic shock is secondary to the damage of the sympathetic nervous system. ⋯ Medical management consists in a standardized ABCDE approach, in order to stabilize vital functions and immobilize the spine. The hospital care includes performing imaging, further measures of neuro-resuscitation, and coordinated surgical assessment and treatment of any other injury.
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Severe sepsis and septic shock are systemic manifestations of the host response to infection. Mortality remains high despite advances in pathophysiological knowledge. Hemodynamic and respiratory management is largely supportive, while early antibiotics administration and source of infection's control are crucial for patient outcome. We review the principles guiding the initial management of these patients in emergency situation.
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Revue médicale suisse · Aug 2014
[Benefit of ultrasound in the early management of patients in shock].
Shock is a hemodynamic situation that aggravates the vital prognostic of every patient regardless of the underlying pathology. It has been well documented that the speed at which hemodynamics is restored to standard values significantly decreases the mortality and morbidity in these patients. Initially described in traumatology, then in every type of shock, the contribution of ultrasonography performed at the bedside by the physician in charge allows for a significant shortening of the diagnostic procedure and thus an earlier start for a goal-directed treatment.
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Concussion, a frequent injury in sports, is rarely evoked and often trivialized in children and teenagers. Knowledge of the diverse symptoms and signs to seek for is essential to an appropriate and secure management. The initial treatment relies on cognitive and physical rest followed by a progressive return to school and subsequently sport activities. The aim of this article is to review an injury whose prognosis is generally favourable, but whose rare complications can prove dramatic.
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Revue médicale suisse · Jun 2014
Review Historical Article[Medicine and pain: history of a relationship].
The vagueness surrounding the terms "suffering" and "pain" invites us to reflect upon the relationships between a physiological fact and a constitutive dimension of the human experience. History shows a constant medical preoccupation facing pain as a clinical symptom, endowed with a rich terminology, many ways of relieving pain and speculations on its diagnostic value. ⋯ This development accompanies an evolution of medical practices on pain that, far from representing continuous progress, adopts rather uneven and sometimes surprising outlines. As a whole, medicine is characterised by an important ambivalence when confronting pain, valuating it as an useful auxiliary or on the contrary denying the painful experience.