Revue médicale suisse
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Revue médicale suisse · May 2019
[Climate change, epidemics and the importance of travel and tropical medicine].
Climate change is one of the factors explaining the increased occurrence of epidemics, their geographical spread as well as their increased severity and broader impact. Climate change makes the environment more favourable for pathogens and their proliferation, as well as for vectors of infectious diseases (such as mosquitoes). Furthermore, the globalisation and intensified travel and trade require international cooperation for epidemic response and training of health professional on emerging infectious risks.
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Testing for ANCA is useful for the diagnosis and monitoring of disease activity in ANCA associated vasculitis. ANCA testing is also sometimes requested for other indications. ⋯ The new approach certainly improves the performance of this test, particularly in Switzerland where, due to the large number of requests, the pre-test probability of ANCA associated vasculitis is relatively low. However, in this article we discuss the possible flaws of the new algorithm based on two recent cases, and highlight the importance of a good communication with the laboratory in order to improve the interpretation of the results.
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Revue médicale suisse · Mar 2019
[Rheumatoid arthritis-associated interstitial lung disease : new genetic data and therapeutic perspectives].
Diffuse interstitial lung disease (ILD) is one of the most frequent extra-articular manifestation of rheumatoid arthritis (RA) and is an important factor of morbidity and mortality. However, the physiopathological mechanisms underlying RA-associated ILD remain poorly understood, and disease management is difficult in the absence of effective treatments and international guidelines. ⋯ Furthermore, new antifibrotic drugs approved for the treatment of IPF, including pirfenidone and nintedanib, could also prove to be effective for RA-associated ILD. Studies are ongoing to confirm this hypothesis.
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Statins are the first line treatment in hyperlipidemia, either in primary or secondary prevention of cardiovascular diseases. One of the most prescribed drug class worldwide, this drug class is often the focus of highly publicized drug controversies. ⋯ This condition varies in severity (from frequent isolated myalgia to rare severe myositis, even rhabdomyolysis) and often leads to treatment termination. Because SAMS are a daily challenge in clinical practice, we review here the recent medical literature on this topic and suggest a management strategy to be shared with the patient as an active partner.
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Revue médicale suisse · Nov 2017
[The electronic patient record - a great opportunity to rethink medical information and its use].
Since the early 2000s, the management of information concerning patient care has fundamentally changed. Previously stored in separate medical and nursing paper medical records, patient data are now gathered in a single electronic health record (EHR) thanks to the digitization of our hospitals, whose development and mastery are a major issue in today's health system.