Revue médicale suisse
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Revue médicale suisse · Feb 2011
[Multidisciplinary management of post-partum hemorrhage: new strategies].
Post-partum hemorrhage (PPH) is a dramatic obstetrical complication, responsible for one maternal death every 4 minutes in the world. Clinical management requires prevention, coordination and multidisciplinary care. Whatever the etiology, it is based on a stepwise approach. ⋯ Resuscitation efforts, transfusion and hemostatic strategies must be continuous and adapted. In case of failure, selective embolization of pelvic arteries can sometimes avoid surgery. Exploratory laparotomy with haemostatic sutures is another option, followed if necessary, by a hysterectomy.
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Revue médicale suisse · Feb 2011
[Risk stratification tools for evaluating thromboembolic risk in atrial fibrillation].
New European recommendations on management of stroke prevention in atrial fibrillation have been published. They introduce a new risk stratification score called CHA2DS2VASc, which may allow for better thromboembolic risk discrimination amongst low risk patients. We review stroke risk stratification in atrial fibrillation, limitations of available scores and discuss the practical implications of the new recommendations.
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Revue médicale suisse · Feb 2011
[Is there a role for prophylactic antibiotic treatment with macrolides in bronchiectasis?].
Prophylactic antibiotherapy with macrolides is commonly used to prevent bronchiectasis exacerbations. Indeed, there is evidence that macrolides possess immunomodulatory and anti-inflammatory properties, which explains their possible efficacy in this condition despite the presence of resistant germs. ⋯ However, available data concerning this issue is limited and remains insufficient to recommend its systematic use. Until larger studies with long-term follow up are available, the use of macrolides in bronchiectasis should be restricted to selected cases and should take into account their potential side effects.