Revue médicale suisse
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Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. ⋯ This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease. The evolution of conservative treatment has allowed to reduce and postpone need for surgery and requires an interdisciplinary collaboration between surgeons, gastroenterologists, interventional radiologists and intensivists.
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Abdominal aortic aneurysm is a disease seen in the elderly. Without intervention, an aneurysm can rupture which leads to death in most cases. ⋯ Nowadays the whole aorta can be treated with endovascular techniques in expert hands. This article presents an overview of different endovascular solutions and innovations in the management of aortic aneurysms.
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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.
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Revue médicale suisse · Dec 2016
[Prevention of perioperative infections in orthopaedic surgery - Role of general practitioner].
Total joint replacement comes with a high success rate and has been shown to have a very positive impact on our patients suffering from arthritis. Against all efforts about 2 % of our patients will suffer an implant related infection. ⋯ Prevention must be performed pre-, intra- and postoperatively. Preoperative optimization of blood sugar levels, nutritional status and correction of general anaemia for example are paramount and the general practitioner as well as the surgeon should be aware of these and other modifiable risk factors in order to operate on the patient in the best possible conditions.