Revue médicale suisse
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Revue médicale suisse · Oct 2010
Case Reports[Clostridium difficile: a serious outpatient infection?].
Secondary to severe hospital outbreaks due to hypervirulent strains of Clostridium difficile, several surveillance systems in North-America and Europe observed an increase in infections due to this micro-organism, also in the outpatient setting. The case reported in the present article illustrates the fulminant presentation that a C. difficile colitis can show in a previously healthy person without prior contact with healthcare facilities. It introduces a review of some recent publications on the current changes in the epidemiology, clinical presentation, diagnosis and treatment of this disease.
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Cocaine use, often not recognized, is a frequent cause of consultation in the emergency room or by primary care physicians. The use of cocaine causes numerous cardiovascular and pulmonary side effects. In this context, the occurrence of a pneumothorax represents a specific complication, often misunderstood by primary care physicians. We describe here three cases of patients who suffered from subcutaneous emphysema and pneumothorax after taking cocaine and emphasize the importance of always keeping in mind the possibility of illicit substance use in such cases, especially among young and healthy patients.
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Revue médicale suisse · Sep 2010
[Administration of propofol by non-anesthesiologists for digestive endoscopy].
Propofol is progressively replacing benzodiazepines for sedation during endoscopy, even when the sedation is administered by non-anesthesiologists. Propofol ensures a more rapid induction of sedation and recovery and, in certain conditions, higher patient satisfaction and improved quality of endoscopic examination. ⋯ After sedation, psychomotor recovery is faster with propofol compared to traditional sedation agents but tasks requiring particular attention (eg, driving) should be avoided. It is important to advise patients of these restrictions in advance.