Revue médicale suisse
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Revue médicale suisse · Aug 2010
[When should a patient with abdominal pain be referred to the emergency ward?].
When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral.
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Revue médicale suisse · Jul 2010
[Interactions between patients and physicians: why should we care about gender issues?].
This article presents the major findings of research on medical interactions from a gender perspective. Male and female physicians give the same amount of medical informations to their patients, but male physicians discuss less the psychosocial aspects of the illness. ⋯ Patients behave less dominantly with male than with female physicians. Finally, male patients are given less signs of empathy and receive less information, whatever the gender of the physician.
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Revue médicale suisse · Jul 2010
[Being a doctor: the influence of gender on the career choices and prospects].
Gender studies of a profession focus on the work distribution between men and women. Sociologists started to study the medical profession in the 80s only. Since it was male-dominated female doctors had no choice but adjusting their behavior to that of men. ⋯ It is mandatory to gain insight into the demographic specificities of the medical population working in a large university hospital (according to sex, age, as well as to the level within the medical hierarchy). It is also important to analyze the key elements that differentiate male and female in their relationship to work and promotion. Finally, it is urgently necessary to change our organizations as well as our practices in order to be able to take into account these major changes of the medical demography.
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Revue médicale suisse · Jul 2010
[Cancer screening in clinical practice: the value of shared decision-making].
Shared decision-making approach to uncertain clinical situations such as cancer screening seems more appropriate than ever. Shared decision making can be defined as an interactive process where physician and patient share all the stages of the decision making process. For patients who wish to be implicated in the management of their health conditions, physicians might express difficulty to do so. Use of patient decision aids appears to improve such process of shared decision making.
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Revue médicale suisse · Jun 2010
Review[What is new in the medical management of acute heart failure?].
Acute heart failure (AHF) is a frequent medical condition associated with a poor prognosis. Based on systolic blood pressure at presentation, patients with AHF can be classified into 5 clinical profiles enabling a more targeted use of standard medications including diuretics, vasodilators and inotropes. The most recent guidelines underline the importance of a rapid management and the favorable impact of heart failure programs, which reduce morbidity and mortality after an admission for AHF. New therapeutic perspectives include ultrafiltration, vasopressin and adenosine antagonists, relaxin and new inotropes such as istaroxime.