Revue médicale suisse
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Revue médicale suisse · Apr 2010
Practice Guideline[Immunization guidelines regarding patients with a chronic disease].
Some chronic diseases--like renal failure, liver insufficiency, chronic lung disease, cardiac involvement, diabetes mellitus, asplenia--present limited defects of the immune system and/or a higher risk of infection; therefore, patients with such pathologies should get selective vaccinations. The efficacy of immunization decreases with disease progression; for this reason, these patients should be immunized as soon as possible. At the beginning of their disease, these patients do not need a specialized treatment and are followed by the general practitioner alone who is in charge of immunizing them as well as contact people of any immunocompromised patient. OFSP's regular vaccinations programme is recommended, as well as selective vaccinations against influenza, pneumococci and viral hepatitis, depending on the underlying chronic disease.
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Obesity is well recognized as a cardiovascular risk factor and being associated with cardio-metabolic diseases. However, certain authors describe the existence of metabolically benign obesity or not-complicated obesity. ⋯ The purpose of this article is to summarize the current concepts of metabolic normality in obese subjects. We conclude that the body weight is the most important factor in the development of the cardio-metabolic consequences of obesity.
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Revue médicale suisse · Mar 2010
Case Reports[Unusually favorable recovery from locked-in syndrome after basilar artery occlusion].
Locked-in syndrome (LIS) after basilar artery occlusion is associated with poor prognosis. For a patient with LIS, rehabilitation aims to restore communication, avoid complications, and ensure a certain comfort. We describe a case with remarkable recovery. After 2 years the patient was independent for daily living activities, walks independently and has comprehensible speech.
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Autosomal dominant polycystic kidney disease is one of the most prevalent genetic diseases and every general practitioner may have to counsel these patients. The follow-up of the patients carrying the trait has changed substantially lately and new treatments have been developed and are close to get approval. We review here the new ultrasound diagnostic criteria, the place of the renal volumetry by MRI in the follow-up, the place of the genetic molecular diagnosis and we discuss the pathogenesis and the future treatment that are in phase III clinical studies and will soon change completely the outcome of the disease.