Revue médicale suisse
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Antibiotics are most commonly prescribed for urinary bacterial infections. The purpose of this article is to review the most common infections of the genitourinary tract and to guide the choice of the most appropriate treatment. This choice depends also on the patients general state, local associated conditions and can range from observation to an emergency hospitalisation. Primary care physicians remain in the first line to take care of these patients but the urologists or the infectious disease specialists can provide some help in complex situations.
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Sarcoidosis is a granulomatous disease characterized by variable manifestations and course. About 50% of patients will require systemic treatment, while the remaining will present spontaneous resolution of the disease. ⋯ Systemic corticosteroids are the first line treatment in sarcoidosis. Because of many side effects, it is essential to consider other drugs in case of intolerance to steroids, as steroid-sparing agents, or in case of inefficiency of corticotherapy alone.
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Revue médicale suisse · Nov 2016
[It all started with a simple symptom and then… Basic palliative medical tools for primary care physicians].
The treatment of symptoms in palliative care is of primary importance, though this in itself is not sufficient for the relief of all aspects of a patient's suffering. Pain, dyspnea, or anxiety cannot be reduced to a single somatic characteristic, the psychological implications and the consequences on the patient's daily life being of paramount importance. A respect with regard to certain basic principles, and a full knowledge of the main therapeutic approaches available, allow for a better initial management of the symptoms. To this end we propose references as a memory aid while pointing out that the apparition of complex elements or instability in this type of case justifies having recourse to a specialised structure.
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Revue médicale suisse · Nov 2016
[Home visits by GPs - Considerations in Europe and in Switzerland].
Home visits are essential for promoting the ability to remain at home and prevent nursing home admissions ; general practitioners play a key role in the development of this specific ambulatory care. Although the frequency of home visits seems to be overall decreasing in recent years, they remain essential, given the expected demographic changes. This is why education on home visits should be introduced in the training of our students during early years. However, there is a gap in literature regarding the optimal number and length of home visits, as well as the kind of groups most likely to benefit from them and thus more research is needed to enlighten these aspects of home visits.
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In case of impossible intubation /oxygenation because of an upper airways obstruction, a cricothyrotomy is indicated. It is a relative simple and safe procedure that may be life saving. A blade, a tube and one's index finger are the only tools needed. ⋯ Several devices have been developed to try to improve it's success rate ; on the contrary, they render the task more complicated and lead to double failure rates with associated lesions, as described in our comparative study. The aim of this article is to recall the technique and make doctors that are not familiar with the use of a knife feel more confident. We emphasize on the use of a finger (index) to facilitate the procedure.