La Revue du praticien
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Prehospital management of acute stroke patients. In France, prehospital management of patients with suspected acute stroke relies on emergency medical communication centers (Samu), which provides first-line telephone assessment and dispatches the most appropriate emergency vehicle. Such tasks are not straightforward because many clinical symptoms may correspond to stroke and alternative diagnoses - stroke mimics - are common. ⋯ Because mechanical thrombectomy only applies to patients with acute ischemic stroke and large-vessel occlusion, prehospital triage is important. However, clinical prediction of large-vessel occlusion is difficult and whether a specific patient should be sent to the nearest primary stroke center (drip and ship paradigm) or a comprehensive stroke center with thrombectomy capability (mothership paradigm) remains uncertain. Prehospital notification of the hospital-based stroke teams by the emergency medical system crews is crucial in reducing delays to achieve reperfusion.
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Covid-19: do not neglect neurological symptoms. Covid-19 is a highly contagious acute viral disease caused by a new coronavirus, SARS-CoV-2. ⋯ Among the diverse symptoms depicted around this pathology neurological ones have been long overlooked. They may be signs of a severe form of Covid-19.
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Takotsubo cardiomyopathy. Takotsubo cardiomyopathy, or transient apical ballooning syndrome of the left ventricle, affects women after menopause often after mental or physical stress. ⋯ Evolution is usually towards recovery of ventricular deformation, and improvement of systolic function, but complications in the acute phase, and recurrences are possible. Treatment is not yet standardised and should include psychological care.
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La Revue du praticien · May 2019
Review[Challenges in the implementation of HPV vaccination for cancer prevention].
In France, every year, HPVs cause approximately 6,300 cancers -cervix, anus, oropharynx, penis, vulva, vagina, oral cavity, larynx- representing 2% of all incident cancers, 35,000 precancerous le-sions of the cervix, and at least 50,000 condylomas in the under- 30s. All 3,000 new cases of cervical cancers are attributable to HPV infections. Cervical cancer prevention is based on the combination of two complementary strategies: vaccination of 11 to 14-years-old girls against HPV and organized screening of cervical cancer for women between 25 and 65 years old. ⋯ However, more than 10 years after their commercialization, HPV vaccines have already demonstrated, in many countries, their effectiveness against HPV infections, genital warts and precancerous cervical lesions. In addition, no association between vaccines and autoimmune diseases has been demonstrated, either by national or international surveillance authorities, or by scientific publications, after the commercialization of 200 million doses worldwide. As the International Papillomavirus Society has declared that the combination of a high VCR against HPV and a high participation in cervical cancer screening, combined with appropriate treatment, can lead to the elimination of cervical cancer as a public health problem, it is important to better communicate the scientific findings in order to better understand vaccination's benefits.