RESUMEN
The use of direct alcohol biomarkers (ethylglucuronide and phosphatidylethanol) has recently been implemented in a clinical setting. Due to their low alcohol detection threshold, high sensitivity, and specificity, these tools are very useful in the pre- and post-liver transplantation setting, where the history and physical signs are not always reliable. However, the interpretation of the results can sometimes be misleading and must be integrated into a global clinical evaluation and, more importantly, in the clinical context of each patient. We present here a case report illustrating a false-positive hair ethylglucuronide caused by the application of a capillary gel in an abstinent patient after liver transplantation. This reminds us that even the most accurate laboratory tests must be interpreted with caution.
RESUMEN
Several studies have been published in 2023, in the field of general internal medicine, addressing various aspects of health and covering topics ranging from hormonal treatment of menopause to the management of chronic and acute diseases. A selection of articles was chosen for this update in outpatient general internal medicine, showing recent studies on outpatient care of patients (treatment, follow-up). The summary of articles is supplemented this year by a table of medical recommendations published in 2023, modestly proposed, and covering various areas. These guidelines, most of them from North America, show advances in the care and monitoring of outpatients, and should be interpreted in light of the various recommendations in Switzerland.
En 2023, plusieurs études ont été publiées dans le champ de la médecine interne générale, abordant divers aspects de la santé et couvrant des sujets allant du traitement hormonal de la ménopause à la gestion de maladies chroniques et aiguës. Un bouquet d'articles a été choisi pour cette mise à jour en médecine interne générale ambulatoire, traitant d'études récentes sur la prise en charge en ambulatoire (traitement, suivi) des patientes et patients. Le résumé d'articles est complété d'un tableau de nouvelles recommandations médicales de 2023, humblement proposé, couvrant divers domaines. Ces guidelines, pour la plupart américaines, montrent les avancées dans la prise en charge et le suivi des patientes et patients en ambulatoire, et sont à interpréter à la lumière des différentes recommandations en Suisse.
Asunto(s)
Atención Ambulatoria , Pacientes Ambulatorios , Femenino , Humanos , Suplementos Dietéticos , Medicina Interna , MenopausiaRESUMEN
Addiction medicine is influenced by societal changes and the environment has an impact on addictive behaviors and how they are experienced. The COVID-19 pandemic has had an impact on addictive behaviors, some of which could be favorable, and others highlight vulnerabilities to be considered by clinicians. Recent legislative changes open possibilities to limit the negative impact of electronic lotteries. In a context favorable to a better acceptance of people of LGBTQIA+ diversity, research and training in addiction medicine also have a role to play. In view of advances in understanding the harmful effects of alcohol, it is necessary to adapt the perception of the risk, in order not to provoke the incomprehension in the population.
La médecine des addictions est liée aux enjeux sociétaux actuels, et l'environnement joue un rôle important sur les comportements addictifs et comment ils sont vécus. La pandémie de Covid-19 a eu un impact sur les comportements addictifs, dont certains pourraient être positifs et d'autres mettent en lumière des vulnérabilités à prendre en compte en clinique. Les récents changements législatifs ouvrent des possibilités pour limiter l'impact négatif des loteries électroniques. Dans le contexte favorable à une meilleure acceptation des personnes issues de la diversité LGBTQIA+ (lesbienne, gay, bisexuel·le, transgenre, queer, intersexe et asexuel·le ou aromantique), la recherche et la formation en médecine des addictions ont aussi un rôle à jouer. Au vu des avancées dans la connaissance des effets nocifs de l'alcool, il est nécessaire d'adapter la perception du risque, afin de ne pas susciter l'incompréhension de la population.
Asunto(s)
Medicina de las Adicciones , Conducta Adictiva , COVID-19 , Conducta Adictiva/terapia , Humanos , Pandemias , SARS-CoV-2RESUMEN
Transsphenoidal surgery is the treatment of choice for acromegaly due to pituitary adenoma but it is not always possible to reduce or control tumor growth, inhibit GH hypersecretion and normalize IGF-I. The first-line drug treatment in 2013 remains the somatostatin analogues. In 2012 and 2013 have been published several publications presenting the prognosis of well-differentiated thyroid cancers of intermediate risk. Indeed, the dose of radioactive iodine administered to patients with "favorable" histology in this risk category should be reduced without change in prognosis. Elastograhy could, in combination with conventional ultrasound features, allow a better selection of thyroid nodules that need a cytology, with, however, still limitations in the detection of follicular carcinomas.