[Prevention and screening recommendations, from paper to electronic, a pilot project with a participative approach]. / Recommandations de préventionet de dépistage : du papierà l'électronique, un projet pilote avec approche participative.

Prevention and screening recommendations have to be adapted on a regular basis to the latest scientific data and should be completed by tools made to facilitated the implication of patients in decision-making. The prevention and screening webpages hosted on the website of the Department of community medicine and ambulatory care of the University of Lausanne facilitate access to clinical recommendations identified by members of the five medical faculties in Switzerland (EviPrev national program), and to various information sources for physicians and patients, including patient decision aids. These webpages have been developed with primary care physicians who have participated in a pilot project in the canton of Vaud. The webpages have also been tested and welcome by a participatory group of citizen-users.

Les recommandations de prévention et de dépistage doivent être régulièrement adaptées aux données scientifiques et souvent accompagnées d'outils développés pour faciliter l'implication des patients dans la prise de décision. Dans cette perspective, les pages web de prévention et de dépistage du site de la Policlinique médicale universitaire (PMU) de Lausanne facilitent l'accès aux recommandations cliniques, identifiées par des membres des cinq facultés de médecine en Suisse (programme national EviPrev), et à diverses sources d'information pour médecins ou patients, y compris des aides à la décision. Ces pages web ont été développées avec des médecins de famille ayant participé à un projet pilote du canton de Vaud. Testées auprès du groupe participatif d'usagers-citoyens, ces pages web ont rencontré un très bon accueil de leur part.

[Knee pain in ambulatory practice]. / Gonalgies: que faire en médecine de premier recours?

Knee pain is a frequent complaint in ambulatory practice. Because of its complexity, the knee is prone to trauma, arthritis and the impact of aging. Septic arthritis is an emergency and has to be suspected when important knee pain is associated with fever, an alteration of the general condition, or in a particular social context. In most cases the clinical examination can identify the type of pathology. Conservative treatment is beneficial in most cases and physiotherapy a major component of the prognosis.

[Shoulder pain in ambulatory practice]. / Epaule douloureuse: prise en charge ambulatoire.

Scapulalgias or omalgias are a frequent complaint, with more than half of them being linked to an injury of the rotators cuff. As they often become chronic, omalgias result in higher rates of absenteeism and significant health care costs. Scapulalgias have three main causes: posttraumatic, intrinsic of the joint, or extrinsic. The extrinsic omalgias, either of neurologic, cardiovascular, pulmonary, or abdominal etiology, require swift identification, as their treatment is often an emergency. Most of the scapulalgias can be treated conservatively. Main factors of poor prognosis are old age, women gender and associated cervicalgias.

Preventive and protective measures reducing influenza transmission in general practice: a systematic review.

BACKGROUND: Seasonal influenza and influenza-like illnesses are widespread, with an impact on GP consultations. GPs apply many preventive and protective measures to prevent seasonal influenza transmission, with no clear evidence of their effectiveness in this setting. AIM: To review the effectiveness of preventive and protective measures to reduce the transmission of seasonal influenza and influenza-like illnesses in GP practices. DESIGN & SETTING: A systematic review was conducted of the literature in Medline, Embase, and the Cochrane Central Register databases published between January 1960 and April 2014, later extended to January 2018. METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were used. Controlled trials and experimental studies were included. Study quality was assessed according to the Cochrane risk of bias tool. RESULTS: Out of 5727 articles screened, only two studies were finally retained: one study about the seasonal influenza vaccination of GPs to prevent transmission from patients or staff, and one about surface disinfection. The first study was a controlled trial, which showed limited evidence for seasonal influenza infection reduction among GPs through vaccination. The second, an experimental study, performed a virus screening on toys in the waiting area before and after disinfection. No study on protection measures was found that assessed the impact on influenza transmission in general practices. CONCLUSION: The evidence is scarce on interventions that reduce influenza transmission in GP practices.