[Promotion of physical activity in the primary care setting: what is the situation in Switzerland?]. / Promotion de l'activité physique au cabinet médical: où en sommes- nous en Suisse?

If many harmful effects of a sedentary lifestyle on health are well known, we still need to better understand how effectively promoting regular physical activity in the general population. Among the currently explored strategies, screening for sedentary lifestyle and promoting physical activity in the primary care setting seem promising. Despite recommendations from governmental agencies and professional associations in favor of physical activity counseling, this approach has not been widely adopted so far. This article summarizes the steps taken in Switzerland with an aim of developing physical activity counseling in the primary care setting. It describes how the early implication of primary care physicians influenced in a concrete way the development of a project dedicated to that task.

[Otitis media with effusion: expectant management] / Otite média crônica secretora: conduta expectante.

OBJECTIVE: Despite the fact that chronic otitis media with effusion (OME) is an entity with a high prevalence among children, the real effectiveness of most treatments in use nowadays has not been completely established. Based on its natural course, we defend an expectant management as the initial treatment. METHODS: We undertook a review of the available data taking into consideration the natural history, epidemiology and therapeutic options for OME. We looked for a guideline concerning the best treatment for OME in children. RESULTS: The treatment of OME still remains controversial, in spite of many therapeutic options. In children, the best management still seems to be the observation, probably for a period of three to six months. However, interventionist treatment should be done earlier on those patients considered as high risk or in which a problem happened with their development, due to hearing loss secondary to OME. CONCLUSIONS: The understanding of the several factors involved in the pathogenesis of OME, as well as of the features in its evolutive course, encourage the idea of a conservative expectant approach at first or up to the moment in which an interventionist approach (clinical or surgical) is justified.