[POCUS (Point-of-Care Ultrasonography) in internal general medicine: applications scope and training]. / POCUS (Point-of-care ultrasonography) en médecine interne générale†: champ d'application et formation.

POCUS is a valuable tool for the internist. Its field of application in internal medicine is multisystemic and requires rigorous training. This training includes an initiation phase, followed by a practical training phase for the acquisition of images from patients or simulators. Supervision by experts is vital for mastering the necessary skills for the safe use of POCUS. Although, supervisors are available in French speaking Switzerland, there are too few to meet training needs. Several associations provide training courses to obtain POCUS certification, the content of which has been established since 2018 in Switzerland. In order to maintain a high level of proficiency and to identify tomorrow's supervisors, it is essential to provide the necessary means to allow more internists to obtain POCUS certification.

Le POCUS (Point-of-care ultrasonography) est précieux dans la pratique de l'interniste. Son champ d'application en médecine interne est multisystémique et requiert une formation rigoureuse qui comporte une phase d'initiation et une phase de formation pratique pour l'acquisition des images sur patients ou simulateurs. La supervision par des experts est primordiale pour l'acquisition des compétences nécessaires à l'emploi sûr du POCUS. Les superviseurs existent en Romandie, mais sont trop peu nombreux pour répondre à la demande. Plusieurs associations offrent des formations pour l'obtention du certificat POCUS dont le contenu est établi depuis 2018 en Suisse. Il est essentiel d'engager les moyens nécessaires pour permettre à plus d'internistes d'obtenir cette certification POCUS, pour maintenir un niveau élevé de compétences et identifier les superviseurs de demain.

[Targeted ultrasound in the general practitioner's office†: The GREC perspective]. / Échographie ciblée au cabinet médical†: la perspective du GREC.

This article has been brought to you by clinicians in general internal medicine passionate about ultrasound, using it for many years daily and having long been committed to training in abdominal ultrasound. The term POCUS, Point-Of-Care Ultrasound or targeted ultrasonography, has appeared in recent years, quickly establishing itself as an essential tool in certain specialties, such as emergency medicine. Since 2018, the Swiss Institute for Medical postgraduate and continues Education (ISFM) delegates training and accreditation of POCUS in various specialties to the Swiss Society of Ultrasound in Medicine (SSUM). However, we did not wait for the term POCUS to use it, our daily medical life leading us to regularly use this tool in a very targeted manner, depending on the requirements of our patients.

Cet article vous est proposé par des médecins internistes généralistes passionnés d'échographie, l'utilisant dans leur pratique quotidienne et engagés de longue date dans la formation des médecins en échographie abdominale. Le POCUS (Point-of-care ultrasonography ou ultrasonographie ciblée), est apparu ces dernières années et s'est rapidement imposé comme un outil incontournable dans certaines spécialités comme la médecine d'urgence. Dès 2018, l'Institut suisse pour la formation médicale postgraduée et continue (ISFM) délègue à la Société suisse d'ultrasons en médecine (SSUM) les formations et l'accréditation du POCUS dans diverses spécialisations. Or, nous n'avons pas attendu l'apparition des POCUS pour en faire, étant régulièrement amenés à utiliser cet outil de manière très ciblée, en fonction de la clinique de nos patients.

Ultrasonography : an useful diagnostic tool for the general practitioner. / Echographie : un outil utile pour la démarche diagnostique en médecine de famille.

The ultrasound has become an increasingly popular tool in the clinical assessment of patients, not least in the field of general medicine. The technical evolution as well as the recent changes of the application of ultrasounds allows for rapid and targeted exams that has the potential to improve the care of patients. With the help of recent articles regarding ultrasound (US) in general medical practice, this article presents several useful indications for the primary care physician as well as shows today's training in Switzerland and demonstrates the need of an adapted training to better respond to today's need.

L'échographie est devenue un outil de plus en plus populaire pour l'évaluation et l'examen clinique des patients, notamment dans le domaine de la médecine de famille. L'évolution de la technique et les modes d'utilisation permettent des examens ciblés et rapides qui promettent d'améliorer la qualité des soins aux patients. Basé sur des études récentes traitant du sujet de l'ultrasonographie (US) en médecine générale, cet article présente les indications d'utilisation de l'échographie par le médecin de premier recours, il démontre le niveau de formation actuelle en Suisse et aborde la nécessité d'une formation adaptée pour mieux répondre aux besoins d'aujourd'hui.

Screening and treatment for latent tuberculosis infection among asylum seekers entering Switzerland.

AIM OF THE STUDY: To evaluate the compliance of doctors and patients with the current recommendations for screening and preventive treatment of immigrants with a positive tuberculin skin test (TST) suggestive of latent tuberculosis infection (LTBI). METHODS: Retrospective cohort study of all asylum seekers entering Switzerland between 1 January 1993 and 31 December 1993 and assigned to the cantons of Aargau, Fribourg, Geneva, Neuchâtel, Valais and Vaud, who underwent a TST at the border. The medical documents of all individuals with a TST size suggestive of LTBI (> or = 10 mm in children <15 years, > or = 18 mm in young adults aged 15-25 years) were reviewed for final diagnosis, therapeutic decision, compliance with treatment if prescribed, and notification for tuberculosis within the next 3 years. RESULTS: Among 2515 asylum seekers, 172 had a positive TST suggestive of LTBI. The documents of 93 persons were available. The final diagnosis was LTBI in 71 cases, possible tuberculosis in 10 cases, an effect of BCG immunisation in 10 cases, and other diagnoses in 2 cases. Among 82 individuals with normal chest X-ray or no radiological examination, only 37 (46%) received a preventive treatment and one a full course of antituberculosis drugs. Among 11 persons with an abnormal chest X-ray, 2 received a full course of antituberculosis drugs, 7 a preventive therapy and 2 had no treatment prescribed. Among the 44 subjects in whom a preventive treatment was prescribed, 30 adhered to the treatment regimen. One case (without prescribed treatment) was notified for tuberculosis two years after entry. CONCLUSIONS: Compliance of doctors and patients with current recommendations for examination and treatment of immigrants with a TST suggestive of LTBI is unsatisfactory. New guidelines are needed to provide a clearer definition of the indications and explain the benefits of treating LTBI.