RESUMO
This article features a selection of ten topics chosen, reviewed, and commented for you by chief residents at the Department of Internal Medicine at Centre hospitalier universitaire vaudois (CHUV). This selection synthesizes the novelties and essential reminders of 2023 in internal medicine. By analyzing the standout publications of the year, it offers an overview of progress in diagnosis and patient management within the hospital and their transition to outpatient care. From oral anticoagulation to community-acquired pneumonias, encompassing the management of heart and kidney failure, each key aspect is explored. This compilation provides practitioners with an essential resource to remain at the forefront of current developments, thereby stimulating more informed and effective care for patients.
Cet article propose une sélection de dix sujets choisis, revus et commentés pour vous par les cheffes et chefs de clinique du Service de médecine interne du Centre hospitalier universitaire vaudois (CHUV). Cette sélection synthétise les nouveautés et rappels essentiels de 2023 en médecine interne. En analysant les publications phares de l'année, elle offre une vue d'ensemble des progrès dans le diagnostic et la prise en charge des patients intrahospitaliers et leur transition ambulatoire. De l'anticoagulation orale aux pneumonies communautaires en passant par la prise en charge des insuffisances cardiaque et rénale, chaque aspect clé est exploré. Cette compilation fournit aux praticiens une ressource essentielle pour rester à la pointe des développements actuels, stimulant ainsi des soins plus éclairés et efficaces pour les patients.
Assuntos
Assistência Ambulatorial , Médicos , Humanos , Coração , Hospitais , Medicina InternaRESUMO
According to PubMed statistics when writing this review, the year 2022 is expected to mark the first dip in the number of articles published in relation to the Covid-19 pandemic. This review, without any mention to Sars-CoV-2, highlight this transition and addresses many topics in internal medicine: gastroenterology, cardiology, endocrinology, respiratory medicine, infectious diseases and venous access. Each year, the chief residents of the internal medicine ward in Lausanne university hospital (CHUV) in Switzerland meet up to share their readings: here is a selection of ten articles that have caught our attention, summarized and commented for you, which should change our daily practice.
D'après les statistiques PubMed au moment de la rédaction de cette revue, l'année 2022 devrait marquer le premier infléchissement du nombre d'articles publiés en relation avec la pandémie de Covid-19. Cette revue d'articles, sans écho au Sars-CoV-2, souligne cette transition et aborde de nombreux sujets de la médecine interne : gastroentérologie, cardiologie, endocrinologie, pneumologie, infectiologie et accès veineux. Chaque année, les cheffes et chefs de clinique du Service de médecine interne du CHUV se réunissent pour partager leurs lectures : voici une sélection de dix articles ayant retenu notre attention, revus et commentés pour vous, et qui devraient faire évoluer notre pratique quotidienne.
Assuntos
COVID-19 , Pandemias , Publicações , Humanos , COVID-19/epidemiologia , Hospitais Universitários , Medicina Interna , Suíça , PubMed , Publicações/estatística & dados numéricosRESUMO
La maladie coronarienne est la principale cause d'insuffisance cardiaque à fraction d'éjection diminuée, avec l'observation chez certains patients d'une amélioration de la fonction systolique ventriculaire gauche après pontage aorto-coronarien. Ceci a conduit à l'hypothèse d'une certaine hibernation myocardique, l'idée étant qu'en reperfusant les territoires ischémiques, on pouvait recruter des cardiomyocytes. L'étude STICH a montré une meilleure survie à 10 ans des patients avec pontage par rapport au traitement médical seul, gain malheureusement non retrouvé à 5 ans en raison de la mortalité peropératoire dans le bras interventionnel. Les auteurs de cette étude (REVIVED) ont cherché à comparer un traitement de revascularisation percutanée par rapport au traitement médical standard chez les patients souffrant d'une insuffisance cardiaque d'origine ischémique.
Assuntos
Insuficiência Cardíaca , Humanos , Angiografia Coronária , Reperfusão , IsquemiaRESUMO
BACKGROUND: In Switzerland, patients may undergo "blood tests" without being informed what these are screening for. Inadequate doctor-patient communication may result in patient misunderstanding. We examined what patients in the emergency department (ED) believed they had been screened for and explored their attitudes to routine (non-targeted) human immunodeficiency virus (HIV) screening. METHODS: Between 1st October 2012 and 28th February 2013, a questionnaire-based survey was conducted among patients aged 16-70 years old presenting to the ED of Lausanne University Hospital. Patients were asked: (1) if they believed they had been screened for HIV; (2) if they agreed in principle to routine HIV screening and (3) if they agreed to be HIV tested during their current ED visit. RESULTS: Of 466 eligible patients, 411 (88%) agreed to participate. Mean age was 46 ± 16 years; 192 patients (47%) were women; 366 (89%) were Swiss or European; 113 (27%) believed they had been screened for HIV, the proportion increasing with age (p ≤ 0.01), 297 (72%) agreed in principle with routine HIV testing in the ED, and 138 patients (34%) agreed to be HIV tested during their current ED visit. CONCLUSION: In this ED population, 27% believed incorrectly they had been screened for HIV. Over 70% agreed in principle with routine HIV testing and 34% agreed to be tested during their current visit. These results demonstrate willingness among patients concerning routine HIV testing in the ED and highlight a need for improved doctor-patient communication about what a blood test specifically screens for.
