[Highlights of Swiss congress of internal general medicine : part 1]. / Highlights du congrès 2022 de la Société suisse de médecine interne générale: partie 1.

From June 1 to 3, 2022, Lausanne held the spring congress of the Swiss Society of General Internal Medicine: "Changes and Opportunities". In this article, chief residents in internal medicine from the CHUV summarize presentations they attended. In this overview, we choose to focus on cardiovascular health, as it a central topic in general and internal medicine. Cardiovascular prevention becomes more personalized by using a step-by-step approach. The benefits of statin treatment in persons over 70 years old is still controversial. Ortho-static hypotension in hypertensive patients should not hold back antihypertensive therapy, but it should favor a combined pharmacological and non-pharmacological approach. Finally, screening for fibrosis in non-alcoholic fatty liver disease in high-risk cardiovascular patients should now part be part of a systematic ambulatory process.

Du 1er au 3 juin 2022 se tenait à Lausanne le congrès de printemps de la Société suisse de médecine interne : « Changes & Opportunities ¼. Les chefs de clinique du Service de médecine interne du CHUV vous résument les présentations auxquelles ils ont assisté. Sujet central en médecine interne générale, nous privilégions la santé cardiovasculaire dans cette synthèse. La prévention cardiovasculaire s'individualise avec une approche dépendante du risque cardiovasculaire. Les statines en prévention primaire sont controversées chez les patients de plus de 70 ans. L'hypotension orthostatique du patient hypertendu ne doit pas entraver le traitement de l'hypertension mais se contrôler par des mesures spécifiques. Finalement, dépister la fibrose de la stéatose hépatique non alcoolique chez les patients à risque fait partie d'une démarche ambulatoire systématique.

[Highlights of Swiss congress of internal general medicine: part 2]. / Highlights du congrès 2022 de la Société suisse de médecine interne générale : partie 2.

From June 1 to 3, 2022, Lausanne held the spring congress of the Swiss Society of General Internal Medicine: "Changes and Opportunities". In this article, chief residents in internal medicine at CHUV summarize presentations they attended. Internal general medicine is established in french-speaking Switzerland as a transversal specialty, which is reflected in this synthesis with very varied subjects. In thromboembolic disease, the duration of anticoagulation is now based on risk of recurrence. The thrombotic microangiopathy benefit nowadays from targeted therapy which improve diseases' outcomes. The new anti-viral therapy against SARS-CoV-2 (nirmatrelvir/ritonavir) is associated with numerous drug interactions. Finally, professors from Switzerland and abroad give their advices for scientific writing and academic career initiation.

Du 1er au 3 juin 2022 se tenait à Lausanne le congrès de printemps de la Société suisse de médecine interne : « Changes & Opportunities ¼. Les chefs de clinique du Service de médecine interne du CHUV vous proposent ici des résumés de quelques présentations. Cette synthèse aborde des sujets très variés reflétant la transversalité de la médecine interne générale. La durée d'anticoagulation de la maladie thromboembolique s'articule selon le risque de récidive. Les microangiopathies thrombotiques bénéficient de thérapies ciblées, qui améliorent leur pronostic. Le n­ouveau traitement antiviral contre le SARS-CoV-2 (nirmatrelvir/ritonavir) induit de multiples interactions médicamenteuses. Et pour finir, quelques conseils pour la rédaction d'un article scientifique et l'initiation d'une carrière académique.

[Geriatrics]. / Gériatrie.

Sleeping enough is associated with a reduced risk of mortality and dementia. New evidence support regular physical exercise, including at home, as a corner stone intervention to prevent falls and fractures. In contrast, supplementation with high doses of vitamin D is ineffective and even deleterious in this indication and a routine screening in asymptomatic adults is not recommended. Several studies illustrate our difficulties in prescribing and deprescribing in frail older patients and a study suggests that statins in cardiovascular primary prevention should considered only when a patient's life expectancy exceeds 2.5 years. Finally, several studies have fueled the debate about screening for hearing impairment.

Dormir ni trop ni trop peu est associé à une réduction du risque de mortalité et de déclin cognitif. De nouvelles études confirment que l'exercice physique régulier, y compris à domicile, constitue la clé de voûte de la prévention des chutes et des fractures. Par contre, la supplémentation par de hautes doses de vitamine D n'est pas efficace, voire délétère, dans cette indication et le dépistage systématique d'un déficit n'est pas recommandé chez les patients adultes asymptomatiques. Plusieurs études illustrent nos difficultés à prescrire et déprescrire, chez les patients âgés fragiles, et une étude suggère qu'un traitement de statines en prévention cardiovasculaire primaire ne se justifie que si l'espérance de vie du patient dépasse 2,5 ans. Finalement, plusieurs études sont venues nourrir le débat sur le dépistage de la presbyacousie.

Associations Between Physical Activity Patterns and Cardiovascular Events and Risk Factors: Cross-Sectional and Prospective Studies.

Background: Moderate-intensity physical activity (PA) is recommended for health benefits, but optimal PA timing regarding cardiovascular disease (CVD) is debated. Objectives: The authors assessed the impact of differing PA patterns on CVD risk factors and outcomes. Methods: Data from 2 surveys (S1 and S2) of the CoLaus-PsyCoLaus study (2,465 and 1,692 participants, respectively; 55.3% [54.3%] females; mean age 61.2 ± 9.7 years [64.4 ± 9.5]), conducted in Lausanne, Switzerland. PA was assessed using a wrist-worn accelerometer, and PA patterns were assessed using K-means clustering. Results: Morning PA was positively associated with hypertension (multivariable-adjusted OR: 1.36 [95% CI: 1.00-1.84]) in S1, similar trend in S2. No significant association was found between PA clusters and total, HDL-, and LDL-cholesterol or triglycerides. Morning PA was positively associated with hypolipidemic drug treatment: 1.88 (1.07-3.30) in S2. Evenly distributed daily PA was positively associated with diabetes: 1.82 (95% CI: 1.06-3.12) in S2, with a similar trend in S1. In the outcome analysis, the early morning PA cluster (7 am-12 am) and the evenly distributed daily PA cluster led to a higher risk of CVD events (HR: 3.33 [95% CI: 1.08-10.3] and 3.16 [95% CI: 1.04-9.57], respectively). Conclusions: In a population-based study, we observed a higher risk for cardiovascular events in participants whose daily PA occurred predominantly in the early morning (7 am-12 am) or was evenly distributed throughout the day. No PA pattern was consistently associated with hypertension, blood lipids, or diabetes markers.