RESUMO
Our selection of articles published in 2021 sheds light on topics related to risk, and to the use of electronic tools in primary care medicine. They cover blood pressure targets, telemonitoring, and the omega-3 fatty acid diet in the elderly and/or in patients with high cardiovascular risk. They present the role of primary care physicians in the management of patients with NAFLD, and in screening for domestic violence in all couples. They assess the risk of recurrence of a depressive episode after stopping antidepressant treatment. Finally, they discuss the place of apps to communicate with foreign-speaking patients and of vaping in smoking cessation.
Notre sélection d'articles parus en 2021 propose un éclairage sur des sujets en lien avec le risque chez nos patient·e·s et l'usage d'outils électroniques. Ils abordent le thème des cibles tensionnelles, du télémonitoring, et du régime riche en acides gras oméga 3 chez la personne âgée et/ou à haut risque cardiovasculaire. Ils présentent le rôle des médecins de premier recours dans la prise en charge de patient·e·s avec une stéatopathie métabolique, et dans le dépistage des violences conjugales dans tous les couples. Ils évaluent les risques de récidive d'épisode dépressif à l'arrêt d'un traitement antidépresseur. Enfin, ils discutent la place des applications pour la communication avec les patient·e·s allophones et du vapotage dans l'arrêt du tabac.
Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Vaping , Idoso , Pressão Sanguínea , Eletrônica , Humanos , Atenção Primária à SaúdeRESUMO
Caring for victims of harassment can be difficult. Different forms exist, some of which are difficult to detect. Every general practitioner must pay attention to the various warning signs that the victim may present. Careful, empathetic listening on the part of the general practitioner is necessary to take care of these victims. An important place in the consultation is the medical report, which can be used later in a legal process. The general practitioner does not work alone, can count on other medical and non-medical partners. Victims of harassment are also supported by various associations.
La prise en charge des victimes de harcèlement peut s'avérer difficile. Différentes formes, dont certaines difficiles à détecter, existent. Chaque médecin de premier recours doit prêter attention aux différents signaux d'alerte et facteurs de risque que peut présenter la victime. Une écoute attentive, empathique de la part du médecin généraliste est nécessaire pour prendre en charge ces victimes. Le constat médical tient une place importante, qui peut servir plus tard dans une démarche judiciaire. Le médecin ne travaillant pas seul peut compter sur d'autres partenaires médicaux et non médicaux. Les victimes de harcèlement sont par ailleurs soutenues par différentes associations.
Assuntos
Médicos de Atenção Primária , Assédio Sexual , HumanosRESUMO
Traditionally, the doctor has focused his efforts on mastering medical knowledge. Given the challenges facing him, the medical institutions and the society, it becomes clear that his concern must also be about how this medical knowledge hits the patients and the general population. Knowing how to deliver our care is now as important as having the medical knowledge ! In this article, we present new models of healthcare delivery that we implemented or plan to implement in Geneva, Switzerland.
Traditionnellement, le médecin a concentré ses efforts sur la maîtrise de la connaissance médicale. Face aux enjeux qui se présentent à lui, aux institutions et à la société, il devient évident que sa préoccupation doit également se porter sur la façon dont cette connaissance médicale atteint les patients et la population en général. Savoir délivrer nos soins est désormais aussi important que d'avoir les connaissances médicales ! Dans cet article, nous présentons des nouveaux modèles de soins de santé que nous avons mis en Åuvre ou prévoyons de mettre en Åuvre à Genève, en Suisse.
Assuntos
Atenção à Saúde , HumanosRESUMO
Violence in men represents a global health burden and a serious problem of public health, with severe repercussions on physical, psychic and social health. The cost is very high for society. Men are often the authors of violence, but they also can be victims or witnesses. Violence presents itself under diverse forms and differently affects women and men in the various phases of their life and also depends from specific features, such as social status, sexual orientation and morbidities. We propose an overview of several points concerning violence in men that are relevant for general practice.
Fléau mondial, les violences sont un véritable problème de santé publique pouvant avoir des répercussions graves sur la santé globale, y compris chez l'homme, qu'il soit auteur, victime ou témoin de violences, et pour lequel cette problématique reste à ce jour peu connue des praticiens. Ces violences se manifestent en partie différemment que chez la femme et dans les différentes phases de la vie, de même qu'en fonction du statut social, de l'orientation sexuelle et des morbidités. Nous aborderons dans cet article différents points nécessaires à la pratique du médecin de premier recours face aux violences chez les hommes.
Assuntos
Saúde Global , Saúde Pública , Violência/estatística & dados numéricos , Feminino , Clínicos Gerais , Humanos , Masculino , Fatores SexuaisRESUMO
Elder abuse and in particular material and financial exploitation involving the misappropriation of the older person's money or property is common but rarely identified or managed in clinical practice. It has a direct impact on quality of life, health and social status. Our aim is to assist clinicians by summarizing this frequently unrecognized problem. We discuss risk factors, alerting signs, clinical manifestations, and specific questions that can be used for screening purposes as well as intervention strategies preferably in the context of a multidisciplinary team.
Assuntos
Abuso de Idosos/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Abuso de Idosos/diagnóstico , Abuso de Idosos/economia , Feminino , Humanos , Programas de Rastreamento/métodos , Fatores de RiscoRESUMO
This review of articles published in 2010 covers the new role of dabigatran in atrial fibrillation, the lack of efficacy on pain of chondroïtine/ glucosamine in knee arthrosis, the risk of thrombosis with antipsychotics, the increase cardiovascular risk in case of migraine with aura and the insufficient prescription of adjuvant chemotherapy in elderly with colon cancer. Authors also highlight public health topics such as the association of poor oral hygiene and increased cardiovascular risk, the positive effect of opioid substitution therapy by primary care practitioners on mortality, the high frequency of prenatal violence on pregnant women and the negative impact of financial constraint on the risk of hospitalization.
Assuntos
Assistência Ambulatorial , Medicina Interna , HumanosRESUMO
In March 2009, the body of a 51-year-old man was found in the boot of his car. The body had been frozen before being dismembered at the abdomen. The autopsy failed to determine the cause of death. Systematic toxicological analyses of the victim's peripheral blood and urine showed the presence of atropine, a powerful anticholinergic. Atropine was therefore specifically detected and quantified throughout the victim's biologic samples by HPLC-MS² in the biologic fluids and UHPLC-MS² in the hair. The atropine concentrations were 887 ng/mL in the cardiac blood, 489 ng/mL in the peripheral blood, 6693 ng/mL in the gastric contents (1.1 µg), 6753 ng/mL in the urine, and 2290 pg/mg in the hair. The blood concentrations measured in the decedent were consistent with an overdose of atropine, which was determined as the cause of death. The manner of death was a homicide with criminal intent.