Revue médicale suisse
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Intensive care units are highly stressful for the patients but for the caregivers as well, including nurse-assistants, nurses and physicians. The psychological syndrome of work exhaustion more commonly named burnout threatens these caregivers. ⋯ We suggest some possible ways to decrease the incidence of burnout. Finally, since the problematic of burnout is not specific to intensive care, we sought to underline some possible consequences of the burnout of caregivers on health systems.
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Revue médicale suisse · Dec 2012
Review[Non-invasive ventilation: indication for acute respiratory failure].
Mask or Non-invasive ventilation (NIV) is used for critically ill patients with acute respiratory failure (ARF): acute exacerbation of chronic obstructive bronchopulmonary disease and severe cardiogenic pulmonary edema are considered as the best indications for NIV since it improves the outcome of these patients. This technique is also proposed for hypoxemic respiratory failure, with more various results. ⋯ NIV is also proposed after invasive ventilation or in patients in whom endotracheal intubation is not desirable. Its use has increased and its effectiveness seems to have improved, due to a better understanding of the technique but also thanks to technological progress.
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Revue médicale suisse · Nov 2012
Review Case Reports[Respiratory bronchiolitis and respiratory bronchiolitis-associated interstitial lung disease].
The increasing use of chest CT imaging in medical practice rises the likelihood of the general practitioner to be confronted with cases of interstitial lung disease. Respiratory bronchiolitis (RB) and respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) are two smoking-related lung damages that may have important implications for the patient's management. The authors present in this paper a review of current knowledge of the epidemiology, clinical features, prognosis, and treatment options of RB and RB-ILD.
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Revue médicale suisse · Jun 2012
Review[Acute and postherpetic neuralgia in the elderly: analysis of evidence for therapeutic options].
Initiated within the first 72 hours of the rash, the aim of antiviral drugs prescribing is to reduce both acute neuralgia (AN) and later complications and especially postherpetic neuralgia (PHN). However their analgesic as well as preventative effect on AN and PHN is modest. ⋯ However medication selection and prescribed dosage in the context of old patients' frailty, co-morbidities and often polypharmacy must be carefully considered. Based on analysing the evidences from the literature, this review presents the therapeutic options we have at one's disposal and proposes a stepwise management for both AN and PHN specifically designed for aged population.
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Lobectomy via video-assisted thoracoscopic surgery (VATS) is now considered as a valid alternative to conventional thoracotomy for early-stage primary lung cancer. Various studies have reported that VATS lobectomy is a safe technique associated with fewer postoperative complications and better post-operative recovery than open thoracotomy. Furthermore, studies suggest oncological equivalence between VATS and open lobectomy.