Revue médicale suisse
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Revue médicale suisse · Feb 2007
Review[The differential diagnosis of cognitive disorders in general practice: dementia and delirium].
Cognitive deficits are frequently encountered in primary care settings, in particular in the elderly. Screening of these deficits is recommended and aims at identifying subjects who are likely to benefit from treatment. ⋯ Laboratory tests and neuro-imaging are often necessary. This multi-dimensional assessment may require the expertise of a memory clinic to distinguish normal aging, mild cognitive impairment, and to identify the different organic and functional aetiologies of the dementia syndrome and delirium.
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Neurology is a polymorphic discipline, with several subspecialties. In 2006, as in the previous years, a huge amount of scientific work focusing on treatment has been published. ⋯ This allows to consider more and more variables when administering a specific treatment, therefore, in each subspecialty a move towards a better patient's care has been made. In this contribution, several specialists analyse and interpret new facts about their respective neurological domain.
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Revue médicale suisse · Jan 2007
Review[Pneumology. Anti-IgE antibodies in the treatment of asthma].
Omalizumab is a humanized monoclonal antibody that is directed against IgE. It has been shown to improve the control of severe allergic asthma in adults and adolescents. Candidates to the treatment are asthmatic patients with positive prick tests and/or in vitro markers of allergy, altered pulmonary function tests, and persistent daytime or nocturnal symptoms despite appropriate treatment with inhaled corticosteroids and long-acting beta-2-agonists.
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Revue médicale suisse · Dec 2006
Review[What about quality of life in elderly intensive care survivors?].
Elderly patients are more and more frequent in intensive care units (ICU). Few studies focused on the ouality of life (QOL) of those patients after ICU. QOL refers to the subjective perception of the health status by the patient himself. ⋯ Elderly patients have usually a reduced functional status compared to the general population, or compared to younger ICU patients. QOL of these patients seems to be comparable to the QOL before ICU admission, especially in the psychological and mental domains, but it is sometimes reduced in the physical domains. Those results seem to be explained by a better acceptance by the elderly of their physical difficulties.
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Revue médicale suisse · Dec 2006
Review[Tight glucose control in the ICU: how aggressive should we be?].
The issue of tight glucose control in intensive care remains controversial. Compelling evidence supports the use of intensive insulin therapy in postoperative patients, particularly those who have undergone cardiac surgery. ⋯ These data suggest that the optimal target for blood glucose needs to be better defined in critical care practice and might depend on the underlying pathology. Therefore, while awaiting the results of multi-centric studies, including a large heterogeneous cohort, a less aggressive approach for glucose control is preferable in the majority of critically ill patients.