Revue médicale suisse
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Revue médicale suisse · May 2012
Review Case Reports[Diffuse pulmonary lymphangiomatosis: (corrected) case report and literature review].
A 38 year old woman with a medical history of left pleurectomy and thoracic duct ligation for a recurrent chylothorax at age 21 was hospitalized for evaluation and treatment of a right sided pleural effusion and a pericardial effusion. A diffuse pulmonary lymphangiomatosis was diagnosed based on evidence obtained from a thoracic CT scan and from pleural and pericardial biopsies. ⋯ Although both effusions initially recurred and required subsequent drainage and treatment by colchicine, evolution at 19 months of diagnosis is favorable. This case illustrates the fact that the prognosis of diffuse pulmonary lymphangiomatosis in adults may be characterized by a less aggressive evolution and by a more favorable prognosis than that observed in children.
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Revue médicale suisse · May 2012
[General practitioners facing social inequalities in health: which power to act?].
The link between social inequalities and health has been known for many years, as attested by Villermé's work on the "mental and physical status of the working class" (1840). We have more and more insight into the nature of this relationship, which embraces not only material deprivation, but also psychological mechanisms related to social and interpersonal problems. Defining our possible role as physicians to fight against these inequalities has become a public health priority. Instruments and leads, which are now available to help us in our daily practice, are presented here.
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Revue médicale suisse · May 2012
Review[Treatment of chronic pain: transcranial stimulation of the motor cortex?].
Chronic pain refractory to medical therapy poses a therapeutic challenge. The repetitive Transcranial Magnetic Stimulation (rTMS) and transcranial Direct Current Stimulation (tDCS) modulate brain activity offering a new approach. Current evidence suggests a potential therapeutic efficacy of motor cortex stimulation for the treatment of pain, but does not (yet) support their recommendation for clinical practice. These methods allow to deepen our knowledge in the pathophysiology of chronic pain while providing new therapeutic approaches.