Revue médicale suisse
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Revue médicale suisse · Jun 2014
Review Historical Article[Childrens' pain, a complex entity to be explored].
From unrecognized babies' pain, to new discoveries made on early emotional memory and sensory capacities, chronic pain in childhood remains a complex field still to be explored. Besides, the discovery of early fetal sensorial receptions is an opening to new understanding of the origin of psychological chronic pain from early childhood to adolescence. From the silent babies suffering of emotional regulation disorder to adolescents' chronic recurrent pains, a common point is the expression of a psychic disease through the body. Different therapeutic actions are described, because without treatment chronic or recurrent pains may lead to a real risk of intellectual, affective and drive impoverishment for the suffering child.
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Revue médicale suisse · Jun 2014
Review Historical Article[Medicine and pain: history of a relationship].
The vagueness surrounding the terms "suffering" and "pain" invites us to reflect upon the relationships between a physiological fact and a constitutive dimension of the human experience. History shows a constant medical preoccupation facing pain as a clinical symptom, endowed with a rich terminology, many ways of relieving pain and speculations on its diagnostic value. ⋯ This development accompanies an evolution of medical practices on pain that, far from representing continuous progress, adopts rather uneven and sometimes surprising outlines. As a whole, medicine is characterised by an important ambivalence when confronting pain, valuating it as an useful auxiliary or on the contrary denying the painful experience.
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Revue médicale suisse · Jun 2014
Review[Adolescents with chronic pain: practical assessment and management].
More than 20% of adolescents in the general population suffer of chronic pain mainly headaches, abdominal or musculoskeletal pain. Often, these complaints are self limited without impact on adolescent development but the cause of emergency consultations, unnecessary costs or inappropriate prescriptions. ⋯ Primary care phyisicians play a crucial role (private practice, adolescent clinic...). Efforts should be made to increase access to modern approaches of chronic pain taking into account family, development as well as aspects related to pain in itself.
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This article presents a critical review of the literature about the potential benefit of cardiac pacing in patients suffering from vasovagal or neurocardiogenic syncope. The manifestation of vasovagal syncope comprises some reflex bradycardia and vasoplegia resulting in cerebral hypoperfusion that ultimately leads to a loss of consciousness. ⋯ A detailed analysis of the inclusion criteria of these studies permits to clarify the discrepancy. Only patients older than 50 years with prolonged sinus pause at time of syncope benefit of the implantation of a cardiac pacemaker.
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Revue médicale suisse · May 2014
Review[Quality improvement initiatives in hospitals: which one to choose].
The number of quality improvement initiatives in hospitals has been steadily increasing in the last decades. Most of these initiatives are inspired by three quality control and improvement models developed in the manufacturing industry: the final inspection, the quality assurance and the total quality management. The purpose of this review is to describe how these methods have been implemented in healthcare organizations and to assess their effectiveness and acceptability by healthcare professionals. This review should help quality managers and healthcare professionals to choose a model that is best adapted to their needs and expected goals.