Revue médicale suisse
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In critical care medicine, collaborative networks are well-developped for clinical research. This model is equally interesting for care, education and management. ⋯ Networks are very interesting for their members because they allows some small ICUs to survive and avoid very expensive costs related to restructuration of the larger ones. Thus, this model will certainly develop during the next years.
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The authors express their views on the past, present and future of intensive care medicine in Switzerland. They point some past and present concerns in critical care medicine, but they insist on the future needs of this medical specialty: the critical patients necessitate, and have the right to obtain, a highly trained and specialized personnel, working in strong connection with the whole hospital, in a systemic way of treating patients. The authors insist on the very high complexity of the ICU-patients treated today.
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Rhino-sinusitis is one of the most complaint in ambulatory clinic sitting and nasal obstruction. This diagnosis is however difficult and general practitioners might overdiagnose acute bacterial sinusitis. ⋯ Acute sinusitis is very often a self-limiting disease. Antibiotics should be prescribed only after one week of symptoms' duration and in case of the presence of two additional criteria: pain and purulent nasal discharge with nasal obstruction.
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Hazards due to active smoking are known for a long time. On the other hand, the importance of the harmful effects of passive smoking are less recognized, having been shown initially mainly in the pediatric population. However, the importance of significant increased risks on various respiratory pathologies of the adult are well known today, in a Swiss society where the number of active smokers remains high, leading to a high prevalence of passive smoking exposure On the basis of recent publications and updates of various organizations, we propose a review of the history, noxious mechanisms and effects on various respiratory pathologies of the exposure to passive smoke in adults.