Revue medicale suisse最新文献

The indwelling urinary catheter is a frequent procedure which has a significant nosocomial impact with a risk of infectious and non-infectious complications. Studies show a reduction in the risk of these complications thanks to better monitoring of recommendations as part of programs within healthcare establishments aimed at improving professional practices (indication, monitoring, etc.). A program of this type has been set up at the Trois Chêne geriatric hospital (Geneva University Hospitals). This is an interprofessional quality project developed along 4 axes: improving knowledge and use of equipment, developing an interprofessional training course to develop a common culture of good practices, improving clinical documentation and developing monitoring indicators quality.

The concept of femoro-acetabular impingement (FAI) rests on three pillars: cam-deformity, pincer-deformity and abnormal femoral torsion. Several treatment modalities exist, ranging from conservative management to open or arthroscopic surgery. The type of treatment depends on the pathomorphology, the severity of symptoms, thepatient's age and the extent of the degenerative lesions. The aim of treatment is to reduce pain, obtain a physiological range of movement as well as a stable hip, and ideally to delay the onset of secondary osteoarthritis in the long term. A first article dealt with the concept and diagnosis of FAI, this one takes a look at its treatment.

This article explores the diagnosis of Mild Cognitive Impairment (MCI) in general practice. It examines the subtypes of MCI and their specific diagnostic criteria for different neurodegenerative conditions such as Alzheimer's disease, Parkinson's disease, fronto-temporal dementia and cerebrovascular disorders. It highlights the preferential use of the Montreal Cognitive Assessment (MoCA) over the Mini-Mental State Examination (MMSE) for detecting MCI. A MoCA score below the norm (< 26 points) warrants a more thorough diagnostic work-up, including a full neuropsychological assessment and possibly brain imaging.

Faecal incontinence (FI) in the elderly is a common but underdiagnosed condition. It leads to social stigma and impacts patients' quality of life. The aetiology of FI is multifactorial. Assessment, diagnosis and management involve a comprehensive evaluation. Treatment encompasses a multimodal approach, ranging from lifestyle modifications, the use of certain drugs, a physiotherapeutic approach to surgical interventions in selected cases. The important role of health professionals in education, support, and personalised interventions is emphasised.

Patients aged 80 years and older represent a growing proportion of admissions to intensive care units (ICU) and are burdened by high mortality rates. Due to the complexity of their medical and social needs, a holistic approach is essential. Collaboration between intensivists and geriatricians could improve the overall management of older patients. This cooperation will enable more accurate assessments and personalized treatment decisions throughout the triage, hospitalization, and discharge phases, thus optimizing the outcomes for this vulnerable population.

The concept of autism has led to the inclusion of increasingly heterogeneous and atypical individuals. Clinicians find it difficult to establish clear boundaries between autism, other psychiatric and/or neurodevelopmental disorders and atypical individuals, despite standardized instruments. What's more, these standardized instruments have been built around the male phenotype, and do not allow for an accurate assessment of autism in women. Whatever the gender, the diagnosis is based on multiple, variable, disabling and persistent deficits. Finally, we'll mention a few recommendations to help clinicians make a diagnosis or invoke the precautionary principle.

The use of GLP-1 receptor agonists and iSGLT2 is becoming increasingly common, in line with new guidelines issued by the learned societies of cardiology, nephrology and diabetology. However, the enthusiasm aroused by these new drugs needs to be tempered and their use in the very elderly and/or frail needs to be carefully considered by the lack of scientific studies in this population category, , and their prescription requires a comprehensive geriatric assessment before initiating this type of treatment.