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Revue medicale suisse最新文献

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[No education without feedback: why and how to give it in the clinical setting]. [没有反馈就没有教育:为什么以及如何在临床环境中提供反馈]。
Q4 Medicine Pub Date : 2024-10-23 DOI: 10.53738/REVMED.2024.20.892.1945
Louise Bergqvist, Amandine Berner, Pauline Darbellay-Fahroumand, Matteo Coen

The number of medical students and doctors in training is growing, particularly in private practices due to the promotion of the internal medicine and primary care curriculum. Therefore, doctors increasingly find themselves in a teaching role with the responsibility to give feedback to the people in training. This article aims to give the definition of feedback and to review the reasons for its central role in pre- and postgraduate medical education. We describe the opportunities and barriers to giving feedback, how to make it effective and present a selection of frequently used feedback models.

由于内科和初级保健课程的推广,医科学生和受训医生的人数不断增加,尤其是在私人诊所。因此,医生们发现自己越来越多地扮演着教学角色,有责任向受训人员提供反馈。本文旨在给出反馈的定义,并回顾其在医学预科和研究生教育中发挥核心作用的原因。我们描述了反馈的机会和障碍,如何使反馈有效,并介绍了一些常用的反馈模式。
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引用次数: 0
[Management of opioid-induced constipation : the old and the new]. [阿片类药物引起的便秘管理:新与旧]。
Q4 Medicine Pub Date : 2024-10-23 DOI: 10.53738/REVMED.2024.20.892.1919
Jérémy Arm, Matteo Coen, Sophie Pautex, Mathieu Nendaz

The use of opioids has increased over the past 20 years. Among their side effects, constipation is probably the most common. Managing opioid-induced constipation primarily involves laxatives from the onset and addressing any additional causes of constipation. The laxatives of choice for this condition are, firstly, macrogol, followed by stimulant laxatives. If these first-line measures fail, peripheral mu-opioid receptor agonists (PAMORA) can be considered ; however, their coverage by Swiss health insurances remains limited to date.

在过去 20 年里,阿片类药物的使用有所增加。在阿片类药物的副作用中,便秘可能是最常见的一种。治疗阿片类药物引起的便秘主要包括从一开始就使用泻药,并解决引起便秘的其他原因。治疗这种情况的首选泻药首先是大环内酯类泻药,其次是刺激性泻药。如果这些一线措施无效,可以考虑使用外周μ-阿片受体激动剂(PAMORA);不过,迄今为止,瑞士医疗保险对这些药物的承保范围仍然有限。
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引用次数: 0
[Alternatives to the intravenous route in emergency situations]. [紧急情况下静脉注射途径的替代方案]。
Q4 Medicine Pub Date : 2024-10-23 DOI: 10.53738/REVMED.2024.20.892.1961
Elise Ramel, Thomas Schmutz, Alexandre Deglise, Vincent Ribordy, Youcef Guechi

Patients in emergency situations or life distress most often need a intravenous line (IV) to give them the medications they need. The IV route is the preferred route to treat most of the patients in emergency situations out of hospital or in the emergency room but can be very tricky to obtain. Various alternatives have been developed, such as the intraosseous route, particularly useful in cases of venous collapse (shock, cardiorespiratory arrest), the intramuscular route (anaphylaxis, sedation) or the intranasal route (status epilepticus, analgesia). This article reviews the indications, contraindications and pharmacology of these different routes.

急诊或生命垂危的病人通常需要静脉注射给药。静脉注射是在医院外或急诊室治疗大多数急诊病人的首选途径,但获得静脉注射非常困难。目前已开发出多种替代途径,例如在静脉塌陷(休克、心肺骤停)情况下特别有用的骨内途径、肌肉注射途径(过敏性休克、镇静)或鼻内途径(癫痫状态、镇痛)。本文回顾了这些不同途径的适应症、禁忌症和药理学。
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引用次数: 0
Formation post-graduée, carrière médicale et bien-être : c’est possible ! 研究生培训、医疗事业和幸福:这是可能的!
Q4 Medicine Pub Date : 2024-10-23 DOI: 10.53738/REVMED.2024.20.892.1911
Amandine Berner, Violene Porto, Camille Renold, Jean-Luc Reny
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引用次数: 0
Une nouvelle arme contre la maladie rénale chronique chez les diabétiques de type 2 ? 防治 2 型糖尿病患者慢性肾病的新武器?
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1907
Kevin Villat
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引用次数: 0
Comment former les médecins de demain ? 如何培养未来的医生?
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1898
Mathieu Nendaz
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引用次数: 0
L’identité professionnelle pour ­réenchanter la médecine. 重新赋予医学以专业身份。
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1899
Idris Guessous
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引用次数: 0
[Trial of labor and gynecological uterine scars : a narrative review]. [试产与妇科子宫疤痕:叙述性综述]。
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1880
Chiara Santarelli, Pauline De Vries, Patrice Mathevet, Hélène Legardeur

The increasing number of women of childbearing age with gynecological uterine scars presents a significant clinical challenge. -Planning the route of birth for a subsequent pregnancy necessitates -careful consideration and should be the subject of an informed -discussion. Unfortunately, the heterogeneity of data in the literature with regards to gynecological uterine scars makes this choice -debatable. Although the use of less invasive surgical procedures in this context is on the rise, there is currently a lack of robust data on their obstetric repercussions. This article -explores risk factors for uterine rupture in the view of gynecological uterine scars and -provides pragmatic recommendations for clinicians.

越来越多的育龄妇女患有妇科子宫疤痕,这给临床带来了巨大的挑战。-为以后的妊娠规划分娩途径需要慎重考虑,并应在知情的情况下进行讨论。遗憾的是,文献中关于妇科子宫疤痕的数据不尽相同,使得这一选择存在争议。尽管在这种情况下使用创伤较小的手术方法的情况正在增加,但目前缺乏有关其产科影响的可靠数据。本文探讨了妇科子宫疤痕导致子宫破裂的风险因素,并为临床医生提供了务实的建议。
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引用次数: 0
[Uterine conservative treatment for placenta accreta : new standard?] [胎盘早剥的子宫保守治疗:新标准?]
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1856
Tania Metaxas, Elisabeth Garcia Vilaplana, Clarisse Peter-Berner, Jose Miguel Palacios-Jaraquemada, Albaro Jose Nieto-Calvache, Begoña Martinez De Tejada, Jean-Marie Pellegrinelli

Placenta accreta spectrum (PAS) is among the most dangerous obstetric conditions due to elevated risk of massive hemorrhage. Ultrasound is PAS's preferred screening method. This article -introduces the new topographic classification of PAS, allowing for treatment selection, whether radical or conservative. This classification enables considering the One-Step Conservative Surgery (OSCS), a technique that could potentially avoid up to 80% of cesarean -hysterectomies in cases of PAS. This article details the procedure and -eligibility criteria for the OSCS. This promising technique could significantly reduce maternal morbidity and mortality. Finally, the possibility of training in these techniques through telemedicine opens new avenues for conservative uterine treatment in the -context of PAS.

胎盘早剥谱(PAS)是最危险的产科疾病之一,因为大出血的风险很高。超声波是 PAS 的首选筛查方法。本文介绍了 PAS 的新地形分类,以便选择根治或保守治疗。通过这种分类,可以考虑一步保守手术(OSCS),这种技术有可能避免多达 80% 的 PAS 剖宫产手术。本文详细介绍了 OSCS 的手术过程和资格标准。这项前景广阔的技术可以大大降低孕产妇的发病率和死亡率。最后,通过远程医疗对这些技术进行培训的可能性为PAS情况下的子宫保守治疗开辟了新的途径。
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引用次数: 0
Image en dermato. 皮肤图像。
Q4 Medicine Pub Date : 2024-10-16 DOI: 10.53738/REVMED.2024.20.891.1904
Christophe Hsu
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引用次数: 0
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Revue medicale suisse
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