[Parenteral nutrition : choosing the adequate vascular access].

Malnutrition is a common condition among hospitalized patients and has an important impact on morbidity and mortality. Despite enteral nutrition being the preferred option for patients requiring artificial alimentation, parenteral nutrition (PN) can be required. This article emphasizes the importance of choosing the adequate vascular access based on the chosen PN.

[Haloperidol is not the first choice for every case of delirium].

Haloperidol is frequently used as first-line treatment for delirium. The Swiss Smarter medicine campaign recommends to favor non-pharmacological interventions and treatment of the underlying causes, in order to limit the use of haloperidol. When antipsychotics are necessary, they should be prescribed cautiously, taking into account contraindications and potential side effects.

SARS-CoV-2 neutralizing antibody response in vaccinated and non-vaccinated hospital healthcare workers with or without history of infection.

Between March 2021 and February 2022, SARS-CoV-2 neutralizing antibodies dynamics was investigated in a prospective observational study in 903 healthcare workers of a hospital in Switzerland. A surrogate neutralization assay measuring the competitive inhibition of the angiotensin converting enzyme 2 (ACE2) binding to the spike protein (S) of the SARS-CoV-2 wild type virus and to five variants of concern (Alpha, Beta, Gamma, Delta, Omicron) was used. We observed a broad distribution of neutralization activity among participants and substantial differences in neutralizing titers against variants.

SARS-CoV-2 seroprevalence in hospital healthcare workers in Western Switzerland at the end of the second pandemic wave.

In early January 2020, the pandemic of COVID-19 (coronavirus disease 2019) rapidly spread from China and caused a worldwide pandemic. Healthcare workers represent a high-risk group for acquiring COVID-19 and for nosocomial transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2). We aimed to investigate over a 1 year period, across two pandemic waves, the SARS-CoV-2 seroprevalence in employees at a Western Switzerland public hospital.

Association between chronic pain and physical activity in a Swiss population-based cohort: a cross-sectional study.

Objective: To assess the bidirectional association between chronic pain and both subjectively and objectively measured physical activity (PA).

Design: Cross-sectional study.

Setting: Population-based sample in Lausanne, Switzerland, May 2014 to April 2017.

[Infectious diseases: Achievements, new Developments and Perspectives in 2021].

The substantial progresses during the last decades in the field of infectious diseases have significantly improved their prevention, diagnosis and treatment. Basic and medical sciences have efficiently dealt with the challenges of emerging infections, infectious complications related to the increasing complexity of medical practices and marked slow-down in the development of new antimicrobial agents. During the worldwide crisis related to the COVID-19 pandemic, the « medical normality » has been put in stand-by, but medical advances have fortunately continued.

Burnout, depression and anxiety among Swiss medical students - A network analysis.

It is well established that burnout in medical students is associated with depression and anxiety at a syndromal level. Moreover, there is an ongoing debate about the extent to which burnout overlaps with depression and anxiety. The emerging network approach to psychopathology offers a new perspective on the interrelations between mental disorders focusing on symptom-level association.

The dark side of SARS-CoV-2 rapid antigen testing: screening asymptomatic patients.

Several reports showed SARS-CoV-2 rapid antigen tests (RATs) performances among COVID-19 symptomatic subjects in outpatient settings during periods of highest incidence of infections and high rates of hospital admissions, but few data are present for asymptomatic patients. We investigated the role of RATs in an emergency department, as a novel screening tool before admission for COVID-19 asymptomatic patients. A total of 116 patients were screened on admission in a 250-bed community hospital in Morges, Switzerland.

Physical and psychological health of medical students involved in the coronavirus disease 2019 response in Switzerland.

Students involved in the COVID-19 response reported a similar proportion of COVID-19 symptoms or confirmed diagnoses, but lower levels of anxiety, depression and burnout compared with their non-involved peers.

[How to fight against overtreatment ? Example of neuroleptic prescriptions for acute delirium].

Since 2014, the Swiss Smarter medicine - choosing wisely campaign has established lists of recommendations, with an emphasis on futile treatments and tests where risks may outweigh benefits. Ultimately this initiative aims to develop, disseminate and implement educational programs to improve quality of care. Literature shows a positive impact of this initiative on clinical practice.

Development of health care workers' mental health during the SARS-CoV-2 pandemic in Switzerland: two cross-sectional studies.

Background: Virus outbreaks such as the current SARS-CoV-2 pandemic are challenging for health care workers (HCWs), affecting their workload and their mental health. Since both, workload and HCW's well-being are related to the quality of care, continuous monitoring of working hours and indicators of mental health in HCWs is of relevance during the current pandemic. The existing investigations, however, have been limited to a single study period.

[Medical students at the bedside of COVID-19 patients : motivations and challenges].

The SARS-CoV-2 pandemic is putting our healthcare system under exceptional pressure, given the number of affected patients. In a context of limited human healthcare resources, senior medical students represent a valuable workforce that can quickly be mobilized for patient care. This is the approach followed in Switzerland and other countries, in several outpatient structures or inpatient services, including the Department of Internal Medicine, of the Lausanne University Hospital (CHUV).

[The internal medicine articles that struck us the most in 2019].

2019 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From new indications for SGLT2 inhibitors and rivaroxaban, to antibiotic duration for Gram negative bacteriemia, passing by the delay for cardioversion of recent-onset atrial fibrillation or for beginning sacubitril/valsartan after stabilization of a cardiac failure, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings: here is their selection of eleven articles, chosen, summarized and commented for you.

[Surgical treatment of proximal femur metastases].

Aging of the population results in an increase of the incidence of cancer and bone metastases. The proximal femur is one of the most frequent locations of bone metastases. A pathological fracture has a major impact on the quality of life and potentially on survival.

[The internal medicine articles that struck us the most in 2018].

2018 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From bezafibrate in primary biliary cholangitis to the new Clostridioides difficile guidelines, passing by use of procalcitonine, cristalloids, copeptin and how to administer furosemide, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings : here is their selection of 12 articles, chosen, summarized and commented for you.

[Venous thromboembolism prophylaxis in internal medicine : for whom ?].

The incidence of thromboembolic events remains high in hospitalized medical patients, despite known risk factors and international recommendations regarding prevention of venous thromboembolism. Several studies have proven that the use of a thromboembolic prediction risk score, associated with an informatic alert system, improve the prescription of adequate thromboembolic prophylaxis and decrease the number of thromboembolic events. In this article, we present an overview of thromboembolic risk factors, thromboembolic prediction risk scores, and interventions that improve thromboembolic prophylaxis prescription.

[The internal medicine articles that struck us the most in 2017].

2017 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From bedside screening for beta-lactam allergies, to statins as primary prevention in the elderly, SGLT2 inhibitors in heart failure, azithromycin in severe asthmatics and tofacitinib in ulcero-haemorrhagic recto-colitis, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings: here is their selection of eleven articles, chosen, summarized and commented for you.

[Use of clinical practice guidelines in medicine : what's new ?].

Clinicians are confronted to an abundance of clinical practice guidelines (CPG). It has been proven for several pathologies that the use of guidelines improves quality of care by reducing mortality, the number of hospitalisations and the length of stay. Despite these proven benefits, adherence to CPGs remains low, mainly due to lack of awareness and familiarity with the guidelines, as well as lack of applicability and flexibility for elderly and comorbid patients.

[What is new in 2016 for the specialist in hospital internal medicine?].

The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances.

[2015 highlights in hospital-based internal medicine by chief residents].

The year 2015 gave us many scientific publications, among whom some will have an impact on our daily practice and some will influence our way of considering some well known diseases. Chief residents in the Service of internal medicine of the Lausanne University hospital, gathered like every year, to share their readings together in order to presentyou a small part of the many publications of 2015, which have been considered to have an impact on our future daily practice.

Lymphocytic choriomeningitis virus infection induced by percutaneous exposure.

We report a case of acquired lymphocytic choriomeningitis virus (LCMV) infection due to an accidental percutaneous inoculation of LCMV at work. The injured worker developed a flu-like syndrome, followed by pericarditis and meningoencephalitis. Seroconversion was confirmed by ELISA.

[What is new in 2014 for the specialist in hospital internal medicine? The point of view of university hospital chief residents].

The year 2014 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice and on the way we manage one problem or another. From the use of the ultrasound for the diagnosis of pneumonia to the choice of the site of venous access and the type of line, and the increasing complexity of choosing an oral anticoagulant agent, this selection offers to the readers a brief overview of the major advances.

Self-aggregated perfluoroalkylated hexa-peri-hexabenzocoronene fibers observed by cryo-SEM and fluorescence spectroscopy.

The self-assembled architectures in solution of a new HBC derivative bearing perfluoroalkylated side chains were investigated by optical excitation and emission spectroscopy and correlated to cryo-SEM, a new technique in organic chemistry.

Yeast sphingolipids do not need to contain very long chain fatty acids.

Synthesis of VLCFAs (very long chain fatty acids) and biosynthesis of DHS (dihydrosphingosine) both are of vital importance for Saccharomyces cerevisiae. The bulk of VLCFAs and DHS are used for ceramide synthesis by the Lag1p (longevity-assurance gene 1)/Lac1p (longevity-assurance gene cognate 1)/Lip1p (Lag1p/Lac1p interacting protein) ceramide synthase. LAG1 and LAC1 are redundant but LIP1 is essential.