Publications by authors named "Ardigo S"

Background: Chronic pain is a common and serious health problem in older patients. Treatment often includes non pharmacological approaches despite a relatively modest evidence base in this population. Hypnosis has been used in younger adults with positive results.

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In developed countries, 12-25 % of the aged population (>65 years old) have diabetes. Treatment of the old diabetic patients is less well studied compared to younger patients although diabetic and geriatric medical associations have issued specific treatment and priority guidelines for these patients. Treatment and targets of glycemic control must be adapted to the functional condition of the patients, prevent symptoms and complications of the geriatric syndrome.

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[Trauma in the elderly].

Rev Med Suisse

August 2012

Older patients can suffer severe trauma, especially in home environment. In Switzerland, falls are the main cause of trauma mortality in patients older than 65. Low kinetics mecanisms can cause severe trauma.

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Background: Type 2 diabetes usually occurs in the context of obesity and associated insulin resistance. Current treatment recommendations are based on lifestyle modifications and incremental drug therapy. However, this approach could lead to inappropriate priorities upon ageing, when diabetes may be compounded by malnutrition and reduced insulin resistance.

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Glucocorticoid therapy (GCT) is commonly used for the treatment of many chronic diseases. It is prescribed in almost 3% of the population > or = 70-years-old. Numerous short- and long-term side effects can occur even at low doses.

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Hypoglycaemia represents the limiting factor to obtain good glycemic control. Dysregulation of counteracting mechanisms and autonomic nervous system neuropathy contribute a strong increase in the incidence of hypoglycaemia in type 1 diabetic patients, but also in long lasting type 2 diabetic patients. Hypoglycaemia in elderly poses a diagnostic and clinical challenge of the unsual clinical presentation causing a delay in treatment.

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Severe hypertension represents a frequent problem for the general practitioner. One has to decide if the blood pressure needs to be decreased immediately (hypertensive emergency), or if the blood pressure maybe progressively decreased in a few hours and normalized in a few days (hypertensive crisis). Thus it is crucial to identify on the basis of the clinical history and a careful physical examination, the patients for whom the arterial blood pressure elevation represents an acute danger for organ damage or a vital threat in the absence of immediate blood pressure control.

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