[Ten years of manual medicine at Unisanté : retrospective and illustration].

A manual medicine consultation has existed in the canton of Vaud for ten years now, developed within Unisanté, the university centre for general medicine and public health in Lausanne. For a long time, this consultation was the only one of its kind set up in a university setting in Switzerland. Despite a growing interest and a more important development in German-speaking Switzerland and Germany, this approach remains relatively unknown to patients and therapists in the French-speaking cantons.

[2020 scientific breakthroughs in ambulatory general internal medicine].

Functional weakness of the limbs has an uncertain prognosis and little chance of recovery. Obese people in precarious situations may succeed in losing weight through an intensive lifestyle-based weight loss program. In patients with gonarthrosis, physiotherapy may decrease pain and disability when compared to injected corticosteroids.

Correlation of clinical decision-making with probability of disease: A web-based study among general practitioners.

Background: Medical decision-making relies partly on the probability of disease. Current recommendations for the management of common diseases are based increasingly on scores that use arbitrary probability thresholds.

Objective: To assess decision-making in pharyngitis and appendicitis using a set of clinical vignettes, and the extent to which management is congruent with the true probability of having the disease.

[2018 scientific breakthroughs in ambulatory general internal medicine].

Mindfulness meditation and cognitive-behavioral therapy are more cost-effective than conventional management of chronic low back pain. Women with iron deficiency can be treated with oral iron substitution every other day to improve tolerance. Smokers who smoke four or less cigarettes per day have a disproportionately high risk of cardiovascular and cerebrovascular events.

[General internal medicine : 2017 scientific breakthroughs in ambulatory care].

Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism.

[2016 literature findings in internal general medicine].

Treatment with diclofenac appears to be more effective compared to other NSAIDs in the treatment of osteoarthritis of the large joints. Opioids do not diminish significantly the pain in chronic lower back pain. Degenerative tears of the meniscus, without signs of osteoarthritis, should be treated conservatively.

[Clinical decision making : from theory to practice… and backward].

Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making.