Antigen rapid tests, nasopharyngeal PCR and saliva PCR to detect SARS-CoV-2: A prospective comparative clinical trial.

Background: Nasopharyngeal antigen Rapid Diagnostic Tests (RDTs), saliva RT-PCR and nasopharyngeal (NP) RT-PCR have shown different performance characteristics to detect patients infected by SARS-CoV-2, according to the viral load (VL)-and thus transmissibility.

Methods: In October 2020, we conducted a prospective trial involving patients presenting at testing centres with symptoms of COVID-19. We compared detection rates and performance of RDT, saliva PCR and nasopharyngeal (NP) PCR, according to VL and symptoms duration.

Diagnostic Performance of Individual Symptoms to Predict SARS-CoV-2 RT-PCR Positivity and Symptom Persistence among Suspects Presenting in Primary Care during the First Wave of COVID-19.

This study aimed to estimate the diagnostic performance of patient symptoms and to describe the clinical course of RT-PCR-positive compared with RT-PCR-negative patients in primary care. Symptomatic COVID-19 suspects were assessed clinically at the initial consultation in primary care between March and May 2020, followed by phone consultations over a span of at least 28 days. Sensitivity and specificity were estimated for each symptom using the initial RT-PCR result as a reference standard.

An Online Influenza Surveillance System for Primary Care Workers in Switzerland: Observational Prospective Pilot Study.

Background: A better understanding of the influenza epidemiology among primary care workers could guide future recommendations to prevent transmission in primary care practices. Therefore, we designed a pilot study to assess the feasibility of using a work-based online influenza surveillance system among primary care workers. Such an approach is of particular relevance in the context of the coronavirus disease (COVID-19) pandemic, as its findings could apply to other infectious diseases with similar mechanisms of transmission.

[Wellbeing of the doctor and health of the patient : for a sustainable family medicine].

The health sector is one of the most stressed occupational sectors. In family medicine, the risk is especially high: the prevalence of burnout increased. This article explores four facets of the problem : 1) the elements influencing physicians' satisfaction and well-being at work ; 2) prevention and detection of burnout in doctors ; 3) the impact of the doctors' stress on patient care and 4) the organization of the practice to improve the practitioners' well-being.

A prospective multicentre study of healthcare provider preference in rapid HIV testing kits: Determine versus INSTI.

Rapid HIV testing may circumvent the practical barriers to HIV testing in several settings. User preference of the testing kits available has been relatively underexplored. We examined healthcare provider (HCP) ratings of two validated rapid testing kits in clinical practice.

Patients satisfaction in an academic walk-in centre: a new model of residents training achieved by family doctors.

Background: Walk-in centres may improve access to healthcare for some patients, due to their convenient location and extensive opening hours, with no need for an appointment. Herein, we describe and assess a new model of walk-in centre, characterised by care provided by residents and supervision achieved by experienced family doctors. The main aim of the study was to assess patients' satisfaction about the care they received from residents and their supervision by family doctors.

[Emergencies and general practitionners. Which prospects? Which education?].

Professionalisation of emergency medicine and triage before most of emergency consultations led to a major reduction in exposure of general practitionners (GP) to vital emergencies, which participates in reduction of their aptitudes to manage such emergencies. The risk for a GP to face a vital emergency is weak nowaday, but did not totaly disappear. Therefore, it seems important for the GPs to maintain the skills required to manage these emergencies properly.

[Benefits of using rapid HIV testing at the PMU-FLON walk-in clinic in Lausanne].

Lab tests are frequently used in primary care to guide patient care. This is particularly the case when a severe disorder, or one that will affect patients' initial care, needs to be excluded rapidly. At the PMU-FLON walk-in clinic the use of HIV testing as recommended by the Swiss Office of Public Health was hampered by the delay in obtaining test results.

[Added value of family practitioners' supervision of junior doctors in a walk-in clinic].

The pending workforce crisis in family medicine has triggered various initiatives. This article describes the PMU-FLON walk-in clinic, a project of the Institute of General Medicine University of Lausanne. The working conditions in this clinic are close to that of a family practice.

[Dark or white chocolate? Cocoa and cardiovascular health].

Epidemiological data show that a regular dietary intake of plant-derived foods reduces the risk of cardiovascular disease. Recent research indeed demonstrates interesting data about cocoa consumption, with high concentrations of polyphenols, and beneficial effects on blood pressure, insulin resistance and platelet function. Although still debated, a range of potential mechanisms through which cocoa might exert their benefits on cardiovascular health have been suggested: activation of nitric oxide, antioxidant, anti-inflammatory, anti-platelet effects, which might in turn improve endothelial function, lipid levels, blood pressure and insulin resistance.

[How frequent are cardiovascular diseases a cause of work absenteeism and of disability in Switzerland?].

Cardiovascular diseases (CVD) are a major cause of morbidity and mortality in industrialized countries, and also in Switzerland. In 2004/2005, CVD were in first line of all medical diagnosis by primary care physicians (12.4%) and of all causes of hospitalisation (9.

[Fibromyalgia: how to appreciate work capacity?].

Fibromyalgia is a chronic pain syndrome of which there remains difficult to evaluate the functional repercussion. As in other affections without, or with weak shown organic substrate, the evaluation of the work capacity requires a rigorous approach, which adopts an integrative bio-psycho-social model. Diagnostic classification poses problems insofar as the same syndromic association can result in different diagnoses.

[Off label use of recombinant activated factor VII: a practice survey].

Objectives: To evaluate the impact of local recommendations on off label use of recombinant activated factor VII.

Type Of Study: Observational, retrospective.

Material And Methods: Recommendations have been diffused by a local working group in 2004, concerning seven groups of indications (traumatology, cardiac, hepatic and various surgeries, obstetrics, neurology and haematology).

[Evolution of cardiac risk factors management among patients aged 65 years and older with coronary artery disease].

The aim of this retrospective study was to compare the appropriateness of cardiac risk factors (CV-RF) management in a Swiss cardiac rehabilitation center. The comparison of the control of CV-RF among 342 patients with coronary artery disease (CHD) aged > or =65 years was improved. The CV-RF management has globally improved during the two periods of observation (1994-95 and 1999-2000).

[Necrotizing bacterial skin and software tissue infection with muscular involvement revealing of cancer of the colon].

We report the case of a 38-year-old woman with a necrotizing bacterial skin and soft tissue infection with muscular involvement. The clinical picture was similar to a gaseous gangrene of the right lower limb with a septic shock and multiple organ failure, without predisposing factor such as trauma, and necessitating a hip amputation. The primary site of the disease was a perforated colic adenocarcinoma with peritoneal and retroperitoneal infection.

Sigmoidal equation for lung and chest wall volume-pressure curves in acute respiratory failure.

To assess incidence and magnitude of the "lower inflection point" of the chest wall, the sigmoidal equation was used in 36 consecutive patients intubated and mechanically ventilated with acute lung injury (ALI). They were 21 primary and 5 secondary ALI, 6 unilateral pneumonia, and 4 cardiogenic pulmonary edema. The lower inflection point was estimated as the point of maximal compliance increase.

A program based on a 'selective' least-squares method for respiratory mechanics monitoring in ventilated patients.

This paper proposes a program for continuous estimation of respiratory mechanics parameters in ventilated patients. This program can be used with any ventilator providing airway pressure and flow signals without additional equipment. Overall breathing resistance, dynamic elastance (E) and positive end expiratory pressure (P(0)) are periodically estimated by multiple linear regression on selected parts of breathing cycles.

[Dyslipidemias and cardiovascular diseases: towards a new perspective].

During the last decades, new developments in the detection and therapy of dyslipidemia provided a firm conviction for the efficacy and the safety of lipid-lowering therapies in primary and secondary prevention of cardiovascular diseases. To be cost-effective in primary prevention, the statin-therapy needs to select high risk patients. According to the guidelines, the global assessment of cardiovascular risk is based on traditional risk factors (RF-CV).