[Practical management of post-COVID-19 condition. Update and illustration by clinical situations].

Persistent manifestations of COVID-19, known as «long COVID» or post-COVID-19 condition (RA02, CIM-11), affect many infected individuals, with a 24-month prevalence depending on the studies context (18 % in a recent Swiss study). The diversity of clinical presentation, the sometimes complex diagnostic methods, and the multidisciplinary management highlight the importance of a holistic approach, with practical advice for assessing work capacity in the outpatient setting. This article offers an update and synthesis of current knowledge concerning post-COVID-19 condition with practical recommendations for primary care medicine, illustrated by real clinical situations.

[Leptospirosis, the diagnostic challenge of an indigenous case].

Leptospirosis is a global widespread zoonosis caused by a Gram-negative bacterium of the genus Leptospira, belonging to the Spirochaetes phylum, favored by unhealthy living conditions and some professional and recreational aquatic activities. Its diagnosis could be very difficult due to the presence of non-specific clinical presentation and biological anomalies common to other infectious diseases. To detect it, the choice of the right diagnostic method is fundamental.

Should we treat Blastocystis sp.? A double-blind placebo-controlled randomized pilot trial.

Background: Blastocystis sp. is a worldwide-distributed protist colonizing the guts of humans and a great variety of animals. It is unclear whether it is just a commensal or an infectious parasite that prompts eradication.

[Clinical presentation and short-term treatment of pulmonary actinomycosis].

Actinomycosis is an uncommon disease caused by Actinomyces, a commensal of the oropharyngeal, digestive, and genital tract. Commonly, it manifests as cervicofacial infection and is often related to poor oral health, smoking, chronic alcoholism or immune deficiency. Pulmonary actinomycosis is a rare disease, characterized by unspecific clinical, biological, and radiological manifestations that may be confused with other diseases.

[COVID-19, how to treat the disease during Fall 2022?].

Since the arrival of COVID-19, we have witnessed a series of new variants and new therapies, and it is therefore becoming difficult to stay up to date on the best management of an outpatient infected with SARS-CoV-2. In a patient at risk of an unfavorable evolution in the first 5 days of illness, the antiviral Paxlovid is recommended. Evusheld, administered in the hospitals, is recommended in patients with a documented negative serology, for treatment in early disease or as a pre-exposure prophylaxis.

Point prevalence study of antibiotic appropriateness and possibility of early discharge from hospital among patients treated with antibiotics in a Swiss University Hospital.

Background: The growing threat of multidrug resistant organisms have led to increasingly promote prudent and rational use of antimicrobials as well as early hospital discharge plan. Antibiotic stewardship programs (ASP) have been developed as multifaceted approaches to improve use of current antibiotics and are now widely applied through different strategies. Proactive interventions are still limited in Switzerland and data on antimicrobial appropriateness and early discharge strategies are lacking.

[Travel vaccines: what is in the pipeline?].

While no vaccine is on the horizon to prevent traveler's diarrhea, progress has been made in the field of malaria and dengue fever. In both cases, the objective is not primarily the prevention among travelers but rather the reduction of morbidity and mortality in populations living in endemic areas. The immune mechanisms protecting against parasitosis are not well understood, which further complicates vaccine development.

[Management of human papillomavirus at the doctor's office : what to do for men ?].

In primary care medicine, doctors may be facing with human papillomavirus (HPV)-related questions regarding prevention, screening or treatment, more so with women than with men. Through three clinical vignettes, this article aims to offer some clinical management recommendations in a primary care setting when HPV-related questions are raised by the male population.

[Practical management of long Covid disease in outpatients: illustration by clinical cases].

The SARS-CoV-2 pandemic has caused an unprecedented global public health crisis. The term long Covid is used to describe diverse and heterogeneous symptoms that persist more than 4 weeks after infection with an estimated incidence of 10-40%, which varies between studies. The principal characteristics of long Covid are fluctuating symptoms of prolonged duration affecting multiple organs, such as fatigue, dyspnea, cough, anosmia, dysgeusia, chest pain, palpitations, headache, myalgia, cognitive and gastrointestinal disorders.

Expert guidance for COVID-19 vaccine deployment in Switzerland: a Delphi process.

Background And Aim: Vaccines providing protection against COVID-19 are a core tool for ending the pandemic. Though international organisations created guidance in 2020 for vaccine deployment, this had to be adapted for each country's situation and values. We aimed to assist public health decision makers by identifying areas of consensus among Swiss experts for the deployment of one or more novel COVID-19 vaccines.

[What does a general practitioner need to know about whooping cough?].

Pertussis (whooping cough) is a vaccine-preventable bacterial infectious disease. Nevertheless, serious cases continue to be reported every year in the paediatric population. Pertussis poses a danger mainly to unimmunized or partially immunized infants under six months of age.

[A story of neuroborreliosis : case report].

Neuroborreliosis affects approximately 15 % of people infected with Borrelia burgdorferi. The symptoms are very varied, which can sometimes delay the diagnosis. We can diagnose a neuroborreliosis in front of a compatible clinic and laboratory examinations, in particular a lumbar puncture showing a pleocytosis, an intrathecal synthesis of antibodies against B.

[Ticks-borne diseases in 2019 : between false beliefs and good practices].

In recent years, the media and internet have been the stage of a campaign of scientific disinformation led by patient advocacy groups, supported by some « experts » in the field, demanding recognition of health problems attributed to Lyme disease. The controversy has led several professional societies and leading scientific journals in Europe and the United States to reaffirm their position and update their recommendations. Tick bites are common in our area, and medical practitioners must know their potential complications, respond to questions from worried patients, and confront their own doubts and uncertainties.

[Consensus for the management of infectious diseases among asylum seekers and detainees in the canton of Vaud].

Our work develops procedures and useful tools for the screening, assessment and management of prevalent infectious or parasitic diseases (tuberculosis, measles, chickenpox, scabies, bed bugs) among asylum seekers and detainees in the canton of Vaud, populations living in similar closed settings. Its aim is to support health professionals in their work, to maintain the health of the target population and to protect the health of the community. Through a literature review and a focus group with experts, it is proposed to harmonize the existing procedures in asylum seekers centres end prisons of the canton of Vaud.

Efficacy and safety of continuous infusions with elastomeric pumps for outpatient parenteral antimicrobial therapy (OPAT): an observational study.

Objectives: This study aimed to evaluate the efficacy and safety of continuous antimicrobial infusion using elastomeric pumps in an outpatient setting, while simultaneously documenting circulating antibiotic concentration exposure achieved with this mode of administration.

Methods: Clinical outcomes, adverse events and antibiotic plasma concentrations were recorded for all patients treated by continuous infusion with elastomeric pumps at the outpatient parenteral antimicrobial therapy (OPAT) unit of the University Hospital of Lausanne between December 2013 and January 2017. The study was registered under ClinicalTrials.

Malaria prevention strategies and recommendations, from chemoprophylaxis to stand-by emergency treatment: a 10-year prospective study in a Swiss Travel Clinic.

Background: There are several possible malaria prevention strategies for travellers. In Switzerland, chemoprophylaxis (CP) is recommended for persons visiting areas highly endemic for malaria and stand-by emergency treatment (SBET) for areas with moderate to low risk.

Objective: To describe the type of malaria prevention prescribed to travel clinic attendees with a specific focus on changes over time following adaptation of recommendations.

[Multiplex PCR gastro-intestinal panels for the management of traveller's diarrhea : are they accurate and useful?].

Until recently, the search for enteropathogens causing travellers' diarrhea was based on stool culture (Campylobacter spp., Salmonella spp. and Shigella spp.

[Multidrug-resistant bacteria and travel].

Antimicrobial resistance is a global problem which affects also tropical countries. Travelers to these regions expose themselves to the risk of being colonised and infected with multidrug-resistant bacteria. The region visited, the occurrence of diarrhoea and the use of antibiotics are the principal risk factors leading to colonisation with multidrug-resistant Enterobacteriaceae, which can affect up to 80% of travellers.

Adequate plasma drug concentrations suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps.

Background: Elastomeric pumps can be useful for the administration of antibiotics in the outpatient setting.

Objectives: To determine amoxicillin degradation in elastomeric pumps, as well as the effectiveness of amoxicillin treatment administered by elastomeric pumps.

Methods: Antibiotic degradation was measured in elastomeric pumps filled with 6 g of amoxicillin in 240 mL of NaCl 0.

Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial.

Background: Escherichia coli infections are increasing worldwide in community and hospital settings. The E coli O-antigen is a promising vaccine target. We aimed to assess the safety and immunogenicity of a bioconjugate vaccine containing the O-antigens of four E coli serotypes (ExPEC4V).