Publications by authors named "Thierry Favrod Coune"

Tobacco use affects about 25% of the population and is the most important modifiable risk factor for many diseases, namely cancers, cardiovascular and pulmonary diseases. The role of the primary care physician is essential in providing screening and brief intervention to all patients, particularly to those at higher risk. This will help them to quit smoking, or adopt risk reduction strategies, according to their own wish.

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The cannabis plant is used to relieve incapacitating symptoms that are refractory to recommended treatments and to improve quality of life, often as a treatment of last resort. Despite growing patient demand and political will in Switzerland, access to cannabinoids for medical use remains complicated in practice, due to the limitation of robust medical indications, high cost (most often non-reimbursed) and doctor's lack of knowledge how to prescribe them. Given the low risks of cannabinoids for medical use, a pragmatic approach would be to respect "the right of patients" to access these treatments, enabling patients to evaluate their effect, reinvest in the therapeutic relationship and regain a central and active role in the management of their illness.

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The use of direct alcohol biomarkers (ethylglucuronide and phosphatidylethanol) has recently been implemented in a clinical setting. Due to their low alcohol detection threshold, high sensitivity, and specificity, these tools are very useful in the pre- and post-liver transplantation setting, where the history and physical signs are not always reliable. However, the interpretation of the results can sometimes be misleading and must be integrated into a global clinical evaluation and, more importantly, in the clinical context of each patient.

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Atrial fibrillation (AF) is the most frequent tachyarrhythmia with a significant morbimortality. The diagnosis is based on a 12 lead ECG. New technologies such as connected watches have shown similar sensibility and specificity.

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The limits for low-risk drinking have been a topic of debate among expert groups for several years, with variations observed across countries. In Canada, the recently established low-risk drinking limits are notable for their unprecedented and historically low threshold, allowing for 2 standard drinks (of 13.6 grams) or less per week.

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Addictions appear everywhere, mutate, transform with new products and behaviors, playing on our painstaking efforts to try to control them. Drawn into this current, the impression that dominates invites more to understand and to coax rather than to fight. Addictions are our condition, let's deal with it, rather than fight against them.

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Chronic obstructive pulmonary disease (COPD) is common and should be suspected in any patient with chronic dyspnea, cough, or sputum with a history of exposure to tobacco or harmful particles. Spirometry is used for diagnosis. Full evaluation includes the severity of obstruction and clinical data, following the Global Initiative for Chronic Obstructive Lung Disease guidelines.

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Background And Objectives: There is limited data on primary care physicians (PCPs) who suffered from COVID-19. We aimed to assess the proportion of PCPs with COVID-19, the proportion hospitalized with COVID-19, and the number of days off work. We also explored their psychological suffering due to the pandemic.

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A recent survey conducted in the French-speaking part of Switzerland ("Romandie") showed that only about half of the primary care physicians (PCP) in Romandie had a personal doctor. Moreover, 37 % of the PCP declared they had foregone consulting a doctor for a health problem or a check-up during the past year. Finally, 29 % of them had chosen to continue working despite being ill.

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Having a healthy lifestyle is important not only for the health of physicians, but also for the realisation and effectiveness of counselling on patients. Information on lifestyle habits and the presence of health-related behaviours in primary care physicians (PCPs) is lacking. Using a cross-sectional study design, an anonymous questionnaire was sent to a random sample of 1'000 PCPs practicing in the seven Western cantons of Switzerland.

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The aim of this study was to describe the prevalence of forgoing care and forgoing sick leave among primary care physicians (PCPs) in Switzerland and to investigate associated factors. A random sample of 1,000 PCPs in French-speaking regions of Switzerland (participation rate: 50%) was asked whether they had forgone care and sick leave during the last year. Sociodemographic, personal and occupational characteristics were recorded.

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Our selection of articles published in 2021 sheds light on topics related to risk, and to the use of electronic tools in primary care medicine. They cover blood pressure targets, telemonitoring, and the omega-3 fatty acid diet in the elderly and/or in patients with high cardiovascular risk. They present the role of primary care physicians in the management of patients with NAFLD, and in screening for domestic violence in all couples.

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Addiction medicine is influenced by societal changes and the environment has an impact on addictive behaviors and how they are experienced. The COVID-19 pandemic has had an impact on addictive behaviors, some of which could be favorable, and others highlight vulnerabilities to be considered by clinicians. Recent legislative changes open possibilities to limit the negative impact of electronic lotteries.

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There is limited data on the general health of primary care physicians (PCPs). We aimed to assess the physical and psychological health of Swiss PCPs. We selected a random sample of 1000 PCPs in Western Switzerland.

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The development of research, clinical practice and prevention in addiction medicine is, compared to other disciplines, more influenced by socio-political factors. Research on psychedelics has thus long been hampered by prohibitive policy but has recently been revived thanks to the relaxation of these political positions. The extensive prescription of baclofen for alcohol addiction is mainly the consequence of popular support and has so far not been clearly supported by specific research.

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Behavioral disorders in people with developmental and intellectual disability are frequent but their management is rarely taught. This article is to help primary physicians prescribe drug treatment. We will also discuss the key elements of two of the most commonly used classes of drugs, taking into account the patient's co-morbidities, contraindications and the main side effects.

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General internal medicine is particularly concerned by the shift from stationary to ambulatory care, a shift that unfortunately is more often discussed from an economic perspective than from the angle of evidence. This article presents the results of studies and reviews published in 2019 that investigated the effectiveness of ambulatory instead of stationary care.

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Aims Of The Study: Controlled drinking as a therapy goal for problematic alcohol use is still a matter for debate, especially with regard to dependent drinkers. Furthermore, few structured controlled drinking programmes have been evaluated. The aim of this study was to observe the evolution of excessive and dependent drinkers in a French-language six-step controlled drinking programme called “Alcochoix+”.

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Objective: Harmful use of alcohol represents a large socioeconomic and disease burden and displays a socioeconomic status (SES) gradient. Several alcohol control laws were devised and implemented, but their equity impact remains undetermined.We ascertained if an SES gradient in hazardous alcohol consumption exists in Geneva (Switzerland) and assessed the equity impact of the alcohol control laws implemented during the last two decades.

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Acute ethanol intoxication (AEI) is frequent in emergency departments (EDs). These patients are at risk of mistriage, and to leave the ED without being seen. This study's objective was to describe the process and performance of triage and trajectory for patients with suspected AEI.

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For biological and social reasons, men have to face pressure and incentives towards competivity, performance and risk seeking behaviours. These put them at risk for substance use, abuse and dependence, also in a recreational context, to improve their performances. Men's substance use is therefore significantly higher compared to women (2/3 of the global prevalence).

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