[Elevated liver enzymes: update 2024].

Elevated liver enzymes are a common finding in primary care medicine, with an estimated prevalence of 8 %. Steatotic liver diseases are the most frequently encountered etiologies and r-epresent the main cause of liver-related morbidity and mortality. This article looks at the latest developments in these diseases, with a particular focus on MASLD (Metabolic dysfunction associated steatotic liver disease).

[Syncope : updates in primary care medicine].

Syncope is a common reason for consultations and hospitali-zations. A diagnosis is established in 50 % of cases with the initial assessment. It can also be used to stratify the risk of cardiovascular events or recurrence, and their potentially fatal consequences.

Validation and Refinement of the Sense of Coherence Scale for a French Population: Observational Study.

Background: Salutogenesis focuses on understanding the factors that contribute to positive health outcomes. At the core of the model lies the sense of coherence (SOC), which plays a crucial role in promoting well-being and resilience.

Objective: Using the validscale Stata command, we aimed to assess the psychometric properties of the French version of the 3-dimension 13-item SOC questionnaire (SOC-13), encompassing the comprehensibility, manageability, and meaningfulness dimensions.

[Phone triage in primary care practices].

In primary care medicine for adult or pediatric populations, phone calls from patients or parents are common. The variety of questions is broad, going from simple administrative requests to life-threatening emergencies. The safety of the patient is the main priority when answering these calls.

[The challenges of pediatric emergencies in the office].

This article examines the diversity of pediatric emergencies in a medical office, shedding light on the complexity of some situations. To address emergencies that are both psychosocial and biomedical, the pediatrician must possess a variety of skills and have an in-depth understanding of the local medical network. Limited communication with young children requires the search for clues, generating uncertainty.

[Deep vein thrombosis: new developments and recommendations for the primary care physician].

The management of deep vein thrombosis is becoming more specific in terms of diagnostic methods and drug treatments. The use of the dichotomous Wells' score is now established. The indications for direct oral anticoagulants have expanded.

[Urticaria : updates of a chronic condition].

Urticaria is a frequent disease and exist in an acute or chronic form. The pathophysiology, focused on mast cells and histamine among other mediators, is an active research field but still poorly understood. The medical care focus on the avoidance of triggers and aggravating factors.

[Pilot project for a Medical Home in Geneva].

The aging of the population and the increase in chronic diseases are overloading our healthcare system, with complex patients requiring more care. To meet their needs and keep them at home, interprofessional team management is necessary. The Directorate of Health of the Canton of Geneva issued a call for tenders to set up Medical Homes.

[Story of a multi-professional health center in Lyon, France. Individuals, a group, serving complex patients.].

The Mermoz multi-professional health center is a healthcare practice, including 24 professionals, on the outskirts of a major French metropolis. This article presents the challenges faced from the idea to the implementation of an interprofessional primary care offer. The difficulty of freeing up time for the construction of the common real estate and sanitary project has been overcome thanks to powerful motivations: the desire for more interprofessionality in practices that are sometimes fragmented, the need for support in the management of complex patients, the pleasure of being a group, and the improvement of healthcare.

[Collaboration in home care: first interprofessional ambulatory proximity network].

While interprofessionality is indispensable to respond to home care current issues, its implementation in the practice is a real challenge. The Genevan domiciliary model (reference by a nurse, targeted areas of interventions, etc.) needs to integrate all the resources of proximity.

[Environmental impact of prescribing in family medicine - Example of simple urinary tract infection].

As the pharmaceutical industry keeps growing, the presence and impact of drug residues in water is becoming increasingly well documented. These end up in wastewater after human consumption, and then in surface water if they are not sufficiently removed in wastewater treatment plants, harming aquatic organisms even in minute quantities. Antibiotics and NSAIDs are the most worrying for the environment.

[New developments in headache management in 2022].

Headaches are one of the most common causes of consultation in primary care. Due to their polymorphic character and sometimes severe etiologies, it is very important to properly classify these symptoms and to look for possible associated signs of severity. It is with this objective that the international classification of headache delivered its 3rd version in 2018 with the ICHD-3.

[Latest developments in the non-pharmacological treatment of depression - A more integrative approach].

Non-pharmacological treatments of depression have become more widespread recently, especially for mild to moderate forms of depression. These complementary approaches are particularly interesting for patients who are reluctant to start an antidepressant. Novel approaches are found in psychotherapy, alternative treatments, plant-based treatments as well as the prevention of relapse through the use of digital tools.

[Anemia: new developments and diagnostic and management strategies].

Anemia is a major public health problem that affects approximately 25% of the world's population. Its prevalence is increased in certain populations: it affects 40% of pregnant women, 42% of children under 5 years old and it increases with age from 50 years old. Anemia can be an emergency in case of hemorrhage or acute hemolysis, but it is most often chronic.

[Management of chronic heart failure: updates and implications for the primary care physician].

The latest recommendations of the European Society of Cardiology on chronic heart failure published in 2021 propose several new concepts. The main changes include a revision of the classification but most importantly modifications in the therapeutic management, especially concerning the first-line treatment of heart failure with reduced ejection fraction. Since heart failure affects approximately 2% of the general population, these new recommendations will have a definite impact on the practice of primary care physicians.

[COPD: Guidelines for primary care physicians].

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.

[Major change in asthma management].

According to the latest recommendations, there is no longer place for the use of short-acting beta-2 agonist alone in chronic asthma treatment, due to an increased risk of severe exacerbations and exacerbation-related mortality. Current management of asthma is based on the use of inhaled corticosteroids in combination with formoterol as maintenance and as rescue treatment, thanks to the rapid and prolonged action of formoterol. General practitioners must evaluate, with the patient's collaboration, the treatable factors linked to poor asthma control.

[Physician selfcare or the cobblers of Montaigne].

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.

[Self-care for anxiety in primary care].

Anxiety is a very common problem in primary care consultations. In addition to standard treatments (psychotropic medications and psychotherapy), many self-care techniques can improve patients' anxiety. A few explanations (psychoeducation) about the role of the autonomic nervous system in stress and anxiety can be helpful to motivate patients to experiment techniques that allow their body to relax and unwind, and to thus take care of themselves.