Entorse de la cheville : paracétamol ou diclofénac ?

peer reviewedAnalyse de Lyrtzis C, Natsis K, Papadopoulos C, et al. Efficacy of paracetamol versus diclofenac for grade II ankle sprains. Foot Ankle Int 2011;32:571-5

Contraception orale pour les kystes ovariens fonctionnels?

peer reviewedCette synthèse méthodique des RCTs évaluant l’intérêt d’un traitement contraceptif oral pour traiter un kyste fonctionnel de l’ovaire chez une femme en âge de procréer montre la faible qualité méthodologique des trop rares études originales et l’absence de preuve de l’intérêt d’un tel traitement pour une affection à résolution très fréquemment spontanée

Traitement antiandrogénique pour le cancer de la prostate localisé

peer reviewedCette étude d’observation qui évalue le bénéfice d’un traitement anti androgénique versus traitement conservateur chez des hommes âgés d’au moins 66 ans présentant un cancer localisé de la prostate n’apporte pas d’argument en faveur d’une modification des recommandations actuelles : une surveillance active est à préférer

Moins d’antibiotiques, moins de résistances

peer reviewedAnalyse de Butler CC, Dunstan F, Heginbothom M, et al. Containing antibiotic resistance: decreased antibiotic-resistant coliform urinary tract infections with reduction in antibiotic prescribing by general practices. Brit J Gen Pract 2007;57:785-92

Clinical practice guide on sore throat. WOREL 2017

peer reviewe

Those stories that make sense

editorial reviewed10. Reduced inequalitie

Support document for the medical consultation of flood victims and carers

Voici le document de support à la consultation médicale auprès de personnes sinistrées par les inondations et les aidants, à destination des Médecins généralistes. Il s'agit d'une compilation de différentes sources à propos de problématiques spécifiques qui peuvent apparaitre dans ces conditions exceptionnelles. Cela pourra être utile aux MG travaillant dans les zones directement touchées mais aussi à tout MG rencontrant des personnes qui ont été porter main forte dans ces zones et qui ont été exposées aux mêmes conditions lors de leur présence. Ce document pourra être amélioré et être suivi d'autres recommandations qui seront édictées dans les prochains jours par les autorités sanitaires (Sciensano, AVIQ). Il est primordial de continuer à consulter régulièrement ces sources et les directives qui seront émises à ce sujet. Une attention particulière doit être portée sur la déclaration des maladies obligatoires (Leptospirose, Légionnellose, toxi-infection digestive) par le support prévu à cet effet (MATRA) et sur la communication et le monitoring des problèmes de santé qui apparaissent dans les cabinets de consultation et les postes avancés, pour pouvoir jouer le rôle de veille sanitaire qui est primordial dans ces conditions. Les groupements locaux de MG, les GLEMs, les cercles de MG, l'OST local (Outbreak Support Team) peuvent être des endroits de partage sur ces questions

Learning and teaching professional communication. Added-value of simulation with simulated patient and debriefing

editorial reviewedThe "communication" skill is part of the competence framework of the Master of Specialization in General Medicine at ULiège. The teaching devices in communication in the 1st year have two main objectives: to structure the consultation and to seek the patient's perspective. The simulated interview workshops with a simulated patient[2] are part of a continuous and progressive communication learning process. After a small group "theory" workshop, the 100 students participate in two simulation workshops: patient perspective seeking in an acute problem and motivational interviewing in the follow-up of a chronic disease. At the end, each student participates in a test involving Medical Simulated Interviews for formative purposes but also for certification. The physician-teachers and the simulated patients are volunteers. They have been trained on the content and modality of the simulation by the course director and by a professor who is an expert in the field of health simulation in Canada. In each workshop, the students are in pairs: they play one scenario and observe another, using an observation grid. A debriefing is then led by a physician-teacher: the feelings and observations of each person are discussed: student, simulated patient, physician-teacher, in order to identify areas for improvement. The device thus offers students several learning modalities: action in a scenario, familiarization with the criteria of good communication thanks to the use of a grid, multi-source feedback. The implementation of these workshops is the starting point for the implementation of a coherent longitudinal communication curriculum in the training of future general practitioners in Liège. Significant resources were deployed to recruit and train simulated patients and tutors, but also to create scenarios that promote learning of the targeted skills. The support of the university through a pedagogical support grant (CUEF-ULiege) has been decisive. The program is being evaluated for regulatory purposes up to Kirkpatrick Level 2. This evaluation shows that the students have learned a great deal about communication (importance of seeking the patient's perspective, etc.) and modalities (direct feedback from simulated patients and the teacher, etc.). The device allows for the integration of simulated patients in the MSI where previously teachers played the patients. The writing of the scenarios has been improved. Standardization and authenticity of the examination has been increased. The collaboration with simulated patients raises the question of the necessary and sufficient skills for this type of intervention and reposition the place of patients in the training of health professionals. The system will later aim at verifying what has been learned in a real clinical situation (Kirkpatrick level 3). It is indeed planned, in the long term, to organize the supervision of students in clinical activity by direct or recorded and deferred observation

Suggestions for improving continuity of medication between hospital and home in a local context of Wallonia

Background: Unjustified modifications of the patient’s usual medication during his hospitalisation induce various problems for the patient (confusion, additional costs) and for healthcare professionals (work overload, additional cost). The principle of favouring dialogue between local actors to reach commonly accepted solutions (KCE, 2010) was used in the current study. Research question: Which local strategies could be implemented to improve continuity of drug therapy when the patient moves to hospital or back home? Method: The study took place in Liège (Wallonia). Participants were recruited within four professional groups: general practitioners, hospital specialists, pharmacists and hospital stakeholders. First, a nominal group was carried out for each professional group. Prioritized suggestions were obtained. In a second phase, Delphi method was used. Suggestions from the nominal group were submitted to representatives of each profession (a total of 40) to evaluate relevance, acceptability and feasibility of each one. Results: A total of 101 suggestions were evoked in the first phase. They were related to two main themes: implication of well-defined actors and development of specific means. Five consensual suggestions emerged from the Delphi process: provision by the general practitioner of a complete list of medication on hospital admission; provision by the hospital specialist of a list of drugs at discharge; development of formal hospital processes to keep the patient’s usual medication; centralisation of medication data; development and use of a unique medical record. Conclusion: A link medium handled by the patient when he moves to the hospital and back home is the major idea mentioned and accepted by local actors.Peer reviewe