L'adénome hépatique : une pathologie si simple, si bénigne ?

L'adénome hépatique est une tumeur bénigne du foie retoruvée prinicipalement chez des femmes jeunes et est associée fréquemment à la prise d'une contraception orale riche en oestrogènes. Si cette tumeur est devenue rare contrairement à l'hyperplasie nodulaire focale et à l'hémangiome, elle a la particularité de s'associer à un risque hémorragique et à un risque de dégénérescence. L'épidémiologie, les circonstances de découverte, le diagnostic différentiel et la prise en charge thérapeutique sont discutés sur la base de la littérature. L'expérence du centre de Genève, qui comprend un grand nombre de cas compliqués d'hémorragies et plusieurs cas compliqués de dégénérescence maligne, a été revu. La prise en charge par embolisation percutanée pour les lésions hémorragiques suivie d'une résection hépatique (nécessaire en raison du risque hémorragique et du risque potentiel de dégénérescence) ainsi que les résections hépatiques électives ont été discutées

Allocating Resources in Humanitarian Medicine

Fair resource allocation in humanitarian medicine is gaining in importance and complexity, but remains insufficiently explored. It raises specific issues regarding non-ideal fairness, global solidarity, legitimacy in non-governmental institutions and conflicts of interest. All would benefit from further exploration. We propose that some headway could be made by adapting existing frameworks of procedural fairness for use in humanitarian organizations. Despite the difficulties in applying it to humanitarian medicine, it is possible to partly adapt Daniels and Sabin's ‘Accountability for reasonableness' to this context. This would require: (1) inclusion of internally explicit decisions and rationales; (2) publicity to donors, local staff, community leaders and governments, as well as frank answers to any beneficiary—or potential beneficiary—who asked for clarification of decisions and their rationale; (3) a consistent reasoning strategy to weigh conflicting views of equity in specific situations; (4) advocacy within the organization as a mechanism for revision and appeals; and (5) internal regulation according to publicly accessible mechanisms. Organizations could generate a common corpus of allocation decisions from which to draw in future similar cases. Importantly, the complexity of these challenges should encourage, rather than hinder, broader discussion on ethical aspects of resource allocation in humanitarian medicine

Maladies transmises par des tiques d'ici et d'ailleurs

This article provides a brief overview of some diseases transmitted by ticks. These vectors do not transmit only Lyme disease and tickborne-encephalitis, even in Switzerland. Several tick-borne diseases cause nonspecific flu-like symptoms. Nevertheless sometimes severe, some of these diseases can be treated with specific treatments. Repellents, appropriate clothes impregnated with permethrine and prompt removal of the tick are effective preventive measures to limit the risk of infection. There is an effective vaccine which protects against tick-borne encephalitis

High immunogenicity of delayed third dose of hepatitis B vaccine in travellers

Travellers often present late for the third dose of hepatitis B vaccination and measuring anti-HBs serology is common practice to ensure that these individuals are protected. We assessed the adequacy of immune response in 86 healthy travellers who had their third dose of hepatitis B (HB) vaccine performed more than 1 year (median: 3.4 years; range: 1.1-10.5 years) after the second dose. Eighty-two travellers (95.3%) had evidence of sero-protection (anti-HBs titre >10 UI/L) including 16/17 (94.1%) travellers who had an interval of more than 5 years between second and third vaccine dose. We did not find any risk factor associated with insufficient response

Fleshing Out Vulnerability

In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice

The marriage of science and optimized HIV care in resource-limited settings

SCOPUS: no.jinfo:eu-repo/semantics/publishe