Head To Toe, une plateforme de distribution de connaissances médicales : exemple pratique en urologie

Avec le développement des nouvelles technologies, les smartphones sont ubiquitaires et occupent une place grandissante dans le monde médical. De plus en plus d'applications sont développées à visée d'éducation médicale ou d'aide décisionnelle médicale et sont regroupées sous le nom de mobile-learning ou m-learning. En raison d'une demande existante d'étudiants en médecine à l'Université de Genève, nous avons développé l'application smartphone et tablette Head To Toe qui est une plateforme de distribution mobile de connaissances médicales. Après un succès chez les étudiants, la plateforme s'étend à la formation post-graduée et aux médecins internes. Nous décrivons le fonctionnement de l'application, son rôle pour les étudiants et médecins internes en ciblant le domaine de l'urologie

Case Report: Severe Complement-Mediated Thrombotic Microangiopathy in IgG4-Related Disease Secondary to Anti-Factor H IgG4 Autoantibodies

Objective: To first describe and estimate the potential pathogenic role of Ig4 autoantibodies in complement-mediated thrombotic microangiopathy (TMA) in a patient with IgG4-related disease (IgG4-RD). Methods: This study is a case report presenting a retrospective review of the patient's medical chart. Plasma complement C3 and C4 levels, immunoglobulin isotypes and subclasses were determined by nephelometry, the complement pathways' activity (CH50, AP50, MBL) using WIESLAB® Complement System assays. Human complement factor H levels, anti-complement factor H auto-antibodies were analyzed by ELISA, using HRP-labeled secondary antibodies specific for human IgG, IgG4, and IgA, respectively. Genetic analyses were performed by exome sequencing of 14 gens implicated in complement disorders, as well as multiplex ligation-dependent probe amplification looking specifically for CFH, CFHR1-2-3, and 5

HeadToToe: A Mobile Medical Knowledge dissemination platform: strengths, limitations and preliminary usage assessment

Finding readily accessible high-quality medical references can be a challenging task. HeadToToe is a mobile platform designed to allow easy and quick access to sound, up-to-date, and validated medical knowledge and guidance. It provides easy access to essential clinical medical content in the form of documents, videos, clinical scores and other formats, for the day-to-day access and use by medical students and physicians during their pre- and post-graduate education

A Mobile Health Platform to Disseminate Validated Institutional Measurements During the COVID-19 Outbreak: Utilization-Focused Evaluation Study

As part of the response plans for the current outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), authorities are drafting and implementing containment measures across jurisdictions worldwide in the effort to slow down transmission and reduce the infection rate. A solid communication strategy is needed to increase the reach of valid information to health professionals, reduce misinformation, and efficiently implement recommended measures

Using mHealth to Increase the Reach of Local Guidance to Health Professionals as Part of an Institutional Response Plan to the COVID-19 Outbreak: Usage Analysis Study

The ongoing coronavirus disease (COVID-19) pandemic forced health jurisdictions worldwide to significantly restructure and reorganize their medical activities. In response to the rapidly evolving body of evidence, a solid communication strategy is needed to increase the reach of and adherence to locally drafted and validated guidance to aide medical staff with COVID-19-related clinical decisions

Favoriser le développement du raisonnement clinique des étudiants en médecine : une démarche d’amélioration

Contexte et problématique : La littérature scientifique récente nous force à constater que les étudiants en médecine rencontrent des difficultés pour développer leurs raisonnement clinique. De plus, il semblerait qu’ils gagnent à être stimulés afin de raisonner. Or, ils manquent d’opportunités et de ressources pédagogiques à cet effet. Comment encourager et rendre accessible l’apprentissage du raisonnement clinique, aux étudiants en médecine ? Buts : Présenter les réflexions qui ont conduit à la création d’un nouvel outil pédagogique numérique, visant à favoriser le développement du raisonnement clinique dans le contexte de soins, chez les étudiants de la faculté de médecine à l’Université de Genève. Description de l’innovation : Nous avons développé une vidéo reprenant une consultation médicale complète, exposant explicitement le raisonnement clinique du médecin durant l’anamnèse et l’examen physique. Nous dévoilons le « pourquoi » qui se cache derrière les questions et les gestes de l’examen clinique, et mettons ainsi du sens sur chaque parole et geste du médecin, lors d’une consultation. Conclusion : La valeur des connaissances des étudiants réside dans leur capacité à se les approprier, les exploiter et les réinvestir avec justesse dans une intervention clinique. Notre outil permet de soutenir l’apprentissage précoce du raisonnement clinique afin de permettre aux étudiants de mettre en valeur leurs connaissances en les exploitants de manière pertinente

Intravenous iron supplementation after liver surgery: Impact on anemia, iron, and hepcidin levels-a randomized controlled trial

Anemia is a recognized risk factor for perioperative related morbidity and mortality and is frequently reported in liver surgeries with an estimated incidence of 32%. We aim to assess the impact of intravenous iron administration in the immediate postoperative period on anemia and iron status as well as to determine the kinetics of hepcidin after liver surgery. Methods: The HepciFer trial, a randomized controlled trial, included 50 patients undergoing liver surgery. In accordance with the randomization process, patients received either ferric carboxymaltose (15 mg/kg, maximum 1 g) or placebo 4 hours after surgery

EMOTEO: A Smartphone Application for Monitoring and Reducing Aversive Tension in Borderline Personality Disorder Patients, a Pilot Study

We developed a smartphone application (App; EMOTEO: emotion-meteo [weather forecast]) to help borderline personality disorder (BPD) patients to monitor and regulate their inner tension. The App proposes targeted mindfulness-based exercises

Perioperative evolution of sodium levels in cirrhotic patients undergoing liver transplantation: an observational cohort and literature review

Hyponatremia is an important predictor of early death among cirrhotic patients in the orthotopic liver transplantation (OLT) waiting list. Evidence exists that prioritizing OLT waiting list according to the MELD score combined with plasma sodium concentration might prevent pre transplantation death. However, the evolution of plasma sodium concentrations during the perioperative period of OLT is not well known. We aimed to describe the evolution of perioperative sodium concentration during OLT and its relation to perioperative neurohormonal responses

A Short Intervention Followed by an Interactive E-Learning Module to Motivate Medical Students to Enlist as First Responders: Protocol for a Prospective Implementation Study

Background: In Geneva, Switzerland, basic life support (BLS) maneuvers are provided in only 40% of out-of-hospital cardiac arrests (OHCAs) cases. As OHCA outcomes are markedly improved when BLS maneuvers are swiftly applied, a “first-responder” system was introduced in 2019. When emergency dispatchers identify a possible OHCA, first responders receive an alert message on a specific app (Save-a-Life) installed on their smartphones. Those nearest to the victim and immediately available are sent the exact location of the intervention. First-year medical students only have limited knowledge regarding BLS procedures but might nevertheless need to take care of OHCA victims. Medical students responding to out-of-hospital emergencies are off-duty in half of these situations, and offering junior medical students the opportunity to enlist as first responders might therefore not only improve OHCA outcomes but also foster a greater recognition of the role medical students can hold in our society.Objective: Our aim is to determine whether providing first-year medical students with a short intervention followed by an interactive e-learning module can motivate them to enlist as first responders. Methods: After obtaining the approval of the regional ethics committee and of the vice-dean for undergraduate education of the University of Geneva Faculty of Medicine (UGFM), 2 senior medical students will present the project to their first-year colleagues at the beginning of a lecture. First-year students will then be provided with a link to an interactive e-learning module which has been designed according to the Swiss Resuscitation Council’s first aid guidelines. After answering a first questionnaire and completing the module, students will be able to register for practice sessions. Those attending and successfully completing these sessions will receive a training certificate which will enable them to enlist as first responders. The primary outcome will be the proportion of first-year medical students enlisting as first responders at the end of the study period. Secondary outcomes will be the proportion of first-year medical students electing to register on the platform, to begin the e-learning module, to complete the e-learning module, to register for practice sessions, to attend the practice sessions, and to obtain a certificate. The reasons given by medical students for refusing to participate will be analyzed. We will also assess how comfortable junior medical students would feel to be integrated into the first responders system at the end of the training program and whether it affects the registration rate. Results: The regional ethics committee (Req-2020-01143) and the UGFM vice-dean for undergraduate education have given their approval to the realization of this study, which is scheduled to begin in January 2021.Conclusions: This study should determine whether a short intervention followed by an interactive e-learning module can motivate first-year medical students to enlist as first responders.</p