[2012 literature findings in ambulatory internal medicine]. / Acquisitions thérapeutiques en médecine ambulatoire en 2012.

In 2012 several articles reported interesting findings for the ambulatory practice in internal general medicine. A negative rapid test for influenza does not rule out that diagnosis. A test assessing the walking speed in the elderly can help determining who would benefit from antihypertensive therapy. Antibiotic treatment has no benefit for acute uncomplicated rhinosinusitis and diverticulitis. Probiotics can reduce the risk of post-antibiotic diarrhea. Daily coffee intake could reduce mortality. Oral supplementation of calcium can be harmful to the cardiovascular system. Subclinical hyperthyroidism should be treated to prevent cardiovascular complications. Aspirin can prevent recurrences in case of a primary thromboembolic event. Local injection of corticosteroids under ultrasonographic guidance for plantar fasciitis can be a safe treatment. Ibuprofen can prevent acute mountain sickness.

[Innovations in ambulatory care: screening, treatment and iatrogenicity]. / Nouveautés en médecine ambutatoire: dépistage, traitement et iatrogénicité.

This year we have selected six studies useful for the day to day practice. A mammography in women 40 to 49 years of age should be evaluated taking into account the patient's profile and the possible risks and benefits of this exam. In patients over 65 years of age, a systematic atrial fibrillation screening, with pulse rate measuring then ECG (if irregular beat) should be realised on a regular basis. The risks for complications following colonoscopies do exist, especially after biopsies/polypectomies and this risk should be discussed. Long term proton pump inhibitor treatment is a risk factor for hip fracture. It is important to treat high blood pressure problems in the elderly, but the orthostatic risks should be adressed. A corticoid treatment started quickly for Bell's palsy is efficient.

[Therapy and internal medicine]. / Thérapeutique et médecine interne générale.

This review is based on five articles published in 2006 and dealing with therapies in general internal medicine: in case of acute non complicated rhino-sinusitis, the use of topical corticoids in mono-therapy is indicated; cross-reactivity between penicillins and cephalosporins is less frequent than established so far. In our daily practice we should be more "pro-active" in prescribing probiotics which have proved their efficacy in the prevention of antibiotic-associated diarrhoeas; an antibiotic treatment of three days is recommended in case of non complicated cystitis in women less than 65 years of age. Finally, every patient treated with bisphosphonates must be regularly followed by a dentist.

[Women and tobacco: epidemiological and clinical specificities]. / Femmes et tabagisme: spécificités épidémiologiques et cliniques.

Cigarette smoking amongst women is a major issue in daily clinical practice and in public health. Tobacco is the cause of gender specific diseases. From a psychosocial point of view, female smokers tend to be emotionally vulnerable and relationship sensitive. The risk of weight gain and depression must be anticipated and assessed throughout the smoking cessation process. Professionals involved in smoking cessation must be aware of these somatic and psychosocial specificities in order to be able to offer efficient smoking cessation treatments. Public health strategies must also be developed worldwide to control the expected dramatic impact of the female tobacco epidemic.

[The health consequences of smoking for women at different stages of their life]. / Cycles de vie d'une femme et tabac.

Women who smoke underestimate the risks of smoking on their health, especially the impact of the anti-estrogenic and toxic effects of tobacco at the different stages of their life. The risk of female infertility related to tobacco is now well-proven, as is the risk of arterial and venous thrombotic event when tobacco is associated with oral contraception. Many foetal and maternal pathologies are linked to maternal smoking. Regarding post-menopausal women, smoking is associated with an increased osteoporotic and cardio-vascular risk. Doctors are at the first line to advise women and propose them help and assistance in their quit smoking process in a way adapted to their situation.

Low incidence and prevalence of hepatitis C virus infection among sexually active non-intravenous drug-using adults, San Francisco, 1997-2000.

BACKGROUND: The rate of sexual transmission of hepatitis C virus (HCV) is debated. GOAL: The goal was to measure the risk of sexual transmission of hepatitis C virus (HCV) in a sexually active population. STUDY DESIGN: Sexual behaviors and HCV antibody status were measured in persons seeking repeat HIV testing in San Francisco from October 1997 through March 2000. RESULTS: Among 981 repeat testers, the prevalence of HCV antibody was 2.5%. Among men who have sex with men who denied intravenous drug use (n=746), factors associated with HCV antibody positivity include age greater than 50 years (odds ratio [OR], 8.5; 95% confidence interval [CI], 2.6-27.7), HIV infection (OR, 5.7; 95% CI, 1.6-20.6), and being nonwhite (OR, 3.3; 95% CI, 1.1-10.0). HCV antibody positivity was not associated with sexual risk behaviors. In 576.6 person-years of observation, no new HCV seroconversions occurred (incidence=0 per 100 person-year; 95% CI, 0-.6), whereas 6 new herpes simplex virus-2 infections (2.8 per 100 person-years) and 10 new HIV infections (1.8 per 100 person-years) occurred. CONCLUSION: The absence of new HCV infections in this sample supports the hypothesis that the risk of sexual transmission of HCV is low.