[Apprenticeship in general medicine]. / Apprentissage de la médecine générale.

Residency in general practice/family medicine in Switzerland is ridden with structural difficulties, and suffers from low prestige among trainees and hospital-based trainers. A more attractive postgraduate training is sought by a group of practitioners, through a common initiative with local governments, general practice associations and training sites.

Protection of susceptible potato cultivars against late blight in mixtures increases with decreasing disease pressure.

ABSTRACT Cultivar mixtures can reduce potato late blight severity on susceptible cultivars. While alternating rows of susceptible and resistant cultivars would be more acceptable than random mixtures for commercial use, they increase the genotype unit area, which is an unfavorable factor for mixture efficiency, and have been minimally efficient when disease pressure is high. The effects of disease pressure on the performance of alternating rows of cultivars possessing various types and levels of resistance were investigated in 2000 and 2001 near Quito, Ecuador, where natural pressure of late blight is high. The experiments included the highly susceptible cvs. Cecilia in 2000 and LBr37 in 2001, as well as C114 (moderately resistant) and PAN (highly resistant), planted as pure stands and as the three possible two-way combinations. Different disease pressures were obtained with three spraying schedules of a contact fungicide: nontreated, one spray every second week, and one spray weekly. The area under the disease progress curve (AUDPC) on the susceptible cultivar was 0 to 20% less in mixed than in pure plots when no fungicide was applied, 13 to 26% less with a biweekly application of fungicide, and 32 to 53% less with a weekly application. These values are comparable to those obtained in previous experiments in smaller plots with designs maximizing the distance between susceptible plants. No significant differences in mixture performance were observed according to the resistant cultivar included. Effects on yield were minimal, because of the impact of factors other than late blight. Disease pressure therefore appears as a major factor conditioning the efficiency of potato cultivar mixtures against late blight.

[Dependence: all similar, all different. Point of view of a practitioner, point of view of a specialist]. / Dépendance: tous semblables, tous différents. Point de vue d'un praticien, point de vue d'un spécialiste.

Psycho-active substances dependent patients are similar in the mechanisms of addiction, but are individually very different and need a diversified approach. This paper is showing a general practitioner's point of view and the one of an addiction specialist regarding common clinical problems in such patients. The question of the treatment matching and of the level of care are discussed through an instrument for a rapid evaluation.

[Total arthroplasty of the hip. Periarticular ossifications and ankylosing vertebral hyperostosis (Forestier's disease)]. / Arthroplastie totale de hanche. Ossifications périarticulaires et hyperostose vertébrale ankylosante (maladie de Forestier).

A retrospective study was made on 536 patients in whom a Charnley-Muller total hip prosthesis had been inserted. Two hundred and seventeen cases were available for follow-up, 121 of them having signs of diffuse idiopathic skeletal hyperostosis (Forestier's Disease) which is common in the elderly. Peri-prosthetic ossification was found in 46 p. 100 of patients with hyperostosis and in only 24 p. 100 of patients without it (p = less than 0,01). In both groups the ossification was more frequent in men than in women (p = less than 0,001 in the hyperostosis group and less than 0,03 in the controlled group). In cases of bilateral prostheses, ossification was identical on both sides in 81 p. 100 of cases. Only 66 p. 100 of the men with hyperostosis obtained satisfactory postoperative hip mobility as against 83 p. 100 of men in the control group (p = 0,05). The difference was not significant in women. Pain was relieved in 93 p. 100 of patients with hyperostosis with no significant difference from the control group. It is concluded that the existence of diffuse idiopathic skeletal hyperostosis is not a contra-indication to total hip replacement provided that the main complaint of the patient is of pain.