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Smarter medicine

Société suisse d’anesthésiologie et de réanimation (SSAR)

The risk of increased morbidity and postoperative mortality increases with age, which is increasingly documented from an age > 70 years and also increases with limited functional capacity. This diminished physical performance is the subject of intensive research on frailty. This describes the patient's increased vulnerability to stressors such as surgery and leads to an increased risk of complications. If the perioperative morbidity / mortality is very high, it is necessary to discuss with the ...

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Société Suisse de Neurologie (SSN)

Seminal studies have reported an initial surgical complication rate of 2.3% (ACAS study) at 3.1% (ACST trial) in patients undergoing carotid endarterectomy (CEA) for asymptomatic stenosis> 60%. In these cases, the reduction of the absolute risk of stroke or death was approximately 5 to 6% after 5 years in the operated group. As a result, several medical organizations have recommended that CEA should be performed in asymptomatic patients only if the risk of perioperative complications is <3% and ...

Smarter medicine

Société Suisse de Neurologie (SSN)

Interferon-beta and glatiramer acetate do not prevent the progressive development of permanent disability in progressive forms of multiple sclerosis. These medications also have side effects that can adversely affect the quality of life of the patient. Finally, they have a high cost.

Smarter medicine

Société Suisse de Neurologie (SSN)

Opiates to treat migraine should be avoided because there are specific treatments for migraine more effective. Frequent use of opiates can aggravate headaches. Opiates should be reserved for patients with conditions that prevent the use of specific treatments for migraine, or for whom these treatments have failed.

Smarter medicine

Société Suisse de Neurologie (SSN)

Carotid occlusion does not cause fainting but rather focal neurological deficits such as unilateral weakness. Carotid imaging does not identify the cause of fainting and increases costs. Fainting is a common discomfort that affects 40% of people in their lifetime.