Principes d'evaluation et de prise en charge des patients agés polymorbides: guide a l'intention des cliniciens [Principles for the assessment and management of polymorbid elderly patients: a guide for clinicians].

Providing care to multimorbid older patients is complex, not only because of the coexistence of multiple chronic conditions, but also because of their frequent intrication with psychological and social problems. This article describes a guide for clinicians to assess and manage multimorbid older patients. This guide was adapted from the work of a group of expert US geriatricians. It proposes seven steps: identification of the main problem; identification of patients' preferences; setting of goals of care; estimation of life expectancy; identification of relevant evidence in the literature; revision of the plan of care; and discussion of the options with the patient. The use of this guide is illustrated by a clinical case.

[2 phot. de la grotte de Monnetier (Savoie) et du pas de l'Echelle (Haute-Savoie), don E. Reclus en 1886]

Donateur : Reclus, Élisée (1830-1905)

[13 phot. de l'île de Wight par F. Hudson, phot. à Ventnor, don E. Reclus en 1886]

Donateur : Reclus, Élisée (1830-1905)

Contribution de l'étude CoLaus à l'élucidation des déterminants de l'acide urique sérique. [Contribution of the CoLaus study to decipher the determinants of serum uric acid].

Asymptomatic hyperuricemia affects one in five adults in the general population and is associated with elevated cardiovascular risk. It is however not clear whether asymptomatic hyperuricemia is a cause or simply a marker of conditions associated with high cardiovascular risk. Sex, age, obesity, renal function and selected drugs are major determinants of serum uric acid. Moreover, recent genome-wide association studies have identified new genes involved in the control of serum uric acid levels, in particular SLC2A9, which encodes a urate transporter located in the kidney. A genetic score based on several genetic variants associated with serum uric acid is strongly associated with the risk of gout, but not with cardiovascular events so far.

[20 phot. de l'Andalousie après le tremblement de terre de la fin de 1884, provenant de la mission française dirigée par F. Fouqué. Voir l'article de ce dernier dans le n°311, du 14 mars 1886, du Bulletin hebdomadaire de l'Association scientifique de France. Don Fouqué en 1886]

Donateur : Fouqué, Ferdinand (1828-1904)

[11 phot. de l'île d'Heligoland par Albert Meyer, Louis Koch (phot. à Brême), Jacob Kruss (phot. à Aeuckens) et G. Friederichs, Hof-Photograph, don Raoul de Clermont en 1886]

Donateur : Clermont, Raoul de (18..-19..?)