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Physical activity (PA) promotion has become a central objective of Public Health Organisations, due to its long-lasting global benefits on health. The 2023 recommendations recommend at least 150 minutes of moderate physical activity or 75 minutes of intense physical activity per week for adults. New approaches focus on physical exercise as an integral part of daily life. Primary care doctors play a key role in promoting physical activity. Yet in 2010, only 30% of them advised their patients on PA. This is partly due to their own sedentary lifestyle, caused by heavy workloads, irregular working hours, lack of free time and insufficient institutional and financial support for promoting physical activity. An active doctor is an active patient, and the promotion of physical activity in the workplace should be supported by institutions., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

A 78-year-old smoker patient with COPD (GOLD 3E) is admitted for COPD exacerbation. The initial examination shows abnormal fingers and nails. The hyponychial angle is 195 degrees and there is a positive Schamroth sign. A diagnosis of nail clubbing is made. Because the association of nail clubbing and COPD is rare, the history is completed and reveals significant weight loss over the past few months. A -pulmonary CT-scan shows a peri-hilar mass, and biopsy confirms small cell lung cancer.

Asymptomatic bacteriuria is frequently encountered in clinical practice and should be treated only in pregnant women and before invasive urological procedures. Inappropriate treatment of asymptomatic bacteriuria is associated with numerous adverse effects including allergic reactions, increased antibiotics resistance and increase risk of Clostridioides difficile infection. Positive urinary culture often leads to antimicrobial treatment, irrespective of urinary symptoms. Therefore, urine analysis and culture should be performed only in symptomatic individuals or in asymptomatic individuals with a clear indication for treatment.

Rapidly progressive dementia is distinguished from other neurocognitive disorders by its rapid onset (less than two years from first symptoms to diagnosis). It comprises a wide range of etiologies, including Creutzfledt-Jakob disease and Alzheimer's disease. When faced with a recent and rapid onset of major cognitive impairment, it is essential to rule out delirium or any other cause that may lead to rapid cognitive decline (such as stroke, encephalitis, or epileptic seizure). The work-up is based on a detailed history (drugs, exposure, medical history), a thorough clinical examination, and a broad biological work-up including MRI, lumbar puncture and EEG. Management should rapidly involve a neurologist or a specialized center., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

High output heart failure (HOHF) is a particular type of heart failure with multiple etiologies but a similar underlying mechanism, namely a decrease in systemic vascular resistance, in some instances associated with increased metabolic requirements. This leads to neurohormonal activation, fluid and sodium retention and a chronic hyperdynamic state resulting in a classic congestive state associated with clinical signs of high output. While no clear definition of HOHF exists, such findings and an increase in cardiac output (cardiac index >4 L/min/m2) strongly suggest the diagnosis. This probably under-diagnosed entity should actively be sought, particularly in obese patients and/or patients labelled with heart failure with preserved ejection fraction (HFpEF). Treatment and prognosis depend on the etiology., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Iodinated contrast products have been incriminated for a long time in the development of acute renal failure after injected procedures. This trend is now being questioned and this article reviews the current state of knowledge concerning the risk of acute renal failure after intra-arterial and intravenous iodinated contrast media injection. It also proposes a review of prophylactic measures for these two modalities as well as a practical attitude to adopt with patients requiring an injected examination., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.