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Swiss Medical Weekly

Benedikt Habermeyer, Lea Wyder, Patrik Roser, Marc Vogel
According to the Swiss legal system, involuntary admission is one of the farthest-reaching incursions into personal autonomy. The effect of compulsory admission in treatment of substance use disorders (SUDs) on variables such as length of stay or leaving treatment before recommended discharge remains elusive. In order to elucidate these effects, we retrospectively analysed the clinical course of treatment of 608 patients who were admitted between November 2016 and October 2017 to the Department of Addictive Disorders of the canton of Aargau...
August 27, 2018: Swiss Medical Weekly
Christian Auer, Sabine Kiefer, Meike Zuske, Christian Schindler, Kaspar Wyss, Johannes Blum, Xavier Bosch-Capblanch, Ursula Widmer, Sonia Sauthier, Jean-Paul Janssens, Katharina Bossard, Christophe Chatonnet, Jesica Mazza-Stalder, Bea Začek, Jean-Pierre Zellweger, Ekkehardt Altpeter, Mirjam Mäusezahl
AIMS OF THE STUDY: To assess the health-seeking behaviour, the patient delay (onset of symptoms to first consultation) and the health system delay (first consultation to start of tuberculosis treatment) among patients with pulmonary tuberculosis (TB) diagnosed in Switzerland, and to assess the predictors of the various types of delay. METHODS: A survey among pulmonary TB patients was carried out in six cantons, covering 42% of all pulmonary adult TB cases notified in Switzerland...
August 27, 2018: Swiss Medical Weekly
Christian Rothermundt, Claudio Thurneisen, Richard Cathomas, Beat Müller, Walter Mingrone, Anita Hirschi-Blickenstorfer, Tobias Wehrhahn, Christian Ruf, Sacha I Rothschild, Bettina Seifert, Angelika Terbuch, Thomas Grassmugg, Regina Woelky, Christian Fankhauser, Thomas Kunit, Natalie Fischer, Natalie F Fischer, Roman Inauen, Jörn Kamradt, Katrin Ziegler, Alan Haynes, Peter Jüni, Silke Gilessen
No abstract text is available yet for this article.
August 27, 2018: Swiss Medical Weekly
Nathalie Vernaz, Alexandra Calmy, Samia Hurst, Yves Jackson, Francesco Negro, Arnaud Perrier, Hans Wolff
Hepatitis C is a potentially fatal viral infection that mainly affects vulnerable patient groups. Given the high efficacy of the new direct-acting antivirals (DAAs), the World Health Organization (WHO) aims to eliminate viral hepatitis as a global health threat by 2030. However, due to the high cost of DAAs, this recommendation has put significant pressure on the budgets of countries with mandatory health insurance, such as Switzerland. There are particular challenges related to populations with low socioeconomic status or without residence permits who might not be covered by health insurance, or who forgo health care for economic reasons...
August 13, 2018: Swiss Medical Weekly
Julia Kempf, Alexander Schmitz, Aline Meier, Neele Delfs, Beat Mueller, Javier Fandino, Philipp Schuetz, Sven Berkmann
AIMS OF THE STUDY: Acromegaly due to a growth hormone-secreting pituitary adenoma is a rare disease with high morbidity if not treated adequately. Using data of the Swiss Pituitary Registry (SwissPit), we studied initial presentation and predictors for adverse clinical outcomes in acromegalic patients treated during the last 10 years in our institution. METHODS: We evaluated 21 patients from the SwissPit registry with a final diagnosis of acromegaly confirmed by laboratory results (insulin-like growth factor-1 [IGF-1] and growth hormone suppression tests) and magnetic resonance imaging...
August 13, 2018: Swiss Medical Weekly
Thorsten Jentzsch, Burkhardt Seifert, Valentin Neuhaus, Rudolf M Moos
BACKGROUND: Providing efficient healthcare is important for hospitals. Shorter and longer length of hospital stay (LOS) outliers influence financial results and reimbursement. The objective of this study was to identify independent diagnosis related group (DRG)-related risk factors for shorter and longer LOS outlier status. METHODS: A retrospective case-control study was conducted at a Swiss level 1 trauma centre between January 2012 and December 2014. The study included all patients with available information on LOS based on DRG...
August 13, 2018: Swiss Medical Weekly
Vladimira Hinic, Helena Seth-Smith, Marcel Stöckle, Daniel Goldenberger, Adrian Egli
Shigella sonnei causes foodborne infections, but has recently also been described as a sexually transmitted infection (STI), with increased levels of antimicrobial resistance. We describe three cases of sexually acquired Shigella sonnei infection - the first report of this emerging infection in Switzerland. We used in-house whole genome sequencing (WGS) to investigate possible transmission routes and epidemiological correlations between the three cases. The genomic analysis demonstrated that two of three case isolates were very closely related, with only two single nucleotide polymorphism differences between them, despite being isolated from two unrelated patients at time-points six months apart, and the infections having been acquired at different geographic locations within Europe...
August 13, 2018: Swiss Medical Weekly
Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: Continuous deep sedation until death is increasingly used to treat intolerable suffering of terminally ill patients. One of the highest incidences and strongest increases has been observed in Switzerland. Variation in prevalence estimates indicates a potential effect of differences in sedation practice between care settings and professionals. AIM: To explore physicians' and nurses' conceptual understanding of continuous deep sedation and unravel decision-making processes in everyday clinical practice...
August 13, 2018: Swiss Medical Weekly
Ivan Zeljkovic, Haran Burri, Alexander Breitenstein, Peter Ammann, Andreas Mueller, Angelo Auricchio, Etienne Delacrétaz, Kenneth Dickstein, Cecilia Linde, Camilla Normand, Christian Sticherling
AIM: Between October 2015 and December 2016, 11,088 patients from 42 countries having cardiac resynchronisation therapy (CRT) devices implanted were included in the CRT II Survey. We compared the characteristics of Swiss CRT recipients with the overall European population. METHODS: Demographic and procedural data from seven Swiss centres recruiting all consecutive patients undergoing either de-novo CRT implantation or an upgrade to a CRT system were collected and compared with the European population...
August 13, 2018: Swiss Medical Weekly
Christoph T Berger, Gregor Sommer, Markus Aschwanden, Daniel Staub, Christof Rottenburger, Thomas Daikeler
Historically, giant cell arteritis (GCA) was considered to be synonymous with temporal arteritis. However, the disease spectrum of GCA extends much further, and includes vasculitis of the aorta and its branches with or without involvement of the temporal arteries. Imaging is crucial for the diagnosis and follow-up of GCA patients. Large vessel GCA (LV-GCA) often presents as an inflammatory syndrome and is only detected by imaging modalities such as: colour duplex sonography (CDS), computed tomography (CT) / CT angiography (CTA), magnetic resonance imaging (MRI) or 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) / CT...
August 13, 2018: Swiss Medical Weekly
Fausto Salaffi, Marina Carotti, Marco Di Carlo, Marika Tardella, Valentina Lato, Andrea Becciolini, Ennio Giulio Favalli, Andrea Giovagnoni
AIMS OF THE STUDY: To assess the performance of the Expanded Risk Score in Rheumatoid Arthritis (ERS-RA), a disease-specific cardiovascular disease (CVD) prediction score, in evaluating the 10-year risk, in comparison with other traditional algorithms in patients with rheumatoid arthritis (RA). METHODS: Consecutive RA patients, aged 40-75 years, without established CVD, were included. We calculated the disease-specific ERS-RA and four traditional CVD prediction scores: the modified Systematic Coronary Risk Evaluation (mSCORE), the Framingham Risk Score using body mass index (FRS BMI), the calculator developed by the American College of Cardiology / American Heart Association in 2013 (ACC/AHA 2013) and the QRISK3...
August 13, 2018: Swiss Medical Weekly
Ulrich Pecks, Ibrahim Alkatout
No abstract text is available yet for this article.
August 13, 2018: Swiss Medical Weekly
Anna Gamell
No abstract text is available yet for this article.
July 16, 2018: Swiss Medical Weekly
Sarah Vilpert, Carmen Borrat-Besson, Jürgen Maurer, Gian Domenico Borasio
BACKGROUND: Advance directives enable people to describe their preferences for medical treatment (living will) and/or to appoint a healthcare proxy who may decide on their behalf should they lose decision-making capacity. Advance directives are potentially important in determining the course of end-of-life care, as deaths are frequently preceded by end-of-life treatment decisions, which often require someone to make decisions on the patient's behalf. Switzerland introduced legally binding advance directives through its new child and adult protection law of 2013...
July 16, 2018: Swiss Medical Weekly
Simon Wieser, Marion Schmidt, André B Kind, Viola A Heinzelmann-Schwarz
OBJECTIVE: The methods used to diagnose and classify ovarian cancer have changed over the past decade. We used hospital registry data to assess the incidence, treatment durations and hospital costs of ovarian cancer in Switzerland. METHODS: We carried out a retrospective analysis of a hospital registry covering all inpatient care episodes in Switzerland between 1998 and 2012. Ovarian cancer incidence was assessed by identifying patients with a first ovarian cancer diagnosis as the main reason for hospital stay after an event-free period...
July 16, 2018: Swiss Medical Weekly
Christian Rothermundt, Claudio Thurneysen, Richard Cathomas, Beat Müller, Walter Mingrone, Anita Hirschi-Blickenstorfer, Tobias Wehrhahn, Christian Ruf, Sacha Rothschild, Bettina Seifert, Angelika Terbuch, Thomas Grassmugg, Regina Woelky, Christian Fankhauser, Thomas Kunit, Natalie Fischer, Roman Inauen, Jörn Kamradt, Katrin Ziegler, Alan Haynes, Peter Jüni, Silke Gillessen
BACKGROUND: The majority of germ cell tumour (GCT) patients can be cured by orchiectomy followed by active surveillance or subsequent systemic and/or local treatments. There are various guidelines for a structured follow-up including radiographic and clinical examinations. OBJECTIVE: The Swiss Austrian German Testicular Cancer Cohort Study (SAG TCCS) prospectively evaluates follow-up, indicator of relapse and late toxicities. This is a descriptive analysis; we present baseline characteristics and treatment strategies for the first 299 patients with primary GCT or relapsed GCT after completion of treatment...
2018: Swiss Medical Weekly
Raphaël Giraud, Karim Bendjelid, Carlo Banfi
No abstract text is available yet for this article.
2018: Swiss Medical Weekly
Mario Bargetzi, Reto Baumann, Sergio Cogliatti, Pierre-Yves Dietrich, Michel Duchosal, Jeroen Goede, Felicitas Hitz, Carolin Konermann, Andreas Lohri, Ulrich Mey, Urban Novak, Alexandros Papachristofilou, Frank Stenner, Christian Taverna, Thilo Zander, Christoph Renner
Over the last few years, there have been many changes in the management of patients with follicular lymphoma, resulting in improvements in progression-free survival and quality of life. In addition to established regimens such as radiotherapy and immunochemotherapy, new treatment options are on the horizon. Furthermore, even the use of established chemotherapy agents has evolved, with new combinations moving to the forefront of the current treatment strategy. Nevertheless, there remains an unmet need for patients who have early relapses, those who are not responsive to anti-CD20 treatment regimens and for those in whom minimal residual disease persists even after immunochemotherapy...
2018: Swiss Medical Weekly
Argelia Medeiros Domingo, Stephan Bolliger, Christoph Gräni, Claudine Rieubland, Deborah Hersch, Babken Asatryan, Christian Schyma, Ardan Saguner, Daniel Wyler, Zahir Bhuiyan, Florence Fellman, Antonio Marco Osculati, Rebekka Ringger, Siv Fokstuen, Sara Sabatasso, Matthias Wilhelm, Katarzyna Michaud
There is a need to standardise, within a coordinated Swiss framework, the practical aspects of genetic testing and genetic counselling on possibly inherited cardiovascular disorders in relatives of a sudden cardiac death (SCD) victim. Because of the major advances in genetic investigation techniques and recent publication of international guidelines in the field of cardiology, genetics and pathology, we consider it important to summarise the current evidence and propose an optimal approach to post-mortem genetic investigation for SCD victims and their families in Switzerland...
2018: Swiss Medical Weekly
Heidi Lederer, Magnus Stalder, Kai Tisljar, Fabio Lanzi, Emmanuelle Landmann, Tamina Mosimann, Franziska Zeeh, Stephan Zuercher, Vincent Mosimann, Rainer Spiegel, Raoul Sutter, Patrick Hunziker
Morbid obesity plays an increasingly important role in healthcare. Patients who are severely obese often suffer from a range of medical problems. One problem is obesity-related hypoventilation syndrome with its resulting hypercapnia. We report a case of a 33-year-old female patient who was in an extraordinarily bad medical state, with severe hypercapnia (pCO2 15.1 kPa), sepsis, acute anuric kidney failure and resulting acidosis (pH 6.96). Her body mass index was 84 kg/m2. Her chances of survival were considered very low after failed attempts at noninvasive ventilation...
2018: Swiss Medical Weekly
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