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Swiss Medical Weekly

Michael Osthoff, Martin Siegemund, Gianmarco Balestra, Mohd Hafiz Abdul-Aziz, Jason A Roberts
Prolonged infusion of β-lactam antibiotics as either extended (over at least 2 hours) or continuous infusion is increasingly applied in intensive care units around the world in an attempt to optimise treatment with this most commonly used class of antibiotics, whose effectiveness is challenged by increasing resistance rates. The pharmacokinetics of β-lactam antibiotics in critically ill patients is profoundly altered secondary to an increased volume of distribution and the presence of altered renal function, including augmented renal clearance...
2016: Swiss Medical Weekly
Paul Hasler, Stavros Giaglis, Sinuhe Hahn
Polymorphonuclear neutrophil granulocytes are the first responders of the immune system to threats by invading microorganisms. In the traditional view, they combat the intruders by phagocytosis and externalisation of granules containing lytic and microbicidal factors. A dozen years ago, this concept was expanded by the observation that neutrophils may react to bacteria by extruding their nuclear chromosomal DNA with attached nuclear and cytoplasmic constituents to form extracellular reticular structures. Since they trapped and immobilised the microbes, they were designated neutrophil extracellular traps (NETs), and their ensuing cell death NETosis...
2016: Swiss Medical Weekly
Andreas Stuck
No abstract text is available yet for this article.
2016: Swiss Medical Weekly
Marine Desarmenien, Anne Laure Blanchard-Courtois, Bara Ricou
Advances in intensive care medicine have created a new disease called the chronic critical illness. While a significant proportion of severely ill patients who twenty years ago would have died survive the acute phase, they remain heavily dependent on intensive care for a prolonged period of time. These patients, who can be called "Patient Long Séjour" in French (PLS) or Prolonged Length of Stay patients in English, develop specific health issues that are still poorly recognised. They require special care, which differs from treatments that are given during the acute phase of their illness...
2016: Swiss Medical Weekly
Nathalie Rouiller, Pedro Marques-Vidal
AIM: Weight misperception precludes effective management of pre-obesity and obesity, but little is known regarding its status in the Swiss population. Our study aimed to assess the prevalence and determinants of weight over- and underestimation in an adult urban Swiss population. METHODS: Cross-sectional study conducted between 2009 and 2012 in the city of Lausanne. Height and weight were measured using standardised procedures. Weight perception and other socio-demographic variables were collected through questionnaires...
2016: Swiss Medical Weekly
Nikola Biller-Andorno
No abstract text is available yet for this article.
2016: Swiss Medical Weekly
S Morteza Seyed Jafari, Pitschna Jäckle, Aude Michel, Sarina Angermeier, Robert Hunger, Maziar Shafighi
BACKGROUND: Although sentinel lymph node biopsy (SLNB) is the most sensitive and accurate investigative modality for establishing regional node status in patients with melanoma, its role and benefit in melanoma of different Breslow's thickness is still controversial. OBJECTIVE: The current study aimed mainly to evaluate the effects of SLNB results on important outcome parameters in primary melanomas with different Breslow's thicknesses. METHODS: In a retrospective cohort (1990 to 2014), all cases of single, primary localised cutaneous melanoma tumours were evaluated...
2016: Swiss Medical Weekly
Georg Kägi, Natascha Leisi, Marian Galovic, Marlise Müller-Baumberger, Werner Krammer, Bruno Weder
BACKGROUND: Up to 50% of ischaemic stroke patients show initial dysphagia, which may persist for months. Guidelines recommend switching nasogastric (NG) to percutaneous endoscopic gastrostomy (PEG) tube feeding at the second week after the stroke if impaired deglutition is expected for another 4 weeks. Precise prognostic criteria are lacking. We hypothesised that the Parramatta Hospitals' Assessment of Dysphagia (PAHD) performed 8 to 10 days after the stroke predicts impaired deglutition for another 4 weeks...
2016: Swiss Medical Weekly
Hasier Eraña, Joaquín Castilla
Compelling evidence from the last three decades clearly shows that transmissible spongiform encephalopathies (TSEs) develop as a result of a poorly understood misfolding event that converts the cellular prion protein (PrPC) to an isoform known as PrPSc which is aggregated, protease resistant and able to impose its aberrant conformation onto PrPC, leading to its accumulation in the central nervous system. Despite all the knowledge gathered in more than thirty years of research and the general understanding of the pathological processes, the molecular mechanisms remain elusive, making it difficult to develop rational therapeutic strategies for this group of incurable diseases...
2016: Swiss Medical Weekly
Ulrich Heininger
No abstract text is available yet for this article.
2016: Swiss Medical Weekly
Katrin Straubhaar, Philipp Schuetz, Claudine Angela Blum, Nicole Nigro, Briel Matthias, Mirjam Christ-Crain, Beat Mueller, Step Study Group
PRINCIPLES: In-hospital care of patients with community-acquired pneumonia (CAP) varies across hospitals. Understanding of the underlying factors is the basis for tailored quality improvements. Using data from a randomised controlled Swiss-wide multicentre trial, we compared length of stay (LOS) and other patient outcomes according to (A) the use of a procalcitonin (PCT)-based antibiotic stewardship protocol, (B) institution type (university vs non-university), and (C) historical time period in relation to the introduction of Diagnosis Related Group (DRG) reimbursement (2012)...
2016: Swiss Medical Weekly
Angelique H Sadlon, Dimitrios A Tsakiris
BACKGROUND: Concerns regarding the use of direct oral anticoagulants (DOACs: apixaban, dabigatran, edoxaban, rivaroxaban) in the elderly persist owing to the lack of randomised controlled trials targeting this age group. OBJECTIVES: The aim of this study was to assess the efficacy and safety of DOACs in elderly patients (aged 75 years or more) with atrial fibrillation or venous thromboembolism (VTE), based on already published large randomised trials. METHODS: EMBASE, MEDLINE and the Cochrane Library were searched from inception to June 2015 for phase III trials...
2016: Swiss Medical Weekly
Manuela Funke, Thomas Geiser, Otto D Schoch
In 2015, the international guidelines for diagnosis and treatment of pulmonary hypertension (PH) were updated. Group 3 of the current classification includes PH associated with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), other pulmonary diseases with restrictive and obstructive pattern, sleep-disordered breathing, alveolar hypoventilation disorders, chronic exposure to high altitude, and developmental lung diseases [1]. PH associated with COPD and ILD is common but difficult to manage, as no long-term randomised controlled trial (RCT) has been conducted with specific pulmonary arterial hypertension (PAH) drugs in PH associated with COPD, and the one recent RCT in PH associated with ILD had to be stopped early due to a possible increased risk of death and side effects in the treatment group...
2016: Swiss Medical Weekly
Nina Khanna, Claudia Stuehler, Anna Lünemann, Agnieszka Wójtowicz, Pierre-Yves Bochud, Salomé Leibundgut-Landmann
In spite of the ever-increasing incidence and poor outcome of invasive fungal infections in immune compromised patients, there is currently no reliable method to accurately predict the risk, to monitor the outcome and to treat these infections. Protective immunity against Candida and Aspergillus depends on a highly coordinated interaction between the innate and adaptive immune systems. Genetic and immunological defects in components of these networks result in increased risk of invasive fungal infections among patients undergoing chemotherapy or transplant recipients...
2016: Swiss Medical Weekly
Victor Alfred, Thomas Vaccari
Originally discovered as regulators of cargo sorting during endosomal trafficking, ESCRT (endosomal sorting complexes required for transport) proteins are emerging as flexible machines that shape the behaviour of membranes throughout the cell. Deregulation of ESCRT activity is observed in neuro-degenerative diseases, virus infection and cancer. However, the mechanisms of pathogenesis involving ESCRTs have not yet fully come into focus. Here, we review the current knowledge of ESCRT function in health and disease and provide educated guesses for future research and focused therapeutic intervention...
2016: Swiss Medical Weekly
Flaminia Olearo, Werner C Albrich, Nathalie Vernaz, Stephan Harbarth, Andreas Kronenberg, Swiss Centre For Antibiotic Resistance Anresis
BACKGROUND: The global epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) is heterogeneous. The objective of this study was to evaluate MRSA epidemiology in Switzerland over an 11-year period. METHODS: We conducted a retrospective study with time series analysis on S. aureus including MRSA and non-multidrug resistant MRSA (NmMRSA). We used NmMRSA as a marker for community-acquired MRSA. NmMRSA was defined as MRSA susceptible to at least three of the following agents: ciprofloxacin, clindamycin, tetracycline and trimethoprim-sulfamethoxazole...
2016: Swiss Medical Weekly
Franz H Messerli, Stefano F Rimoldi, Bruno Vogt
No abstract text is available yet for this article.
2016: Swiss Medical Weekly
Michael Freuler, Susan De Crom, Christoph Hatz, Silja Bühler
QUESTION UNDER STUDY: In Switzerland, vaccination against varicella is not recommended in the basic immunisation schedule. However, for individuals aged 11-40 years who do not have a reliable varicella history the Swiss Federal Office of Public Health recommends either (i) a vaccination or (ii) a serology test and vaccination of those with a negative result. In the Travel Clinic of the University of Zurich, the second strategy is followed. In this study we retrospectively assessed the overall percentage of individuals with varicella-specific antibodies despite a negative history and we examined the influence of age, number of siblings, order of siblings, age difference to siblings and nationality on varicella seropositivity...
2016: Swiss Medical Weekly
Heloise Wüthrich, Fahad Alromaih, Alexander So
Gout is a common condition and its management is suboptimal. A number of guidelines on the management of gout have been published in the last decade by professional societies with the aim of informing the physician of the recommended therapeutic strategies and the treatment options. We have tried to synthesize the current recommendations and to highlight some challenges that still need to be resolved in clinical practice in Switzerland.
2016: Swiss Medical Weekly
Katharine Ea Darling, Anna Hachfeld, Matthias Cavassini, Ole Kirk, Hansjakob Furrer, Gilles Wandeler
In 2014, there were 36.9 million people worldwide living with human immunodeficiency virus (PLWH), of whom 17.1 million did not know they were infected. Whilst the number of new human immunodeficiency virus (HIV) infections has declined globally since 2000, there are still regions where new infection rates are rising, and diagnosing HIV early in the course of infection remains a challenge. Late presentation to care in HIV refers to individuals newly presenting for HIV care with a CD4 count below 350 cells/µl or with an acquired immune deficiency syndrome (AIDS)-defining event...
2016: Swiss Medical Weekly
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