Swiss medical weekly
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Swiss medical weekly · Apr 1991
[Diagnosis of susceptibility for malignant hyperthermia using in-vitro muscle contraction testing in Switzerland].
Malignant hyperthermia is a potentially fatal pharmacogenetic disorder triggered by volatile anesthetics (halothane, enflurane, isoflurane) and/or succinylcholine. The inheritance of malignant hyperthermia susceptibility is thought to be autosomal dominant and the incidence could be as high as 1:10,000. ⋯ Of 45 families analyzed, 28 had at least one person who was susceptible to malignant hyperthermia with a total of 64 malignant hyperthermia-susceptible individuals. 36 subjects in the 45 families were normal. In addition, our study shows that a femoral nerve block can be used in outpatients as a reliable anesthetic technique to perform biopsies from the vastus medialis muscle for malignant hyperthermia screening.
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Swiss medical weekly · Apr 1991
[Percutaneous echography-guided alcohol block of the celiac plexus as treatment of painful syndromes of the upper abdomen: study of 21 cases].
Celiac plexus block is usually performed under fluoroscopic or tomodensitometric guidance. We report on a new procedure using sonographic guidance. the patient lies in supine position. We use a real-time sonograph with a 3.5 MHz probe. ⋯ No treatment-related complication was observed. We conclude that sonography is a simple and safe method of guidance in performing alcohol block of the celiac plexus. The anterior approach may prevent neurologic complications occurring with other methods of guidance using a posterior approach.
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Swiss medical weekly · Mar 1991
[Home mechanical ventilation in Switzerland in 1990. Future developments].
Home mechanical ventilation (HMV) was initiated in polio centers in the mid-50s (iron lung). Ten years ago, chronic respiratory insufficiency patients began to be treated with positive pressure ventilation via tracheostomy tube. Survival of kyphoscoliotic and myopathic patients was impressive in uncontrolled studies. ⋯ The present situation of HMV in Switzerland (number of patients and their location) and the results of this treatment are described. In addition, we report on a short series of 24 Swiss patients collected in 4 centers. We show that HMV is possible in Switzerland and that the results in survival and quality of life are excellent, provided that the indications for this technique are consistent with the recommendations in the literature.
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In a follow-up study patients with "restless legs" investigated in 1986 were reexamined three years later. In 1989 the patients showed similar psychopathological symptoms, i.e. a depressive-anxious-hypochondric syndrome. The connection between restless legs syndrome and psychic disorders, and in particular the possibility of a common pathogenesis, are discussed.
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Although pain is not considered a typical symptom of multiple sclerosis, more than 50% of patients with MS present with pain syndromes. In the setting of an incurable disease, symptom control and particularly pain control is very important in achieving a better quality of life. ⋯ On the other hand, drugs are not always effective in treating the various chronic pain syndromes such as dysesthetic extremity pain or leg spasms. In these conditions, individualized regular physiotherapy may relieve pain.