Swiss medical weekly
-
Neurotoxicity is of increasing importance in the treatment of cancer patients. Since the dose-limiting hematological toxicity of most cytostatic drugs can now be overcome by modern supportive therapy, high-dose chemotherapy with curative intent can be used more often. Non-hematological toxicities such as neurotoxicity will therefore become dose-limiting with greater frequency, and to avoid disabling neurological side effects of chemotherapy the drug-induced neurological disturbances must be recognized before irreversible damage has occurred. The neurological side effects of the cytostatic drugs are reviewed.
-
Swiss medical weekly · Jul 1989
Case Reports[Monoclonal gammopathies of undetermined significance called "MGUS"].
While the discovery of a monoclonal gammopathy in the blood of a patient sometimes leads to the diagnosis of multiple myeloma, immunocytoma or other B-cell lymphoproliferative syndromes, "secondary" monoclonal dysproteinemia is seldom considered. In most cases "monoclonal gammopathy of undetermined significance" (MGUS) is diagnosed. ⋯ Other MGUS usually remain asymptomatic, though sometimes a complication such as amyloidosis or cryoglobulinemia may occur as a result of the "perverse" effect of the monoclonal protein. Some cases are described.
-
Bacterial arthritis is an emergency situation in which rapid diagnosis and immediate therapy are the main factors conditioning a satisfactory functional outcome. Not infrequently, bacterial arthritis may involve only mild clinical features, thus leading to a delay in diagnosis. ⋯ Other signs of bacterial infection (i.e. leukocytosis, positive blood cultures, synovial fluid pleocytosis) were less frequent than expected. Functional outcome was better for patients with a short latent period between the onset of clinical symptoms and initiation of treatment.
-
Swiss medical weekly · Apr 1989
Case Reports[Acute pregnancy fatty liver with survival of the mother and child].
A case of acute fatty liver as a rare cause of pregnancy-induced jaundice is reported. Near term the 25-year-old patient became rapidly jaundiced. On admission laboratory tests showed signs of incipient coagulopathy and impaired renal function. ⋯ Despite the marked bilirubin elevation the hepatic enzymes were only slightly raised. In addition, acute renal insufficiency, pancreatitis and hyperuricemia developed. Under intensive care the patient recovered slowly and was discharged after 4 weeks with a healthy baby.
-
Swiss medical weekly · Jan 1989
Comparative Study[Chronic backache in migrant workers from Mediterranean countries in comparison to central European patients: demographic and psychosocial aspects].
The standardized interviews of 26 chronic back pain patients from central Europe (Switzerland, Germany, Poland) were compared with those of 28 patients from Mediterranean countries (Italy, Spain, Yugoslavia, Turkey), all of whom had been referred for participation in an integrated treatment program for chronic back pain. The two samples differed significantly in most of the psychosocial aspects studied. Patients from Mediterranean countries had a significantly lower level of education and were mostly employed as unskilled workers, while patients from central Europe were mostly housewives or skilled workers with higher levels of education. ⋯ Unskilled workers are significantly overrepresented in the latter segment of the adult working population of the study area (city of Basel, Switzerland). This overrepresentation is similar to that in our patient sample. The special situation of foreign workers from Mediterranean countries seems to account for their high incidence of chronic intractable back pain.