Swiss medical weekly
-
Swiss medical weekly · Jan 2015
Building legitimacy by criticising the pharmaceutical industry: a qualitative study among prescribers and local opinion leaders.
The literature has described opinion leaders not only as marketing tools of the pharmaceutical industry, but also as educators promoting good clinical practice. This qualitative study addresses the distinction between the opinion-leader-as-marketing-tool and the opinion-leader-as-educator, as it is revealed in the discourses of physicians and experts, focusing on the prescription of antidepressants. We explore the relational dynamic between physicians, opinion leaders and the pharmaceutical industry in an area of French-speaking Switzerland. ⋯ Local experts were vocal critics of the industry, which nevertheless sponsor their continuing education. This critical attitude enhanced their credibility in the eyes of the prescribing physicians. We discuss how the experts, despite their critical attitude, might still be beneficial to the industry's interests.
-
Elevation of the mean pulmonary arterial pressure to ≥25 mm Hg within the low-pressure system of the pulmonary circulation is defined as pulmonary hypertension. Pulmonary hypertension may be the consequence of various clinical and pathophysiological entities. ⋯ Remodelling is arguably the most important factor: its complex pathogenesis is not completely understood and no specific treatment directly targets vascular remodelling. This article aims to review the current understanding of the pathogenesis of pulmonary hypertension and to give insights in future developments in this evolving field.
-
Swiss medical weekly · Jan 2015
Comparative StudyImpact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation.
Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months. ⋯ Our study demonstrates for the first time that the number and type of vascular lesions as assessed with OCT did not predict the success of BP reduction after RDN. However, we observed a substantial decrease in office SBP in relation to the number of ablation points at 6 months.
-
Swiss medical weekly · Jan 2015
Observational StudyThe proportion of correct diagnoses is low in emergency patients with nonspecific complaints presenting to the emergency department.
To determine the proportion of correct emergency department (ED) diagnoses and of hospital discharge diagnoses, in comparison with final diagnoses at the end of a 30-day follow-up, in patients presenting with nonspecific complaints (NSCs) to the ED; to determine differences between male and female patients in the proportion of missed diagnoses. ⋯ Patients presenting to the ED with NSCs present a diagnostic challenge. New diagnostic tools are needed to help in the diagnosis of these patients.
-
Swiss medical weekly · Jan 2015
Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland.
To describe acute toxicity of recreational drugs including novel psychoactive substances. ⋯ Medical problems related to illicit drugs mostly concerned cocaine and cannabis and mainly involved sympathomimetic toxicity and/or psychiatric disorders. ED presentations associated with novel psychoactive substances appeared to be relatively rare.