Swiss medical weekly
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Swiss medical weekly · Jan 2015
Increasing prehospital emergency medical service interventions for nursing home residents.
In the ageing European population, the proportion of interventions by the emergency medical services (EMS) for elderly patients is increasing, but little is known about the recent trend of EMS interventions in nursing homes. The aim of this analysis was to describe the evolution of the incidence of requests for prehospital EMS interventions for nursing home residents aged 65 years and over between 2004 and 2013. ⋯ Our results confirmed an important increase in the incidence of EMS interventions in nursing homes during the last decade, far exceeding the actual increase of the nursing home population during the same period. This evolution represents an important opportunity to reconsider the EMS missions in the context of an ageing society.
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Swiss medical weekly · Jan 2015
Observational StudyA low observed-to-expected postoperative mortality ratio in a Swiss high-standard peri-operative care environment - an observational study.
The objective was to assess observed-to-expected in-hospital postoperative 30-day mortality and to identify associated risks. ⋯ The postoperative observed-to-expected mortality ratio was favourable. Independent postoperative risk factors for mortality were well-established factors such as age, ASA PS, non elective surgery but also duration of PACU-IMC stay which was considered as a surrogate of postoperative complications.
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Swiss medical weekly · Jan 2015
Post-treatment surveillance of head and neck cancer: pitfalls in the interpretation of FDG PET-CT/MRI.
We investigated non-malignancy-associated (¹⁸F)fluoro-deoxy-D-glucose (FDG) uptake in the head and neck cancer (HNC) post-treatment follow-up with positron emission tomography - computed tomography / magnetic resonance imaging (PET-CT/MRI). A retrospective study on HNC patients undergoing follow-up or re-staging PET-CT/MRI examinations was performed. Thereby, FDG-positive regions were morphologically correlated to the CT and MRI images and a statement regarding tumour persistence/recurrence. ⋯ Post-treatment follow-up of HNC patients requires interdisciplinary management and familiarity with the patient's past medical history. Awareness of common confounders of FDG positivity often allows clarification of indistinct lesions. However, a substantial number of approximately 12% of FDG-positive lesions remain unclear unless invasive diagnostic procedures are performed.
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Swiss medical weekly · Jan 2015
Patients with an extraordinarily elevated serum ferritin: think of haemophagocytic lymphohistiocytosis.
We retrospectively analysed charts of patients with blood ferritin level >5000 µg/l. The aim of the study was to look for the likelihood of haemophagocytic lymphohistiocytosis (HLH) in these patients. ⋯ HScore reflects a higher specificity than the algorithm for diagnosing HLH. The discrepancy may indicate the difficulty that a specific marker still is missing. Hyperferritinaemia was strongly associated with HLH in patients with haematological or oncological malignancies. HLH may be underdiagnosed because the majority of these patients suffer from a severe underlying disease, which easily might suggest a flare or infection. In this population, hyperferritinaemia and SIRS should rise suspicion because mortality in HLH is high.