Swiss medical weekly
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Swiss medical weekly · Jul 2010
ReviewNovelties in the early management of acute heart failure syndromes.
The recent European Society of Cardiology (ESC) guidelines delineate the diagnosis and management of distinct categories of acute heart failure syndromes. However, physicians dealing with these patients may need guidance in choosing therapeutic alternatives as soon as the dyspneic patient arrives at the emergency department, until distinct categories of the ESC guidelines are identified. ⋯ Early initiation of diagnostic and goal-directed treatment strategies are key factors in improving patient outcomes. Early and frequent reassessment is also imperative so that adjustments to the initial therapeutic approach can be made, as clinically indicated.
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Swiss medical weekly · Jun 2010
Pain in the emergency department: adherence to an implemented treatment protocol.
Although pain is one of the most common presenting complaints in the Emergency Department (ED), pain management is often inadequate. Pain management protocols have been shown to be useful. The objective of this study was to assess the adherence to an already implemented pain management protocol in an urban ED. ⋯ The benefits of pain management protocols are proven. However, adherence to these protocols needs to be monitored regularly in order to optimise pain management.
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Swiss medical weekly · May 2010
Review5% lidocaine medicated plaster in painful diabetic peripheral neuropathy (DPN): a systematic review.
Several pharmacological treatments are used to manage painful diabetic peripheral neuropathy (DPN). ⋯ The results suggest that the effects in pain reduction of 5% lidocaine medicated plaster are comparable to those of amitriptyline, capsaicin, gabapentin and pregabalin. Topical agents such as 5%LMP may be associated with fewer and less clinically significant adverse events than is the case for systemic agents. However, the results are limited by the number and size of studies included, and thus further studies are needed.
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Swiss medical weekly · May 2010
Barriers to Swiss guideline-recommended cholesterol management in general practice.
Standard guidelines for the management of dyslipidaemia are often not followed in general practice. The reasons for guideline non-adherence are not known. ⋯ More than half of all patients aged 35-80 years are not screened or treated according to current guidelines. The reasons are to an equal extent patient-related (relevant comorbidity) and physician-related (acceptance and knowledge of guidelines). These reasons should be considered when programmes to improve the quality of GPs' adherence to guidelines are implemented.
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Swiss medical weekly · Apr 2010
ReviewCryoballoon ablation for pulmonary vein isolation in patients with paroxysmal atrial fibrillation.
Cryoballoon ablation has emerged as a novel treatment option for drug-refractory atrial fibrillation (AF). The purpose of this manuscript is to report the initial experience of a Swiss centre performing cryoballoon ablation, and to provide a critical review of the literature. Fourteen patients (age 59 +/- 10 years, LVEF 57 +/- 5%, left atrial size 41 +/- 3 mm) with paroxysmal AF were studied. ⋯ The success rate of 71% after a 1-year follow-up is not higher when compared to radiofrequency ablation. Furthermore, data on long-term outcomes are lacking. Randomised comparisons with radiofrequency catheter ablation are needed.