Swiss medical weekly
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Swiss medical weekly · Jul 2006
Comparative StudyThe absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?
The diagnosis of obstructive lung disease (OLD) may be overlooked because of the poor correlation between the intensity of symptoms and the severity of airway obstruction (AO). Undiagnosed airflow obstruction (UDAO) is associated with health impairment and mortality. Questions remain such as the reasons for its occurrence and the underlying diseases. In a pulmonologist's private practice, the objectives were to detect UDAO in the absence of dyspnoea, cough and wheezing, to improve its screening following other anamnestic data, and to separate UDAO patients into "silent asthma" (SA) or "persistent obstruction". ⋯ The absence of dyspnoea, cough and wheezing is a fairly frequent finding and a reason for UDAO. PFTs are warranted with any suggestive symptoms and AO risk factors. The favourable follow-up underlines the importance of screening for UDAO.
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Swiss medical weekly · Apr 2006
Randomized Controlled TrialPrevalence and influence of diagnostic tests for acute respiratory tract infections in primary care.
General practitioners (GPs) use diagnostic tests to help distinguish between viral and bacterial acute respiratory tract infections (ARTI). We investigated the prevalence of these tests, and how tests are associated with diagnosis, treatment and patient satisfaction. ⋯ Nearly half of these patients with ARTI received a diagnostic test. Older patients, those with higher education and those in more discomfort were more likely to get tests. A positive test was strongly associated with antibiotic treatment.
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Swiss medical weekly · Apr 2006
ReviewSarcoidosis is a multisystem disorder with variable prognosis--information for treating physicians.
Sarcoidosis is a chronic granulomatous inflammatory disorder of unknown origin with heterogeneous outcome. In most cases the disease is self-limited, others progress or die from organ involvement, which is often associated with extensive scarring. ⋯ Modern treatment strategies appraise a critical awareness for the side-effect-ratio of long-term medication. A main interest of research is to identify those patients with unfavourable outcome.
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Swiss medical weekly · Apr 2006
Unlicensed and off-label drug use in a Swiss paediatric university hospital.
Many medicines used in newborns, infants, children and adolescents are not licensed ("unlicensed") or are prescribed outside the terms of the marketing authorization ("off-label"). Several studies have shown that this is a common practice in various healthcare settings in the USA, Europe and Australia, but data are scarce in Switzerland. ⋯ The use of unlicensed or off-label medicines to treat children was found to be common. Co-operation between the pharmaceutical industry, national regulatory authorities, clinical researchers, healthcare professionals and parents is required in order to ensure that children do not remain "therapeutic orphans".
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Inflammation and coagulation play pivotal roles in host defence. As phylogenetically old responses, there is extensive cross-talk between inflammation and coagulation in enabling an adequate immune response against potentially injurious stimuli. ⋯ Vice versa, coagulation proteases have significant immunomodulatory effects. Understanding the mechanisms involved in the crosstalk between inflammation and coagulation may yield new therapeutic strategies for human diseases.