Swiss medical weekly
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Swiss medical weekly · Jun 2005
Case ReportsGenetic testing for glucokinase mutations in clinically selected patients with MODY: a worthwhile investment.
The differential diagnosis for children with diabetes includes a group of monogenic diabetic disorders known as maturity-onset diabetes of the young (MODY). So far, six underlying gene defects have been identified. The most common subtypes are caused by mutations in the genes encoding the transcription factor HNF-1a (MODY 3) and the glycolytic enzyme glucokinase (GCK) (MODY 2). ⋯ In addition, a diagnosis of MODY 2 may reassure patients and their families, as microvascular complications are uncommon. Thus there are both health and financial benefits in diagnosing MODY 2. We recommend genetic testing for MODY 2 in clinically selected patients even though this analysis is currently not available in Switzerland and costs are not necessarily covered by the health insurances.
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Swiss medical weekly · Jun 2005
Non-invasive ventilation in the recovery room for postoperative respiratory failure: a feasibility study.
Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing NIV in this setting, and its impact on lung function. ⋯ In recovery ward patients after general surgery, NIV is seldom required. When applied, NIV seems to exert favourable effects on lung function. NIV can be safely implemented with a bilevel device in a recovery ward not accustomed to the use of ICU ventilators. The cost-effectiveness of its systematic use in this setting should be assessed.
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Swiss medical weekly · May 2005
Randomized Controlled Trial Clinical TrialIncidence of contrast nephropathy in patients receiving comprehensive intravenous and oral hydration.
Contrast-induced nephropathy (CIN) remains a major complication of percutaneous coronary interventions (PCI) and a common cause of acute renal failure. The most effective preventive strategy is unknown. ⋯ Applying the combination of intravenous and oral volume supplementation results in a very low incidence of CIN following PCI. Hydration remains the cornerstone for the prevention of CIN.