Swiss medical weekly
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Swiss medical weekly · May 2005
Case ReportsAnti-infectious prophylaxis after splenectomy: current practice in an eastern region of Switzerland.
Overwhelming post-splenectomy infection (OPSI) is a long-term risk in asplenic patients, which may be minimised by appropriate preventive measures. In this survey anti-infectious strategies after splenectomy were evaluated in an eastern part of Switzerland. We found 91 individuals in the canton of Thurgau, who underwent splenectomy between 1998 and 2003. ⋯ Three adults had a supply of stand-by antibiotics at home. Less than half of the patients who were interviewed knew that asplenia puts them at greater risk for life-threatening infections and few practitioners were aware that travel and animal bites pose a special threat. We conclude that after splenectomy vaccination discipline and patient education should be substantially improved and suggest the publication of comprehensive guidelines.
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Swiss medical weekly · Mar 2005
ReviewPulmonary computed tomography and adult respiratory distress syndrome.
Computed tomography has completely changed the views and interpretation of ARDS, opening a new era in our understanding of the physiological, pathological and clinical aspects of this syndrome. In this brief review we will emphasize the most relevant new knowledge achieved using CT scanning and we will briefly discuss its clinical use in ARDS patients.
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Swiss medical weekly · Mar 2005
Pitfalls in the emergency department triage of frail elderly patients without specific complaints.
Elderly patients represent an increasing proportion of emergency department (ED) admissions. When no specific complaint is identified, the reason for referral is commonly called "home care impossible". The aim of this study was to describe a population of elderly patients who present to the ED of a 1200-bed university hospital without specific complaint, and to assess how they were evaluated in the ED. ⋯ Frail elderly patients admitted without specific complaints are at risk of inappropriate or delayed evaluation due to undertriage at the door of the ED. A more specific geriatric assessment should be integrated early in the triage process of these patients.
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Swiss medical weekly · Feb 2005
Adherence to the Swiss guidelines for management of COPD: experience of a Swiss teaching hospital.
Swiss guidelines for the management of chronic obstructive pulmonary disease (COPD) were published in 2002. We aimed at assessing adherence to the proposed guidelines by the physicians in charge for all patients referred to our hospital for acute exacerbations of COPD over a one year period. ⋯ Confirmation of the diagnosis of COPD by spirometry is lacking in a significant number of patients. Most patients were treated with regular bronchodilators, however, relevant over-treatment with beta-adrenergic substances and overuse of inhaled corticosteroids in mild disease stages are common. Efforts for disease prevention and education as well as awareness of the potential benefits of pulmonary rehabilitation programs are still insufficient. Efforts to improve the adherence to the Swiss guidelines for the management of COPD should be intensified.
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Swiss medical weekly · Feb 2005
Antipsychotic use in patients with schizophrenia treated in private psychiatry.
The aim of this study was to assess antipsychotic treatment practices among private psychiatrists in Switzerland. ⋯ The findings of this survey suggest that Swiss private psychiatrists prescribe according to international guidelines in terms of drug choice as well as maintenance treatment. Moreover they show low rates of polypharmacy and comedication practice as compared to their colleagues in other European countries. This may reflect solid experience in prescribing second-generation antipsychotics of a subgroup of private psychiatrists in Switzerland.