Swiss medical weekly
-
Swiss medical weekly · Nov 2003
ReviewMechanisms of alveolar epithelial repair in acute lung injury--a translational approach.
In patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), extensive damage to the alveolar epithelial and endothelial barrier is observed, resulting in the influx of protein-rich oedema fluid into the air spaces. Efficient alveolar epithelial repair is crucial to ALI/ARDS patients' recovery. Future therapeutic strategies may therefore include acceleration of the epithelial repair process in the injured lung. ⋯ Further studies using primary alveolar epithelial cells from rats revealed that IL-1beta induced alveolar epithelial repair by an epidermal growth factor (EGF)/transforming growth factor-alpha (TGF-alpha)-dependent pathway. Besides EGF and TGF-alpha, keratinocyte growth factor (KGF) and hepatocyte growth factor (HGF)--both present in pulmonary oedema fluid obtained from patients with ALI/ARDS--stimulate alveolar epithelial repair in vitro. Further experimental and clinical studies will show whether acceleration of alveolar epithelial repair by modulating cytokines and growth factors in the injured lung represents a promising new therapeutic strategy in patients with ALI/ARDS.
-
The role of statistics in medical research starts at the planning stage of a clinical trial or laboratory experiment to establish the design and size of an experiment that will ensure a good prospect of detecting effects of clinical or scientific interest. Statistics is again used during the analysis of data (sample data) to make inferences valid in a wider population. In simple situations computation of simple quantities such as P-values, confidence intervals, standard deviations, standard errors or application of some standard parametric or nonparametric tests may suffice. ⋯ Such advanced methods should only be applied with a clear understanding both of their purposes and the implication of any conclusions based upon their use. Close collaboration between statisticians, whether professionals in that field or medical research workers with a sound statistical background, and other members of a research team is needed to ensure a seamless integration of the statistical elements into the reporting and discussion of research outcomes. Some suggestions are made as to how that collaboration is best achieved.
-
Swiss medical weekly · Jun 2003
Von Willebrand factor-cleaving protease (ADAMTS-13) activity in thrombotic microangiopathies: diagnostic experience 2001/2002 of a single research laboratory.
Severe deficiency of von Willebrand factor-cleaving protease (ADAMTS-13) activity (<5% of normal) is specific for classical thrombotic thrombocytopenic purpura (TTP), a disorder presenting with thrombocytopenia, microangiopathic haemolytic anaemia and often with organ dysfunction such as neurological symptoms, renal failure, and fever. A certain, though according to several case series, variable percentage of patients with clinically diagnosed TTP and most patients with other forms of thrombotic icroangiopathies (TMA) do not show severe ADAMTS-13 deficiency. ⋯ Severe ADAMTS-13 deficiency is found in about 60% of patients diagnosed with idiopathic TTP but in none of 111 diagnosed with HUS. Plasma ADAMTS-13 activity <5%, however, does not identify all patients clinically diagnosed with TTP. Detection of inhibitory antibodies against ADAMTS-13 helps to differentiate between acquired and constitutional forms of TTP, which may be important for treatment strategies.
-
Swiss medical weekly · May 2003
ReviewMacrolide antibiotic therapy in patients with cystic fibrosis.
This summary of the current knowledge of macrolide therapy serves as an example of recent progress in the therapeutic approach to treating patients with cystic fibrosis (CF). The benefit of macrolides in the treatment of patients with diffuse panbronchiolitis and Pseudomonas aeruginosa infections, as seen in Japan, was the rational behind trials in patients with CF. Thus far, the majority of reports of positive trends in the therapeutic potential of macrolides have studied azithromycin. The data presented in peer reviewed journals are, however, too sparse to already justify firm recommendations for the general use of azithromycin, erythromycin or clarithromycin on a long-term basis for the treatment of chronic lung disease in CF.
-
Swiss medical weekly · May 2003
Sociodemographic and career characteristics in female and male faculty members of Swiss medical schools.
Women are still underrepresented in the senior ranks of medical school faculties. Thus far information has been lacking on gendersensitive career paths for professorial and nonprofessorial staff of Swiss medical schools. The aim of this study was to survey faculty members of all Swiss medical schools on sociodemographic aspects, career paths and current career position. ⋯ The data show that Swiss medical faculties reflect the same underrepresentation of women in the higher echelons of medicine as most other Western countries. Gender-sensitive mentoring is needed in medical faculties to support women, especially in advancing to tenure and increasing their publication activities.