Swiss medical weekly
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Swiss medical weekly · May 2000
Review[Recent development in the treatment of lung cancer: from the point of view of the medical oncologist].
After a short introduction to recent developments in the field of tobacco control, the non-surgical treatment of small cell and non-small cell lung cancer is summarised with special reference to practical aspects. The promising results obtained with newer cytostatic agents are reviewed. In small cell lung cancer, modern chemotherapy prolongs survival five-fold to an average of one year and 5-10% of all patients achieve long-term disease-free survival. ⋯ Newer cytostatic agents such as the taxanes, vinorelbine and gemcitabine are highly active. These agents are currently incorporated into new, highly active combination chemotherapies. Whether these newer polychemotherapies will bring a significant improvement awaits the results of future randomised trials.
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Swiss medical weekly · May 2000
Functional MR imaging of the craniocervical junction. Correlation with alar ligaments and occipito-atlantoaxial joint morphology: a study in 50 asymptomatic subjects.
Whiplash injuries are frequent in industrialized countries. The acute and chronic symptoms following such injuries are incompletely understood and objective clinical or imaging findings are rare. Several authors have suspected that rear end collisions occurring when the head is rotated may result in tears of the alar ligaments. There has been experimental proof that a torn alar ligament increases the rotation of the C0/C1 and C1/C2 segments to the contralateral side. Functional cross sectional imaging has therefore been proposed to diagnose injuries of the alar ligaments. So far, published data on normal ranges of rotation in an asymptomatic population have been sparse. The aim of this study was to determine by MR imaging the normal range of rotation in the first three cervical segments and their relation to the morphology of the alar ligaments and the occipito-atlantoaxial joints. ⋯ There is wide variation of segmental motion in the upper cervical spine. Differences in right-to-left rotation are frequently encountered in an asymptomatic population. Therefore, these measurements are unsuitable for indirect diagnosis of soft tissue lesions after whiplash injury and should not be used as a basis for treatment guidelines.
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Swiss medical weekly · May 2000
Continuous monitoring of liver oxygenation with near infrared spectroscopy during naso-gastric tube feeding in neonates.
Near infrared spectroscopy (NIRS) is a non-invasive method of estimating the haemoglobin concentration changes in certain tissues. It is frequently used to monitor oxygenation of the brain in neonates. At present it is not clear whether near infrared spectroscopy of other organs (e.g. the liver as a corresponding site in the splanchnic region, which reacts very sensitively to haemodynamic instability) provides reliable values on their tissue oxygenation. ⋯ The test-retest variability for intra-individual measurements was 2.7 +/- 2.1%. After bolus feeding the tissue oxygenation index of the liver increased as expected. This indicates that near infrared spectroscopy is suitable for monitoring changes in tissue oxygenation of the liver in newborn infants.
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Swiss medical weekly · Apr 2000
Characteristics of Caucasian type 2 diabetic patients during ketoacidosis and at follow-up.
To analyse among adult Caucasian patients hospitalised for diabetic ketoacidosis the relative frequency of patients with type 2 diabetes and their characteristics. ⋯ Diabetic ketoacidosis is more common than previously thought in patients with type 2 diabetes, occurring in 16% of all cases. Distinctive features at presentation are the degree of acidosis, the duration of diabetes, BMI and HbA1c. However, the basal plasma C-peptide value remains the best discriminating factor.
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Swiss medical weekly · Apr 2000
Comparative Study[Quality assessment of multiple trauma management bu ISS, TRISS or ASCOT?].
Scores have been developed to assess the quality of trauma treatment. Our objective was to investigate prospectively whether there is a significant difference between the predicted survival and mortality rates with ISS, TRISS and ASCOT and observed rates in our patients. If the answer is affirmative, we also wished to evaluate whether the difference is significant enough to justify the greater data collection effort required for ASCOT as opposed to TRISS, and for TRISS as opposed to ISS. ⋯ In our unit ISS, which is simple to use, is not suitable for quality assessment. TRISS and ASCOT are of equal value. We prefer TRISS until a better, internationally recognised score is available, since it involves less effort and is less error-prone. General recommendations for Switzerland cannot be made until further results from other national accident and emergency units are available.