Swiss medical weekly
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Oesophageal carcinoma is frequently diagnosed at an advanced stage of the disease not amenable to curative treatment. For these patients relief of dysphagia is of foremost importance to quality of life for the remaining survival time. ⋯ The majority of patients will benefit from implantation of a self-expanding metal stent. In this article the most frequently employed techniques of endoscopic palliation are briefly reviewed, with emphasis on metal stents.
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Swiss medical weekly · Jul 1999
[Video-assisted thoracosopic sympathectomy: spectrum of indications and our own results (1995-1997)].
Video-assisted thoracoscopic (VATS) sympathectomy is the most frequently used technique for surgical sympathectomy of the upper limbs. It has proven to be particularly effective in hyperhidrosis of the hands. The aim of this study is to review and discuss possible indications and analyse our own results from 1995 to 1997, including technical details on the use of a new 2-mm thoracoscope and instrumentation. ⋯ Primary hyperhidrosis showed the best results after thoracoscopic sympathectomy. Although experience with angina pectoris is still limited, thoracoscopic sympathectomy seems to be a valuable alternative in otherwise inoperable cases. In upper-extremity vascular diseases the operation can be performed as a last therapeutic option, but relapse often occurs in these patients. 2-mm instrumentation decreases trauma and postoperative pain and improves cosmetic results, which obviously may play a role in younger patients with hyperhidrosis. Patients should be warned about compensatory sweating before thoracic sympathectomy.
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Swiss medical weekly · May 1999
Comparative Study[Development of mortality in Switzerland since 1950. I. International comparison and differences in sex, age and nationality].
All-cause mortality is an important criterion for assessing the health status and the living conditions of a population, thus indicating possible preventive measures. ⋯ In spite of low overall mortality risks, international age-specific rates suggest considerable potential for preventive measures in Switzerland. There is some evidence of substantial under-registration of the mortality risks of foreigners living in Switzerland. As foreigners represent a substantial part of the total population--with a maximum of 30% of men aged 25-34 years--figures for Switzerland as a whole may be biased seriously. Therefore, for mortality analyses and comparisons with international data, we suggest the study be restricted to Swiss citizens. When assessing mortality risks for foreigners in Switzerland alternative data sources and methods should be taken into account.
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Swiss medical weekly · May 1999
Effect of environmental tobacco smoke exposure on respiratory symptoms in children. SCARPOL Team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution, Climate and Pollen.
This study determines the prevalence of exposure to environmental tobacco smoke and its relation to respiratory and allergic symptoms among schoolchildren in Switzerland. ⋯ Almost half of all schoolchildren in Switzerland, especially those from lower socioeconomic classes, are exposed to environmental tobacco smoke. Children with environmental tobacco smoke exposure suffer significantly more often from respiratory symptoms. Maternal smoking during pregnancy additional to current smoking further increases the risk of respiratory morbidity. These findings underline the importance of prevention strategies to reduce the prevalence of smoking and its impact on children's health.
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Swiss medical weekly · May 1999
[Iodine-induced hyperthyroidism (iodine-induced Basedow's disease): a current disease picture].
Iodine-induced thyrotoxicosis or "jodbasedow phenomenon" has been reported throughout the world since iodine has been administered to treat endemic goitre. Nowadays, iodinated radiocontrast agents and the antiarrhythmic drug amiodarone are the most common sources of excess iodine load subsequently leading to iodine-induced thyrotoxicosis, especially in elderly patients with underlying goitre. The aim of the study was to identify the number of cases of iodine-induced thyrotoxicosis among patients with thyrotoxicosis in a large urban hospital. ⋯ One patient (with still elevated free thyroxine levels) died of myocardial infarction 4 weeks after antithyroid drug therapy had been installed. The incidence, mechanisms and features of iodine-induced thyrotoxicosis are discussed. Iodine-induced thyrotoxicosis is a common disease, and the recognition and treatment of iodine-induced thyrotoxicosis, particularly in elderly patients and patients with goitre, are of clinical importance.