Swiss medical weekly
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Non-invasive ventilation has been in use for many years to provide long-term home ventilatory support to patients with chronic respiratory failure. In recent years, it has emerged on the intensive care scene as a means of avoiding intubation in acute respiratory failure. The results of several studies indicate that such an approach can lead to a reduction in mortality and duration of hospital stay compared to conventional mechanical ventilation with endotracheal intubation. The purpose of this article is to explore the various ventilatory techniques available, the choice of respirator and ventilatory mode in various clinical conditions, and to discuss some of the logistics involved in the optimal use of this technique.
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Swiss medical weekly · Nov 1996
[Extrapulmonary infections with Mycobacterium tuberculosis complex].
In a retrospective study we reviewed all records of patients with newly diagnosed Mycobacterium tuberculosis complex infection during the years 1990-1994. Of the 45 patients identified, 27 (60%) had only pulmonary tuberculosis and 18 (40%) had extrapulmonary tuberculosis with (5 patients, 11%) or without (13 patients, 18%) concomitant pulmonary infection. The extrapulmonary manifestations were as follows: miliary 5, joint 3, meningeal 2, pleural 2, kidney 1, peritoneal 1, bone 1, psoas 1, lymphatic 1, and anal 1. In the 18 patients with extrapulmonary tuberculosis the infection was due to Mycobacterium tuberculosis 14 times, Mycobacterium bovis twice, and Mycobacterium bovis BCG once.
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Swiss medical weekly · Nov 1996
Biography Historical Article Classical Article[SMW 100 years ago. William Thomas Green Morton and the discovery of anesthesia].
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Swiss medical weekly · Nov 1996
Multicenter Study[HIV infection, tuberculosis and tuberculin test in Switzerland. The Swiss HIV Cohort Study].
The usefulness of the tuberculin skin test (TST) for HIV-infected subjects may be questioned because false-negative results are increasingly common with advanced immune deficiency. The objectives of this research were thus to describe the use and the results of TST among patients with HIV infection in Switzerland and to measure the usefulness of isoniazid preventive chemotherapy and the incidence of tuberculosis (TB) relative to TST and CD4 cell count at the time of TST. ⋯ Despite its usefulness, TST is often performed too late and is therefore difficult to interpret. TST should be done as early as possible. TST should be done as early as possible. Among patients with CD4 < 200 per mm3, a negative TST should not preclude the use-of preventive chemotherapy, particularly in those originally from countries with a high incidence of tuberculosis.
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Swiss medical weekly · Oct 1996
Case Reports[Group A beta-hemolytic streptococcal meningitis in a pregnant woman].
A case of group A streptococcal meningitis in a normally healthy pregnant woman is described, with a review of the literature. Streptococcus pyogenes is a very rare cause of bacterial meningitis and especially affects immunocompetent subjects. The evolution is often associated with severe neurologic deficits, but the prognosis is favourable under treatment with penicillin. In the light of the recrudescence of invasive infections, this germ could assume a more important role in bacterial meningitis comparable to that in the pre-antibiotic era.