Swiss medical weekly
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Swiss medical weekly · Jul 1995
Biography Historical Article Classical Article[Scientific raisins from SMW (Swiss Medical Weekly). Insulin action in psychotic agitation states. 1932].
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Swiss medical weekly · Jun 1995
Case Reports[Penis carcinoma in a young chimney sweep. Case report 200 years following the description of the first occupational disease].
We report on a 32-year-old patient who, following exposure to soot over a total of 78 weeks as a professional chimney sweep, developed squamous cell carcinoma of the penis. Since the epoch-making description of occupational cancer of the scrotum by Percivall Pott in 1775, soot-related cancer of the scrotum and penis has become anecdotal. As our patient presented with inguinal lymph node metastases, a wide circumcision was performed, followed by preoperative chemotherapy and bilaterial lymphadenectomy. The patient has been free of disease for over 9 years with no functional loss.
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Swiss medical weekly · Apr 1995
Case Reports[Cerebral toxoplasmosis with central diabetes insipidus and panhypopituitarism in a patient with AIDS].
Endocrine disorders in the course of HIV infection are often a result of opportunistic infections of endocrine organs. We describe the case of a 30-year-old HIV positive man in whom diabetes insipidus developed initially with no abnormal findings in cranial magnetic resonance imaging. 2 months later the patient presented with symptoms of panhypopituitarism. At this time, neuroradiologic examination was consistent with cerebral toxoplasmosis. ⋯ Toxoplasmosis is the most frequent opportunistic infection of the brain in patients with AIDS. In HIV positive patients with malfunction of the hypothalamic-hypophyseal system cerebral toxoplasmosis must be considered in differential diagnosis. Treatment of this disorder may alleviate symptoms and signs of endocrine malfunction.
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Swiss medical weekly · Mar 1995
[Prehospital resuscitation in urban conditions--results and prognostic decision criteria].
From 1983 to 1991, 214 patients (age 62 +/- 15 years; 72% male) with out-of-hospital cardiac arrest were resuscitated in the field and transported to the hospital with basic cardiac life support only (manual chest compression, assisted ventilation by bag-air-valve). In 64 patients (30%; 95% confidence interval [CI]: 24-36%) a stable circulation allowing admission to the intensive care unit was restored in the emergency room. 26 patients (12%; CI: 8-17%) survived to hospital discharge. 20 patients showed no or only mild neurological impairment, 4 had moderate cognitive deficits, and 2 patients were in a permanent vegetative state. ⋯ Patients who arrive in ventricular fibrillation and who were resuscitated by a bystander prior to the arrival of the ambulance team have a realistic chance of survival. Delegation of competence to defibrillate to trained, non-physician ambulance personnel may reduce the duration of cardiac arrest in patients with ventricular fibrillation and thus save lives.