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PubMed2001

A national survey of iron and folate status in pregnant women in Switzerland.

Women often do not meet the increased iron and folate needs of pregnancy. Maternal iron-deficiency anemia is associated with poor maternal and infant outcomes, including preterm delivery and low birth weight. Poor folate status increases risk for maternal anemia, spontaneous abortion, and congenital defects. Because of this, supplemental iron and folate are often recommended during pregnancy. There are few data on iron and folate status in pregnant women in Switzerland. We measured iron and folate status in a national sample of Swiss pregnant women, estimated the prevalence of anemia, and determined if supplement use is associated with iron and/or folate status in this group. A 3-stage probability to size cluster sampling method was used to obtain a representative national sample of pregnant women (n = 381) in the second and third trimester. We measured hemoglobin, hematocrit, mean corpuscular volume, and serum folate and ferritin concentrations. Serum transferrin receptor concentration was determined in anemic subjects. The use of iron and folate supplements was evaluated by questionnaire. Mean hemoglobin (+/- SD) in the sample was 123 g/L (+/- 1.0). The prevalence of anemia was 6%. Of the 21 anemic women, 11 were iron-deficient, giving an iron-deficiency anemia prevalence of 3%. Nineteen percent of women had low serum ferritin concentrations (< 12 micrograms/L) and 4% had low serum folate concentration (< 2.5 micrograms/L). Supplements containing iron were taken by 65% of women, and 63% were taking folate-containing supplements. Women in the second and third trimester taking folate-containing supplements had significantly higher serum folate concentrations compared to those not taking a folate supplement (p < 0.001). In the third trimester, women taking iron-containing supplements had significantly higher serum ferritin concentrations compared to those not taking an iron-containing supplement (p < 0.01). Our findings indicate that iron and folate status appears to be adequate in the majority of pregnant women in Switzerland, and that use of iron and folate supplements may have a positive impact on status.

Adolescent↗
PubMed2002

[Acamprosate and psychosocial intervention. An integrative treatment approach for prevention of alcohol dependent patients in Switzerland].

105 patients with severe alcohol dependence, who were treated in 13 centers in Switzerland, took part in this open study. The abstinence rate achieved under treatment with Acamprosat, which was used within the framework of established psychotherapeutic intervention programmes in which the doctors could choose between five different procedures, was determined over a period of 24 weeks. In addition, a sociodemographic profile was drawn up, a physical examination was carried out and data were collected on the safety aspect of Acamprosat. It was also of interest to ascertain whether, and if so how, the patients' quality of life changed under the treatment, and in what form they received psychosocial support. As supportive therapy almost two-thirds of the patients (63%) received individual psychotherapy, in 28% the doctor decided on cognitive behavioural therapy, in 4% a short intervention was carried out, in 4% group therapy and in 2% family therapy. In 85.7% of the patients the doctor continued with the initial form of psychotherapy, while in the remaining patients it was changed once. Due to the very uneven distribution a comparison of the outcome in regard to the concomitant therapy was rather problematical. Psychiatric problems (21%), polyneuritis (12%) and liver damage (10.6%)--all known complications of chronic alcohol abuse--were the most frequent concomitant diagnoses. Of the 91 patients who had remained abstinent for the first two weeks after the start of the study, 12.9% had a recurrence at the end of the study, 56% did not have a recurrence (they were abstinent, but did have a binge or a lapse) and 31.8% did not return for the control visits. When a recurrence did occur, however, significantly less alcohol was consumed than before the treatment. As a result of the combined intervention all the parameters relating to the quality of life that were documented in connection with the SF 36 showed improvement. With this study carried out in Switzerland, which is part of an European study programme, it was again possible to demonstrate the beneficial effect of Acamprosat in patients with severe alcohol dependence. Acamprosat was well tolerated by all patients.

Acamprosate↗
PubMed2003

[Immigrants with female circumcision in Switzerland: background information and recommendations for medical practice].

Due to increasing international migration Switzerland hosts women who have undergone female genital mutilation. Complications of female genital mutilation call for a comprehensive medically, socially and culturally adapted care. Health care providers in Switzerland are not adequately prepared to meet the specific needs of the women concerned, particularly because they are rarely exposed and have no national guidelines to rely on. This article based on qualitative research provides recommendations with the aim to improve the care for concerned African immigrant women in the Swiss health care system.

Adolescent↗
PubMed2003

[Pulmonary rehabilitation of COPD in Switzerland--an assessment of current status].

The aim of this survey was to characterize respiratory rehabilitation programmes for patients with COPD in Switzerland. Rate of return of questionnaires was 94%. In 2001, 2238 patients with COPD followed an inpatient (1790) or outpatient (448) respiratory rehabilitation programme. This corresponds to 1% of all patients with COPD in Switzerland. Physical exercise is estimated to be significantly more important compared to breathing exercises, patient education and psychosocial support although this prioritization is not as pronounced as in the current literature. Disease-specific instruments to measure health related quality of life that represents the most important outcome measure for patients with COPD should be implemented in practice. Thereby both the components of rehabilitation programmes and predictive factors for a successful rehabilitation could be evaluated.

Adult↗
PubMed2005

[Nutrition in Switzerland 2002--results of the Swiss Health Survey].

The 2002 Swiss Health Survey is the third survey conducted by the Federal Office of Statistics in intervals of five years. Data are collected of a random sample (n = 19706) of persons aged 15 and over, living in Switzerland: 29% are overweight (BMI 25-29.9 kg/m2), and 8% are obese (BMI 30+ kg/m2). 31% do not care about their nutrition. Less than daily consumption is reported by 34% for fruit, by 18% for vegetable, by 64% for milk, by 39% for milk products. 20% eat every day meat or meat products, 38% do rarely or never consume fish. Inadequate nutritional habits are observed more often in men, young people, and in participants with a low level of education. According to the Swiss Health Surveys of 1992, 1997, and 2002 nutritional habits have hardly improved during the last ten years in Switzerland.

Adolescent↗
PubMed2000

[Treatment methods and outcomes of tibial shaft fractures in Switzerland. A prospective multicenter study of the Swiss AO].

Fractures of the tibial shaft are very common and often associated with severe tissue damage. The aim of this study was to investigate the methods of treatment, the results and complications of tibial shaft fractures in Switzerland. In a prospective planned study the Swiss Association for the Study of Internal Fixation (AO) analyzed 585 tibial shaft fractures that were treated in 41 hospitals between 1st of July, 1994 and 30th of June, 1995. The cases were documented in the specific AO-documentation-forms, 78.3% (n = 458) of the cases received an effective follow-up. The most common type of accident were sports accidents with 41.5% (n = 243), followed by traffic accidents in 35.6% (n = 208). Conservative treatment was applied in 9.4% (n = 55). The most frequent used implant was the plate in 43.8% (n = 256), followed by the nail in 36.8% (n = 215) and by an external fixator in 9.5% (n = 56). In the group of patients treated with a nail 116 received an AO-Universal nail, 94 were treated with the solid tibial nail (UTN). 92.4% (n = 423) of the fractures healed with radiological alignment. 11.6% (n = 53) had a delayed or non-union. In this group 37.7% (n = 20) of patients sustained severe soft tissue damage, due to high-energy-trauma in 60% (n = 12). Of the patients with delayed or non-union one was treated primarily conservative, eight were treated with a plate, 24 with a nail and 20 with an external fixator primarily. The indications for fracture treatment with a plate or a nail was nearly the same in different fracture types. In summary, in Switzerland most tibial shaft fractures were treated with a plate or a nail with an equally good outcome.

Adolescent↗
PubMed2000

[ATLS (advanced trauma life support) in Switzerland].

We analysed the ATLS courses organized in Switzerland since 1998. At the students courses the surgeons exceed the participants with a percentage of 45.7%, followed by the anaesthesiologist with 36.3%. The senior residents dominate with 49.1%, followed by the residents with 42.3%. The chief surgeons come only to a per cent of 4.1%. The statistics of the instructors show about the same pattern, the percentage of senior residents is even more impressive. The aim of ATLS is the same concept, the idea of ATLS in all emergency units throughout the whole country of Switzerland.

Curriculum↗
PubMed2000

Surveillance of antituberculosis drug resistance in Switzerland 1995-1997: the central link.

The purpose of the present paper is to investigate the usefulness of routine notification of antituberculosis drug susceptibilities. In Switzerland, laboratories have to report susceptibilities to isoniazid, rifampicin, ethambutol, and pyrazinamide to the Federal Office of Public Health. All clinical and laboratory information on every single tuberculosis case is routinely linked. Proportions of drug resistance were calculated and logistic regression was applied to evaluate the role of potential risk factors. Eighty percent (1056) of all culture-positive tuberculosis cases reported between October 1995 and December 1997 were analysed. The strains of 66 (6.3%) patients had resistances to at least one drug. Risk factors identified were previous antituberculosis treatment (adjusted odds ratio 7.3, 95% confidence interval 3.9-13.6), male sex (1.4, 1.1-2.0), and age <65 yrs (1.5, 1.0-2.3). Fourteen cases (1.3%), 13 of them foreign-born, were resistant to at least isoniazid and rifampicin. Reporting of drug susceptibilities allows routine assessment of the proportion of drug resistant tuberculosis and populations at risk. This proportion was found to be small in Switzerland. Risk factors were previous treatment for tuberculosis, male sex, and age <65 yrs. Resistance to at least isoniazid and rifampicin was predominantly found in foreign-born patients.

Adult↗
PubMed2003

Skin biophysical properties of a population living in Valais, Switzerland.

BACKGROUND/PURPOSE: Switzerland has one of the highest rates of skin diseases and particularly skin cancer, in Europe. Skin elastosis, roughness and atopy are also frequent. High UV exposure and prevalence of light skin individuals could be the cause. Valais, in Southern Switzerland, is a mountain region with elevated sun irradiation and low air humidity, an ideal location to study the effect of the environment and life style on skin biophysical characteristics. The purpose of the study was to measure skin biophysical parameters non-invasively on healthy subjects living in Valais, and to correlate the measures with their life style. METHODS: One hundred and ten women were examined between October 2001 and February 2002. Measures of skin hydration, sebum content, pH and visco-elasticity were taken in a closed environment with constant temperature and controlled air humidity, utilizing commercially available non-invasive devices. Subjects were interviewed using a questionnaire and data on personal traits and life style were collected. Correlations between subject's skin parameters and life style were statistically examined. RESULTS: On average we observed low values of skin capacitance that identify subjects with dry skin. Measures of skin visco-elasticity ratios were also particularly low, while skin pH and sebum content were in the normal range. Age was correlated with a decrease of skin elasticity and sebum content, but there was no correlation with hydration or pH. CONCLUSIONS: We confirm, as reported in other studies, the effect of age on skin elasticity and sebum content and we identify, for the first time, a region with a population characterized by particularly low levels of skin hydration and skin visco-elasticity. Although people examined were free of skin diseases, we believe that protection from the sun and treatment of skin with hydrating products need to be emphasized as a prevention strategy, in regions such as Valais, with high sun irradiation and low humidity.

Adolescent↗
PubMed1978

Epidemiological study in Switzerland.

A study group of originally 623 employed women of Northwestern Switzerland who were aged 30 to 49 yr and showing objective evidence of intake of phenacetin-containing analgesics, and a control group of 621 comparable women showing no such intake, were examined in 1968 and followed-up five times from 1969 to 1975 for laboratory evidence of urorenal disorders. Mortality was higher in the study group, with 21 deaths, compared to the control group, with 5 deaths, and was higher than expected in a comparative population in Switzerland (P less than or equal to 0.05). In both study and control groups, morbidity was low. There was no difference between the study and control groups with respect to subsequent proteinuria and hematuria. The seven-year incidence of low urine specific gravity after overnight thirsting was higher in the study group than in the control group (2.9% vs. 1.0%), and the incidence of raised serum creatinine was also significantly higher in the study group (2.9% vs. 0%). However, when the study group was further subdivided into a subgroup showing evidence of high intake of phenacetin-containing analgesics and one showing low-intake, only the high-intake subgroup had an incidence of raised serum creatinine concentrations (5.3%), significantly higher than the control group (0%), whereas the low-intake subgroup had an incidence (0.4%) similar to the control group. Also the high-intake subgroup showed significantly higher rates of bacteriuria than the controls (P less than or equal to 0.004).

Adult↗
PubMed1999

Iodine supply in different geographical areas of Switzerland: comparison between rural and urban populations in the Berne and the Ticino regions.

OBJECTIVE: We studied the question of possible regional differences of iodine intake in the population of rural and urban areas north and south of the Alps. DESIGN: Transversal study. SETTING: Six different regions from northern (Canton Berne) and southern Switzerland (Canton Ticino). SUBJECTS: For each region 30 individuals were studied. RESULTS: While significant differences of urinary iodine between some regions were found (range from 79 microg iodine/g creatinine in Chiasso to 130 microg iodine/g creatinine in the Maggia Valley), no significant differences between rural and urban populations of north and south of Switzerland were observed. Mild iodine deficiency affected 35%, moderate iodine deficiency 12% and severe iodine deficiency 0.6% of the total population investigated. CONCLUSIONS: 49% of this population showed at least mild or moderate iodine deficiency. The mean urinary iodine was just at the lower recommended limits. Significant differences were found between individual regions (such as Chiasso and the Valley of Maggia), but not generally between rural and urban areas in the north and south of the Alps.

Creatine↗
PubMed2001

Monitoring the adequacy of salt iodization in Switzerland: a national study of school children and pregnant women.

BACKGROUND: Several countries with long-standing salt iodization programs, including Switzerland, have recently reported declining and/or low urinary iodine (UI) levels in their populations. In Switzerland, in response to studies indicating low UI levels in children and pregnant women, the salt iodine level was increased in 1998 from 15 to 20 mg/kg. OBJECTIVE: Our objective was to evaluate iodine nutrition in a national sample of Swiss school children and pregnant women 8 16 months after the increase in the salt iodine level. DESIGN: A 3-stage probability proportionate to size cluster sampling method was used to obtain a representative national sample of 600 children aged 6-12 y and 600 pregnant women. We then measured UI in both groups, thyrotropin (TSH) in pregnant women and thyroid volume by ultrasound to determine goiter prevalence in school children. RESULTS: The median UI (range) of the children and pregnant women was 115 microg/l (5-413) and 138 microg/l (5-1881), respectively. The median blood TSH concentration (range) of pregnant women was 0.6 mU/l (0.2-2.1). Based on the current WHO/ICCIDD normative data for thyroid volume, none of the children were goitrous, using either age/sex-specific or BSA/sex-specific cutoffs. CONCLUSIONS: The iodine status of the Swiss population is once again adequate, illustrating the value of periodic monitoring and prudent adjustments to the iodine level in salt. This approach could serve as a model for countries struggling to maintain dietary iodine intake in the face of shifting dietary habits and changes in the food supply.

Adult↗
PubMed2006

Obesity during growth in Switzerland: role of early socio-cultural factors favouring sedentary activities.

Depending upon age, gender and geographical area, 3-20% of the children and young adolescents in Switzerland are overweight and 0-6% obese, using the criteria of the International Obesity Task Force. The most likely explanation for this increasing prevalence of overweight and obesity is a decline in physical activity, and hence diminished energy expenditure that is not matched by a corresponding reduction in energy intake. In this paper, we first review the epidemiological situation in Switzerland regarding the rising prevalence of obesity and the decline in physical activity, and then focus upon the environmental, social and cultural factors that predispose children to sedentary behaviours. Several of these socio-cultural factors and in particular television viewing and poor-parental model, confer early 'learned behaviours' for low physical activity which track throughout growth into adulthood, and which also predispose to the overconsumption of less healthy foods. It is time to focus on preventive strategies directed at curtailing these 'learned behaviours', that we have acquired during the transition from the stone-age to the chip-age, if we want to hold the current pandemic of obesity.

Adolescent↗
PubMed2004

Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland.

OBJECTIVES: Use of domestic reference values is known to improve the accuracy of flow cytometric analysis by integrating local variation due to race, gender, and age. In the absence of previously published estimates, we now report establishment of reference values for a wide range of peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland and other regions with similar demographic characteristics. METHODS: A representative sample population was recruited from among well characterized local blood donors (n = 70) and quantitative multiparametric flow cytometry used to estimate absolute and proportional values for a range of T-, B-, and NK-cell subsets, including those associated with activation and maturity. Distribution-free methods were then applied to generate 95% reference values and to estimate the significance of gender and age-related differences. RESULTS: Reference values were obtained for the absolute and proportional levels of total CD3(+) T cells (536-1787 cells/microL, 54.90-84.03%), helper CD4(+) T cells (309-1139 cells/microL, 32.53-62.88%), cytotoxic CD8(+) T cells (137-823 cells/microL, 11.55-38.60%), activated CD3(+) T cells expressing CD25 (7-94 cells/microL, 0.50-5.95%), CD38 (102-554 cells/microL, 5.98-26.80%), HLA-DR (18-186 cells/microL, 1.25-9.68%) or CD38/HLA-DR (4-52 cells/microL, 0.30-2.30%), activated CD4(+) T cells expressing CD25 (7-52 cells/microL, 0.33-2.80%), CD38 (69-547 cells/microL, 6.13-32.20%), HLA-DR (11-55 cells/microL, 0.80-4.43%) or CD38/HLA-DR (4-22 cells/microL, 0.30-1.35%), activated CD8(+) T cells expressing CD25 (0-12 cells/microL, 0.00-0.69%), CD38 (13-124 cells/microL, 0.93-7.03%), HLA-DR (6-108 cells/microL, 0.33-6.38%) or CD38/HLA-DR (2-47 cells/microL, 0.13-2.68%), naive CD4(+) T cells expressing CD45RA(+)/CD62L(+) (84-761 cells/microL, 9.48-41.88%), naive CD8(+) T cells expressing CD45RA(+)/CD62L(+) (42-360 cells/microL, 3.68-19.23%), memory CD4(+) T cells expressing CD45RO(+) (247-807 cells/microL, 16.50-42.15%), memory CD8(+) T cells expressing CD45RO(+) (72-377 cells/microL, 3.78-22.80%), B-cells expressing CD19 (72-460 cells/microL, 4.70-19.13%) or CD20 (66-529 cells/microL, 4.63-21.00%), total CD3(-)/(CD16(+)/CD56(+)) NK-cells (77-427 cells/microL, 5.35-30.93%), and activated NK-cells expressing CD25 (0-10 cells/microL, 0-0.50%) or HLA-DR (3-99 cells/microL, 0.20-7.28%). CONCLUSION: It is anticipated that availability of localized reference values for an extended range of peripheral blood lymphocyte phenotypes should supplement previously published reference values and enhance the utility of flow cytometric analysis undertaken in Switzerland.

Adult↗
PubMed2001

Screening for trisomy 21 by fetal nuchal translucency and maternal age: a multicenter project in Germany, Austria and Switzerland.

OBJECTIVE: To examine the effectiveness of screening for trisomy 21 by a combination of maternal age and fetal nuchal translucency thickness at 10-14 weeks of gestation in Germany, Austria and Switzerland. METHODS: This was a multicenter study of screening for trisomy 21 by a combination of maternal age and fetal nuchal translucency thickness at 10-14 weeks of gestation. All the sonographers involved in the study had received The Fetal Medicine Foundation Certificate of Competence in the 10-14-week scan. Fetal nuchal translucency thickness and crown-rump length were measured in 23 805 singleton pregnancies with live fetuses. In each case the risk for trisomy 21 was estimated on the basis of maternal age and fetal nuchal translucency thickness for crown-rump length with the use of The Fetal Medicine Foundation's software. The distribution of estimated risk was determined and the sensitivity and false-positive rate for a risk cut-off of 1 in 300 was calculated. RESULTS: Fetal nuchal translucency thickness was successfully measured in all 23 805 pregnancies and outcome was available in 21 959. The median maternal age was 33 (range 15-49) years and in 7935 (36.1%) the age was 35 years or greater. The median gestation at screening was 12 (10-14) weeks and the median fetal crown-rump length was 61 (range 38-84) mm. The estimated risk for trisomy 21 based on maternal age and fetal nuchal translucency thickness for crown-rump length was 1 in 300 or greater in 13.0% (2800 of 21 475) normal pregnancies, in 87.6% (184 of 210) of those with trisomy 21 and in 87.2% (239 of 274) with other chromosomal defects. CONCLUSIONS: In Germany, Austria and Switzerland the results of screening for chromosomal defects by measurement of fetal nuchal translucency thickness, in centers with appropriately qualified sonographers and using The Fetal Medicine Foundation's software, are similar to those reported in the UK using the same methodology.

Austria↗
PubMed1996

Drug treatment in Switzerland: harm reduction, decentralization and community response.

This paper first outlines the history of illicit drug issues in Switzerland, and then describes drug treatment services and shifts in treatment concepts. In the last 15 years the drug treatment system in Switzerland has expanded considerably. In particular there has been an unprecedented growth of the non-residential sector and of low-threshold programmes, including methadone treatment, the establishment of injection rooms and controlled drug-prescription pilot projects. In the second part, the paper considers some selected factors that promote or impede changes in drug treatment systems, such as treatment policy and the public response to treatment measures. This is manifested in the influence of community action groups on local programme development.

Community Networks↗
PubMed2003

Changes in alcohol consumption following a reduction in the price of spirits: a natural experiment in Switzerland.

AIMS: To discover what changes in alcohol consumption had occurred in subgroups defined by age, sex, volume of drinking and drinking occasions, following a reduction in the price of spirits in Switzerland in July 1999. DESIGN: Quasi-experimental. Longitudinal general-population survey with baseline 3 months before and follow-up 3 months after price change. PARTICIPANTS: Probabilistic telephone sample of 1347 individuals with at least monthly consumption on average in the previous 6 months at both interviews. The response rate at baseline was 74,8% and the attrition rate from baseline to follow-up 20.2%. MEASUREMENTS: Alcohol consumption was assessed by means of a beverage-specific graduated-frequency measure. High volume of drinking was defined as 40 + g/day for men and 20 + g/day for women. Binge drinking was defined as six + drinks on an occasion for men and four + drinks for women. FINDINGS: Spirits consumption increased significantly (by 28.6%) in the total sample, and specifically in young males and in individuals who were low-volume drinkers at baseline. Consumption of alcohol overall, or of wine or beer, did not change significantly. No indication of effects of substitution was found. CONCLUSIONS: Spirits consumption showed price-responsiveness in the early postintervention period. This finding is of particular interest, as (a) the increase in spirits consumption took place at a time of generally declining consumption of alcohol in Switzerland; and (b) in contrast to the findings of most studies, the intervention, namely price reduction, increased availability.

Adolescent↗
PubMed2003

A survey of viral diseases in farmed and feral salmonids in Switzerland.

A field survey was carried out to study the occurrence and distribution of viruses causing diseases of major impact in fish farming, namely viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN) and infectious pancreatic necrosis (IPN) in farmed and wild fish in Switzerland. The presence of VHS virus (VHSV), IHN virus (IHNV) and IPN virus (IPNV) in the tissue samples was tested by virus isolation in cell cultures, and subsequent virus identification by immunofluorescence. The sera were screened for anti-VHSV antibodies (VHSV-AB) using a serum plaque neutralization test with complement addition. These data were then compared with results of a similar survey performed in 1984/85, and with data from routine diagnostic work completed at the Centre for Fish and Wildlife Health (FIWI) of the University of Bern from 1978 to 2001. Sampling sites included private and government fish farms as well as natural habitats from all major river catchments in Switzerland. In 2000/01, 522 tissue samples and 1910 sera were collected from 3400 fish. In 1984/85 1239 tissue samples and 694 sera were collected from 1628 fish. During the last 24 years of routine diagnostics at the FIWI, 1776 tissue samples were examined for presence of viruses. The results of the tissue analysis from the surveys in 1984/85 and 2000/01 showed low numbers of sites with virus-positive fish (five VHSV, three IPNV and three VHSV, one IPNV, respectively) in Swiss fish farms and rivers. The sites with virus-positive fish were located throughout the country. The decline in virus-positive cases observed between the two surveys agrees with data from the routine diagnostic work of the FIWI which show a decrease in total virus isolations from approximately 35 cases per year in the late 1970s, to approximately 10 cases per year during the last 10 years. However, in 1984/85 8.3% (58 of 694 serum samples) and in 2000/01 6.3% (121 of 1910 serum samples) proved to be positive for VHSV-AB. The 58 positive samples in 1984/85 originated from 40 of 175 sites (23%) and the 121 positive samples in 2000/01 were from 84 of 217 (29%) sites. These results are indicative of a wider distribution of VHSV than expected from the results of the virus isolations.

Animals↗