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At least 379 records · Page 21Linked to original sources
PubMed2000

Laparoscopic appendectomy in Switzerland: a prospective audit of 2, 179 cases.

BACKGROUND/AIMS: Since its introduction in 1983, laparoscopic appendectomy (LA) has not replaced the conventional open procedure. The patient benefit seems limited to a decreased wound infection rate, and the overall morbidity and mortality rates remain equal to those of open appendectomy. METHODS: The data (collected by the Swiss Association of Laparoscopic and Thoracoscopic Surgery) from 2, 179 patients undergoing LA at 84 surgical institutions in Switzerland between January 1995 and December 1997 were retrospectively analyzed. RESULTS: More than 90% of all patients had no intra- or postoperative complications. However, perforated appendicitis was associated with more complications, in particular a threefold increased wound infection rate (9.2 vs 3.5%). Furthermore, the conversion and reoperation rates of perforated appendicitis were significantly increased compared to 'simple' acute appendicitis (25. 5 and 10.4% vs 4.8 and 2.1%, respectively). LA performed with a stapling device is superior to LA performed with loops, although the difference is not significant. CONCLUSION: Therefore, LA is a safe and effective procedure. The postoperative morbidity and mortality rates are comparable to those of open appendectomy, which is still the most commonly used procedure in Switzerland. The question of whether perforated appendicitis is better treated laparoscopically or by the open procedure cannot be answered with our data.

Adolescent↗
PubMed2002

Survey of dermatophyte infections in the Lausanne area Switzerland.

BACKGROUND: The dermatophytes are important in the Swiss medical environment since 5-10% of consultations in dermatology concern mycotic infections. OBJECTIVE: To obtain information about the prevailing species of dermatophytes in the south-west of Switzerland and their pattern of infection. METHODS: An analysis was made of the dermatophytes isolated in the Department of Dermatology at the University Hospital of Lausanne and from samples collected in private practices of Switzerland during an 8-year period (1993-2000). The total number of samples sent for mycological analysis was 33,725. RESULTS: 4,193 cultures revealed a dermatophyte. Trichophyton rubrum was the most frequently isolated species accounting for 62.5% of the strains followed by T. mentagrophytes (24.5%) and Microsporum canis (5.0%). Less frequent isolates included Epidermophyton floccosum, M. langeroni, M. gypseum, T. soudanense, T. violaceum, T. verrucosum, T. gourvili and T. tonsurans. Analysis of the localisation of the isolated fungi confirms that the dermatophyte species have a predilection for certain body areas. CONCLUSIONS: The relative frequencies of isolation of the dermatophyte species partially depending of the record of the different tinea vary from one country to another. Our study reveals the importance of T. rubrum and the appreciable frequency of M. canis in the Swiss autochthonous population and the apparition of new species with immigrants.

Arthrodermataceae↗
PubMed2003

Estimated trends in the prevalence of heroin addiction in Switzerland. A multiple-indicator approach.

Data on the prevalence of heroin addiction have considerable relevance in the field of public health as a means of evaluating measures aimed at improving the lives of the individuals concerned. The number of heroin addicts in Switzerland was estimated by six different methods based on various data sources. This resulted in an overall estimate for the reference year 1997 ranging from a minimum of 24,000 to a maximum of 35,000 heroin addicts. In the 1990s, the trend in the prevalence of heroin addiction was characterised by a rapid rise up to 1993/94 followed by a gradual decline. The increasing medicalisation (focus on treatment rather than on punishment) of Switzerland's heroin problem has therefore not translated into a clear downward trend in the estimated prevalence of heroin addiction; however, the data for the various sub-groups lend plausibility to the assumption that this population is more integrated, less conspicuous and receiving better medical care.

Forecasting↗
PubMed2005

Sexually transmitted infections in Switzerland: return of the classics.

Recent trends in western Europe show an increase in sexually transmitted infections (STIs). Available surveillance data in Switzerland confirm this rising trend. Gonorrhoea rates more than doubled between 1996 and 2003, and for Chlamydia there was a 64% increase from 1999 to 2003. Notifications of syphilis cases almost doubled in the year 2002 and rose to 174% compared to the period of 1998-2001. The resurgence of syphilis in 2002 and 2003 was most important in Zurich and Geneva with 54 and 24% of all cases, respectively. Eighty-four percent occurred in males, 40% affecting males who had sex with males, and at least 17% were HIV co-infected. For 2004, further increases in these bacterial STIs are expected. Increased awareness of the symptoms and signs of acute infections is needed as well as considering the diagnosis of STIs in patients with vague symptoms. In addition, laboratory reporting or mandatory disease notifications are needed to monitor syphilis trends in Switzerland.

Adolescent↗
PubMed2006

Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public.

OBJECTIVE: To assess the level of awareness about glaucoma and its consequences and to evaluate associated eye health attitudes in a randomly selected general urban and rural population in Switzerland. METHODS: A cluster random sample of the Swiss population was interviewed. Five-hundred and two telephone interviews with subjects who were representative of the 35- to 70-year-old population of the German- and French-speaking parts of Switzerland were conducted. Data were collected about their gender, age, educational status and professional situation. STUDY TYPE: Cross-sectional survey. RESULTS: In total, 76% (n = 383) of respondents did not have any (or any correct) association with the term 'glaucoma'. Only 24.7% (n = 123) of the interviewees could describe glaucoma as an eye condition. Awareness of glaucoma was independent of age, gender, educational status, and household income. Associated therapeutic measures were surgery (75%) and medical treatment (57%). Seventy-one percent of all respondents wear eyeglasses, 74% of all females and 67% of males. CONCLUSION: Awareness and knowledge about glaucoma are relatively low in the average Swiss population across all segments of society. The lack of awareness on this insidious disease has important implications for the uptake of ophthalmic care and may result in avoidable blindness. These data also show that the ophthalmologist is considered by the majority of people to be the primary contact for eye health-related information and sight corrections.

Adult↗
PubMed2006

The "Protocole d'Examen Cognitif de la Personne Agée - Lausanne" (PECPA-L): a cognitive assessment tool for the French-speaking elderly in Switzerland.

OBJECTIVE: The main objective of this study was to validate and normalize, in the French-speaking population of Switzerland, an empirically derived structured cognitive assessment scale for the elderly. METHOD: 237 healthy elderly and 115 elderly with mild-to-moderate dementia as well as a preliminary sample of 27 subjects with MCI, all community-dwelling, were assessed using the PECPA-L for its validation and normalization using Crohnbach's alpha, rank comparisons, and AUROC measures. RESULTS: The internal consistency of the PECPA-L was good (Crohnbach's Alpha=0.79). The discriminating power of the PECPA-L between the normal elderly and the mildly to moderately demented (AUROC=0.940) and those with MCI (AUROC=0.925) was high. Normal aging does not influence all cognitive domains equally; therefore, the subscores of the PECPA-L vary in their discriminating power between the normal and the demented elderly, with gnosis abilities having the least (AUROC=0.719) and delayed memory performance having the highest (AUROC=0.927) discriminating power. Normative data according to age and education are provided. CONCLUSIONS: The PECPA-L is a highly appropriate tool for the detection and documentation of early cognitive impairment in the French-speaking population in Switzerland while accounting for age and education.

Aged↗
PubMed1989

Multiple sclerosis in relation to meat preservation in France and Switzerland.

In order to test a recent hypothesis on the possible role of defined agents from wood smoke in the etiology of multiple sclerosis (MS), the practices of meat preservation, as reported in ethnographic bibliography, were analyzed in relation to the MS distribution in France and Switzerland. In both countries, but more so in Switzerland, a significant association between both features could be demonstrated.

Food Preservation↗
PubMed1988

Childhood cancer in Switzerland: mortality from 1951 to 1984.

Cancer mortality among children in Switzerland was analysed using (1) age-specific and age-standardized (0-14) rates from 1951 to 1984 and (2) comparison of observed numbers of deaths over the period 1960-1984 with expected one obtained by application of age-specific rates for the period 1951-1959 to the population structure of subsequent 5-year calendar periods. Certified mortality fell about 60% for leukaemias, 21% for lymphomas, 66% for Wilms' tumours, 40% for bone sarcomas and 30% for other and unspecified sites. Thus, the overall decline in childhood cancer mortality in Switzerland was around 45%, slightly more marked in females (-48%) than in males (-42%), and more pronounced in younger children (over 50% before age 5). This corresponds to an absolute number of about 50 deaths from childhood cancer per year avoided in the early 1980s as compared with expected numbers computed on the basis of rates registered in the 1950s (30 deaths per year for leukaemias alone). The estimated total number of deaths avoided during the whole period 1960-1980 was 820 (430 leukaemias alone). Trends in childhood cancer mortality persisted steadily downwards in the early 1980s, suggesting that further progress is being achieved in the treatment of these neoplasms.

Adolescent↗
PubMed1997

Lung function and long term exposure to air pollutants in Switzerland. Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) Team.

The effect of long-term exposure to air pollutants was studied in a cross-sectional population-based sample of adults (aged 18 to 60 yr; n = 9,651) residing in eight different areas in Switzerland. Standardized medical examination included questionnaire data, lung function tests, skin-prick testing, and end-expiratory CO concentration. The impact of annual means of air pollutants on FVC and FEV1 was tested (controlling for age and age squared, sex, height, weight, educational level, nationality, and workplace exposure). Analyses were done separately for healthy never-smokers, ex-smokers (controlling for pack-yr), for current smokers (controlling for cigarettes per day and pack-yr smoked), and for the whole population. Significant and consistent effects on FVC and FEV1 were found for NO2, SO2, and particulate matter < 10 microm (PM10) in all subgroups and in the total population, with PM10 showing the most consistent effect of a 3.4% change in FVC per 10 microg/m3. Results for ozone were less consistent. Atopy did not influence this relationship. The limited number of study areas and high intercorrelation between the pollutants make it difficult to assess the effect of one single pollutant. Our conclusion is that air pollution from fossil fuel combustion, which is the main source of air pollution with SO2, NO2, and PM10 in Switzerland, is associated with decrements in lung function parameters in this study.

Adolescent↗
PubMed1992

Multiple personality disorder in Switzerland.

OBJECTIVE: There are no reliable data on the prevalence of multiple personality disorder. The objective of the study was to determine whether and, if so, how frequently patients with multiple personality disorder are encountered and diagnosed in Switzerland. METHOD: All qualified Swiss psychiatrists were sent a questionnaire on multiple personality disorder along with the DSM-III description of multiple personality disorder and three case examples. A total of 836 psychiatrists (66%) answered after two mailings, and 770 questionnaires qualified for evaluation. In addition, a random sample of nonresponders were contacted by telephone. RESULTS: Three percent of the psychiatrists indicated that, at the time of the inquiry, they were treating or examining one or more patients who met DSM-III criteria for multiple personality disorder, and 10% indicated that they had seen multiple personality disorder at least once during their professional career. The patients were not equally distributed among the psychiatrists; three colleagues reported that they had seen much higher numbers of patients with multiple personality disorder. The point prevalence of multiple personality disorder among patients seen by psychiatrists in Switzerland amounts to 0.05%-0.1%. CONCLUSIONS: Multiple personality disorder appears to be a disorder that genuinely exists, even though it occurs relatively rarely.

Adolescent↗
PubMed2004

No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland.

Prevalence rates of childhood asthma and allergy have been on the increase for several decades. The present study investigated whether this trend continued during the 1990s in adolescents living in Switzerland. Between 1992 and 2000, the change in prevalence of specific immunoglobulin E to aeroallergens, asthma symptoms and hay fever symptoms assessed by parents' and students' answers to the International Study of Asthma and Allergies in Childhood questions was investigated using three cross-sectional surveys. In total 1,324 (74.9%), 1,668 (80.6%) and 1,250 (73.9%) adolescents participated. Prevalence rates of asthma and current asthmatic symptoms remained constant, irrespective of whether the assessment was based on parental questionnaires or the student's self-completed written or video questionnaires (students' report of current wheeze 8.8, 7.3, and 8.3%). Similarly, no further increase was observed for reported hay fever rates and allergic sensitisation rates (positive multiscreen allergy test, SX1-test: 34.6, 38.9, and 35.6%, respectively). Although time trends in the occurrence of a series of known risk factors were recorded, none of these factors had a significant impact on asthma and allergy prevalence over time. No further increase in asthma and allergy rates occurred during the 1990s in adolescents living in Switzerland. However, to adequately assess the trend a longer period of observation is needed.

Adolescent↗
PubMed1996

Risk factors for tuberculosis among HIV-infected patients in Switzerland. Swiss HIV Cohort Study.

The aim of this study was to determine the risk factors associated with tuberculosis among human immunodeficiency virus (HIV)-infected persons living in Switzerland, a country with low prevalence of tuberculous infection. We performed a nested case-control study and logistic regression. Cases (n = 239) were patients participating in the Swiss-HIV Cohort study (n = 7,103), diagnosed with bacteriologically confirmed tuberculosis. The rest of the cohort population was used as control. Patients from industrialized countries had a risk of tuberculosis similar to those from Switzerland (adjusted odds ratio (OR) 1.1; 95% confidence interval (95% CI) 0.7-1.5); whereas the risk among patients from Eastern Europe (OR 2.8, 95% CI 1.9-3.7), Brazil (OR 10.6; 95% CI 9.6-11.5), and Africa (OR 3.0; 95% CI 2.4-3.6) was markedly higher. Immune suppression, as indicated by low CD4 + cell count, was an independent risk factor for tuberculosis (OR 7.8; 95% CI 7.3-8.3 for patients with CD4 + < 50 cells.mm-3 compared to those with CD4 + > 500 cells.mm-3). Age, sex and HIV-transmission category did not appear to increase the risk of tuberculosis after adjustment for other patient characteristics. In conclusion, in countries of low prevalence of Mycobacterium tuberculosis infection, to originate from a country with high prevalence of tuberculosis infection and to have advanced immunodeficiency are significant risk factors for tuberculosis. They may be used to complement the tuberculin skin test in targeting patients for preventive chemotherapy.

Adult↗
PubMed2006

Disease control in asthmatic children seen in private practice in Switzerland.

BACKGROUND: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice. METHODS: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2. RESULTS: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2. CONCLUSIONS: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.

Asthma↗
PubMed2005

Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland.

BACKGROUND: In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT). METHODS: Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud. RESULTS: The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons. CONCLUSION: GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.

Ambulatory Care↗
PubMed2006

Seasonal variation in orthopedic health services utilization in Switzerland: the impact of winter sport tourism.

BACKGROUND: Climate- or holiday-related seasonality in hospital admission rates is well known for many diseases. However, little research has addressed the impact of tourism on seasonality in admission rates. We therefore investigated the influence of tourism on emergency admission rates in Switzerland, where winter and summer leisure sport activities in large mountain regions can generate orthopedic injuries. METHODS: Using small area analysis, orthopedic hospital service areas (HSAo) were evaluated for seasonality in emergency admission rates. Winter sport areas were defined using guest bed accommodation rate patterns of guest houses and hotels located above 1000 meters altitude that show clear winter and summer peak seasons. Emergency admissions (years 2000-2002, n = 135'460) of local and nonlocal HSAo residents were evaluated. HSAo were grouped according to their area type (regular or winter sport area) and monthly analyses of admission rates were performed. RESULTS: Of HSAo within the defined winter sport areas 70.8% show a seasonal, summer-winter peak hospital admission rate pattern and only 1 HSAo outside the defined winter sport areas shows such a pattern. Seasonal hospital admission rates in HSAo in winter sport areas can be up to 4 times higher in winter than the intermediate seasons, and they are almost entirely due to admissions of nonlocal residents. These nonlocal residents are in general -and especially in winter- younger than local residents, and nonlocal residents have a shorter length of stay in winter sport than in regular areas. The overall geographic distribution of nonlocal residents admitted for emergencies shows highest rates during the winter as well as the summer in the winter sport areas. CONCLUSION: Small area analysis using orthopedic hospital service areas is a reliable method for the evaluation of seasonality in hospital admission rates. In Switzerland, HSAo defined as winter sport areas show a clear seasonal fluctuation in admission rates of only nonlocal residents, whereas HSAo defined as regular, non-winter sport areas do not show such seasonality. We conclude that leisure sport, and especially ski/snowboard tourism demands great flexibility in hospital beds, staff and resource planning in these areas.

Adult↗
PubMed2002

Incidence of reinfections with Mycoplasma hyopneumoniae and Actinobacillus pleuropneumoniae in pig farms located in respiratory-disease-free regions of Switzerland--identification and quantification of risk factors.

The objective of the study was to identify risk factors for reintroduction of Actinobacillus pleuopneumoniae and Mycoplasma hyopneumoniae (enzootic pneumonia) onto pig farms in areas in Switzerland that were involved in an eradication programme from 1996 to 1999 and to assess the role of dealers in relation to these reinfections. The study was based on the comparison of pig farms that were reinfected in the year 2000 (cases) and pig farms that remained uninfected in the same area (controls). Additionally, data were collected from Swiss pig dealers and transport companies. Out of a total of 3983 farms, 107 farms were reinfected in the year 2000. The incidences were 0.1% for Actinobacillus pleuopneumoniae and 2.6% for Mycoplasma hyopneumoniae (enzootic pneumonia). Compared to reinfection rates prior to the eradication programme, this is a considerable reduction. Statistically significant risk factors for the reinfection were 'finishing farm', 'large mixed breeding-finishing farm', 'reinfected neighbour' and 'parking site for pig transport vehicles close to the farm'. Pig farmers that purchased pigs from only one supplier per batch had a lower risk of reintroducing infection (protective factor). As long as infected and uninfected regions co-exist in Switzerland, direct and indirect contact between farms, pig herds and slaughter sites via transport vehicles are a major pathway of disease spread. Risk management measures linked to these contacts are therefore of key importance. The survey of dealers indicated various areas for improvement such as strategic planning of pick-up routes or cleaning and disinfecting of trucks.

Actinobacillus Infections↗
PubMed2024

Exploring the potential of genetic analysis in historical blood spots for patients with iodine-deficient goiter and thyroid carcinomas in Switzerland and Germany (1929-1989).

Iodine deficiency-induced goiter continues to be a global public health concern, with varying manifestations based on geography, patient's age, and sex. To gain insights into clinical occurrences, a retrospective study analyzed medical records from patients with iodine deficiency-induced goiter or thyroid cancer who underwent surgery at the Community Hospital in Riehen, Switzerland, between 1929 and 1989. Despite today's adequate iodine supplementation, a significant risk for iodine-independent goiter remains in Switzerland, suggesting that genetic factors, among others, might be involved. Thus, a pilot study exploring the feasibility of genetic analysis of blood spots from these medical records was conducted to investigate and enhance the understanding of goiter development, potentially identify genetic variations, and explore the influence of dietary habits and other environmental stimuli on the disease.Blood prints from goiter patients' enlarged organs were collected per decade from medical records. These prints had been made by pressing, drawing, or tracing (i.e., pressed and drawn) the removed organs onto paper sheets. DNA analysis revealed that its yields varied more between the prints than between years. A considerable proportion of the samples exhibited substantial DNA degradation unrelated to sample collection time and DNA mixtures of different contributors. Thus, each goiter imprint must be individually evaluated and cannot be used to predict the success rate of genetic analysis in general. Collecting a large sample or the entire blood ablation for genetic analysis is recommended to mitigate potential insufficient DNA quantities. Researchers should also consider degradation and external biological compounds' impact on the genetic analysis of interest, with the dominant contributor anticipated to originate from the patient's blood.

Humans↗
PubMed2002

High reliability of neonatal screening for congenital adrenal hyperplasia in Switzerland.

Newborn screening for congenital adrenal hyperplasia (CAH) is justified by the sometimes difficult clinical diagnosis and the risks associated with missed diagnosis, particularly the life-threatening salt-wasting crisis. In Switzerland, nationwide screening for CAH by measuring 17-hydroxyprogesterone levels in dried blood spots was introduced in 1992. At the Zurich University Children's Hospital, 50% of the population of Switzerland is screened. The aim of the study was to evaluate the efficiency of the Zurich screening program. Between January 1, 1993, and May 31, 2001, 333,221 newborns were screened for CAH. Thirty-one newborns had CAH (incidence, 1 in 10,749); 30 were detected through screening (sensitivity, 97%). A recall for suspected CAH was performed in only 60 cases, corresponding to a very low recall rate (0.0018%). In 30 recalls CAH was confirmed (positive predictive value, 50%; specificity, 99.99%). Fifteen of 31 patients profited from screening, as CAH had not been recognized clinically. The timely availability of screening results made therapy possible within the first week of life in most cases and helped in preventing salt-wasting crisis in all patients. With a sensitivity of 97%, a specificity of 99.99%, and a positive predictive value of 50%, the Zurich neonatal screening program for CAH can be considered highly reliable.

17-alpha-Hydroxyprogesterone↗