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PubMed2006

Deaths caused by malaria in Switzerland 1988-2002.

Despite sophisticated intensive medicine, between one and three malaria-associated deaths occur annually in Switzerland. In this retrospective study, 33 deaths (25 men and 8 women) caused by falciparum malaria reported in Switzerland from 1988 to 2002 were analyzed. The case fatality ratio (CFR) for the falciparum infections for the 15-year period was 1.2%, with a peak of 2.2% in 1991. Sub-Saharan Africa was the source of all the imported fatal infections. Non-immune Europeans had a significantly higher case fatality ratio than the non-Europeans (1.7% versus 0.2%; P < 0.001). Careless use or non-use of prophylaxis, sometimes because of physicians giving unsatisfactory pre-travel advice, and initially missed diagnosis post-travel were factors that contributed to the development of severe infections leading to death. Travelers should be sensitized to the risk of malaria by well-informed general practitioners. Updated information is readily available (www.safetravel.ch). Regarding diagnosis and treatment, greater physician awareness of the disease is needed, and expert advice should be sought without hesitation. Rapid malaria tests may be a useful diagnostic adjunct in centers where microscopic expertise is lacking. Falciparum malaria in a non-immune patient is an emergency requiring immediate treatment.

Adult↗
PubMed1991

[Private accident insurance in Switzerland with reference to liability insurance as a part of social security].

On the Swiss market there exist various different accident insurance schemes and systems. Private accident insurance which is offered by the private insurers, date back to the middle of the 19th century. Since 1912 accident insurance is compulsory for all employees working in particularly dangerous industries, since 1984 it covers all employees in the country. In Switzerland there exists no general compulsory accident insurance. To perform as insurance carriers are qualified: private insurance companies, the Swiss Accident Insurance Company, and a number of the social health (sickness) insurers. Depending on the insurance system there are different approaches to renumerate the health costs. In the various social insurance systems the patient is rather free to chose his doctor and hospital (among those who have a contract with the insurer); in private insurance he is completely free. Yet the billing systems and the applicable rates and tarifs differ considerably. There are trends to simplify these systems and bring them more into mutual accordance. Due to the important rise of the health costs in Switzerland, there exists the danger that possible simplifications will bring about more public influence yet less private initiative and less incentives to really control costs without lessening the patients' possibilities.

Humans↗
PubMed1991

[The occurrence of the parasite Collyriclum faba (Bremser in Schmalz, 1831) in wild birds in Switzerland].

The infection of our indigenous wild birds by the parasite Collyriclum faba represents a rare event. The adult trematodes reside in the subcutaneous tissue of the host, where prominent cysts can be found. In summer 1988, two cases were diagnosed, in a house sparrow (Passer domesticus) and in a goldcrest (Regulus regulus), which led us to a description of this unusual parasitic disease, whose cycle still remains unknown, and to a review of the prior known appearances in Switzerland. In the time between 1960 and 1989, a total of 2070 wild birds were examined in our Institute. In only four cases could an infection with C. faba be demonstrated. All of the affected birds belonged to the order of the Passeriformes. The occurrence rate of infestation among all wild birds was of 0.2%, and of 0.6% within the order of the Passeriformes. On the basis of this infection rate in our samples, we conclude that the rate of C. faba infections in wild birds of Switzerland is extremely low.

Animals↗
PubMedDate not supplied

Lung cancer patterns in Switzerland: a search for geographical and occupational patterns.

Simple descriptive methods (geographical correlation, variance and covariance analysis; gradients of mortality by quantiles; proportionate ratio methods) have been used to characterize the distribution patterns of lung cancer in Switzerland since 1969: Geographical patterns. In males, the temporo-spatial distribution of lung cancer mortality indicates that male smoking became prevalent earlier in the conurbations than in the countryside. The culturolinguistic gap between the German and French/Italian-speaking parts is mirrored by higher lung cancer rates in the latter. For female lung cancer the urban-rural gradient overshadows differences between the linguistic regions. Occupational patterns. The consistency of occupationally associated lung cancer risks within Switzerland is remarkable, even in small occupational groups with only a few deaths, and parallels the patterns known from international statistics. An analysis of lung cancer incidence within the Zurich cancer registry by histological types reveals the same consistent patterns with high risks in blue-collar trades.

Adolescent↗
PubMed1991

[Transfusion-associated HIV infections in Switzerland 1982-1989].

Up to summer 1987, 19 patients who had acquired HIV infection by blood transfusion had been recorded in Switzerland. In the subsequent period, up to 1989, a further 15 patients with transfusion-associated HIV infection were recorded. In December 1989, 7 of these patients were asymptomatic, 4 had ARC, 5 Aids and 11 had died of Aids. One patient died of another disease and no detailed records were available in 6. It is estimated that some 170 persons may have been infected with HIV by transfusion in Switzerland before anti-HIV testing was introduced in fall 1985. Of these only 31% (20%) are recorded today. The average incubation time from infection to diagnosis of Aids was 54 months. The 11 patients who died of Aids had mean survival of 57 months after diagnosis of the disease. In 6 instances HIV-infected blood recipients have transmitted the disease to their sexual partners.

AIDS Serodiagnosis↗
PubMed1991

[Home mechanical ventilation in Switzerland in 1990. Future developments].

Home mechanical ventilation (HMV) was initiated in polio centers in the mid-50s (iron lung). Ten years ago, chronic respiratory insufficiency patients began to be treated with positive pressure ventilation via tracheostomy tube. Survival of kyphoscoliotic and myopathic patients was impressive in uncontrolled studies. Today it appears that similar results may be obtained with a new non-invasive technique, nasal mechanical ventilation. The present situation of HMV in Switzerland (number of patients and their location) and the results of this treatment are described. In addition, we report on a short series of 24 Swiss patients collected in 4 centers. We show that HMV is possible in Switzerland and that the results in survival and quality of life are excellent, provided that the indications for this technique are consistent with the recommendations in the literature.

Adolescent↗
PubMed1991

[A case of spongiform encephalopathy ("cattle madness") in a cow in Switzerland].

Spongiform encephalopathies occur in humans and several domestic animal species. Among them, the bovine spongiform encephalopathy (BSE) has aroused considerable interest because of a massive outbreak of this disease in Great Britain, which is thought to result from feeding meat and bone meal contaminated with the spongiform encephalopathy agent. We observed the first case of BSE in Switzerland, which is also the first case on the European continent. A 6 year old cow suffered from progressive neurological disease. On neuropathological examination typical spongiform changes and neuronal vacuolation were found. The origin of the infection remains unknown. It cannot be excluded that the animal was exposed to cattle feed derived from Great Britain. It is possible that additional sporadic cases may occur in Switzerland, an outbreak such as in England is unlikely to happen.

Animal Feed↗
PubMed1990

[Caprine arthritis-encephalitis in Switzerland: epidemiologic and clinical studies].

The prevalence of infection with caprine arthritis-encephalitis virus was assessed using an indirect ELISA. Antiviral antibodies could be detected in 42% of 5974 goat serum specimens included in this study (Switzerland except Ticino and Graubünden 61%). Infected animals were found in all breeds of goats and in all regions of the country, with the lowest prevalence in the Canton Ticino in southern Switzerland. A comparison of clinical and serological data showed that only 20-30% of the infected animals develop carpitis or mastitis. We did not see any cases of encephalitis in young kids, indicating that this manifestation occurs only infrequently. According to the goat owners, each year, approximately 5-10% of the total goat population are eliminated because of arthritis. The decrease in milk production in infected animals is estimated at 10-15%.

Animals↗
PubMed1990

[Coronary angiography, percutaneous transluminal coronary angioplasty and coronary surgery, valvular interventions and anti-arrhythmia agents and fibrinolysis for acute myocardial infarction in Switzerland].

Besides the description of the activities of the Working Group PTCA and Fibrinolysis of the Swiss Society of Cardiology, number and distribution of coronary angiograms and angioplasties (PTCA) and aortocoronary bypass operations performed in 13 Swiss centers during 1989 are presented and commented. It is of note that the number of PTCA procedures has increased further during the last year, whereas the number of bypass operations stayed fairly constant over the last three years. PTCA is done today almost as frequently as coronary artery bypass surgery in Switzerland. There are, however, marked differences between individual centers: the number of PTCA procedures in relation to coronary angiograms varies between 5% and over 40%. A large part of these interventions is performed at private hospitals. More than 85% of the PTCA procedures were single vessel procedures. Catheter interventions on heart valves and on the conductive system were done almost exclusively at University Hospitals. The 1989 survey of the treatment of acute myocardial infarction with fibrinolysis covers only hospitals with catheterization laboratories and is therefore not entirely representative for the total activity in Switzerland. Almost 20% (0-80%) of all patients admitted for acute myocardial infarction received fibrinolysis with important differences between individual centers.

Angiocardiography↗
PubMed1990

[Prevention of skiing accidents in Switzerland].

In Switzerland, the prevention of skiing accidents has had a long tradition. The prevention of skiing accidents concept is based on three elements: "The facilities (slopes, runs), the equipment, the human-being". Together with partner organisations (the authorities, federal offices, medical circles, trade and sport associations), the Swiss Council for Accident Prevention bfu has put together an extensive package of measures for the increase of safety in skiing. The efforts made over the years are showing results. Since the beginning of the eighties, the number of skiing accidents which take place in Switzerland every year shows a decreasing trend.

Accident Prevention↗
PubMed1990

[Imported diseases in Switzerland: development and perspectives].

During the last years, imported diseases have become more frequent in Switzerland. This is easily explained by the enormous increase of tourism to tropical and subtropical countries. Immigration from these countries has equally seen an important augmentation. The principal imported diseases are still malaria and gastrointestinal infections. Viral infections are rarely diagnosed, with the exception of hepatitis and HIV infection. The prevalence of sexually transmitted diseases is most certainly underestimated. The differential diagnosis of imported skin diseases is still difficult. Rare tropical diseases will probably become more frequent in the coming years as travellers leave more and more the traditional tourist paths. Practitioners have to look out for such problems, and continuous training programmes for them will have to take these new problems into account. Referral centres of infectious diseases should be established in all regions of Switzerland. High priority should be given to the prevention of imported diseases.

Communicable Diseases↗
PubMed1989

[Mortality in influenza epidemics in Switzerland 1969-1985].

In Switzerland from 1969-1985, 9 out of 11 influenza epidemics were associated with a statistically significant increase in mortality. A total of 12,202 excess deaths from all causes was identified. Expected deaths were forecast for each epidemic period separately for 4 age groups using Fourier and Arima modeling. 75.7% of all-cause excess deaths occurred in age group 70 to 89 and 5.1% in age group 1-59. In the 70-89 years old group the excess mortality risk during influenza epidemics was 271.6 per 100,000, whereas in age group 1-59 it was only 1.7 per 100,000. Only 40% of all excess deaths had been ascribed to acute respiratory conditions. Influenza viruses A H3N2 were the most frequently identified agents. In some instances mortality increased before the morbidity reports of the Swiss practitioners indicated the occurrence of an epidemic. Also, morbidity reporting decreased over successive years. A decrease in mortality following the epidemics was not observed. A more complete vaccination of high risk patients in Switzerland is desirable.

Adolescent↗
PubMed1989

[The frequency and geographic distribution of Giardia infections in ruminants in Switzerland].

In various districts (Cantons) of Switzerland 815 calves (a few days up to 6 months old), 382 lambs and 20 young goats (both groups 1-6 months old) were selected randomly for a single coprological examination (flotation method) for Giardia infection. In average 26.6% of the calves, 29.8% of the lambs and 4 of 20 young goats excreted Giardia cysts. In 9 Cantons the percentages of cyst excretors among the calves varied between 15 and 32, but these differences were not significant. Further there were no significant differences in the frequency of cyst excretion between calves of 3 different breeds and 2 age groups (up to 3 months old and 3 to 6 months). The intensity of cyst excretion was high and varied in random samples between 4.1 x 10(3) and 3.0 x 10(5) cysts per g of faeces in calves and between 2.2 x 10(3) and 1.6 x 10(5) in lambs. In 5 of 7 farms where calves and lambs were maintained simultaneously both animal species were Giardia infected. As expected, trophozoites of Giardia isolates from calves and lambs belonged to the Giardia duodenalis type and could not be differentiated on a morphological basis. Giardia cysts from calves (average measurements: 13.7 x 9.1 microns) and lambs (13.8 x 9.2 microns) were indistinguishable both morphologically and morphometrically. The results indicate that Giardia infections are frequent and geographically widely distributed in calves and lambs in Switzerland.

Animals↗
PubMed1988

[Switzerland changes from U-40 to U-100 insulin].

At present over 95% of the insulin used in Switzerland is sold in a concentration of 40 units per ml (U-40 insulin). Only recently a small but increasing amount of more concentrated insulin has been introduced through the use of "pen" injectors which are all designed for U-100 (= 100 units per ml) insulin. Experience in other countries has shown that when different insulin concentrations are available on the market the risk of dosage errors with potentially severe consequences is high. The Swiss Diabetes Association has therefore taken the initiative in standardizing the concentrations available in Switzerland. A change from U-40 and U-100 to exclusively U-100 insulin is planned for the period from October 1988 to March 1989. A survey among 82 Swiss doctors and 243 IDDM patients has shown that about 60% of doctors and patients are in favour of the change while the remaining 40% are either neutral or opposed to it. Advantages, disadvantages and logistic problems of the change to exclusive use of U-100 insulin, and the possibility of pharmacological differences between insulins of different concentrations, are discussed. It is stressed that the change to U-100 must be medically supervised in every patient. An intensive information campaign providing detailed advice for patients, doctors and pharmacists is essential for the prevention of accidents.

Diabetes Mellitus, Type 1↗
PubMed1988

[3 discoveries of amputations in Bern canton, Switzerland].

At La Neuveville (Switzerland) close to the Blanche Eglise a separately buried amputated leg from the 19th century was discovered. The pathological lesions of the knee joints are most likely due to a nonspecific infection (Osteomyelitis). However, postmortal defects made an exact diagnosis difficult. Two foot-amputated male burials were discovered on St. Petersinsel (Switzerland) in the monastery cemetery of the 11th to 15th century. The possible causes of these amputations are being discussed within the historical context.

Amputation, Surgical↗
PubMedDate not supplied

Polymorphism of human orosomucoid in populations of western Germany and Switzerland.

The orosomucoid 1 (alpha-1-acid glycoprotein locus 1) gene frequencies have been studied in 670 individuals from Western Germany (Düsseldorf region) and in 220 individuals from Switzerland (Zürich region). The frequencies are ORM1*1 0.6269 and ORM1*2 0.3731 for Western Germany and ORM1*1 0.6068 and ORM1*2 0.3932 for Switzerland.

Adult↗
PubMed1987

[Neonatal respiratory distress syndrome in Switzerland. Data for 1984 and comparison with 1974].

In a retrospective study (questionnaire) covering all the neonatal special care units of Switzerland, information was obtained on, the problem cases in 84% of all babies born in 1984. 8.3% were hospitalized. Clinical respiratory distress syndrome (RDS) was diagnosed in 31% of these infants and hyaline membrane disease (HMD) in 6.3%. Mortality in clinical RDS was 7.1% and in HMD 19%. Mortality showed a high degree of correlation with birth-weight. Comparison of the 1984 data with a similar study in 1974 showed no significant change in the incidence of clinical RDS. The incidence of HMD (diagnosis by the same criteria) has fallen from 10.1% to 6.3%. Overall mortality in hospitalized newborns in Switzerland has decreased from 8.8% in 1974 to 4% in 1984.

Cross-Sectional Studies↗