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PubMed1980

[Infant nutrition in Switzerland 1978. A prospective study on the nutritional habits during the first 6 months of life. I. Natural nutrition: breast feeding].

With the help of 55 nurses counseling young mothers in northern, central and eastern Switzerland the feeding habits of 371 infants born in March and April 1978 were studied during the first 6 months of life. Infants who were still breastfed at the end of the observation period were monitored for another 6 months. 92% of all infants were breastfed during the puerperium (62% receiving exclusively mother's milk). At the end of the second month some 60% of the infants were breast-fed (40% exclusively). At the end of the fourth month the numbers were 30% (15%) and after 6 months 18% (2%). The "mean corrected nursing period" was 10.25 weeks. The length of this period showed a direct correlation with the socioeconomic class of the family and especially with the educational status of the mother. A small difference in duration of the nursing period between male and female infants was not statistically significant, although during childbed there was a significant difference in favour of boys. There appeared to be a relationship between duration of nursing and age, parity and bodyweight of the mother. There were marked differences in frequency and duration of breast-feeding according to whether rooming-in was practiced during childbed or not. At the end of the first half year of life babies with a long nursing period had a significantly lower body weight than those with partial or no breastfeeding. A much smaller difference in body length resulted in a lower and probably more favourable weight/length ratio. There was no difference in head circumference. As compared with other industralized European countries, the authors regard current nursing habits in Switzerland as satisfactory.

Body Height↗
PubMed1980

[Iodine deficiency is still endemic in Switzerland].

To obtain information on the present state of iodine supply in Switzerland random urine samples have been collected from 770 individuals for the purpose of measuring iodine and creatinine excretion. As a first step the widely used method of measuring iodine concentration per gram creatinine in casual urine samples was validated by quantitatively collecting urines for 6 consecutive 4 h periods in 11 healthy volunteers. True ioduria could thereby be compared with that calculated from random samples. 83% of all values were found to be within +/- 30% of the true mean value. The mean iodine content of all 770 samples collected in the field study was 93.3 microgram per gram creatinine (I/Cr). This mean value is slightly below the adequate iodine supply. Of even more concern is the fact that less than 60 microgram I/g Cr was found in 20% of all samples. Therefore, in the population sample as a whole the mean ioduria is still clearly below that indicating a sufficient iodine supply, and in one out of five individuals iodine excretion was typical of marked iodine deficiency. Low ioduria correlated significantly with low natriuria in both male and female subjects. This finding indicates that iodized table salt is an important though inadequate source of alimentary iodine. The increase in iodine admixture to table salt already agreed upon appears to be an appropriate means of improving nutritional iodine availability. Iodine deficiency may still be an important cofactor in the high prevalence of goiter in Switzerland. The long established goiter prophylaxis by iodine admixture to table salt may have lost part of its efficiency due to the sharp decrease in per capita consumption of salt.

Creatinine↗
PubMed1995

[Human echinococcosis in Switzerland, 1984-1992].

In a retrospective study (1984-1992), new cases of human echinococcosis were registered in Switzerland based on information obtained from (a) questionnaires sent to 294 of the 300 acute hospitals in all parts of the country and to 17 institutes of pathology (268 answers form hospitals: 91%), and (b) from tracing back cases reported under the official notification system since 1 January 1988 by laboratories to the Federal Health Office or recorded at the Institute of Parasitology in Zurich. Cases were regarded as verified if the diagnosis was documented by unequivocal findings (by radiology, ultrasonography, pathomorphology etc. and often by additional detection of anti-Echinococcus antibodies). Patients with antibodies but without reports on further findings were classified as suspected cases. From 1984 to 1992 (9 years), 302 new cases of human echinococcosis were diagnosed in Switzerland and verified in this study, corresponding to an annual average of 34 new cases and a range between 26 and 43 cases. The total number of 302 cases included 228 (75%) of cystic echinococcosis (CE) (Echinococcus granulosus), 65 (22%) of alveolar echinococcosis (AE) (E. multilocularis), and 9 (3%) of non-specified echinococcosis (NSE) (Echinococcus sp.). Among 185 patients with CE and 60 patients with AE and known geographic origin, the ratio of Swiss nationals to foreigners was 25%:75% and 88%:12% respectively. Based on a total population (Swiss nationals and foreigners) of 6.62 million in 1988 and the case numbers of 1984-1992, the following average annual incidence rates per 100,000 inhabitants were calculated: 0.51 for all new cases, 0.38 for CE, 0.11 for AE and 0.01 for NSE. In the 37 years since 1956 there has been steady increase in new cases of CE due to the importation of such cases by foreigners, whereas the case numbers of AE have remained nearly constant with a range between 7 and 10 new cases per year. In our study 258 suspected seropositive patients were registered but not added to the total number of cases, due to the lack of further findings.

Adolescent↗
PubMed1995

[Root canal treatment in Switzerland. The quantitative aspects--a determination of its status].

No recent data is available on the number of patients treated for root canal therapy in Switzerland. The aim of this study was to determine, by means of questionnaires, how many and which teeth were root canal treated in Switzerland by private practitioners. One questionnaire concerned the frequency of certain endodontic treatments performed during 10 consecutive working days. 30.1% of the posted questionnaires were correctly completed, returned and evaluated. Per dental practitioner, a total of 4.4 root canal treatments were begun during the 10 consecutive working days. A further 2.2 antiseptic dressings per practitioner were changed during the 10 days. Each dentist completed a root canal therapy on 5.3 teeth, 0.7 re-treatments and 0.1 pulpotomies during the 10 consecutive working days. 40% of all root canal treated teeth were molars which is rather high when compared to data available from other countries. Extrapolating the results to the entire Swiss population, 12.1 patients have a root canal therapy or a re-treatment per year. A similar result (12.9 patients) was recorded for the USA in 1979.

Humans↗
PubMed1975

[Dialysis and kidney transplantation in Switzerland in 1973].

A separate computer print-out for Switzerland of the EDTA registry concerning all patients on dialysis or carrying a renal transplant has been analysed. Of a total number of 857 registered patients, 584 or 91 per million inhabitants were alive on 31 December 1973; 306 patients were on hospital hemodialysis, 68 on home hemodialysis and 2 on peritoneal dialysis. 353 patients had received 385 renal transplants, 208 of which were still functioning at the end of 1973. No major change was noted in cumulative survival rates of Swiss patients, who, as expected, showed lower survival with increasing age. Graft survival in a group of 148 first cadaver transplants with poor tissue match (2 or fewer HL-A identities) was better with 66+/-4% at one year than the 53+/-7% survival in the 63 grafts with at least 3 HL-A identities. The number of patients alive on home dialysis increased by 74% through 1973; one year survival equalled the European average at 93+/-4%. Rehabilitation was rather poor in dialysed patients, 21% of whom were reported to be working full time in the hospital-dialysed group and 42% in the home-dialysed group. Patients with functioning transplants, on the other hand, showed very satisfactory rehabilitation (75% working full time). Hepatitis among staff appeared be on the decrease, with only 9 cases in 1973 despite the fact that some 20% of dialysed and transplanted patients were still reported as hepatitis B antigen carriers. The number of new patients accepted for treatment in Switzerland has stabilized at 25-27 per million population per year since 1971. Average mortality was 15.3% in 1973. At the beginning of 1980 we can thus expect to be treating some 135 patients per million population with dialysis and renal transplantation.

Female↗
PubMed1995

[Should a preventive congenital toxoplasmosis program be established in Switzerland?].

The Swiss Federal Office of Public Health established a multidisciplinary working group whose objectives were to review the subject of congenital toxoplasmosis (CT), to strengthen, as far as possible, the level of knowledge concerning congenital toxoplasmosis in Switzerland (particularly the epidemiological and economic aspects) and to propose a CT prevention programme acceptable to all concerned medical disciplines. Two main questions were considered: (1.) Does the size of the congenital toxoplasmosis problem justify the cost of a systematic screening programme for pregnant women? (2.) How secure is laboratory diagnosis? Neither the national system of reporting by laboratories and physicians, mortality statistics nor insurance records are adequate to estimate the incidence of congenital toxoplasmosis. A study carried out at the main hospital departments of neonatology and pediatrics in Switzerland provides a more accurate estimate but does not match the number of cases predicted by mathematical models. The discrepancy does not put the seroprevalence studies in doubt but rather the estimate of the rate of transmission of T. gondii to the fetus and its degree of virulence. The implementation of a better surveillance system would provide information for adoption and funding of a prevention programme based on facts rather than estimations. Those who support a generalized screening programme for pregnant women must also make an effort to convince the community of its importance. A prenatal screening programme for pregnant women should resolve problems rather than create new ones. The security of the diagnosis of an infection and the effects to the fetus are of vital importance for the principle primum nil nocere.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1995

[Cardiac interventions in Switzerland 1993].

As in the previous years, a survey of all cardiac invasive, interventional and surgical procedures was carried out 1993 by a detailed questionnaire, which was sent to all Swiss centers. The resulting data are presented here for the whole of Switzerland and per individual center. The outstanding findings are: For the first time, more coronary angioplasties than coronary bypass graft operations were performed. At the same time, angioplasty in two or more vessels during the same session was attempted in 10% only. Overall the coronary stent represents the most frequently used new device in interventional cardiology in Switzerland, but large differences regarding the incidence of stent implantations exist among the centers. Compared with the public or university hospitals, the private centers have increased their interventional and surgical volume dramatically during the past years.

Angioplasty, Balloon, Coronary↗
PubMed1994

[AIDS--a leading cause of death among young people in Switzerland].

Analysis of Swiss mortality statistics reveals that from 1980 to 1992 AIDS has become one of the leading causes of death among Swiss women and men aged 25 to 44 years. In 1992 77% (n = 414) of all AIDS-related death cases (n = 540) were in this age group. In the mortality statistics of men aged 25-44 years, AIDS (n = 307; death rate = 27.8/100,000) was found to be in third place after accidents and suicides. Among women aged 25-44 years, AIDS (n = 107; death rate = 9.9/100,000) was second after cancer. In spite of the inadequate epidemiological data position in Switzerland it may be suspected that in a few years AIDS will be the leading cause of death for both sexes in this age group in Switzerland.

Acquired Immunodeficiency Syndrome↗
PubMed1994

High prevalence of familial defective apolipoprotein B-100 in Switzerland.

Familial defective apolipoprotein B-100 (FDB) is caused by a single G-to-A substitution at nucleotide 10,708 leading to an arginine to glutamine change at amino acid 3,500 of the apolipoprotein B-100 and thus, a reduced binding of the apolipoprotein B to the low density lipoprotein (LDL) receptor. In the present study, the prevalence of FDB in Switzerland was estimated, on the one hand, from a sample of 728 healthy volunteers whose origin was spread out over the entire German, French, and Romansh speaking parts of the country, and, on the other hand, from 142 unrelated Swiss families with primary hypercholesterolemia comprising 520 individuals. Using polymerase chain reaction (PCR)-based methods, three individuals were identified with the point mutation in the sample of volunteers, equivalent to a prevalence of approximately 1/240 (90% confidence interval: 1.51 x 10(-3)-1.03 x 10(-2)). The frequency of FDB in the sample of hypercholesterolemic subjects was 7/142, yielding a prevalence of approximately 1/190 extrapolated to the general population (90% confidence interval: 2.63 x 10(-3)-9.17 x 10(-2)). The combined prevalence based on both samples was 1/209. Thus, the investigated point mutation was highly prevalent in Switzerland and appeared to be more frequent than in other populations studied hitherto. Furthermore, the presence of the mutation was not necessarily associated with an elevation of serum cholesterol levels, particularly in young individuals. While in the non-affected volunteers cholesterol levels increased between the age of 19 and 23 years by 0.22 mmol/l or by 5.6% (P = 0.001), this phenomenon was even more pronounced in individuals with FDB. The three volunteers with the point mutation demonstrated an increase in total cholesterol concentrations by 1.30 mmol/l or by 25% within 2 years, suggesting that, in the early twenties, cholesterol concentrations increase markedly from normal to elevated levels. Considering the estimated high prevalence and the relative ease of PCR-based tests, screening for FDB may become a standard procedure in patients with suggested familial forms of hypercholesterolemia.

Adult↗
PubMed1994

[The caries occurrence in 7- to 12-year-old schoolchildren in Switzerland. The results of a country-wide survey 1987-89].

Between 1987 and 1989, a random sample of school children aged 7 and 12 years in Switzerland was drawn. In the first stage, districts were chosen. Within the districts, 12 children in the two specified age groups were selected. In addition, Switzerland was subdivided into two strata. The children of stratum 2 had consumed fluoridated salt since birth while those of stratum 1 had only done so during the preceding 4 to 5 years but had benefitted since the age of 5 to 7 from dental health education programs using fluorides at school. The oral examinations were carried out according to the methodology of the World Health Organization. Attendance was 94% (1115 children). 47% of the seven-year-old children were caries-free, and the average dmft was 2.20 (95% confidence limits at 1.87 and 2.52). The average dt was 1.06. These children had an average DMFT of 0.40, with 77% having DMFT = 0. At the age of 12, the average DMFT was 2.03, with confidence limits at 1.73 and 2.33. On average, they had 0.45 DT and 38% of them were caries-free (DMFT = 0). There were only minor differences between the 2 strata. These results agreed well with the data from 6 local surveys carried out during 1987 to 1989. When compared with the majority of European countries, caries experience of Swiss children was fairly low.

Age Distribution↗
PubMed1994

[5 leprosy cases in the 20th century in Switzerland].

Leprosy had a great impact on everyday life during the Middle Ages, which is reflected in many works of art and also in some preserved buildings. Worldwide, leprosy is still an unsolved problem; this fact has led the World Health Organization to develop a specific strategy to fight the disease. For physicians in Europe, leprosy has lost its significance. In the archives of the Swiss Canton of Valais leprosy in the 20th century is documented by photographs and written records. It is deplorable to see how a young woman can become crippled, lose her eyesight and die within a couple of years. Probably a pocket of leprosy persisted since the Middle Ages in this remote mountain area. The limited contagiousness of the disease is astonishing, since only a few of the closest family members and inhabitants of the some house were infected, while others remained healthy. The social situation of these patients at the beginning of this century was pitiable. The federal laws on epidemics of 1886 did not mention leprosy, as no one seemed to believe in its existence in Switzerland. Even after the cases of leprosy in the Canton of Valais were revealed, the reaction of the political authorities was reserved. An engaged effort by the involved physicians was necessary to establish the appropriate hygienic measures. In the literature of the time there were regular reports of cases in people who emigrated from the endemic areas. Today, in Switzerland one case of leprosy is discovered per year; thus, leprosy is still a disease which physicians must cope with.

History, 19th Century↗
PubMed1994

Cost containment: Europe. Switzerland.

Thanks to Switzerland's very favorable economic situation over the last 20 yrs, intensive care medicine in the country has reached a very satisfactory level. The country is covered by a dense network of ICUs certified by the Swiss Society of Intensive Care Medicine (SSICM). Bed allocation is generous, technological equipment plentiful, and nurses are well trained in a specialized certification program. Rules imposed on physician training by the SSICM have recently become more stringent. A large supply of money in Switzerland has made cost containment efforts a low priority; no well defined program to reduce intensive care costs is in effect. Due to an increasingly difficult economic situation in the future, Switerland's near optimal healthcare system may change; cost containment will probably have to be dealt with seriously in the near future.

Attitude to Health↗
PubMed1993

Between rationality and metaphysics: the legal regulation of assisted reproduction in Germany, Austria and Switzerland--a comparative analysis.

The article discusses various legal aspects of assisted procreation. Emphasis is put on the law in Germany, Austria and Switzerland, where several acts have already been passed by parliament or are in preparation. Even among these countries there is no common approach towards the regulation of reproductive medicine. Whereas Germany criminalizes many of the new reproductive techniques, Austria has laid down an excessive number of administrative requirements that the gynaecologist has to meet. In Switzerland the legal situation is difficult to survey because each canton can decide its own regulation.

Austria↗
PubMed1993

[Prevalence of diabetes in Switzerland: calculation based on drug sales].

Data on prevalence of diabetes mellitus in Switzerland are scarce. In connection with a EURODIAB project the prevalence of diabetes was assessed in a standardized form, based on sales data for antidiabetic drugs. The prevalence of diabetes treated by specific drugs was calculated on the basis of Swiss sales data for antidiabetic drugs (corrected for combination therapies), the average prescribed daily dosages of insulin and oral antidiabetic drugs (OAD) defined by an inquiry in 38 pharmacies, and the mean annual population of Switzerland. The following prevalence rates were obtained (patients per 1000 inhabitants): [table: see text] Prevalence data obtained by the same, standardized method are higher in France (1.3%), Belgium (1.64%), Sweden (1.7%), and much higher in Italy (2.2%). Calculation based on drug sales data is an easy method of obtaining prevalence rates of diabetes mellitus. In comparison with field studies, discompliance and non-inclusion of diabetics treated only with diet do admittedly lead to low prevalence rates. Nevertheless, the chosen method is very useful for longitudinal observations and for international comparisons.

Diabetes Mellitus↗
PubMed1993

[Drug prices in Switzerland: European comparison of "comfort" drugs].

We compared the average Swiss prices of so-called "comfort medicines" with the prices operating in several other European countries. These drugs, which are numerous in Switzerland, were defined as having no demonstrable efficacy or as being prescribed for physiopathological entities of uncertain scientific basis. The comparison shows that the average price of comfort medicines in Switzerland is not different from the German price (-17%, ns), but is higher than in Sweden (+35%, p < 0.05), France (+61%, p < 0.01) and Italy (+65%, p < 0.01). Furthermore, the average price of innovative new chemical entities is strongly correlated with that of the comfort medicines in all the countries considered and despite the vastly different therapeutic value of these two categories of drugs.

Drug Costs↗
PubMed1996

[Clinical studies on gabapentin in Switzerland].

Gabapentin is a new antiepileptic for the combination therapy of partial seizures. It was introduced in January 1995 in Switzerland. This article describes briefly the ongoing clinical studies in Switzerland; meanwhile, these multicenter studies are conducted in different countries. An open study will evaluate the number of seizure-free patients under therapy with different dosages of gabapentin as add-on therapy. The efficacy and tolerance of gabapentin will be compared with carbamazepine as monotherapy. The last study examines the efficacy of gabapentin for the treatment of partial seizures in pediatric population.

Acetates↗
PubMed1995

[Seroepidemiologic investigations in the Alpine ibex (Capra i. ibex) of Piz Albris in the canton of Grigioni (Switzerland)].

Sero-epidemiological investigations in wild animals may allow to assess distribution of selected pathogens that sometimes seem to be involved in sanitary interrelationships between wild and domestic ungulates sharing the same areas. Serological studies were carried out to investigate the prevalence of antibody against 8 pathogens in Alpine ibex of Albris colony (Grisons, Switzerland). Investigated sera came from 89 animals shot by gamekeepers in 1990-1991. Antibody against smooth Brucella, Coxiella burnetti, Leptospira interrogans, Borrelia Burgdorferi, Mycobacterium paratuberculosis, BHV-1 and ovine-caprine lentiviruses were not detected in the tested sera. However, 31% of sera analysed were found to be positive for Chlamydia psittaci. Three sera showed high antibody titres ( > or = 1/128) suggestive of active infection in the animals. Any influence of Chlamydia psittaci in reproductive performance of free-ranging alpine ibex should be investigated through isolation of the agent. Results are discussed with reference to methods used and with epidemiological picture in Switzerland and were compared with results of serological investigations carried out in ibex in Italy and France.

Animals↗
PubMed1995

[Ambulatory rehabilitation of cardiac patients in Switzerland].

In 1989, there were 21 rehabilitation clinics and 21 ambulatory cardiac rehabilitation programs in Switzerland. Approximately 3/4 of the cardiac rehabilitation programs are offered within rehabilitation clinics, which cater for 6000 patients. The first ambulatory cardiac rehabilitation program in Switzerland was instituted in 1972. Since then a continuous rise in the number and importance of such programs has been observed. There is a wide variety of program selection and intensity. All programs include physical activity, risk factor interventions and psychosocial support. The mean duration of the programs is 3 months, the range being from 6 weeks to a year. Evaluation after 8 years' existence of the ambulatory cardiac rehabilitation program at the Kantonspital Olten indicates that such a program in an out-patient setting in conjunction with a community hospital is feasible; it can be conducted with a high degree of safety and is followed by similar lifestyle changes to those observed after in patient rehabilitation at specialist clinics. The results with regard to cardiovascular risk factors and ability to return to work are comparable.

Ambulatory Care↗