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PubMedDate not supplied

Female thyroid cancer: the role of reproductive and hormonal factors in Switzerland.

We conducted a study on 91 women with thyroid cancer and 306 controls in hospital for acute nonneoplastic, non-hormone-related disorders in order to investigate the role of reproductive and hormonal factors in the etiology of epithelial thyroid cancer in the Canton of Vaud, Switzerland. Non-significant increases in cancer risk with an increasing number of full-term pregnancies (odds ratio, OR, after allowance for age and previous benign thyroid disease = 1.6, for > or = 3 vs. 0 full-term pregnancies, 95% confidence interval, CI: 0.7-3.6) and spontaneous abortions (OR = 2.0 for > or = 2 vs. 0 spontaneous abortions, 95% CI: 0.7-5.2) were seen. A significantly elevated OR (2.8, 95% CI: 1.1-7.2) was found in those women whose first pregnancy ended with an abortion. Whereas most other reproductive, menstrual and hormonal factors examined did not seem to affect the risk of thyroid cancer significantly, a clue emerged of an association between thyroid cancer and artificial menopause (OR = 6.3, for women who underwent artificial menopause vs. premenopausal women, 95% CI: 1.7-23.2). Although not necessarily causal, the relationship between the risk of epithelial thyroid cancer and the occurrence of spontaneous abortions and artificial menopause deserves attention in future studies, in the light of the high incidence of thyroid cancer in young and middle-aged women.

Abortion, Spontaneous↗
PubMed1995

Prevalence of atopy and pollinosis in the adult population of Switzerland (SAPALDIA study). Swiss Study on Air Pollution and Lung Diseases in Adults.

The Swiss SAPALDIA study is a large multicenter cross-sectional study initiated in 1991 to evaluate the relationship between environment and respiratory symptoms and diseases in adults, and included subjects from eight areas in Switzerland with distinctive environmental characteristics. We present here prevalence data for atopy, pollinosis and atopic asthma obtained from a random sample of 8,357 adults (18-60 years) assessed by standardized computer-based interview as well as by allergy skin prick tests (SPTs) (performed with Phazet) to grass, birch and Parietaria pollen, house dust mite, cat and dog epithelia and the moulds Alternaria and Cladosporium and by an in vitro allergy screen test (Phadiatop CAP FEIA system). On the basis of a positive Phadiatop (total 28.9%; males 32.9%, females 25.0%; p < 0.001) and/or a positive SPT (total 23%; males 25.0%, females 20.8%; p < 0.001), 32.3% of the study population were considered atopic (males 35.7%, females 28.8%; p < 0.001). Concerning the prevalence of skin sensitization (SPT wheal > or = 3 mm), the highest rate was observed for grass (12.7%), followed by house dust mite (8.9%), silver birch (7.9%), cat (3.8%) and dog (2.8%), whereas moulds and Parietaria elicited less than 1% positive SPTs. The prevalence of atopic rhinitis (rhinitis symptoms associated with atopy) was 13.5% (males 14.3%, females 12.6%; p < 0.05) and the prevalence of current hay fever varied between 9.1% (questionnaire answer and a positive SPT to at least one pollen), 11.2% (questionnaire answer and presence of atopy) to 14.2% (questionnaire answer only) with no significant difference by sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1978

Streptococcus pneumoniae isolates relatively insensitive to penicillin G recovered from patients in Switzerland.

The sensitivity to penicillin G of pneumococci isolated in Switzerland has been determined by the quantitative tube dilution method. 3 out of 100 strains were relatively insensitive to this antibiotic (minimum inhibitory concentration greater than 0.1 microgram/ml), thus confirming observations already made in other countries. These results underline the necessity of routinely testing the sensitivity of pneumococci to penicillin G.

Culture Media↗
PubMed1983

Epidemiology of anorexia nervosa in a defined region of Switzerland.

The authors conducted a retrospective study of the incidence of anorexia nervosa in the industrialized canton of Zurich, Switzerland, during three randomly selected sampling periods from 1956 to 1975. The data were derived from case histories from nearly all medical, pediatric, and psychiatric clinics in this region. The incidence of anorexia nervosa increased significantly, from .38/100,000 for 1956-1958 to .55/100,000 for 1963-1965 to 1.12/100,000 for 1973-1975. This increase was not due to the fact that nowadays anorectic patients are hospitalized earlier or that they are hospitalized for less severe illness.

Adolescent↗
PubMed2002

Determinants of attitude to volunteering in psychiatry: results of a public opinion survey in Switzerland.

BACKGROUND: The United Nations proclaimed 2001 the "International Year of Volunteers". Little is known about factors influencing the attitude to volunteering in psychiatry. However, knowledge about these factors is important as target groups to be addressed by an awareness and promotion campaign could be identified. AIMS: To determine the influence of demographic, psychological and sociological factors on the attitude to volunteering in psychiatry. METHODS: Multiple logistic regression analysis of the results of an opinion survey conducted on a representative population sample in Switzerland (n = 1737). RESULTS: Public attitude is mostly positive. It depends, however, on the form of volunteering. Two explanatory models for volunteering in psychiatry were found: first, the "antipathetic person" having social distance to and negative stereotypes towards the mentally ill. Second, the "people with social responsibility and commitment" who have former experience in volunteering, a positive attitude to community psychiatry, interest in mass media, a social profession and perceive discrimination of mentally ill persons. Age and gender are significant predictors. CONCLUSIONS: An awareness and promotion campaign to use the vast potential of people willing to volunteer in psychiatry can be primarily focused on those with a basic interest in social issues. Volunteering must be limited in time and responsibility. Contacting people with a positive attitude by mass media is a promising way.

Adult↗
PubMed2005

Human research tissue banks: the ATRA Project for establishing a human research tissue bank in switzerland.

A large number of experiments in biomedical research are carried out on tissues, but, even though the results should be applicable to humans, these tissues are mainly of animal origin. The difficulty encountered in obtaining human organs and tissues is an acknowledged problem: not enough human tissues are available to meet research needs. We are introducing the ATRA Project, with the purpose of supporting progress in biomedical research in Switzerland through the establishment of one or more human tissue banks, which will be able to find, treat, preserve and supply human material. Where similar projects have already been launched, concerns have been expressed that donation for research purposes might compete with donation for transplantation, but most organs and tissues are in any case non-transplantable. Surplus surgical tissue is considered "sanitary waste", and must be treated according to specific regulations for collection, packaging, transport, treatment and disposal. A human tissue bank would not only abate the costs of treating sanitary waste, but would actually turn what is now considered waste into a resource which could be used to save human and animal lives.

Animal Testing Alternatives↗
PubMedDate not supplied

Zolpidem in insomnia: a 3-year post-marketing surveillance study in Switzerland.

A multicentre post-marketing surveillance study was conducted in Switzerland in routine practice and involved 1972 insomniac patients treated with zolpidem, an imidazopyridine hypnotic agent. The patients were representative of the general insomniac population (65% women; mean age 55 years; 29% over 65). Of the patients, 87% were treated with a zolpidem dosage of 10 mg/day and the median treatment duration was 30 days. All adverse events were collected through spontaneous reporting. A total of 175 patients (8.9%) reported 343 adverse events, and 102 (5.2%) of them discontinued treatment. CNS (central nervous system)-related adverse events accounted for 66% of the total, the most common events being residual daytime sedation and insufficient efficacy in 3.7% and 1.6%, respectively; confusion, disorientation, nervousness, nightmares, amnesia, impaired concentration and anxiety were observed in a lower proportion. Gastro-intestinal symptoms, headache and skin reactions were the most frequent non-CNS related effects. No serious adverse event was reported and no new risk factors or at-risk populations were identified. The safety profile of zolpidem is thus consistent with its known pharmacological properties, the results of previous clinical trials, and the cumulative international experience gained with this short-acting hypnotic drug.

Adolescent↗
PubMedDate not supplied

Risk of basal and squamous cell carcinomas of the skin in Sion, Switzerland: a case-control study.

AIMS AND BACKGROUND: Non-melanocytic skin cancers are the most common cancers in white populations. Studies on populations of Anglo-Saxon and Mediterranean origins highlighted different patterns of risk of basal-cell carcinoma and squamous-cell carcinoma in relation to sunlight exposure, skin characteristics and phenotype susceptibility. In Sion, and in Switzerland as a whole, the high incidence suggests the possible presence of additional risk factors or of a different pattern of exposure to solar radiation as well as different composition of pigmentary traits and skin sensitivity to sun. METHODS AND STUDY DESIGN: We conducted a case-control study of 146 cases (73% of eligible cases) and 144 controls (81% of eligible subjects) to further evaluate the relationship between nonmelanocytic skin cancer and risk factors in the Sion population. Interviews were conducted by trained interviewers with a standardized questionnaire. RESULTS: Pigmentary characteristics such as blonde and red hair as well as tendency to sunburn without tanning and number of sunburns showed a statistically significant and independent risk increase in basal-cell carcinoma. Sun exposure during recreational activities (outdoor sports) showed a risk increase in basal-cell carcinoma with borderline statistical significance. Analysis of squamous-cell carcinoma risk was limited by the small number of cases, but it was positively associated with lifetime exposure to sun during outdoor work and with skin characteristics. CONCLUSIONS: Results confirmed previous suggestions of a different mechanism leading to malignant transformation of target cells from the basal and squamous epidermal layers, mediated by different phenotypes, and conditioning the ability to develop an effectively protective tan.

Adult↗
PubMed2002

In invisibility and isolation: the experience of HIV-affected families in German-speaking Switzerland.

Based on critical hermeneutics, the author presents insights about caregiving experiences of HIV-affected families in Switzerland. Using a qualitative approach, she interviewed 11 families and conducted 3 group discussions with members of different families. Two main themes emerged--Caught In Between: Family Changes Forced by HIV/AIDS and No Request for Support: Family Caregiving in the Context of Invisibility. The former portrays the families' struggle with new family constellations. Members felt close to, ambivalent toward, or distant from the infected member and built subgroups representing these connections and values. The latter portrays the families' withdrawal from their environment, whereby one or two close family members almost invisibly provided caregiving without outside support. These behaviors were reinforced by the Swiss health care system, which focuses on individuals. Suggestions for interventions are introduced.

Attitude to Health↗
PubMedDate not supplied

Economic evaluation of the use of nadroparin in the treatment of deep-vein thrombosis in Switzerland.

OBJECTIVE: To compare the cost implications, from the payer's perspective, of the use of nadroparin instead of unfractionated heparin in the initial treatment of deep-vein thrombosis. DESIGN: Cost-minimization study. SETTING: Switzerland. MATERIAL: Survey of clinical practice in six Swiss hospitals used to model three treatment regimens. MAIN OUTCOME MEASURES: Cost of treatment ($ US) per patient. RESULTS: Treatment with nadroparin instead of unfractionated heparin would reduce costs by $153 per patient. Treatment with nadroparin instead of subcutaneous unfractionated heparin would reduce costs by $109 per patient. CONCLUSIONS: The cost of initial treatment of deep-vein thrombosis is considerably lower with nadroparin than with either of the alternative regimens. Nadroparin reduces costs through greater ease of administration and by reducing the amount of laboratory monitoring. Treatment with nadroparin might also allow patients to be discharged from the hospital more quickly than is possible with intravenous infusion of unfractionated heparin.

Anticoagulants↗
PubMed2003

Awareness of vaccination status and its predictors among working people in Switzerland.

BACKGROUND: Adult vaccination status may be difficult to obtain, often requiring providers to rely on individual patient recall. To determine vaccination status awareness and the sociodemographic predictors of awareness for tetanus, hepatitis A and B, tick born encephalitis (TBE) and influenza vaccination. METHODS: Multivariate analyses were used to evaluate a questionnaire survey of 10,321 employees (4070 women and 6251 men aged 15-72 years) of two companies in Switzerland. RESULTS: Among 10,321 respondents, 75.5% reported knowing their tetanus vaccination status, 64.1% hepatitis A, 61.1% hepatitis B, 64.3% TBE and 71.9% influenza. Between 1 in 4 and 1 in 3 employees were not aware of their vaccination status. Differences in awareness for the five vaccinations considered correlated with gender and language. These differences persisted in multivariate analyses. CONCLUSION: Women employees, German-speaking employees and employees who paid more attention to their diet were more often aware of their vaccination status. A more reliable and readily accessible data source for vaccination status is needed in order to capitalize on opportunities to update vaccinations among Swiss employees.

Adolescent↗
PubMed2005

Hospital service areas -- a new tool for health care planning in Switzerland.

BACKGROUND: The description of patient travel patterns and variations in health care utilization may guide a sound health care planning process. In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models. This paper presents the methodology to create and characterize population-based hospital service areas (HSAs) for Switzerland. METHODS: We employed federal hospital discharge data to perform a patient origin study using small area analysis. Each of 605 residential regions was assigned to one of 215 hospital provider regions where the most frequent number of discharges took place. HSAs were characterized geographically, demographically, and through health utilization indices and rates that describe hospital use. We introduced novel planning variables extracted from the patient origin study and investigated relationships among health utilization indices and rates to understand patient travel patterns for hospital use. Results were visualized as maps in a geographic information system (GIS). RESULTS: We obtained 100 HSAs using a patient origin matrix containing over four million discharges. HSAs had diverse demographic and geographic characteristics. Urban HSAs had above average population sizes, while mountainous HSAs were scarcely populated but larger in size. We found higher localization of care in urban HSAs and in mountainous HSAs. Half of the Swiss population lives in service areas where 65% of hospital care is provided by local hospitals. CONCLUSION: Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants. HSAs and health utilization indices provide valuable information for health care planning. They will be used to study variation phenomena in Swiss health care.

Catchment Area, Health↗
PubMed2006

Analysis of patient flows for orthopedic procedures using small area analysis in Switzerland.

BACKGROUND: In general cantons regulate and control the Swiss health service system; patient flows within and between cantons are thereby partially disregarded. This paper develops an alternative spatial model, based upon the construction of orthopedic hospital service areas (HSAOs), and introduces indices for the analysis of patient streams in order to identify areas, irrespective of canton, with diverse characteristics, importance, needs, or demands. METHODS: HSAOs were constructed using orthopedic discharge data. Patient streams between the HSAOs were analysed by calculating three indices: the localization index (% local residents discharged locally), the netindex (the ratio of discharges of nonlocal incoming residents to outgoing local residents), and the market share index (% of local resident discharges of all discharges in local hospitals). RESULTS: The 85 orthopedic HSAOs show a median localization index of 60.8%, a market share index of 75.1%, and 30% of HSAOs have a positive netindex. Insurance class of bed, admission type, and patient age are partially but significantly associated with those indicators. A trend to more centrally provided health services can be observed not only in large urban HSAOs such as Geneva, Bern, Basel, and Zurich, but also in HSAOs in mountain sport areas such as Sion, Davos, or St.Moritz. Furthermore, elderly and emergency patients are more frequently treated locally than younger people or those having elective procedures. CONCLUSION: The division of Switzerland into HSAOs provides an alternative spatial model for analysing and describing patient streams for health service utilization. Because this small area model allows more in-depth analysis of patient streams both within and between cantons, it may improve support and planning of resource allocation of in-patient care in the Swiss healthcare system.

Adolescent↗
PubMedDate not supplied

Sodomy and heresy in early modern Switzerland.

The author compares records, from the early modern era, of sodomy trials in two parts of French Switzerland (Geneva, a Protestant city, and Fribourg, A Catholic pastoral area) and presents evidence that: (1) men charged with "sodomy" were prosecuted more often for homosexuality in cities and for bestiality in rural areas, (2) male homosexual subcultures were associated with the growth of large urban centers, (3) sodomy was punished with greater severity than any other crime than infanticide, (4) in both Geneva and Fribourg repression of sodomy increased during periods of religious zeal. With the advent of the Enlightenment, the number of sodomy trials fell as prosecutions for crimes of personal violence declined and prosecutions for crimes against property increased. This is the first English translation of Monter's article, originally written in French.

Capital Punishment↗
PubMed2006

Chlamydia-related abortions in cattle from Graubunden, Switzerland.

In 2001, the first case of bovine chlamydial abortion was reported in canton Graubunden, Switzerland. In this region, Chlamydophila (Cp.) abortus is endemic in small ruminants. Hence, we aimed to investigate the incidence of chlamydia-related abortions in cattle from Graubunden. During breeding seasons of 2003-2004, formalin-fixed and paraffin-embedded placenta specimens (n = 235) from late-term abortions in cattle were analyzed by histopathology, immunohistochemistry with a Chlamydiaceae-specific monoclonal antibody against chlamydial lipopolysaccharide (LPS), and 2 different polymerase chain reaction (PCR) methods (16 S ribosomal ribonucleic acid [rRNA] PCR, intergenic spacer [IGS-S] PCR), followed by PCR product sequencing. In 149 of 235 cases (63.4%), histopathologic lesions such as purulent and/or necrotizing placentitis were observed. Chlamydial antigen was clearly demonstrated in immunohistochemistry in only 1 of 235 cases (0.4%). Cp. abortus or Cp. psittaci was found in 12 of 235 (5.1%) and 10 of 235 cases (4.2%) by 16 S rRNA PCR and IGS-S PCR, respectively. However, we detected, by 16 S rRNA PCR, 43 of 235 cases (18.3%) to be positive for chlamydia-like organisms. In contrast to the situation in small ruminants in the canton Graubunden, bovine abortion from Cp. abortus seems not to play an important role. Nevertheless, zoonotic potential should be taken into account when handling abortion material from cattle. The significance of chlamydia-like isolates other than Waddlia chondrophila remains an open question in abortion and needs further investigation.

Abortion, Veterinary↗
PubMed2000

Seasonal variation of livebirths, stillbirths, extramarital births and twin maternities in Switzerland.

A study was made of the seasonal variation in all births, and births according to marital status, multiplicity and birth status (live and still) in Switzerland recorded between 1876 and 1990. To obtain seasonal variation in as pure as possible form, our analyses are based on rates. When comparing the seasonality in data sets showing markedly different levels, standardised indices were used. Assuming the length of pregnancies with twins to be about one month shorter than for pregnancies with singletons, lagged twinning rates were calculated but, in comparison with actual twinning rates, the general seasonal variation remained. Therefore, this study was based on actual twinning rates. A monotonic increase in the amplitude of the seasonal variation in general births was noted for the period 1876-1930, with strong seasonal variation holding for 1921-1980. After that, a marked decline in the amplitude can be observed. Seasonality of both all births and twin maternities showed very similar pattern for the periods 1876-1930 and 1969-1990, with maxima in the spring (March-May) and troughs in late autumn (October-December). Twin maternities showed a strong seasonality for the period 1876-1930, being about 20% higher in March than in October. The twinning rate in the period 1876-1930 was about 2.6 per thousand units higher than in the period 1969-90. For twin maternities there was also a stronger seasonal variation during the earlier period than during the later one. The pattern of the seasonal variation for extramarital births, showing a maximum in February (conceptions in May-June) and a minimum in August (conceptions in November-December) with a difference of no less than 24% was more marked than for the marital births. It seems likely that this seasonality of extra-marital maternities was due mainly to seasonal variation of coital rates and multiple ovulation in the early summer months coinciding with optima of light, temperature and food supply. A strong reduction in the rate of stillbirths (gestational age more than 29 weeks) was observed during the twentieth century. The stillbirth rate declined from about 40 per 1000 in the 1870s to fewer than 5 per 1000 in the 1980s. Irrespective of this strong decline in the stillbirth rate, the same seasonal rhythm was noticed throughout the period with high stillbirth rates among births around March and low rates during the summer and autumn.

Abortion, Spontaneous↗
PubMedDate not supplied

Unintentional injuries among 16 to 20 year old students in Switzerland.

In our society, accidents constitute a major public health problem, especially among youth. The objective of this paper was to describe the incidence of nonfatal injuries that required medical care among 16 to 20 year-old in Switzerland, its distribution by type of injury and whether there were differences by gender or by academic track and whether these injuries had sequels (hospitalisation, physical and psychological sequels). Overall, 28.3% of the sample reported at least one accident needing medical care in the previous 12 months, with males having more accidents than females and apprentices more than students. By type of accident, sports were the most frequently reported, followed by traffic, leisure time and work accidents. Half of males and one-third of females reported more than one accident, and 16% and 8% of them, respectively, reported four or more. Both physical and psychological sequels were more frequent among females, while hospitalisation was more frequent among males. Accident prevalence rates remain high among adolescents. Safety counselling and environmental measures need to be implemented.

Accident Prevention↗
PubMed1995

Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency.

In 1980 the iodide content of salt was increased in Switzerland from 7.5 to 15 mg/kg. This raised the mean urinary iodine excretion from 90 (indicating mild iodine deficiency) to 150 micrograms/g creatinine. We examined whether this public health measure was followed by a change of the incidence of hyperthyroidism in a defined catchment area of 109,000 persons. Except for a 27% rise in the first year of the new salt, the total incidence of hyperthyroidism declined steadily to reach 44% of the control level in 1988/89. This was due to a decrease mostly of toxic nodular goitre (minus 73%), less so of Graves' disease (minus 33%). We conclude that correction of mild iodine deficiency has beneficial effects on the incidence of hyperthyroidism, contrary to what is seen initially after correction of severe deficiency.

Female↗