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PubMed1990

[Interruption of pregnancy in Switzerland 1982-1986].

Official statistics available for the 5-year period considered in this paper reveal a general trend: decrease in the number of terminations, in absolute terms, both in women non-resident and in women resident in Switzerland. Amongst the latter, figures show a relative decrease in the 15 to 44-year age group and in relation to birth rate. Attitudes in 'liberal cantons' concerning termination of pregnancy are clearly justified. Efforts to ensure more widespread use of modern contraceptive methods must be continued (in conjunction with AIDS prevention).

Abortion, Induced↗
PubMed1990

[Liver transplantation in Switzerland. Initial results].

In Switzerland four university hospitals have engaged in a liver transplant program. Of the 40 transplanted patients, 21 were alive on May 31, 1989. This survival rate is encouraging as it relates to teams which have only recently started up; it should, however, be improved if it is to equal the results achieved by the best centres in the world. Several issues must be urgently addressed: the shortage of donors, requiring a better harvesting organization at the national level; a possible association with existing European bodies; and critical discussion regarding the number of centers which should perform liver transplants in the country.

Humans↗
PubMed1977

[The etiology of sylvatic trichinellosis in Switzerland].

Three Trichinella strains from Swiss wild foxes (Vulpes vulpes) were tested in crossbreeding experiments with Trichinella spiralis, T. nativa and T. nelsoni using white mice as laboratory animals. The results demonstrated that T. nelsoni Britov et Boev 1972 is the etiologic agent of sylvatic trichinellosis in Switzerland. Former isolations of these species were successful in materials from East and South Africa, USSR (Republics of Tadzhikistan, Turkmenia and Kazakhstan) and Bulgaria. The area of T. nelsoni covers probably the whole southern part of the Old World up to the 48th degree of northern latitude.

Animals↗
PubMed1990

[The medical care of newborn infants in Switzerland].

Switzerland has one of the lowest neonatal mortalities in the world (5%) which has barely decreased during the last 10 years. The aim of care for newborn infants has therefore shifted from reducing mortality to reducing morbidity and increasing quality of life. Diseases which were frequent and severe some twenty years ago, such as rubella embryopathy and rhesus incompatibility, have almost disappeared today due to general prophylaxis. On the other hand, new, partly iatrogenic diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia, considerably affect present morbidity of newborn infants. Due to newly developed imaging techniques and genetic, biochemical and immunological methods for screening of risk groups or all pregnant women or newborns, more and more diseases are detected earlier. Therefore the optimal procedure has to be settled early and on an interdisciplinary basis, and include prenatal investigation and possibly treatment, planning of delivery, and early and late postnatal diagnostic and therapeutic measures. The consequence of this development is close cooperation between obstetricians, neonatologists, and pediatric specialists, and a rapidly increasing need for neonatal beds, especially for intensive care. In spite of identification and centralization of women with high risk pregnancy before delivery, every newborn may develop sudden, unpredictable problems of adaptation which need immediate action. Therefore, at every delivery in a clinic or at home the necessary equipment and skilled staff must be available in order to cope with acute problems during adaptation from intrauterine to extrauterine life.

Congenital Abnormalities↗
PubMed1987

[Social psychiatry in Switzerland].

Based on a previous questionnaire about psychiatric care in the Swiss cantons (and from other sources), the author tries to give an overview of the evolution of socio-psychiatric concepts, methods of treatment and changes in institutions in Switzerland during the last 10-15 years. According to certain criteria he shows that social psychiatry developed extensively in many places during this period. Most important are the new half-way-institutions (day- and night-hospitals, foster-homes, centers of rehabilitation, sheltered apartments etc.) which have been created; also, the number of coordinated, integrated socio-psychiatric services based on global concepts of care has increased. On the whole, this evolution has contributed nearly everywhere to a reduction of psychiatric beds and length of stay in hospital, and an improvement in the chances of rehabilitation and quality of life for long-term patients. There are, however, still great differences between the cantons. Contrary to initial exaggerated hopes, socio-psychiatric methods of treatment have not been able to solve the problems of chronification of psychoses, drug-addiction or geronto-psychiatric patients in a satisfactory way. - In order to improve the possibilities of future treatment, the development of socio-psychiatrically orientated, global concepts of care should be promoted including decentralized catchment areas, integrated in-patient, half-way and out-patient services and free access to resources of both internal and external services according to the local needs.

Community Mental Health Services↗
PubMed1989

[Medicosocial characteristics of hospitalized alcoholic patients in 2 internal medicine departments of hospitals in French-speaking Switzerland].

Two prospective studies were performed in the medical services of two hospitals located in the French-speaking part of Switzerland to assess the prevalence of alcoholism and the comparative medico-social characteristics of alcoholic and nonalcoholic patients aged 18 to 75. Both investigations used the Michigan Alcoholism Screening Test, with a cut-off score of 5. The prevalence of alcoholism was similar in the two institutions (19.6 and 20.5%) and was much higher in males (30 to 32%) than in females (3 to 5%). Among alcoholics, the percentage of unmarried or divorced patients was higher than in nonalcoholics, as was the percentage of unemployed and subjects from lower socio-economic brackets. The most frequent type of alcohol-related disease was alcoholic liver disease, encountered in 25% of alcoholics in both services. Cigarette smoking was also much more frequent in alcoholics (60%) than in nonalcoholic patients (29%). The length of stay was 2 days longer for alcoholics in both hospitals, despite the lower mean age of these patients.

Adolescent↗
PubMed1977

[Dental care of prison inmates in Switzerland].

The dental status of inmates of 10 Swiss penitentiaries (capacity 50 to 245 persons) was investigated, and also organization and economic questions pertaining to dental treatment of penitentiary inmates. In all 10 institutions, the minimal claims of the UNO (1955) relative to dental treatment of penitentiary inmates are fulfilled. Nevertheless, there are significant differences between the 10 institutions. In some, practically only pain therapy is customary, while in others the whole spectrum of modern dentistry is used. Preventive measures are uniformly insufficient. Since the administering of punishment in Switzerland is cantonal, the differences in dental treatment will not be easy to eliminate.

Dental Care↗
PubMed1989

[Sudden death during mass running events in Switzerland 1978-1987: an epidemiologico-pathologic study].

Between 1984 and 1987 there were 7 cases of sudden cardiac death during organized mass runs in Switzerland, and between 1978 and 1987 there were 3 cases during the nine largest mass running events (total 8 cases of sudden death during the race). Based on numbers of participants in all events 1984-1987, or in the nine largest events 1978-1987, an incidence of 1 sudden death per 129,500 hrs. of running (95% confidence interval 1/62,500-1/263,000 hrs.), or 1 sudden death per 117,000 hrs. of running (1/45,000-1/311,000 hrs.) respectively, was estimated. This estimate is higher than the rate of 1 sudden death per 396,000 hrs. of noncompetitive jogging found in a study from the United States (Thompson et al.: J. Amer. med. Ass. 1982; 247: 2535-2538). The Swiss incidence of sudden cardiac death during organized mass runs was 50 to 1000 times higher than the incidence expected by chance alone (as estimated from national death register data). All 8 cases of the study were men, the younger four aged 23 yrs. on average (range 20-31 yrs.), the older four aged 49 yrs. (46-53 yrs.). Autopsy in three of the younger men identified hypertrophic cardiomyopathy in one instance whereas in the two other cases no plausible cause of death could be found. The two autopsies performed in older men both showed severe coronary heart disease. Only in 1 case out of the 8 were possible prodromal symptoms of the subsequent death, such as fatigue and nausea, observed, and the average prevalence of known cardiovascular risk factors was low. None of the 8 runners dying suddenly was completely untrained, but 6 out of 8 had only modest running experience, i.e. a low number of years of running. This study confirms that there is probably a clearly increased risk of sudden death during running events with a competitive character, but this acute elevation of risk should probably not be overstated in view of both its very low population - attributable risk and the important potential of regular exercise for overall coronary risk reduction and health promotion.

Adult↗
PubMed1989

[Key-Gaskell syndrome in a cat in Switzerland].

As far as the authors know this is the first case of Key-Gaskell-syndrome being described in Switzerland. The clinical signs of megaoesophagus, anorexia, constipation, dryness of all mucous membranes, reduced tear production, protrusion of the membrana nictitans, mydriasis, regurgitation and bradycardia are pathognomonic and can't be mistaken by any other disease. The subject of the Key-Gaskell-syndrome is a dysfunction of the autonomic nervous system. Histopathological changes are exclusively related to the autonomic nervous system and to neurons of some nuclei in the cranial nerves. Less severe changes can be found in the neurons of the spinal cord or in the dorsal root ganglia. The etiology remains still unclear. There is a relationship to the grass sickness syndrome in horses and to dysautonomia of man and dog.

Animals↗
PubMed1989

Incidence and morbidity of cancer of the cervix in Geneva, Switzerland.

The incidence and mortality rates of invasive carcinoma of the cervix in the state of Geneva, Switzerland, is reported for the time periods 1970-1973 and 1980-1983. A reduction in mortality (7 to 4.3/100,000) occurred as well as a considerable decrease in the overall incidence (20.3 to 11.4/100,000). This decrease is particularly marked in the age group of 35-64 years. It is less marked between the ages of 60 and 69 and did not appears before 35 years or after 70 years of age. In the time period 1980-1983, more than one half of the cases were found after age 60 years, two thirds of them in stage 2 or worse. It is therefore essential that screening programs recruit a high enough proportion of older women.

Female↗
PubMed1989

[Perspectives of maxillary surgery in Switzerland].

In Switzerland maxillofacial surgery is qualified as a special surgical discipline according to the regulations of the Foederatio Medicorum Helveticorum. The Swiss Association of Maxillofacial Surgeons has acquired the membership of the Union of Swiss Surgical Specialties. Even before this step maxillofacial divisions were built up in several surgical centers. The urgent need for a special surgery in the field of the viscerocranium has shown up in traumatology, orthopedics and tumor surgery. This experience leads to concrete perspectives which lead to a controlled postgraduate training and intensification of the cooperation with adjacent surgical specialties and with dental medicine.

Curriculum↗
PubMed1989

[Long-term oxygen therapy in Switzerland].

In Switzerland long-term oxygen treatment is chiefly performed with oxygen concentrators provided by the Swiss Association against Tuberculosis and Pulmonary Diseases through its cantonal leagues. Prescription and supervision are carried out according to the Association's guidelines. To assess compliance with these guidelines, the prescription forms of 447 patients (1981-1985) were analyzed concerning diagnosis, lung function and blood gases. Of the 398 diagnoses mentioned, 73% were COPD, 16% restrictive syndromes and 11% cardiovascular diseases (including cor pulmonale). Lung function results were given in 81% of the total but in only 73% and 67% of two non-COPD groups. Blood gases at ambiant air were given in 92% and under oxygen at the flow chosen for treatment in 72%. At ambiant air the PaO2 was greater than 7.33 kPa in 21% (8.18 +/- 0.85 kPa) and less than 5.33 kPa in 19% (4.86 +/- 0.33 kPa). - These results show that prescription criteria are not always correctly met, especially in non-COPD patients. They also suggest that long-term oxygen treatment is often prescribed mainly on the basis of clinical criteria, despite a PaO2 which would not require it, and also in unstable state, as indicated by the high proportion of cases with very low PaO2. The rationale behind the guidelines should be explained more clearly to prescribing doctors, in order to confine this difficult and costly treatment to patients who really need it.

Aged↗
PubMed1989

[The feeding of dogs in Switzerland. The results of an inquiry].

Results of inquiry made of 2190 dog owners about customs of feeding and keeping dogs in Switzerland are presented. The diet most often used consists of cereal flakes which are given together with feedstuff from animals or other commercial dogfood. Usually, only one meal per day is given and the amount of food is based on a constant body weight. Regular feeding of bones appears to have a good effect on digestion and dental health.

Animal Feed↗
PubMed1985

[Prevalence of antibodies against HTLV-III in various regions in Switzerland].

Acquired immune deficiency syndrome (AIDS) has been etiologically linked with the human T-cell lymphotropic virus HTLV-III. In a study on the prevalence of antibodies to this virus in Switzerland, sera from 941 individuals were collected in 5 major urban areas (Basel, Berne, Geneva, Lausanne and Zurich) in 1983 and 1984. All sera were tested by ELISA and the majority also by Western blot. We found an antibody prevalence of 100% among 22 cases of AIDS, of 94% among 48 cases of AIDS-related complex (ARC), and of 57% among 14 homosexual contacts of AIDS patients. Among 55 sera collected from i.v. drug addicts in 1984, 53% were positive, whereas the rate had been 36% among 103 sera collected in 1983. The rate was 19% among 227 sera collected from asymptomatic active homosexuals in 1984, against 10% among 40 sera collected in 1983. 8% positives were found among 98 patients with various types of viral hepatitis. In addition, 4% of 84 sera of individuals from Equatorial Africa were positive. No positives were found among 15 sera of individuals from other African regions, among 32 sera of persons from various regions of Asia, and among 203 Swiss blood donors. These results demonstrate the high and increasing rate of HTLV-III infection among groups at risk for AIDS, and suggest that HTLV-III-related diseases will be a serious problem in the years ahead.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Focal epithelial hyperplasia: first cases in Switzerland and review of the literature].

Three cases of 'focal epithelial hyperplasia' (FEH) of the oral mucosa observed for the first time in Switzerland are reported. The patients were of Turkish and North African extraction. The lesions of FEH were multiple, painless, located at various sites of the oral mucosa including the tongue, in the form of either soft papules or hard nodules. Evidence of a human papilloma virus origin was ascertained. Among the 1,067 cases reported in the literature and reviewed for this study, this condition has been described to occur among American Indians, Eskimos and Cape Coloureds; also in Israeli and European cases the disorder was often reported in individuals of Turkish or North African extraction.

Adult↗
PubMed1986

[Transfusion-associated LAV/HTLV-III infections in Switzerland. Report of 2 cases].

Two patients developed signs of LAV/HTLV-III infection one and two years respectively after a blood transfusion. The leading symptom in one patient was generalized lymphadenopathy, while the other patient presented with Candida stomatitis. In both cases, blood transfusions administered in 1983 were found to be the only possible source of infection; one blood donor of each patient was anti-LAV/HTLV-III positive. Family members and sexual partners of the two were negative for antibodies against LAV/HTLV-III. Our findings document the first two cases of LAV/HTLV-III associated disease most probably related to blood transfusions in Switzerland.

Acquired Immunodeficiency Syndrome↗
PubMed1977

[Screening of newborn infants in cystic fibrosis. Evaluation of a 4-year study in Switzerland].

The results of an evaluation over 4 years (1973-1976) of 16,620 BM-tests (Boehringer-Mannheim newborn screening for cystic fibrosis) at 8 hospitals in Switzerland are presented and the data from analysis of albumin, protein and alpha1-antitrypsin concentrations, and on trypsin-inhibitory capacity of the meconia are discussed. 99.5% of the tests were negative. Of the remaining 0.5% BM-positive tests, the diagnosis of cystic fibrosis required confirmation by sweat test and clinical course in 6 cases, or 0.04% of the total collective. The test was false-negative in 2 cases (0.012%), of which one had a primary pulmonary form of cystic fibrosis. The study shows that the BM-test, as screening test for cystic fibrosis, makes it possible to distinguish between "normal" and "suspect". By calculating the ratio albumin to alpha1-antitrypsin, it would be possible to verify the probability of a reliable diagnosis as early as a few days after birth. As before, however, it would be indispensable to confirm the diagnosis of cystic fibrosis by a sweat test with pilocarpin iontophoresis. By consistent screening in all obstetric and pediatric clinics it would be possible to improve early diagnosis still further.

Cystic Fibrosis↗