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PubMed1994

[Overweight in Switzerland. Cross-comparison of various studies with the Heureka Study].

In this study the most important Swiss studies on the incidence of overweight and obesity are summarized and compared to the corresponding prevalence rates from the Heureka study. Interestingly, data on body weight indexes (mostly mass indexes) and the various prevalence rates showed good accordance for younger age groups. In the upper age classes however, phenotypic differences concerning determinants and risk factors for overweight became obvious in the different Swiss populations (i.e. from geographically different regions of Switzerland). Nevertheless, regional risk factors could not been detected because specific data were lacking. The importance of uniform weight definitions for studies as well as for daily practise is stressed.

Adult↗
PubMed1994

[Cardiac interventions in Switzerland 1992. PTCA and Fibrinolysis Work Group of the Swiss Cardiology Association].

In 1992, 14,348 coronary angiographies were performed in Switzerland (2110 per 1 million population). This represents a 10% (+1332) increase over the previous year. About 50% were performed at university hospitals. Over the past 5 years, interventions for myocardial revascularization (coronary angioplasty [PTCA] and coronary artery bypass grafting [CABG] have increased constantly and nearly linearly. The increase from 1991 to 1992 was 8% (510) (PTCA: +18% [+469]; CABG: +1% [+41]). The PTCA/CABG ratio amounted to 0.9/1 for all Swiss hospitals. At university hospitals, angioplasty was performed more frequently than bypass grafting (PTCA/CABG 1.3/1) in contrast to the private hospitals (PTCA/CABG 0.4/1). More than a third of all revascularizations were performed in private hospitals. The increase in angioplasty is a consequence of an increase in coronary angiography and not of an increase in the percentage of multivessel PTCAs. This indicates that coronary artery disease is being diagnosed and treated more actively without necessarily adopting more aggressive PTCA indications. There was an obvious difference in morbidity and mortality rates, both after PTCA and CABG, between some private and public hospitals. The fact that public hospitals are obliged to accept high risk emergency cases is to their disadvantage. So is their more complete data collection, which reveals the actual incidence of complications more accurately.

Angioplasty, Balloon, Coronary↗
PubMed1994

[Helicobacter pylori resistance against metronidazole in Switzerland: implications for eradication therapy?].

Gastroduodenal ulcers are strongly associated with Helicobacter pylori (HP) infection. Successful eradication drastically diminishes ulcer recurrence. Most of the eradication schemes include metronidazole (Flagyl). The present study was designed to establish the metronidazole resistance rate in Switzerland. Antral biopsies were taken in 153 patients with suspected ulcers (115 men, 38 women, mean age 46 +/- 16 [SD] years) during upper endoscopy for bacteriological testing. Metronidazole resistance (> 8 micrograms/ml) was found in 47/153 (31%) of the isolates. Resistance was found in no case to amoxicillin (Clamoxyl) (0/104 = 0%) and only in 3% (2/66) to clarithromycin (Klazid). Metronidazole resistance of HP in a third of the isolates studied is comparable to numbers found in other European countries. These findings raise the question whether eradication schemes including metronidazole without prior sensitivity testing are justified. Amoxicillin and clarithromycin appear to be valid alternatives.

Adult↗
PubMed1993

[Chronic tumor pain and opiates: a survey of prescription practice among physicians of German-speaking Switzerland].

Motivated by clinical experience that opioids are still not administered adequately in cancer pain, a survey about their use involving 1200 physicians of the German-speaking part of Switzerland was conducted. The results confirm that a part of the treating physicians uses opioids not rationally, but that the majority follows established guidelines in the treatment of cancer pain. The results are compared and discussed with the current literature on the management of cancer pain.

Analgesics, Opioid↗
PubMed1993

[Burns in workers in Switzerland: epidemiology and financial sequelae].

A complete statistical evaluation of epidemiologic data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5% of the burn victimes are admitted to a hospital, 0.2% die. Only one fifth of the costs caused by burns are due to medical treatment and rehabilitation. All other expenses result from continuation of payments of salaries and annuities. The few treatments of severely burnt patients in the burn units cause effective costs higher than the tariff paid by the insurance. Even so, the predominant portion of the enormous costs is taken up by wages while off work and annuities. As our conclusion we stress the importance of primary care for all severe burns including all burns of the hands in a specialized centre. Any economic effort for primary burn treatment, however high it may be, is justified if the duration of rehabilitation and invalidity can thus be reduced.

Accidents, Occupational↗
PubMed1994

[Allergology general practice in Switzerland: present and future].

The conditions of an allergological evaluation was determined in Switzerland, based on a questionnaire (1535 physicians and 648 pharmacists, of whom 33% answered). Besides dermatologists and allergists, ENT specialists are most frequently confronted with allergological problems. Serological determination of IgE are performed more frequently than skin tests, specifically by specialists for internal medicine and paediatrics. Pharmacists are quite often asked for remedies and tend to use alternative medical approaches more frequently than physicians. The data show that the specialty of allergology is changing and that, along with the high frequency of allergological patients, many non-allergologists participate in their treatment. The allergist of the future will deal more with complicated cases and be on the front line for establishing new diagnostic tools and therapies.

Allergy and Immunology↗
PubMed1993

[Eugenics and public health: legal sterilization of mentally ill in the Vaud canton (Switzerland)].

In 1928 the canton of Vaud (Switzerland) voted a bill which legalized eugenics sterilization. The sterilization of the mentally ill was a public-health measure among others. It fitted in a wide variety of policies whose aims were to increase the physical and psychical well-being of the population. Vaud eugenics was progressive, reformist and non-partisan. This paper examines the intellectual, social and political conditions of the 1928 bill.

Eugenics↗
PubMed1993

[Switzerland: a country with high skin cancer rate].

On an European scale, Swiss melanoma incidence and skin cancer mortality rates are exceedingly high, in contrast to the neighbouring countries. Incidence rates of melanoma and nonmelanoma skin cancers are on the increase. From 1921 up to the present, melanoma death rates have been increasing; the excess of male over female mortality has developed since 1950 only. Since the mid-1970s, melanoma mortality under the age of 65 fluctuates without increasing. In the older age-groups increase continues, especially in older men, in whom the melanoma is often localized on the trunk. Compared to other European sources spinalioma and basaloma are rather frequent. Kaposi's sarcoma is rare but increasing. The annual number of new skin malignancies in Switzerland is estimated to be approximately 5000 for men and 4000 for women.

Basal Cell Carcinoma↗
PubMed1993

[Incidence of resistance of tuberculosis bacteria in Switzerland].

Based on a survey, results on resistant tubercle bacilli in Switzerland during October 1987 through April 1991 are presented. In 94% of 2482 tuberculosis cases reported, susceptibility testing results have been available. The radiometric BACTEC technique was used in 76%. Resistance was detected radiometrically for INH in 7%, for rifampin in 1.9% and for ethambutol in 0.7%. The age-specific resistance among Swiss was 12% in the youngest and 3% in the oldest age group. In patients from South American and from Far Eastern countries, INH and rifampin resistance was the highest. Resistance was found in 5.7% of the Swiss and in 7.5% of all. In addition, suggestions for the surveillance of resistant tubercle bacilli have been made.

Adolescent↗
PubMed1993

[Health survey of 15-20-year-old adolescents in French-speaking Switzerland].

During the year 1992, under the auspices of the Federal Office for Public Health, the Institute for Social and Preventive Medicine of Lausanne conducted a survey on the health and life-style of a representative sample of adolescents aged 15 to 20 years from the French speaking part of Switzerland. The main objective of the study was to explore adolescent health attitudes and behavior as well as health needs. After exclusion of non valid questionnaires (1.2%), 3324 subjects have been included in the analysis (females: 1477; males: 1847; apprentices: 59%; students: 41%). The majority of the respondents feel in good health (females: 87.5%; males: 94.3%), but a large proportion express needs in various areas: stress, depression, love, professional future, nutrition etc. Comparisons with earlier surveys show that cannabis use has become more common (lifetime prevalence: females: 24.1%; males: 39.3%). The use of hard drugs such as cocaine and heroin is not exceptional (lifetime prevalence: 1-3%). By 18 years of age, the majority of respondents are sexually active (17 years: 49.0%; 18 years: 62.6%; 19 years: 72.0%). 76.6% of respondents have used contraception on their first coitus and thereafter. Girls exhibit a tendency towards more perceived health problems and more use of health care structures, whereas boys express their problems in a more "external" way, i.e. violent behavior (injuries, fighting, theft etc.). Differences between apprentices and students are minimal, although apprentices tend to be more sexually active. The paper comments on the results in different areas such as health care, prevention and general setting.

Adolescent↗
PubMed1993

[Alcohol intoxication at the wheel in the Waadt canton (Switzerland).A comparative study of penal and administrative measures 1970 and 1989 in the canton capital city (Lausanne) and a rural area].

The canton of Vaud is one of the major wine-growing areas of Switzerland. The driving ban rate for drunk driving is the highest in the country. This is the result of the very important rise in the number of drivers intercepted by the police for drunk driving (accidentless cases), in the course of the last ten years (+260%). In order to find out what penal and administrative measures were taken against drunk drivers (those who did not commit an accident), a comparative retrospective study of the offenses committed in the area of Lausanne and in rural area of the canton of Vaud (La Broye) was undertaken. This study deals with the years of 1970 and 1989. In a parallel, the average blood alcohol concentration (BAC) value, relative distribution of the BAC (frequency profile), and the concordance between the doctor's medical examination and the suspect's BAC were studied. Our results demonstrate that only the urban area (Lausanne) showed a significant increase in the drunk-driving offenses without accident, resulting in a significant decrease in the average BAC value as well as a veering towards the left of the BAC frequency profile curve. The legal sanctions and the administrative measures diverge according to the different areas, the most striking fact is the lowering of the average term of imprisonment for second-time or multiple offenders in the study group of Lausanne. The results of the clinical examination undertaken by the doctor at the moment of the blood test have shown that there is often a difference between the clinical evaluation and the actual BAC: for a BAC of 2 to 3/1000, the objective clinical symptoms of drunkenness (Romberg, unstable gait, coordination troubles) are noticed in only half of the cases. As a result, the assessment is no longer based on objective criteria but on subjective criteria as well as on the life-style of a certain period. In conclusion it is our belief that the efforts made by the vaudois police (especially in urban areas) should be pursued further, since positive results are apparent. The Judiciary system should however rebalance the sanctions delivered to drunk-drivers, showing greater severity towards second-time or multiple offenders.

Adolescent↗
PubMed1993

[Heureka study: prevalence of overweight and obesity in Switzerland].

Overweight and obesity as well as associated metabolic disorders belong to the most important risk factors. During the exhibition 'Heureka' in Zurich data on body weight and size as well as on other clinical and biochemical parameters were collected by a questionnaire. Age- and gender-specific prevalence rates were calculated. Between 10 and 41% of the visitors showed a body-mass index of > or = 25 kg/m2, as a function of age and gender -0.7 to 6.2% showed a body-mass index of > or = 30 kg/m2. The most important increase in body weight was found in the age groups between 20 and 40 years. The presented epidemiologic data show that overweight is common in Switzerland, too. Prevention of overweight is still one of the most rational medical strategies and should be intensified in the age group between 20 and 40.

Adult↗
PubMed1993

[Change in the drinking behavior in Central Switzerland over two decades].

Based on the medical recordings registered during blood sampling of drunken drivers of the years 1971 and 1989 the changes of drinking behaviour in Switzerland was examined. An increase of female drivers under the influence of alcohol was noted. The younger drivers under 30, which were the most represented in all the age groups, showed a decrease in the average blood alcohol value. Due to the facts, the most blood samples were taken by forensic physicians rather than private physicians a much better information was gained concerning the substances drunken and the times of drinking. The evaluation of final drinking hours, critical incidents and time of blood sampling showed a tendency to post-midnight hours.

Accidents, Traffic↗
PubMed1993

[Dental caries (DMFT) in adults in Switzerland 1988].

In 1988, 864 adults were examined for dental and periodontal conditions in 47 dental offices in Switzerland according to WHO methods. Among the 57 offices selected at random 10 dentists were unwilling to cooperate. Within each office, 36 patients were chosen by a randomizing mechanism. 51 percent of the selected patients presented themselves for the examination whereas 14 percent refused to participate in the study; of the remaining subjects one third could not be reached during the three to five days available for contacting them and two thirds were unable to come to the respective dental office at the preset day of examination. The DMF data obtained were similar to the results of previous local surveys, part of which were based on random samples. Up to age 74, it was concluded that the data of the present survey are fairly representative of the Swiss resident population. In the age group 75 and above, the number of missing teeth (MT) was too low, mainly due to edentulous persons, institutionalized and other, being obviously underrepresented. The Swiss DMFT of 22.3 in the age group 35-44 was almost the highest mean among 26 European countries. However, prevention efforts at school age, already obvious in the age group 30-34, will substantially improve the results at age 35-44 by the year 1998. The number of DT was 1.0 and 1.3 for the ages up to 29 and below 1.0 in the older groups. Up to age 54, FT was the most important component of the DMFT while in the older groups, MT was highest.

Adult↗
PubMed1993

[Laparoscopic appendectomy: techniques and results in Switzerland].

We have tried to assess the actual attitude towards laparoscopic appendectomy in Switzerland. An inquiry on preoperative investigations, operative approach and results in cases of suspected appendicitis in 26 surgical Institutions affiliated to the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTS) was performed. In a 20 month period a total of 3665 laparoscopic procedures were performed. Appendectomy was attempted in 457 cases in 19 institutions. Conversion to open appendectomy was necessary in 51 cases (11%). Average operative time was 62 minutes. There were 27 postoperative complications (7%). 8 patients (1.9%) needed reoperation. Mean hospital stay was 3.9 days. Opinions of the participating institutions on the actual role of laparoscopic appendectomy (feasibility, advantages or disadvantages) are shown.

Adolescent↗
PubMed1993

[The diagnosis of brain death. Guidelines in Germany, Austria and Switzerland].

Today's modern medicine with its nearly limitless possibilities requires a well-founded diagnosis of brain death. After this diagnosis continuation of intensive medical care becomes meaningless, or an essential precondition for organ donation is fulfilled. In view of the delicate problems involved, it is essential that brain death be diagnosed uniformly and in well-founded fashion. Responsible institutions in Germany, Austria and Switzerland have issued guidelines, criteria and aids to decision making that vary only insignificantly.

Austria↗
PubMed1993

[Veterinary radiology in Germany, Switzerland and Austria: a comparative analysis of problems].

The result of an investigation in 1988/89 to grasp the problems of veterinary radiology in Austria left some uncertainties. By an enquiry of 200 vets (49% answered) additional information was received. A comparison between Austria, Germany and Switzerland revealed the same problems: neglected darkroom work. The causes are absent or not seldom false advice by medical/technical firms, the lacking willingness of vets to become advised, false parsimony and insufficient offer of meetings and seminars providing the physical know-how in producing X-ray pictures.

Animals↗
PubMed1996

[Comparison between ski and snowboarding accidents. Current overview from the ski area Arosa (Switzerland) (1988/89 to 1994/95)].

The ski resort of Arosa (Switzerland) is geographically isolated and has recorded it winter sports accidents since 1969. Based on this reliable data, the ski (3877 in total) and snowboard (512 in total) accidents of the last seven years were statistically analyzed. The study showed that snowboarding isn't much more dangerous than skiing the number of accidents was about the same in both groups, whereas snowboarders were less likely to be admitted to a hospital or to get injured by collision. The average age of snowboarders was 21.6 years, almost 20 years lower than that of the skiers. Both sexes were about equally represented. Most snowboarders had injuries of the upper extremity (14% fractures of the radius, 9% distortions), particularly because of falling backward after losing balance. In both groups (skiers and snowboarders) 60% of all injuries were of low grade, which did not lead to long absence from work. The results are discussed and compared with already existing publications.

Accidents↗