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PubMed2005

Brief report: Conclusions and recommendations of the Advisory Committee on Poliomyelitis Eradication--Geneva, Switzerland, October 2005.

The second meeting of the Advisory Committee on Poliomyelitis Eradication (ACPE) was convened in Geneva, Switzerland, on October 11-12, 2005, to provide the World Health Organization (WHO) and the Global Polio Eradication Initiative with advice on program policies for 1) interrupting wild poliovirus (WPV) transmission worldwide, 2) limiting the international spread of circulating polioviruses, and 3) refining the program of work for eventual cessation of immunization with oral poliovirus vaccine (OPV). This report summarizes the results of that meeting.

Global Health↗
PubMed1991

[HTLV-I/II in Switzerland: apropos of 4 case reports].

HTLV-I/II (human T-cell lymphotropic virus type I and II) infection is endemic in South Japan, Subsaharan Africa, the Caribbean and in regions of South America and of the United States. The infection almost always remains asymptomatic but is also associated with two distinct diseases: tropical spastic paraparesis (TSP), and adult T-cell leukemia (ATL). Although very rare in Europe, HTLV-I/II infection may occur in patients originating from endemic areas. We report the cases of four patients seropositive for HTLV-I/II, all of them living in Switzerland. Three of them originate from Zaire; the fourth is a Swiss female married to a Taiwanese. One patient has TSP; one has pyramidal signs along with systemic vasculitis-associated neuropathy; the third is HIV-position with stage III B infection, without symptoms of TSP or ATL; the last is entirely asymptomatic.

Adult↗
PubMed2002

Clinical evaluation of ankylosing spondylitis in Switzerland.

The purpose of this study was to identify the socioeconomic conditions and clinical history of ankylosing spondylitis patients in Switzerland. Data collected from 1177 ankylosing spondylitis patients, through a mail-in questionnaire, was analyzed for epidemiological factors, clinical presentation, musculoskeletal related surgical history and socioeconomic impact. The results showed that the sex ratio, average age at onset of symptoms, latent period until diagnosis, signs and symptoms, peripheral joint involvement and the prevalence of extraarticular organ affection of our patient group all conform with the majority of the published literature. Conversely, most reports suggest a higher frequency of musculoskeletal surgery, yet a lower employment capacity than the Swiss cohort. As described in other publications, aggressive physiotherapy appeared to be linked to a reduction in long-term disability, musculoskeletal deformities and surgical intervention. It was concluded that the present cohort of ankylosing spondylitis patients underwent fewer surgeries for musculoskeletal deformities and represented a lower socioeconomic burden (relative to disability and inability to work) than most patient populations previously studied.

Journal Article↗
PubMed1991

[Role of the A2 hospital in general surgery training in Switzerland].

A full training in general surgery is difficult to achieve and involves an important professional commitment. In Switzerland, surgical theoretical and operative knowledge is mainly acquired in University Hospitals (A1 hospitals). A2 hospitals (smaller teaching hospitals) can be the best complement for this training. In these departments, general surgeons have a broad field of activity, including gastrointestinal, chest, vascular, outpatient surgery, conservative treatment and internal fixation of fractures and, sometimes, surgical endoscopy. Operative activity is intense. These departments thus allow privileged teaching positions for surgical residents and chief residents.

Curriculum↗
PubMed1990

[Nervous system pathology in AIDS: results of a collaborative autopsy study from Switzerland].

Neuropathological lesions were studied in a consecutive autopsy series of 206 cases, comprising 61% of all patients who died of Aids in Switzerland between April 1981 and December 1988. Central nervous system involvement was found in 84% of the patients, and 17% showed multiple concomitant intracerebral lesions. Among the non-viral opportunistic infections, cerebral toxoplasmosis was most frequent (24%), whilst among the viral opportunistic infections, cytomegalovirus (CMV) encephalitis was most frequent (7%). A nodular encephalitis consisting of disseminated microglial nodules without morphological or immunocytochemical evidence of CMV occurred in 13.5% of the patients. The majority of these cases showed evidence of extracerebral CMV infection. Progressive multifocal leukoencephalopathy (PML) was observed in 6% of the patients and was associated with widespread tissue destruction and cyst formation. HIV encephalopathy occurred in 38 patients (18%) and showed two characteristic morphological patterns: progressive diffuse leukoencephalopathy (PDL) and multifocal giant cell encephalitis (MGCE). PDL was observed in 22 patients and was characterized by a diffuse demyelination and gliosis of the white matter with little inflammatory infiltrates and scattered multinucleated giant cells which were immunoreactive to HIV antigens. MGCE was found in 16 patients and was characterized by clusters of macrophages, lymphocytes, and HIV-immunoreactive multi-nucleated giant cells. In our view, PDL and MGCE represent two opposite variants of HIV-induced encephalopathies with numerous intermediate manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Humidifier syndrome as occupational disease in Switzerland].

Control of humidity may be necessary in various industrial processes. Contamination of humidifiers by algae and bacteria may lead in exposed workers to two distinct syndromes: extrinsic allergic alveolitis and humidifier fever. In Switzerland 18 cases of humidifier syndrome were accepted by SUVA as occupational disease. 13 of the 18 cases occurred in the printing industry. In 13 out of 18 cases contaminated humidifiers were the cause of the syndrome and in five cases contaminated air-conditioning systems. Due to the often uncharacteristic clinical signs and symptoms and variable clinical features diagnosis of humidifier syndrome was missed by the general practitioner. Once humidifier fever was clearly diagnosed most workers had to change their working place. Despite the avoidance of exposure respiratory problems, radiographic changes and pulmonary function changes often persisted. Major pulmonary function decreases resulting in pulmonary invalidity were observed in five of the 18 cases (28%). Technical measures to prevent humidifier syndrome are described.

Adult↗
PubMed1989

[Epidemiology of legionnaires' disease in Switzerland in 1988].

Both sporadic cases and outbreaks of legionnaire's disease have been reported. To date, no outbreaks have occurred but several case reports have been published in Switzerland. The newly organized surveillance system of notifiable diseases, introduced in 1987, makes it possible for the first time to analyze reported sporadic cases more precisely. In 1988, the laboratories reported a total of 32 cases with cultural or serologic proof of legionellosis. In 75% of cases patients were aged over 40 years, 78% occurred among males. The majority of them were known to be smokers. In 9 cases an underlying predisposing condition was known: hairy cell leukemia (3 cases), immune hemolytic anemia (1), type 2 diabetes (2), chronic lung disease (1), heart failure (1). The case fatality was 9%. A possible source of exposure, such as air-conditioned rooms or evaporative condensers, was reported in 4 cases.

Adult↗
PubMed1988

Heart valve replacement with St. Jude Medical valve prosthesis. Long-term experience in 743 patients in Switzerland.

Between November 1978 and June 1986, 828 St. Jude Medical valves were implanted in 743 patients whose mean age was 57 years (range, 1-83 years) and who had been admitted to the University Hospitals in Basel, Berne, and Lausanne, Switzerland. Aortic valve replacement was performed in 456 patients, mitral valve replacement in 200, tricuspid valve replacement in six, double valve replacement in 77, and triple valve replacement in four. In 187 patients, additional surgical interventions were performed. Operative mortality was 1.6%, and the 4-week postoperative mortality was 4.0%. During a mean follow-up period of 2.6 years, the annual mortality rate was 3.1%, and the annual cardiac mortality rate was 2.1%. The thromboembolic rate per 100 patient-years was 1.3 after aortic valve replacement, 3.0 after mitral valve replacement, and 1.0 after multiple valve replacement. The incidence of major bleeding was 1.3 per 100 patient-years. Valve dysfunction attributable to thrombotic obstruction occurred in three patients, and that attributable to leaflet dislocation in one (annual dysfunction rate, 0.2%). Twelve patients developed infectious endocarditis, six of whom died. However, in four patients, reoperation and, in two patients, antibiotic treatment alone were successful in treating the infection. A paravalvular leak necessitating reoperation developed in 10 patients. In three patients, the leak was caused by infectious endocarditis. Reoperation had no operative mortality. In three patients (0.4%), a mild hemolytic anemia was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[12 years' experience in bone marrow transplantation in leukemic patients in Switzerland].

Between 1974 and December 1985 180 bone marrow transplants were performed in Switzerland for patients with leukemia. They were performed in 4 centers (Basle 133, Zurich 28, Geneva 17, Berne 2). The overall probability of survival at 10 years for all patients is 20%. Results are better for younger patients, for patients transplanted in recent years and for patients transplanted either in the first complete remission of acute leukemia or in the chronic phase of chronic myeloid leukemia.

Adolescent↗
PubMed1986

[Disease (Lyme disease) in pediatric patients in Switzerland caused by spirochetes (Borrelia burgdorferi) of Ixodes ricinus].

Lyme disease in children is studied in the light of questionnaires sent out twice to departments and divisions of pediatrics in Switzerland. Thirty-six serologically proven cases were collected. The 48 clinical signs attributed to Lyme disease involved the skin in 40%, the nervous system in 40%, and the joints in 20%. They were erythema chronicum migrans (13), lymphocytoma (4), acrodermatitis chronica atrophicans (2), peripheral facial palsy (14), sensomotor radiculoneuritis (2), meningoencephalitis (3) and arthritis (10, 7 of which were monoarthritic). Only half the patients had a history of tick-bite. Antibiotic therapy, usually with penicillin, reduced both the duration of symptoms and frequency of secondary disease. Cardiac involvement and chronic stages with residua were not observed in this series.

Adolescent↗
PubMed1979

[Determination of the IgE serum level: RIST or PRIST? Results of a ring test in Switzerland].

Serum IgE concentrations, determined by two commercial kits (Phadebas RIST and PRIST) in 93 adult controls resulted in a geometrical mean value of 47 (RIST) and 35 U/ml (PRIST) respectively within a + 2 SD value of 195 and 331 U/ml respectively. The difference between the separated random samples is statistically significant (t = 3.79; p less than 1%), but the correlation is still fairly satisfactory (r = 0.79). In the lower regions the IgE values with RIST are as a rule a little higher than with the PRIST method. Surprisingly, one patient showed an extremely low IgE value (7 U/ml) with PRIST, but a considerably higher one (530 U/ml) with RIST. Such marked differences are found occasionally in the literature: heterophile antibodies against bovine gammaglobulin are regarded as responsible for the interference in the Sephadex system of RIST. As the reproducibility of the IgE determinations with the PRIST method is excellent (the correlation coefficient for two PRIST determinations was r = 0.93), and as PRIST allows much lower IgE estimates, this procedure should be given preference, particularly in pediatric patients. On the other hand, RIST must be used for the determination of extremely high values, as for instance in patients with severe atopic dermatitis or with parasitic infestations. In fact they can no longer be exactly evaluated by PRIST. Quality control of IgE serum determinations among twelve randomly chosen laboratories in Switzerland in 5 patients was satisfactory, with one exception. In the case of extremely high values, however, only a few laboratories try to determine the exact value. Indications of more than 500 U/ml were considered sufficient, with actual values amounting to 12,500 U/ml. It is also advisable to standardize the serum dilutions, the use of reference serum and the price. Finally, the indications for IgE determination are discussed. It is considered to have an important bearing on the differential diagnosis and prognosis of atopic diseases in infants and children.

Adult↗
PubMed1984

Outcome of pediatric patients with end-stage renal disease in Switzerland 1973-1982.

The annual incidence of end-stage renal disease (ESRD: 1.32 patients aged 1/2-16 years per million population or 6.5 per million children of same age) and the causes have remained remarkably constant over the last 15 years in Switzerland. 58 patients (69%) were treated by dialysis and/or renal transplantation. The overall survival rate was 77% at 5 years and 65% at 10 years. 26 untreated patients (31%) died of uremia. They had not been treated despite existing facilities for the following reasons: Young age (7 of the 8 patients being less than 2 years old), psychosocial reasons (6), severe mental retardation (6) and associated problems (6). It is estimated that even in the future 20% of all pediatric patients with ESRD will be considered unsuitable for therapy by dialysis and renal transplantation.

Adolescent↗
PubMed1995

[Pneumocystis carinii pneumonia in infants with vertically acquired HIV infection in Switzerland].

OBJECTIVE: Review of incidence, clinical picture, therapy, and outcome of Pneumocystis carinii pneumonia (PCP) in infants with vertically-acquired HIV infection in Switzerland. METHODS: Inquiry among members of the Swiss Pediatrics AIDS Group, review of the data base of the Swiss Neonatal HIV Study and retrospective analysis of the charts from infants with PCP. RESULTS: Since 1986 PCP has been diagnosed in 10 out of 107 infants with vertically-acquired HIV infection. PCP occurred in 7 infants at the age of 3-6 months and in 3 at the age of 9-11 months. 4 infants showed symptoms related to HIV infection before developing PCP. Before the development of PCP, infection with HIV had been ascertained in 6 infants. In 2 the diagnosis was still unclear and in the 2 remaining the risk of HIV infection was not known. None of the infants was on primary prophylaxis against PCP. Signs and symptoms of PCP included cough and tachypnea (100%) as well as high fever up to 40 degrees C (90%). Transcutaneous oxygen saturation was 70-95%. Chest X-rays revealed interstitial infiltrates in 6 infants, localized infiltrates in 2 and interstitial as well as localized infiltrates in 2. The CD4+ cell count was, with one exception, < 1500/microliters, i.e. below the normal value for age. Side effects of high dose cotrimoxazole were noted in 6 patients. 5 infants required intubation and mechanical ventilation. 4 infants died due to PCP, including 3 of those who required intubation and mechanical ventilation. CONCLUSIONS: PCP in infants with vertically-acquired HIV infection preferentially occurs at the age of 3 to 6 months and is often lethal, especially in patients requiring intubation. Evaluation for HIV infection should be done as early as possible in order to introduce primary PCP prophylaxis in infants at risk for this opportunistic infection.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Antibiotic sensitivity of gram-negative bacteria in intensive care units in Switzerland].

The sensitivity to the major antimicrobial agents of consecutively isolated gram-negative rods in intensive care units in Switzerland was investigated. A majority of strains originated from clinical specimens where infection or colonization could not be distinguished from each other. A total of 1024 isolates from 482 patients were tested by a standardized microtiter method. Of the beta-lactam antibiotics, imipenem (92% of bacteria sensitive), ceftazidime (90%), and aztreonam (85%) showed the greatest activity. 94% of the isolates were sensitive to ciprofloxacin, and 93% and 91% to amikacin and tobramycin respectively. There where considerable differences locally and in time, probably reflecting small outbreaks due to resistant bacteria and because selective pressure is locally dependent on the antimicrobial agents used. 122 patients were observed for an extended period. In 67 (55%) the same gram-negative rods persisted for up to 42 days without development of resistance. In 41 patients (34%) there was a change to other more resistant bacteria, especially to multi-resistant Pseudomonas aeruginosa, Flavobacterium meningo-septicum, Xanthomonas maltophilia or Enterobacter cloacae. In 12 patients (10%) bacteria of the same species with resistance to additional antimicrobial agents were observed.

Anti-Bacterial Agents↗
PubMed1995

[Initial results of the HOT-study in Switzerland (hypertension optimal treatment)].

The HOT study (hypertension-optimal treatment) is an international clinical study on primary prevention of cardiovascular events in 19,193 hypertensive patients worldwide. It aims at the recognition of the optimal diastolic blood pressure value (< 90, < 85 or < 80 mmHg?) in order to maximize the possible benefit of an antihypertensive therapy. In addition, the HOT study investigates whether low doses of aspirin (75 mg/day) are able to reduce the occurrence of severe cardiovascular events. In Switzerland a total of 797 patients have been enrolled in the study. Antihypertensive therapy was initiated with felodipine = Plendil (5 mg/day). This vasoelective calcium antagonist could reduce diastolic blood pressure values to < 90 or < 80 mg/Hg, respectively, in one of two or one of three patients within the first three months. In nine or six patients, respectively out of ten a reduction of diastolic blood pressure values to < 90 or < 80 mmHg was reached within one year by combination of felodipine with other antihypertensive drugs (ACE inhibitors, beta blockers and diuretics).

Adrenergic beta-Antagonists↗
PubMed1996

The whole-body incorporation of radioactive caesium in Switzerland during the last 30 years: a survey of young persons in Geneva and some measurements of Belarusian and Ukrainian children.

In a cross-sectional study, at least 40 young men and women about 18 years old (half of each sex) were selected each year, and the body concentration of 137Cs was measured in a whole-body counter. This radioisotope, with a half-life of 30 years, originates from the atom bomb explosions in the atmosphere, which were stopped in 1963, or from the accident at Chernobyl. The concentrations due to the emissions from this reactor remained below one-third of the values due to atomic bombs. The results in children from Belarus who spent a few weeks in Switzerland in the summer are lower than would have been expected according to the literature from Russia, but correspond to those recently obtained in situ by international scientific teams.

Adolescent↗
PubMed1996

[Prevalence of transmission of zidovudine-resistant viruses in Switzerland. l'Etude suisse de cohorte VIH].

Zidovudine (ZDV) was the most widely used anti-HIV drug between 1987 and 1995, and, as already reported, transmission of ZDV-resistant viruses occurs. Several mutations of the reverse transcriptase gene have been identified; one of them affects the 215 codon and is associated with a high degree of resistance. We have determined, using selective PCR, the prevalence of transmission of 215 mutant isolates in 134 patients with primary HIV infection (PHI) and have identified 8 patients with 215 mutant virus between 1989 and 1995 in Switzerland. Mutant resistant viruses have been isolated from patients treated with most antiviral drugs. A systematic search for mutant viruses may provide useful information for the adaptation of treatment strategies.

Adolescent↗
PubMed1998

[Insufficient understanding of second tumors after childhood neoplasms in Switzerland].

Second malignancy after childhood neoplasms is a well-known complication. However, frequency differs considerably according to the types of primary neoplasm and the specifics of therapy. Ten patients with a second malignancy after being cured of the primary tumor are described. There were 2 patients with acute lymphoblastic leukemia, one with non-Hodgkin's lymphoma, and one with breast cancer after Hodgkin's disease. Two patients with heritable retinoblastoma developed osteosarcomas in the irradiation field after a latent period of 7 and 14 years respectively. There was another osteosarcoma in a Wilms' tumor survivor. One patient with acute lymphoblastic leukemia developed a secondary AML 10 years after achieving initial remission, and a meningioma was diagnosed in another patient with cured acute lymphoblastic leukemia. One patient died of peritoneal sarcomatosis of unknown origin 20 years after the diagnosis of acute myeloid leukemia. All patients received radiotherapy for the primary neoplasms. Secondary neoplasms in other patients were probably missed because they occurred in adulthood when the patients were transferred to other medical centres. It is impossible to trace these patients because central registration of patients with neoplasms is lacking. It is therefore important to establish a central cancer registry for the whole of Switzerland. Second malignancy after childhood cancer is not a rare event and requires long-term follow-up of patients with neoplasms.

Adolescent↗