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At least 19 recordsLinked to original sources
PubMed1999

[Changes in mortality in Switzerland since 1950. II. Regional differences within Switzerland].

OBJECTIVES: To examine regional variations in all-cause mortality in Switzerland around 1990 and trends since 1950. Special emphasis is placed on unfavourable aspects that have been identified by comparisons with international trends. DATA AND METHODS: Descriptive analysis of Swiss mortality statistics taken from individual records (1969-94) and data published by the Swiss Federal Statistical Office (1949-68). RESULTS: Swiss citizens aged between 15 and 79 years often show mortality ratios of 1.5 and more between the best and the worst of the 106 regions of Switzerland. In subjects aged under 50 years, relative risk ranges are even larger. However, the regional mortality patterns before and after 50 rarely correspond. Generally, the relative risk difference between the best and the worst regions has not diminished since 1950, whereas the geographical patterns have completely changed. Instead of an obvious rural-urban gradient in 1950, mortality rates are now highest in the largest cities and, at least in men, are at their lowest in the wealthy suburbs. On a larger scale (division into 9 geographical units), central Switzerland has changed significantly from clearly elevated mortality rates in 1950 into a decidedly favourable position in 1990. A contrast between German and French Switzerland has existed for many decades: in the younger and middle age groups the francophone part of Switzerland has a higher mortality rate than the German-speaking part, whereas at ages over 70 French Switzerland has lower rates than German Switzerland. In some urban areas of Switzerland, the turning-point from a decreasing to an increasing trend in the mortality risks of subjects aged 15-49 years was reached around 1960, occasionally resulting in age-specific rates being higher in 1990 than in 1950. This unfavourable partial trend has spread over most, but not all, of Switzerland since 1970. Even in subjects aged 25-34 years, the age group for which Switzerland has the worst relative position on an international scale, some parts of the country do not have elevated all-cause mortality rates, whereas for men in the largest cities mortality risks are more than three times as high as in Japan. The deaths from "external" causes (mainly accidents and suicide) show marked geographical patterns within Switzerland; however, in all parts of the country, deaths from this group are much more frequent than, for example, in Italy or the Netherlands. CONCLUSION: Geographical differences in mortality risks within Switzerland, as well as international disparities, suggest that there is a need for preventive measures in Switzerland, first and foremost concerning males aged 15-49 years and deaths from "external" causes.

Adolescent↗
PubMed1992

[Growing-up of children from HIV-positive mothers in Switzerland. Pediatric AIDS-Group Switzerland].

OBJECTIVE: The social situation (placements, material conditions, needs) of children of HIV-infected mothers living in Switzerland was studied and their future needs were estimated. METHOD: Data were gathered by anonymous questionnaires mailed to the primary care physicians of the children of HIV-infected mothers registered in the Swiss Neonatal HIV Study. The physicians handed a copy to the parents or guardians. RESULTS: The social situation could be adequately evaluated for 84 children. With respect to the proportion of mothers with a history of intravenous drug use (75%) or of foreign origin (19%), the children did not differ significantly from the whole population represented in the Swiss Neonatal HIV Study. Of a total of 3154 months, the children spent 75% with their natural mother, 14% with other family members, 6% in a foster family, 3% in a foster home and 2% with adoptive parents. At the time of the study 32 children (38%) could not be cared for by their own mother. The cumulative probability (by the Kaplan-Meier method) of continuing care by the mother was estimated at 78%, 70%, 60% and 50% for an age of 12, 24, 36 and 48 months respectively. Maternal reasons for placement in foster care were: enrollment in an institutional drug withdrawal program (11), neglect (8), death (8) or illness (5). The following ways of improving social conditions were identified: social acceptance without discrimination, early planning of the future care of children in anticipation of the imminent disruption of the family, financial support, assistance in baby sitting and support groups for parents and guardians. CONCLUSION: A minimum annual requirement of 25 new foster care places for children of HIV-infected mothers can be estimated--assuming a stable annual incidence of some 50 deliveries of seropositive women in Switzerland. For primary care physicians it is a major challenge to stay sufficiently informed about the ever changing social situation in order to identify the often wide variety of assistance needed by the family. The quality and coordination of medical and psychosocial care for families confronted with HIV infection definitely needs improvement, especially outside metropolitan areas.

Adoption↗
PubMed1996

[Surgery of inguinal hernia in Switzerland in 1994. A survey of 142 teaching clinics in Switzerland].

With a response rate of 60.6% to a questionnaire sent out in 1994 it is possible to give an overview of the situation in hernia surgery at the 142 surgical clinics of Switzerland. In general, regional anesthesia is the preferred method (67.4%). Together, Shouldice repair and fascia transversalis repair cover over 90% of the repair techniques in primary hernias. In recurrent hernias the same techniques dominate (70.2%) a large spectrum of different operation methods; implantation of foreign materials is rare (5.9%). Only 4.5% of all Swiss surgical clinics have some experience with endoscopic hernia surgery.

Endoscopy↗
PubMed1986

[The relatively frequent incidence of severe sulfonylurea-induced hypoglycemia in the last 25 years in Switzerland. Results of 2 surveys in Switzerland in 1969 and 1984].

In 1969 and 1984 all emergency wards in Switzerland were asked to report on the incidence of severe episodes of hypoglycemia (HE) during treatment with sulfonylureas. Each of the two surveys referred to a ten-year period (period A 1960-1969, period B 1975-1984). The number of HE reported was 78 for period A and 116 for period B. The number of diabetics treated with sulfonylurea preparations was established on the basis of tablet consumption, which amounted to 35,000 in period A and 47,500 in period B. The incidence of hypoglycemia in each period was comparable (period A 0.22, and period B 0.24 per 1000 patient years), but differed with regard to the sulfonylurea preparations used. In period A hypoglycemic episodes occurred more frequently under chlorpropamide than under tolbutamide and carbutamide. In period B the incidence of episodes under chlorpropamide and glibenclamide was comparable, but was significantly higher than under tolbutamide and glibornuride. The risk of hypoglycemia occurring is thus significantly higher under glibenclamide and chlorpropamide than under glibornuride and tolbutamide. 6.5% of HE were fatal in period A, compared with 4.3% in period B. Advanced age proved to be a risk factor in HE: 77% of patients with HE were over 69 years of age, whereas only 50% of all diabetics treated with sulfonylurea preparations were in this age group. Further risk factors were impaired renal function (21%) and possible drug interactions (27%). There was less likelihood of recurrence of a hypoglycemic episode in period B than in period A.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗