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[Diagnosis and treatment of venous thrombosis]. [静脉血栓的诊断和治疗]。
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.002
Andrea Rosemann, Isabell Witzel, Matthias R Meyer, Giuseppe Pichierri, Thomas Rosemann, Oliver Senn
{"title":"[Diagnosis and treatment of venous thrombosis].","authors":"Andrea Rosemann, Isabell Witzel, Matthias R Meyer, Giuseppe Pichierri, Thomas Rosemann, Oliver Senn","doi":"10.23785/PRAXIS.2024.06.002","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>The subject of this guideline from the Institute of Family Medicine at the University of Zurich (IHAMZ) is the management of venous thrombosis. The review summarizes the current evidence and recommendations from international guidelines (1-6). The IHAMZ-guidelines focus on primary care, they also provide guidance on the coordination of general and specialist medical care as well as on the transition between outpatient and hospital care taking into account the special features of the Swiss healthcare system. The guideline is devided in two parts. Part 1 discusses the diagnosis and treatment of deep vein thrombosis (DVT). A validated algorithm is recommended for the diagnostic process, which begins with the assessment of the clinical probability. With the inclusion of the D-dimer test, the need for subsequent imaging diagnostics can be reduced. The differences between the evaluation of an initial and recurrent DVT are shown and the indications and scope of evidence-based environmental diagnostics (thrombophilia and tumor search) are presented. All patients with DVT should receive anticoagulation (AC) for 3-6 months, as there is a high risk of recurrence with AC  3 months. The duration of the subsequent secondary prophylaxis depends on the presumed risk of recurrence on the one hand and the risk of bleeding on the other. Part 2 is dedicated to special thrombosis situations such as shoulder-arm vein thrombosis (SAVT), cancer-associated thrombosis (CAT) and superficial vein thrombosis (SVT). The article on hormone- and pregnancy-associated DVT, developed together with the Department of Gynecology at the University Hospital of Zurich, discusses the importance of hormonal contraception and menopausal hormone replacement therapy (HRT) as a thrombogenic risk factor as well as special features in the diagnosis and treatment of thrombosis in pregnancy.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Can we learn to die?] [我们能学会死亡吗？ ]
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.003
Annina Seiler, Caroline Hertler, Sophia Rose Evstigneev, Markus Schettle, Steffen Eychmüller, Jan Gärtner, Sandra Eckstein, Cristian Camartin, Beat Müller, Mirjam Buschor-Bichsel, Tanja Fusi-Schmidhauser, Christa Hauswirth Siegenthaler, Brigitte Boothe, Simon Peng-Keller, David Blum
{"title":"[Can we learn to die?]","authors":"Annina Seiler, Caroline Hertler, Sophia Rose Evstigneev, Markus Schettle, Steffen Eychmüller, Jan Gärtner, Sandra Eckstein, Cristian Camartin, Beat Müller, Mirjam Buschor-Bichsel, Tanja Fusi-Schmidhauser, Christa Hauswirth Siegenthaler, Brigitte Boothe, Simon Peng-Keller, David Blum","doi":"10.23785/PRAXIS.2024.06.003","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.003","url":null,"abstract":"<p><strong>Introduction: </strong>The topic of death and the dying is a crucial aspect of patient care, especially for individuals with terminal illnesses. However, discussions about death and dying are often avoided during patient interactions. In this article, our aim is to explore the reasons behind our fear of death and dying and to assess the importance of addressing these issues in shaping and cultivating relationships with our patients and in our personal lives. We argue that being open to impermanence is a valuable tool in our work with patients and their families and should be integrated into conversations with them. Furthermore, discussions about death and dying should play a central role in medical and nursing education as well as professional development.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Erythema and flu symptoms of a hunter with pre-existing conditions]. [一名猎人的红斑和流感症状]。
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.006
Pavla Tlapa, Reto Nüesch
{"title":"[Erythema and flu symptoms of a hunter with pre-existing conditions].","authors":"Pavla Tlapa, Reto Nüesch","doi":"10.23785/PRAXIS.2024.06.006","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.006","url":null,"abstract":"<p><strong>Introduction: </strong>A hunter with a history of oncology, flu-like symptoms and ring-shaped erythema was treated with doxycycline in an outpatient setting on suspicion of a tick-borne disease. After obtaining a positive Francisella tularensis serology, antibiotic treatment was continued for a total of 21 days, followed by freedom of symptoms and falling CRP, but without prompt serological follow-up. In contrast to the previously described tularemia cases in Switzerland, the article shows less pronounced local finding without palpable lymphadenopathy.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blutdrucksenkung bei Patienten mit Schlaganfall in der Prähospitalisationsphase nicht wirksam. 中风患者在入院前阶段降压效果不佳。
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.001
Johann Steurer
{"title":"Blutdrucksenkung bei Patienten mit Schlaganfall in der Prähospitalisationsphase nicht wirksam.","authors":"Johann Steurer","doi":"10.23785/PRAXIS.2024.06.001","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.001","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[28-year-old male patient with headaches on the left side and facial pain]. [28岁男性患者，左侧头痛，面部疼痛]。
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.004
Sena Özkaratufan, Julia Velz, Luca Regli, Daniel Kirschenbaum, Diane Möller-Goede, Urs Eriksson
{"title":"[28-year-old male patient with headaches on the left side and facial pain].","authors":"Sena Özkaratufan, Julia Velz, Luca Regli, Daniel Kirschenbaum, Diane Möller-Goede, Urs Eriksson","doi":"10.23785/PRAXIS.2024.06.004","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.004","url":null,"abstract":"<p><strong>Introduction: </strong>A 28-year-old male suffers for two weeks from new-onset very severe headache located on his left temple radiating to his jaw. He also complains about left sided retroorbital pain and chewing aggravated symptoms. In addition, nausea and emesis in the mornings during the past six months were reported. Clinical examination revealed tender swelling over the left temple, but laboratory results showed no signs of inflammation, normal electrolytes, kidney and liver values. A CT-scan revealed a circumscriptive osteolytic lesion in the left os temporale.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Snakebite in Switzerland - a potentially life-threatening event?] [瑞士的蛇咬伤--可能危及生命吗？］
Praxis Pub Date : 2024-07-01 DOI: 10.23785/PRAXIS.2024.06.005
Jonas Micheroli, Markus Schneemann, Thomas Brack
{"title":"[Snakebite in Switzerland - a potentially life-threatening event?]","authors":"Jonas Micheroli, Markus Schneemann, Thomas Brack","doi":"10.23785/PRAXIS.2024.06.005","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>A 39-year-old healthy patient accidentally stepped barefoot on an adder and was then bitten into the foot. After initially only local complaints, severe systemic symptoms developed within 10-15 minutes with swelling of the lips and soft palate, recurrent vomiting, bradycardia, weakly palpable peripheral pulse, hypotension, dyspnea and intermittent somnolence. The potentially life-threatening consequences of this severe poisoning could be avoided by using adequate emergency measures and immediate intravenous administration of antivenin.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[The CARE (CArdiovasculaR prEvention) Score - an instrument for recording the quality of care of cardiovascular risk patients in the GP practice]. [CARE（CArdiovasculaR prEvention）评分--全科医生诊所心血管风险患者护理质量记录工具]。
Praxis Pub Date : 2024-05-01 DOI: 10.23785/PRAXIS.2024.05.001
Thomas Rosemann, Isabella Sudano, Thomas F Lüscher, Oliver Strehle, Oliver Senn
{"title":"[The CARE (CArdiovasculaR prEvention) Score - an instrument for recording the quality of care of cardiovascular risk patients in the GP practice].","authors":"Thomas Rosemann, Isabella Sudano, Thomas F Lüscher, Oliver Strehle, Oliver Senn","doi":"10.23785/PRAXIS.2024.05.001","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.05.001","url":null,"abstract":"<p><strong>Introduction: </strong>There is potential for improvement in the care of cardiovascular diseases in Switzerland, particularly when it comes to achieving target values defined in guidelines. Adherence scores such as the SGED score for diabetic care established in Switzerland can help to reduce the evidence-performance gap. The CARE score presented here is an adherence score that validly reflects the quality of care for patients with a cardiovascular risk using process and outcome indicators.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost Perception of Cardiological Procedures Among -Medical Students and Doctors in Switzerland. 瑞士医学生和医生对心脏病治疗费用的看法。
Praxis Pub Date : 2024-05-01 DOI: 10.23785/PRAXIS.2024.05.003
Alan Müller, Roger Melliger, Patric Biaggi, Luca Oechslin, Christophe Wyss
{"title":"Cost Perception of Cardiological Procedures Among -Medical Students and Doctors in Switzerland.","authors":"Alan Müller, Roger Melliger, Patric Biaggi, Luca Oechslin, Christophe Wyss","doi":"10.23785/PRAXIS.2024.05.003","DOIUrl":"https://doi.org/10.23785/PRAXIS.2024.05.003","url":null,"abstract":"<p><strong>Introduction: </strong>Aims: The aim of the present study was to analyze the cost awareness of cardiological tests and procedures among medical students, residents and doctors in Switzerland and discuss trends in cost perception in health expenditures. Methods: Using an online questionnaire, participants (randomly recruited by mailing lists, messaging app or via direct contact) had to estimate the costs of the 13 predefined cardiological procedures services, diagnostic tests and procedures in Swiss Francs (CHF). Short technical descriptions of the procedures and tests were provided. Estimated costs were considered accurate if they were within ±25 % of the reimbursement rate. Participant groups were defined: medical students, residents, hospital-based physicians and cardiologists in private practice (practitioners). Results: A total of 939 participants (172 physicians and 767 medical students) were enrolled. The overall proportion of medical gestures estimated correctly within ±25% of the reimbursement rate ranged from 10 % (students) to 55 % in practitioners. Residents (26 %) and hospital-based physicians (38 %) performed intermediately. In general, the costs were overestimated. Conclusions: The level of cost knowledge of cardiological tests and procedures among medical students, residents and doctors in Switzerland is modest. In general, the costs were overestimated. Increasing experience seems to sharpen the accuracy of cost estimation. Overestimation of costs is potentially problematic: Either in systems of governmental defined global budget or systems with substantial out-of-pocket costs for patients, overestimated costs will result in more restrictive ordering than it would be appropriate and affordable for the individual patient.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Hyperinflammatory immune response syndrome PIMS-TS]. [高炎症免疫反应综合征 PIMS-TS]。
Praxis Pub Date : 2024-05-01 DOI: 10.23785/PRAXIS.2024.05.006
Magdalena Müller-Groen, Gian Flury
{"title":"[Hyperinflammatory immune response syndrome PIMS-TS].","authors":"Magdalena Müller-Groen, Gian Flury","doi":"10.23785/PRAXIS.2024.05.006","DOIUrl":"10.23785/PRAXIS.2024.05.006","url":null,"abstract":"<p><strong>Introduction: </strong>PIMS-TS is a rare hyperinflammatory immune response syndrome, usually occurring two to six weeks after SARS-CoV-2 infection, which mainly affects schoolchildren and is often associated with the need for intensive care (2). The most common clinical signs are high fever, gastrointestinal symptoms such as abdominal pain, vomiting and diarrhea, cardiovascular dysfunction (impaired LVEF, hypotension, shock) and neurological symptoms such as headache and encephalopathy (1, 2, 4). The definition criteria include various clinical and laboratory parameters, which vary slightly depending on the authors (4, 6, 7). With intensive care treatment with circulatory support and administration of methylprednisolone, mortality and long-term consequences remain low.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A fish-intoxication as a rare cause of chest pain]. [鱼类中毒是胸痛的罕见原因]。
Praxis Pub Date : 2024-05-01 DOI: 10.23785/PRAXIS.2024.05.004
Giulio Brignoli, Raphael Herzog, Michael Studhalter
{"title":"[A fish-intoxication as a rare cause of chest pain].","authors":"Giulio Brignoli, Raphael Herzog, Michael Studhalter","doi":"10.23785/PRAXIS.2024.05.004","DOIUrl":"10.23785/PRAXIS.2024.05.004","url":null,"abstract":"<p><strong>Introduction: </strong>We describe the case of a 58-year-old patient who developed chest pain and an anaphylaktoide reaction after ingestion of contamined fish containing histamin. Histamin intoxication from food poisoning (also known as scombroid intoxication) can be mistaken for an anaphylactic reaction and occasionaly lead to cardiac symptoms, even in patients without atherosclerotic changes. This condition is called Kounis syndrom and has to be recognized as a separate syndrom with specific clinical features.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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