Swiss medical weekly最新文献

{"title":"Conference report: Trends, new technologies and implications for dementia diagnostics, treatment and care in Switzerland.","authors":"Julius Popp, Reto W Kressig, Mélanie Bieler-Aeschlimann, Miriam Rabl, Marcello Ienca, Andreas U Monsch, Hans Pihan, Stefan Klöppel, Tatjana Meyer-Heim, Stefanie Becker","doi":"10.57187/s.4017","DOIUrl":"https://doi.org/10.57187/s.4017","url":null,"abstract":"<p><p>Dementia diseases represent a major burden for the directly affected people, their relatives and modern society. Despite considerable efforts in recent years, early and accurate disease diagnosis and monitoring is still a challenge while no cure is available in most cases. New drugs, in particular disease-modifying therapies, and recent technological advancements offer promising perspectives. The integration of novel biomarkers, artificial intelligence and digital health tools has the potential to transform dementia care, making it more personalised, efficient and adapted to the living conditions and needs of older people. In November 2023, the 7th Dementia Summit convened a panel of experts from geriatrics, neurology, neuropsychology, psychiatry, ethics as well as general medicine to discuss interdisciplinary challenges, advancements and their implications for the future of dementia care in Switzerland. The conference underscored the importance of a multidisciplinary approach to successfully integrate new technologies in both clinical-translational research and dementia prevention, diagnosis and care. While recent innovations represent major steps forward, their implementation also comes with important challenges including questions on healthcare system preparedness and adaptation, ethical aspects, technology literacy, acceptance and appropriate use.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4017"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between surgeon case load and revision rates in total hip arthroplasty: Evidence from the Swiss National Joint Registry.","authors":"Andreas Ladurner, Karlmeinrad Giesinger, Bernhard Jost, Vilijam Zdravkovic","doi":"10.57187/s.3850","DOIUrl":"https://doi.org/10.57187/s.3850","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study aims: &lt;/strong&gt;Higher surgeon volume has been correlated with improved therapy outcomes following total hip arthroplasty, and many countries have implemented minimum volume standards as a precondition for claiming reimbursement. However, there are large differences between healthcare systems worldwide and the applicability of international studies to a particular local healthcare environment may be limited. The aim of this study was to assess the relationship between surgeon case load (= number of procedures per year) and short-term revision rates (within two years of the index procedure) in patients undergoing primary total hip arthroplasty for hip osteoarthritis in a nationwide, registry-based study. In addition, the effects of increasing minimum volume standard thresholds on the potential reduction of the revision burden was simulated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All patients registered in the Swiss National Joint Registry (SIRIS) for undergoing primary total hip arthroplasty for hip osteoarthritis between 2015 and 2021 were considered. Patients were aggregated according to the lead surgeon's individual code. Surgeons lacking five years of uninterrupted practice were excluded. Multiple logistic and bivariate multinomial regressions were employed to model the odds of revision surgery (overall and for specific diagnoses) as a function of surgeon case load. Two-year revision rates, the proportional reduction of the revision burden and the number of patients hypothetically needing treatment reassignment to higher-volume surgeons were simulated for increasing minimum volume standard thresholds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 74,565 total hip arthroplasty procedures performed by 384 surgeons were assessed. The mean surgeon case load was 28.7 total hip arthroplasties / year (min/max: 1.8/269.1; median: 18.1). The average overall 2-year revision rate in the observation period was 2.25%. A higher surgeon case load was associated with lower cumulative revision rates (revision for any reason, and revision due to infection, dislocation and femoral periprosthetic fracture). Overall revision rates of surgeons with a minimal case load of up to 10 / 20 / 50 total hip arthroplasties / year were 2.18% / 2.01 % / 1.70%, respectively. Implementation of a minimum volume standard of 10 / 20 / 50 total hip arthroplasties / year would reduce the overall 2-year revision rates by 3.2%, 10.5% and 23.8%, respectively, but also require that 5.1%, 18.1% and 53.8% of patients be reassigned to higher-volume surgeons instead of initially intended lower volume surgeons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A higher surgeon case load independently predicts a lower overall 2-year revision rate in patients undergoing primary total hip arthroplasty for hip osteoarthritis in Switzerland. Implementation of a minimal case load has the potential to significantly reduce 2-year revision rates, at the cost of more patients needing to have their treatment rea","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3850"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equitable health care in the context of migration.","authors":"Anne Jachmann, Julia Brandenberger, Matthis Schick","doi":"10.57187/s.4245","DOIUrl":"https://doi.org/10.57187/s.4245","url":null,"abstract":"<p><p>The health policy guiding principle of equitable access to healthcare faces barriers in the context of migration, on the part of both those affected and the health system. The operationalised measurement of health inequity, the training and sensitisation of healthcare professionals regarding needs-based care, diversity, transcultural and socio-medical aspects, and ensuring high-quality communication are among the measures that can contribute to reducing inequitable care (e.g. underuse) in this population.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4245"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health of informal caregivers during the COVID-19 pandemic: a Swiss cohort study.","authors":"Cédric Follonier, Nick Pullen, Hélène Baysson, María-Eugenia Zaballa, Francesco Pennacchio, Stephanie Schrempft, Sara Levati, Mayssam Nehme, Idris Guessous, Silvia Stringhini, Elsa Lorthe","doi":"10.57187/s.3884","DOIUrl":"https://doi.org/10.57187/s.3884","url":null,"abstract":"<p><strong>Aims of the study: </strong>The COVID-19 pandemic and related public health measures have disrupted healthcare systems and may have impacted informal caregivers' mental health due to increased responsibilities and limited access to support services. This study aimed to examine the prevalence of mental distress among caregivers and non-caregivers and identify risk and protective factors for mental distress in caregivers during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data were collected from participants in Specchio-COVID19, a population-based cohort in Geneva, Switzerland. Mental distress was measured using the 12-item General Health Questionnaire (GHQ-12) in June 2021. The prevalence of distress was compared between caregivers and non-caregivers. Risk and protective factors for mental distress among caregivers were explored using logistic regressions.</p><p><strong>Results: </strong>Among the 5416 participants, 1086 (20%) reported helping someone in a non-professional manner with activities of daily life and were considered caregivers. Mental distress was more frequent in caregivers than in non-caregivers (41% vs 37%, p = 0.010). In caregivers, limited social support (adjusted odds ratio [aOR] = 1.25 [95% confidence interval: 1.10, 1.42]), caring for an individual with a mental condition (aOR = 1.21 [1.05, 1.41]), living over 10 km away from the care recipient (aOR = 1.17 [1.02, 1.34]), feeling more isolated in one's caregiving role (aOR = 1.20 [1.08, 1.32]), worrying about caregiving ability in case of COVID-19 or quarantine (aOR = 1.18 [1.08, 1.28]) and experiencing reduced availability of healthcare professionals (aOR = 1.11 [1.02, 1.22]) were associated with increased odds of mental distress.</p><p><strong>Conclusion: </strong>Informal caregivers experienced higher levels of mental distress than non-caregivers during the COVID-19 pandemic. This study highlights the need for public health policies that enhance both formal and informal support networks and include rapidly implementable solutions for caregiving continuity, benefiting both caregivers and their care recipients.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3884"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swiss Stroke Society position paper on atrial fibrillation monitoring and management after ischaemic stroke: a shift from understanding the index stroke to preventing the next one.","authors":"Thomas Meinel, Markus Arnold, Laurent Roten, Philipp Krisai, Marie-Luise Mono, Catherine Gebhard, Leo Bonati, Timo Kahles, Urs Fischer, Marcel Arnold, Mira Katan","doi":"10.57187/s.4170","DOIUrl":"10.57187/s.4170","url":null,"abstract":"<p><p>This position paper on the detection of atrial fibrillation after ischaemic stroke is a statement of the \"Heart and Brain\" committee of the Swiss Stroke Society. This position paper summarises present knowledge on the detection of atrial fibrillation after ischaemic stroke or transient ischaemic attack. An interdisciplinary standard for monitoring on the stroke unit and after discharge is proposed respecting recent developments and Swiss particularities. The main evolution in the field is that the role of atrial fibrillation screening after stroke or transient ischaemic attack has shifted from understanding the index stroke to preventing the next stroke; it therefore should also be performed in patients with certain other stroke aetiologies, e.g. symptomatic carotid artery stenosis. The duration of atrial fibrillation monitoring should be based on an individualised risk assessment incorporating clinical characteristics as well as cardiac and laboratory biomarkers. Given the paucity of randomised controlled data on this topic, this position paper intends to give practical advice to healthcare professionals involved in stroke care in Switzerland based on a consensus between experts in the field.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4170"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of the United Kingdom's and Switzerland's healthcare financing systems for achieving equity and efficiency goals.","authors":"Ata Mohajer-Bastami, Sarah Moin, Benedict Sweetman, Ahmed R Ahmed, Marion Head, Edgar Gelber, Suhaib J S Ahmad, Aristomenis K Exadaktylos","doi":"10.57187/s.4101","DOIUrl":"https://doi.org/10.57187/s.4101","url":null,"abstract":"<p><p>Healthcare financing systems in the United Kingdom and Switzerland were compared with a focus on efficiency and equity. The United Kingdom's National Health Service employs the Beveridge model. It is predominantly funded through taxation and aims to provide free healthcare at the point of use. Switzerland's healthcare financing system is based on the Bismarck model. This social health insurance model is structured around compulsory health plans for all residents.</p><p><strong>Methods: </strong> Healthcare financing systems were compared using World Health Organization reports, national health statistics and peer-reviewed literature. Efficiency was evaluated using metrics including cost-effectiveness ratios and healthcare outcomes. Equity was assessed by examining disparities in access to healthcare and socioeconomic health outcomes.</p><p><strong>Results: </strong> The National Health Service excels at administrative efficiency and providing equitable access to care. It faces challenges such as geographical disparities in service availability and perceptions of underfunding. Switzerland spends comparatively more on healthcare but delivers superior health outcomes. Issues arise with providing equitable care to all citizens, particularly affecting low-income and undocumented populations.</p><p><strong>Conclusion: </strong>The National Health Service is a leader in providing equitable healthcare but must address falling health outcomes while working within financial constraints. Switzerland demonstrates excellent healthcare outcomes and patient satisfaction but requires measures to ensure equitable service delivery. Ongoing policy adjustments are necessary to balance equity and efficiency while meeting meet new healthcare demands.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4101"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age at diagnosis of paediatric unilateral and bilateral permanent hearing loss in Eastern Switzerland: a retrospective cohort study.","authors":"Samuel P Hofmann, Sandro J Stoeckli, Jochen Rosenfeld","doi":"10.57187/s.4014","DOIUrl":"https://doi.org/10.57187/s.4014","url":null,"abstract":"<p><strong>Study aim: </strong>Undiagnosed and therefore untreated permanent paediatric hearing loss can have a detrimental impact on a child's speech, language, social and educational development, and quality of life. Therefore, early diagnosis is required for successful treatment with hearing aids to minimise the negative impact of hearing loss. Newborn hearing screening programmes may have decreased the average age at diagnosis of hearing loss worldwide, but outcomes vary widely between countries. In this study, we therefore aimed to assess the median age of children at diagnosis of permanent unilateral and bilateral hearing loss in Eastern Switzerland.</p><p><strong>Methods: </strong>In this retrospective cohort study, children born in Eastern Switzerland with permanent hearing loss diagnosed at the Division of Paediatric Audiology at the Cantonal Hospital of St Gallen (the tertiary referral centre for Eastern Switzerland) were included. The study period was from 1 January 2014 to 31 December 2019. The primary endpoint was age at diagnosis of permanent unilateral or bilateral hearing loss. Descriptive data collected were the type and WHO grade of hearing loss, the status of newborn hearing screening and other information such as path of referral and place of residence.</p><p><strong>Results: </strong>In total, 107 children with permanent hearing loss were included in this study. Overall, the median age at diagnosis was 45.0 months (interquartile range [IQR] 5.7-74.8). The median age at diagnosis for children with bilateral hearing loss was 25.8 months (IQR 3.6-70.5), compared to 63.1 months (IQR 11.4-88.5) for children with unilateral hearing loss. For children with bilateral hearing loss, the median age at diagnosis was lower with higher WHO grades of hearing loss: 65.6 months (IQR 11.1-131.6) for grade I vs 4.5 months (IQR 2.2-6.0) for grade IV. Children with bilateral hearing loss and a documented failed newborn hearing screen were diagnosed early: median age at diagnosis 4.0 months (IQR 2.2-12.3).</p><p><strong>Conclusion: </strong>In conclusion, the age at diagnosis of paediatric permanent hearing loss in our study is variable and, in some cases, late. This applies particularly to bilateral hearing loss that should have been diagnosed by the newborn hearing screen in congenital cases and unilateral hearing loss.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4014"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical comment on: Nehme M, et al. Chatbots in medicine: certification process and applied use case.","authors":"Hannah Van Kolfschooten","doi":"10.57187/s.4359","DOIUrl":"https://doi.org/10.57187/s.4359","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4359"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evinacumab for the treatment of homozygous familial hypercholesterolaemia: first patient case report in Switzerland.","authors":"Noé Corpataux, Fabienne Aregger, Konstantinos C Koskinas, Catherine Gebhard","doi":"10.57187/s.4024","DOIUrl":"https://doi.org/10.57187/s.4024","url":null,"abstract":"<p><p>We present the first case in Switzerland of a patient with homozygous familial hypercholesterolaemia treated with evinacumab, a new recombinant human monoclonal antibody currently approved in Europe and in the USA but not yet in Switzerland. Homozygous familial hypercholesterolaemia is a rare genetic disorder that causes severely elevated levels of low-density lipoprotein (LDL) cholesterol and early atherosclerotic cardiovascular disease, which, if left untreated, can lead to premature death. As a result of this newly introduced treatment, the patient's LDL cholesterol levels were reduced by more than half, achieving recommended target values of secondary prevention for the first time. This case underscores the efficacy of evinacumab in achieving LDL cholesterol targets in homozygous familial hypercholesterolaemia patients and highlights the importance of early identification and treatment initiation.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4024"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Menière's disease with rimegepant.","authors":"Stefan C A Hegemann, Angela Schell","doi":"10.57187/s.4147","DOIUrl":"https://doi.org/10.57187/s.4147","url":null,"abstract":"<p><p>A recent hypothesis states that Menière's disease is caused by inappropriate expression, i.e. enhanced release of the neurotransmitter calcitonin gene-related peptide. Here, we tested this hypothesis by administering rimegepant, a new calcitonin gene-related peptide antagonist approved for the acute treatment of migraine and for the prevention of episodic migraine, to six patients with both Menière's disease and migraine. Two patients received the first dose of 75 mg rimegepant to treat an acute attack of Menière's disease. One of these two plus the remaining four patients were treated with 75 mg rimegepant every other day for secondary prevention. One patient developed an allergic reaction after the first administration and was excluded from further treatment. In the two patients treated during acute Menière's disease, symptoms were relieved and resolved about 30 min earlier than migraine symptoms. While all five patients had reduced migraine, all completely resolved Menière's symptoms on preventive therapy with rimegepant for up to eight months. These results support the idea that calcitonin gene-related peptide is linked to the pathogenesis of Menière's disease and suggest that inhibition of calcitonin gene-related peptide signalling may represent a promising therapeutic option for Menière's disease patients.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4147"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}