Swiss medical weekly最新文献

{"title":"Sociodemographic and regional differences in neonatal and infant mortality in Switzerland in 2011-2018: the Swiss National Cohort.","authors":"Veronika W Skrivankova, Leonie D Schreck, Claudia Berlin, Radoslaw Panczak, Kaspar Staub, Marcel Zwahlen, Sven M Schulzke, Matthias Egger, Claudia E Kuehni","doi":"10.57187/s.3682","DOIUrl":"https://doi.org/10.57187/s.3682","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study.</p><p><strong>Methods: </strong>We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings.</p><p><strong>Results: </strong>Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64-0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51-0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40-1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21-1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00-1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95-1.61 for compulsory vs tertiary education).</p><p><strong>Conclusion: </strong>We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, l","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3682"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011860","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":"Estimating the burden of disease attributable to non-assisted suicide in Switzerland from 2009 to 2021: a secondary data analysis.","authors":"Annora Mack, Sarah Rajkumar, Jacob Kofler, Kaspar Wyss","doi":"10.57187/s.3522","DOIUrl":"https://doi.org/10.57187/s.3522","url":null,"abstract":"<p><strong>Context and goal: </strong>This research addresses the issue of suicide and attempted suicide, which have a significant impact on global premature mortality and disability. Particularly noteworthy is the prevalence among adolescents, in whom suicide ranks among the top four causes of death according to the World Health Organization (WHO). In Switzerland, suicide has remained the leading cause of death in individuals under 50 since 1990. At the same time, the burden of attempted suicides remains poorly understood. Although the legality of assisted suicide in Switzerland influences the overall suicide data, this analysis focuses solely on non-assisted suicides, as they are relevant for accurately assessing the burden of disease of suicide and attempted suicide. Amid challenges posed by limited reporting infrastructure, this analysis aims to contribute to the existing literature by investigating the cumulative impact of non-assisted suicide and attempted suicide on the population living in Switzerland.</p><p><strong>Methodology: </strong>Pre-existing data from 2009 to 2021 were collected and analysed, drawing from a variety of sources including official health records from the federal offices of statistics and public health, surveys and retrospective studies. From this data, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life-years (DALYs) were calculated in order to estimate the burden of disease. Sensitivity analyses were conducted to determine the robustness of the data and the effect of variables (suicide attempt incidence, sex distribution, disability weight, average duration) on the DALYs.</p><p><strong>Results: </strong>The analysis of the data spanning from 2009 to 2021 revealed a decrease in suicide. The present study determined that, in 2021, 32,771 DALYs were attributable to non-assisted suicide and attempted suicide and 6.4% of all years of life lost (n = 30,516) were attributable to suicide, not including assisted suicide. Using a reference incidence of 33,000 attempted suicides per year in Switzerland, the morbidity associated with attempted suicides was 2255 YLDs (range: 552-6557 YLDs). Further analysis of the data highlighted a stark sex gap in the prevalence of non-assisted suicide: male suicides account for around 2% of all male deaths, whereas female suicides account for approximately 0.8% of all female deaths. Sensitivity analyses found that incidence and sex distribution of attempted suicide were the most impactful factors, while disability weights and average duration of disability had little impact on the variation in YLD estimates.</p><p><strong>Conclusion: </strong>In conclusion, this study provides a detailed analysis of the burden of non-assisted suicide and attempted suicide in Switzerland. With non-assisted suicide accounting for 6.4% of all years of life lost and 30% of deaths in people aged 20-24 in Switzerland in 2021, it emerges that suicide contributes significantly ","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3522"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011885","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":"Supplementum 284: Abstracts of the 56th Annual meeting of the Swiss Society of Nephrology (Basel, Switzerland, December 5−6, 2024).","authors":"Swiss Society Of Nephrology","doi":"10.57187/s.4290","DOIUrl":"10.57187/s.4290","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4290"},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693147","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":"Safety of oral immunotherapy for cashew nut and peanut allergy in children - a retrospective single-centre study.","authors":"Maria Breiding, Maarja Soomann, Michèle Roth, Johannes Trück, Felicitas Bellutti Enders","doi":"10.57187/s.3691","DOIUrl":"https://doi.org/10.57187/s.3691","url":null,"abstract":"<p><strong>Aim of the study: </strong>Oral immunotherapy (OIT) is increasingly used for the treatment of childhood food allergies, with limited data available on cashew nut OIT. This real-life study investigated the safety and feasibility of cashew nut OIT, comparing it with peanut OIT, with a focus on the up-dosing process.</p><p><strong>Methods: </strong>We analysed cashew nut (n = 24) and peanut (n = 38) OIT cases with treatment initiated between 2018 and 2022 at the University Children's Hospital Basel. All patients who commenced therapy within this time frame were enrolled without prior selection. Two different starting protocols were used. Within the up-dosing protocol, the nut intake was incrementally increased by 20-30% every 2 weeks until reaching a maintenance dose of 1 g of nut protein. After consuming the maintenance dose regularly for 18-24 months, a second oral food challenge was performed. Patients who passed this challenge were considered desensitised. The safety of the therapy was evaluated based on the severity of adverse reactions during the up-dosing phase. Symptom severity was evaluated using the validated ordinal food allergy severity scale (o-FASS-5).</p><p><strong>Results: </strong>Over the study period, 33% of cashew nut-allergic and 63% of peanut-allergic patients experienced mild to moderate allergic reactions. Severe allergic reactions occurred in five peanut-allergic children with high baseline allergen-specific IgE levels. Six patients with peanut, and none with cashew nut OIT, discontinued the therapy due to adverse reactions. The mean duration to reach the maintenance phase was longer for children with asthma or another food allergy. Among children who already underwent the second oral food challenge, desensitisation was achieved in 91% (11 out of 12) of cashew nut- and 73% (11 out of 15) of peanut-allergic patients.</p><p><strong>Conclusion: </strong>Cashew nut OIT had a low severity of adverse reactions and was generally well-tolerated. However, patient characteristics influenced side effect risk and treatment duration, emphasising the need for individualised OIT strategies.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3691"},"PeriodicalIF":2.1,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688856","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":"Cardiac amyloidosis.","authors":"Natallia Laptseva, Dominik C Benz, Rahel Schwotzer, Andreas J Flammer","doi":"10.57187/s.4186","DOIUrl":"https://doi.org/10.57187/s.4186","url":null,"abstract":"<p><p>Cardiac amyloidosis is a disease characterised by the accumulation of amyloid protein in the heart tissue. There are several types of amyloidosis, but the most common types affecting the heart are ATTR amyloidosis (caused by transthyretin protein) and AL amyloidosis (caused by abnormal immunoglobulin light chains). Cardiac amyloidosis causes typical signs and symptoms of heart failure. Diagnosis involves a combination of imaging tests such as echocardiography and cardiac magnetic resonance imaging, as well as nuclear imaging scans and tissue biopsies to confirm the presence of amyloid deposits in the heart. Treatment of cardiac amyloidosis depends on the type and severity of the disease and includes medications to manage symptoms as well as treatments targeting the underlying cause of amyloidosis. Importantly, cardiac amyloidosis is a serious condition requiring specialised care from a multidisciplinary team including cardiologists and haematologists as well as other specialists familiar with the management of this rare disease. This is crucial, as early diagnosis and treatment are important for improving outcomes.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4186"},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688846","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":"Blood pressure control and antihypertensive treatment in Swiss general practice: a cross-sectional study using routine data.","authors":"Stefania Di Gangi, Roman Brenner, Thomas Grischott, Jakob Martin Burgstaller, Oliver Senn, Thomas Rosemann, Stefan Markun","doi":"10.57187/s.3898","DOIUrl":"https://doi.org/10.57187/s.3898","url":null,"abstract":"<p><strong>Aims of the study: </strong>Arterial hypertension is a major global health risk. Global surveys indicate that only half of patients with arterial hypertension receive pharmacotherapy, and only a quarter achieve the primary blood pressure target recommended by guidelines. This study aimed to evaluate the achievement of the primary blood pressure target in Swiss general practice, provide insights into arterial hypertension treatment, and identify factors associated with achieving this goal.</p><p><strong>Methods: </strong>This cross-sectional study utilised data from a large Swiss primary care database. Patients with arterial hypertension, aged ≥18 years, who underwent blood pressure monitoring in 2021 were included. The primary observation was blood pressure control, defined as the achievement of the primary blood pressure target of systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg. Demographic data from physicians and patients, blood pressure measurements, comorbidities, cardiovascular risk factors, and pharmacotherapy were collected, and arterial hypertension stages were calculated. Unadjusted and multivariable-adjusted mixed logistic regression models were used to identify factors associated with blood pressure control.</p><p><strong>Results: </strong>A total of 49,290 patients were included, of whom 23,933 (48.6%) were female. The median patient age was 71 years (interquartile range 61-80). Blood pressure control was observed in 23,022 patients (46.7%), and 36,692 patients (74.4%) had an antihypertensive pharmacotherapy prescription. In multivariable analysis, blood pressure control was positively associated with arterial hypertension stage, antihypertensive pharmacotherapy, the intensity of blood pressure monitoring, and the number of blood pressure-increasing drugs, but negatively associated with a long-standing arterial hypertension, female sex, and old age.</p><p><strong>Conclusions: </strong>While general practitioners appear to consider arterial hypertension stages in their treatment strategies, there is still room for improvement in arterial hypertension care by prescribing pharmacotherapy, especially in patients with long-standing arterial hypertension, female sex and old age.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3898"},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688842","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":"Exploring the real-world management of catheter-associated urinary tract infections by Swiss general practitioners and urologists: insights from an online survey.","authors":"Iris Zünti, Emilio Arbelaez, Sarah Tschudin-Sutter, Andreas Zeller, Florian S Halbeisen, Hans-Helge Seifert, Kathrin Bausch","doi":"10.57187/s.3933","DOIUrl":"https://doi.org/10.57187/s.3933","url":null,"abstract":"<p><strong>Aim: </strong>To assess and compare the real-world management of catheters and catheter-associated urinary tract infections (CAUTI) among Swiss general practitioners and urologists, encompassing diagnosis, treatment and prophylaxis.</p><p><strong>Methods: </strong>An anonymised online questionnaire was distributed among Swiss general practitioners and urologists between January and October 2023 via the networks of Sentinella and the Swiss Association of Urology. The questionnaire consisted of questions on catheter management, including diagnosis, treatment and prophylaxis of CAUTI. Analysis was performed by discipline. Fisher's exact test was applied for comparisons (statistical significance with p <0.05).</p><p><strong>Results: </strong>Out of 175 participating physicians, the majority were involved in catheter management. Urologists exhibited significantly higher levels of competence as compared to general practitioners (67.1% vs 20.9%). Although no significant differences were observed regarding diagnostic approaches between disciplines, unrecommended diagnostic methods were frequently applied. general practitioners reported that they treated non-febrile CAUTI for longer durations, while urologists indicated that they treated febrile CAUTI longer. Additionally, the use of fluoroquinolones was more prevalent among general practitioners compared to urologists, while prophylactic measures were more frequently applied by urologists.</p><p><strong>Conclusions: </strong>Catheter and CAUTI management entail significant uncertainty for general practitioners. CAUTI management varied notably between general practitioners and urologists in terms of treatment and prophylaxis. The use of non-recommended diagnostic approaches and drugs was common. This trend, along with inappropriate diagnostic methods and prophylaxis, may increase antimicrobial resistance and CAUTI morbidity. The study emphasises the necessity for diagnostic and antimicrobial stewardship interventions, and proper training in CAUTI management for general practitioners and urologists.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3933"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628745","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":"Prediction of electroconvulsive therapy response and remission in late-life depression: a review.","authors":"Beatriz Pozuelo Moyano, Kevin Swierkosz Lenart, Joëlle Rosselet Amoussou, Armin Von Gunten, Jean-Pierre Schuster","doi":"10.57187/s.3684","DOIUrl":"https://doi.org/10.57187/s.3684","url":null,"abstract":"<p><p>Electroconvulsive therapy is an effective and well-tolerated antidepressant treatment for the elderly population. The place of electroconvulsive therapy in the treatment sequence for depression in the elderly is currently not well established. This review aims to identify the factors that contribute to a positive response and remission in elderly patients with depression undergoing electroconvulsive therapy treatment. We searched five bibliographic databases (Medline ALL Ovid, Embase.com, APA PsycInfo Ovid, Cochrane Library Wiley and Web of Science Core Collection) for articles published between 1995 and June 2023. Of the 2149 articles screened, 19 were included in the review. No significant associations were found between remission and/or response and salivary cortisol, baseline hippocampal and white matter hyperintensities, total amyloid load or global cortical atrophy. The reviewed articles did not show a significant difference in remission between unilateral and bilateral electroconvulsive therapy treatment. Other interesting findings are that moderately elevated levels of CRP and S100B levels, lower retardation scores, poorer performance on the word reading task at baseline and longer post-ictal reorientation time may be associated with higher remission and/or response rates. Medial temporal atrophy can be associated with lower Montgomery-Åsberg Depression Rating Scale (MADRS) decrease after electroconvulsive therapy. Finally, elderly patients had higher rates of electroconvulsive therapy response; retardation and psychotic features may mediate this association. Incorporation of this data into clinical practice may facilitate a personalised approach to electroconvulsive therapy. However, research on this topic is scarce and there are few studies that focus specifically on older people.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3684"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606499","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":"E-cigarettes, synthetic nicotine, heated-tobacco and smokeless nicotine delivery products: the nicotine landscape beyond combustible cigarettes.","authors":"Evangelia Liakoni, Samuel E Christen, Neal L Benowitz","doi":"10.57187/s.3583","DOIUrl":"https://doi.org/10.57187/s.3583","url":null,"abstract":"<p><p>Cigarette smoking remains an enormous public health problem causing millions of preventable deaths annually worldwide. Although safe and efficient smoking cessation pharmacotherapies such as nicotine replacement products and the medications varenicline and bupropion are available, long-term abstinence rates remain low and new approaches to help smokers successfully quit smoking are needed. In recent years, electronic nicotine delivery systems such as e-cigarettes and heated-tobacco products, and novel smokeless nicotine delivery products like nicotine pouches have gained widespread popularity. These products can deliver nicotine without combustion of tobacco and might thus present an alternative to the currently available smoking cessation methods if they prove able to help smokers quit smoking conventional cigarettes while decreasing their exposure to toxicants. In this narrative review, we provide a summary of the characteristics of these novel nicotine delivery products and the available data regarding their efficacy as smoking cessation tools and safety profile with a focus on the current situation in Switzerland.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3583"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011879","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":"Supplementum 282: Abstracts Swiss Anaesthesia 2024, joint annual congress of the Swiss Society for Anaesthesiology and Perioperative Medicine and the Swiss Association for Anaesthesia Care (Interlaken, Switzerland, November 7−9, 2024).","authors":"Swiss Society For Anaesthesiology And Perioperative Medicine, Swiss Association For Anaesthesia Care","doi":"10.57187/s.4283","DOIUrl":"10.57187/s.4283","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"4283"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576030","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}