Swiss medical weekly最新文献

{"title":"Equitable health care in the context of migration.","authors":"Anne Jachmann, Julia Brandenberger, Matthis Schick","doi":"10.57187/s.4245","DOIUrl":"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":"A call for universal access to science: how the Swiss Medical Weekly aims to contribute.","authors":"Stefan Weiler, Natalie Marty, Jan Roth, Gérard Waeber","doi":"10.57187/s.4543","DOIUrl":"10.57187/s.4543","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4543"},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664675","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":"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":"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":"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":"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":"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":"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}

{"title":"The key role of base rates: systematic review and meta-analysis of the predictive value of four risk assessment instruments.","authors":"Michael A Weber, Nina Schnyder, Madeleine A Kirschstein, Marc Graf, Jérôme Endrass, Astrid Rossegger","doi":"10.57187/s.3517","DOIUrl":"10.57187/s.3517","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims of the study: &lt;/strong&gt;Many countries have seen a decline in recidivism rates over the past decades. These base rates are pertinent information for assessing the recidivism risk of offenders. They provide a foundation for clinical assessment and an empirical basis for risk assessment instrument norms, which inform expected recidivism rates. The present study explored the extent to which base rates influence the validity of risk assessment instruments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically reviewed the available evidence on the discrimination ability of four well-established risk assessment instruments used to estimate the probability of recidivism for general (Level of Service Inventory-Revised [LSI-R]), violent (Violence Risk Appraisal Guide [VRAG]), sexual (Static-99R), and intimate partner violent offences (Ontario Domestic Assault Risk Assessment [ODARA]). We conducted a bivariate logit-normal random effects meta-analysis of sensitivity and false positive rates and modelled the positive and negative predictive values. We used base rates as reported in (a) the construction samples of each risk assessment instrument and (b) recent official statistics and peer-reviewed articles for different offence categories and countries. To assess the risk of bias, we used the Joanna Briggs Institute Critical Appraisal Checklist for Diagnostic Test Accuracy Studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We screened 644 studies and subsequently analysed 102, of which 96 were included in the systematic review and 24 in the meta-analyses. Discrimination was comparable for all four instruments (median area under the curve = 0.68-0.71). The information needed to calculate summary statistics of sensitivity and false positive rate was often not reported, and a risk of bias may be present in up to half of the studies. The largest summary sensitivity and false positive rate were estimated for the ODARA, followed by the LSI-R, the VRAG, and the Static-99R. If base rates are low, positive predictive values tend to be relatively low, while negative predictive values are higher: positive predictive value = 0.032-0.133 and negative predictive value = 0.985-0.989 for sexual offences; positive predictive value = 188-0.281 and negative predictive value = 0.884-0.964 for intimate partner violence; positive predictive value = 0.218-0.241 and negative predictive value = 0.907-0.942 for violent offences; positive predictive value = 0.335-0.377 and negative predictive value = 0.809-0.810 for general offences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;When interpreting the results of individual risk assessments, it is not sufficient to provide the discrimination of the instrument; the risk statement must also address the positive predictive value and discuss its implications for the specific case. As recidivism rates are neither stable over time nor uniform across countries or samples, the primary interpretation of risk assessment instruments should rely on the per","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"3517"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469144","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}