Swiss medical weekly最新文献

{"title":"Swiss obesity clinical practice guidance.","authors":"Philipp A Gerber, Tinh-Hai Collet, Lucie Favre, Marco Bueter, Inge Ruiz Arana, Dominique Durrer, Eleonora Seelig, Bernd Schultes, Patrick Pasi, Daniel Konrad, Lia Bally","doi":"10.57187/5415","DOIUrl":"10.57187/5415","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing, and multifactorial disease that poses a significant public health challenge in Switzerland, where approximately 43% of adults are overweight or obese. This new clinical practice guidance establishes a structured, multidisciplinary framework for healthcare professionals, emphasising that assessment, treatment and care should focus on improving overall health metrics, resolving comorbidities and achieving functional gains, rather than solely on numerical weight loss. Crucially, the guidance mandates a non-stigmatising, empathetic approach to combat weight bias, reduce internalised stigma and build therapeutic trust. Accurate diagnosis and risk stratification begin with measuring body mass index (BMI), using adjusted cutoffs for specific ethnic populations. However, since BMI alone may not fully capture cardiometabolic risk, we recommend integrating waist circumference and body composition analyses. Physicians must conduct a comprehensive assessment to identify mechanical and metabolic comorbidities - spanning cardiometabolic, respiratory, gastrointestinal, musculoskeletal and mental health domains, among others - and systematically evaluate the patient's daily functioning and health-related quality of life. Care is organised across a tiered system. Primary care physicians play a central role in screening, initial management, and long-term monitoring. Patients with a BMI of 35 kg/m² or higher, or those with severe obesity-related complications, should be referred to specialised medical obesity services. The foundation of all weight management is a multimodal lifestyle intervention. This intervention includes medical nutrition therapy favouring minimally processed, nutrient-dense diets, such as the Mediterranean pattern; individualised physical activity plans targeting 150-300 minutes of moderate aerobic exercise per week alongside resistance training; and behavioural strategies, such as cognitive behavioural therapy, to address emotional eating and enhance self-efficacy. When lifestyle modifications are insufficient, adjunctive therapies are indicated. The pharmacological landscape has been revolutionised by incretin-based therapies, notably GLP-1 and dual GIP/GLP-1 receptor agonists (e.g. semaglutide and tirzepatide). These medications produce substantial weight reduction and cardiovascular benefits, although clinicians must carefully navigate current reimbursement criteria. For patients with severe or treatment-resistant obesity, bariatric/metabolic surgery, such as Roux-en-Y gastric bypass and sleeve gastrectomy, offers highly effective, durable outcomes but necessitates lifelong interdisciplinary follow-up. Finally, the guidance highlights the necessity of individualised care for special populations, including tailored strategies for children, reproductive-age women and older adults, for whom preserving muscle mass and bone health is prioritised over absolute weight loss.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"5415"},"PeriodicalIF":1.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273168","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 296: Abstracts of the 10th Aannual Spring Congress of the Swiss Society of General Internal Medicine (Lausanne, Switzerland, May 20-22, 2026).","authors":"Swiss Society Of General Internal Medicine","doi":"10.57187/5451","DOIUrl":"https://doi.org/10.57187/5451","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"Suppl. 296"},"PeriodicalIF":1.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273152","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":"Immunophenotyping of very and extremely preterm infants at risk of developing sepsis and necrotising enterocolitis - a prospective, single-centre cohort study.","authors":"Sophie Strasser, Valentin Von Niederhäusern, Noemi Meier, Jasmin Simma, Claudia Knöpfli, Emma Slack, Giancarlo Natalucci, Johannes Trück","doi":"10.57187/4813","DOIUrl":"https://doi.org/10.57187/4813","url":null,"abstract":"<p><p>  BJECTIVE: To characterise adaptive immunity in very and extremely preterm neonates and assess potential immunological markers that predispose them to infection.</p><p><strong>Study design: </strong> Peripheral blood lymphocytes in 30 very to extremely preterm neonates (mean birth weight 815 g) were analysed using 9-colour flow cytometry at days of life 0-7, 8-14, and 15-28. Patients were prospectively recruited at the University Hospital of Zurich from 2021 to 2023. Statistical analyses included group comparisons and longitudinal assessments.</p><p><strong>Results: </strong>Six of the thirty preterm neonates (20%) developed early- or late-onset sepsis, of whom one (3%) also exhibited signs of necrotising enterocolitis. T and B lymphocytes were predominantly composed of naïve T cells and unswitched CD27- B cells, respectively. The CD4/CD8 ratio was initially elevated, especially in extremely preterm neonates, and declined significantly after week 1. EPT neonates also had significantly fewer natural killer cells compared with very premature infants. Although no distinct immunological features were identified as predisposing to infection, B-cell proportions were significantly higher in infected neonates during the second week of life, possibly reflecting an immune response to infection.</p><p><strong>Conclusion: </strong>Adaptive immunity in preterm neonates is characterised by profound immaturity, including an almost complete absence of immunological memory and low CD8 T-cell frequency, which may limit effective pathogen elimination and increase susceptibility to infection. Immunophenotyping provides valuable insights into the immune processes in this vulnerable population and, when combined with clinical observations and routine laboratory findings, could aid in the earlier identification of high-risk neonates and guide targeted interventions.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4813"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273062","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":"Risk factors of delayed kidney graft function following donation after circulatory death - a retrospective cohort study of Swiss kidney transplants.","authors":"Maurice Bischof, Simon Schwab, Julius Weiss, Franziska Beyeler, Christian Brunner, Sabine Camenisch, Raphaël Giraud, Yvonne Hilpertshauser, Matthias Peter Hilty, Marco Rusca, Kai Tisljar, Thomas Müller, Franz Immer","doi":"10.57187/5007","DOIUrl":"https://doi.org/10.57187/5007","url":null,"abstract":"<p><strong>Aims of the study: </strong>On 1 September 2011, donation after circulatory death (DCD) organ donation resumed in Switzerland after the DCD programme had been suspended for four years due to jurisdictional and medico-ethical discrepancies. DCD has gained relevance due to the worldwide scarcity of donor organs and now accounts for nearly half of all donations in the Swiss transplant setting. This study aimed to identify risk and protective factors for the occurrence of delayed graft function, which is a common early complication following kidney transplantation, especially in DCD transplants.</p><p><strong>Methods: </strong>This retrospective cohort study included all Swiss DCD kidney transplants performed between 1 September 2011 and 31 August 2024. The primary outcome was the occurrence of delayed graft function, defined as the need for dialysis within the first week following kidney transplantation. A complete-data, multivariable analysis using a logistic regression model for the event of delayed graft function was conducted for the following variables: donor age and donor comorbidity, cause of death, year of transplantation, functional warm and cold ischaemia time, use of abdominal normothermic regional perfusion, and use of hypothermic machine perfusion.</p><p><strong>Results: </strong>Of 499 controlled DCD donors, 351 were kidney donors. These donors enabled a total of 711 kidney transplants, including 7 double kidney transplants. Of the 650 recipients who qualified for analysis, 315 (48.5%) experienced delayed graft function. Odds ratios for delayed graft function were 0.18 (0.09-0.33) for procurement with abdominal normothermic regional perfusion, 0.55 (0.36-0.83) for preservation with hypothermic machine perfusion, 1.00 (0.73-1.36) for functional warm ischaemia time, and 1.33 (1.01-1.73) for cold ischaemia time.</p><p><strong>Conclusions: </strong>A statistically significant decrease in delayed graft function risk was observed for the use of abdominal normothermic regional perfusion and hypothermic machine perfusion. No evidence was found for an association between functional warm ischaemia time and delayed graft function, and only weak evidence was found for cold ischaemia time. These findings underscore the effectiveness of modern procurement and preservation methods used in kidney transplantation and are consistent with current research findings.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"5007"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273094","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":"Impact of local treatment on survival outcomes in patients with metastatic lung cancer with oligoprogression undergoing immunotherapy.","authors":"Barbara Domenach, Valentine Mismetti, Wafa Bouleftour, Anne Bareille, Olivier Tiffet, Anne-Laure Desage, Pierre Fournel","doi":"10.57187/4790","DOIUrl":"https://doi.org/10.57187/4790","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint inhibitors have revolutionised the management of non-small cell lung cancer (NSCLC) without oncogenic addictions and have improved its prognosis. A manifestation of acquired resistance to immunotherapy, which is typically seen in a restricted number of lesions and metastatic locations (oligoprogression), has been reported. In cases of oligoprogressive disease, local ablative therapies may represent the main therapeutic approaches, and their significance is further amplified for patients with metastatic NSCLC undergoing immunotherapy.</p><p><strong>Methods: </strong>This monocentric retrospective study included 49 patients with metastatic NSCLC treated with immunotherapy, either as a standalone treatment or in combination with chemotherapy. The patients also underwent local ablative therapy in the context of oligoprogression. Clinical and oncological characteristics were assessed, along with overall survival and progression-free survival.</p><p><strong>Results: </strong>The clinical and oncological characteristics were generally consistent with those expected in the general population of patients with metastatic NSCLC. A median overall survival of 28 months (95% CI: 17.4%-33%), measured from the initiation of local treatment, was reported. The 5-year overall survival rate was 12.36%, and the median progression-free survival was 7.56 months (95% CI: 6.01%-11%). The addition of local ablative therapy to immunotherapy was not associated with increased toxicity.</p><p><strong>Conclusion: </strong>The addition of local ablative therapy in cases of oligoprogression as part of the treatment of metastatic NSCLC treated with immunotherapy alone or in combination with chemotherapy appears to be a therapeutic strategy for slowing disease progression.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4790"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273014","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":"Impact of reforms and work environment on resident time allocation in a Swiss internal medicine division: a time motion study with a before-and-after comparison.","authors":"Antoine Garnier, Julien Castioni, Pedro Marques-Vidal, François Bastardot, Matteo Monti, David Gachoud, Marie Méan, Olivier Lamy, Peter Vollenweider, Gérard Waeber, Vanessa Kraege","doi":"10.57187/5190","DOIUrl":"https://doi.org/10.57187/5190","url":null,"abstract":"<p><strong>Study aims: </strong>Increasing clinical complexity, rising admission volumes and shorter hospital stays have intensified demands on internal medicine residents. A 2015 time and motion study at our institution showed that residents spent nearly half of their day on computer work, with frequent task-switching and limited patient contact. These findings prompted organisational reforms to redistribute workload and improve workflow. We aimed to assess how resident time allocation changed after organisational reforms.</p><p><strong>Methods: </strong>We performed a before-and-after time and motion study in the division of internal medicine in a tertiary care centre in Switzerland. Direct observations were conducted over identical periods (May-July) in 2015 (baseline, before implementation of organisational reforms) and 2018 (first assessment after full implementation of these reforms). All residents were eligible. Shifts were randomly selected and stratified by weekday, with two shifts per resident observed whenever possible. Trained observers used a standardised electronic tool to record 22 mutually exclusive activities and contextual factors. The primary outcome was time spent on administrative tasks (patient-related and non-patient-related administration, discharge summaries, information retrieval). Secondary outcomes included task-switching rate, mismatch rate (deviation from planned schedule) and shift duration. Division workload data were collected to adjust analyses.</p><p><strong>Results: </strong>Seventy-five residents were observed over 142 shifts (1478 hours). From 2015 to 2018, mean administrative time increased from 92 to 139 minutes/day (p <0.001) and mean task-switching from 15 to 20 per hour (p <0.001), while mean mismatch rate decreased (38.8% to 31.7%, p <0.001). The mean shift duration shortened (11h38m to 10h45m, p <0.001), with mean personal time increasing (32 to 63 minutes, p <0.001). Mean bedside time declined (113 to 92 minutes, p = 0.011) and mean computer use slightly decreased (327 to 290 minutes, p = 0.009). Mean weekly admissions rose (96 to 146, p <0.001) and mean length of stay was halved (15.5 to 8.5 days, p <0.001). Results were consistent after adjustment for division workload.</p><p><strong>Conclusions: </strong>Targeted reforms improved schedule alignment and work-rest balance but failed to reduce administrative burden in a high-turnover environment. Local time-management interventions should be integrated with hospital-wide strategies addressing workflow complexity, interprofessional communication and task distribution. These results may inform similar initiatives in other high-pressure inpatient training settings.</p><p><strong>Trial registration: </strong>ISRCTN 69703381, https://doi.org/10.1186/ISRCTN69703381.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"5190"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273042","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":"Five years of an Alongside Midwifery Unit at a Swiss Perinatal Centre: a retrospective descriptive study.","authors":"Julia Popelka, Barbara Baur Cavegn, Anne Steiner, Corrado Bernasconi, Monya Todesco Bernasconi","doi":"10.57187/4189","DOIUrl":"https://doi.org/10.57187/4189","url":null,"abstract":"<p><strong>Background: </strong>Overmedicalisation during childbirth, especially in low-risk pregnancies, is an increasing issue. Alongside Midwifery Units (AMUs) are a midwife-led, low-intervention option that maintains access to hospital resources. However, in 2022, only 3.7% of births in Switzerland took place outside hospitals. The UK has emphasised educating women about their birth choices, notably through the \"Birthplace in England\" programme and NICE guidelines. Evidence shows that out-of-hospital births in low-risk pregnancies are safe for mother and child. This retrospective descriptive study analyses maternal and neonatal outcomes, transfer rates and indications for transfer over a 5-year period at the AMU of the Cantonal Hospital Aarau.</p><p><strong>Methods: </strong>All women registering for delivery at the AMU between May 2017 and December 2022 were considered. Strict inclusion criteria ensured a low-risk cohort (singleton, cephalic presentation, 370/7 to 420/7 weeks, uncomplicated pregnancy). Exclusion criteria were pre-existing maternal or fetal disease, prior caesarean section and need for continuous maternal or fetal monitoring. Data were extracted from electronic medical records and included maternal characteristics, mode of delivery, transfer indications, and maternal and neonatal outcomes. Statistical analyses were primarily descriptive. Comparisons between women delivering at the AMU and those transferred to the maternity ward used Wilcoxon rank-sum and Fisher's exact tests (α = 0.05, unadjusted). The study was approved by the regional ethics committee (BASEC-Nr. 2023-00745).</p><p><strong>Results: </strong>Of 1196 women registered, 1034 were included in the analysis. Among 838 women who started labour at the AMU, 75% (n = 627) delivered there, while 25% (n = 211) were transferred peripartum, mainly due to failure to progress (53.1%) or analgesia request (34.6%). Most transferred women (74.8%) still had a vaginal birth. At 48.3% vs 17.7%, women who gave birth at the AMU were significantly more likely to have no birth injury. The postpartum transfer rate was 7.7%, primarily for retained placenta, perineal repair or uterine atony. Neonatal outcomes were favourable: 0.6% of AMU births had a 5-minute APGAR <7 and 0.8% required NICU admission.</p><p><strong>Conclusion: </strong>The AMU with the continuity-of-care model at a Swiss Perinatal Centre provides a safe, low-intervention birth option for low-risk pregnancies, with high rates of vaginal birth and low rates of severe maternal or neonatal complications. Strict selection cr.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4189"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272985","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":"Impact of care reorganisation during COVID-19 waves on non-COVID-19 inpatients in a Swiss hospital: a retrospective cohort study.","authors":"Clement P Buclin, Thomas Agoritsas, Amandine Berner, Sebastian Carballo, Matteo Coen, Pauline Darbellay Farhoumand, Olivier Grosgurin, Omar Kherad, Antonio Leidi, Christophe Marti, Mathieur Nendaz, Omar Ourahmoune, Virginie Prendki, Jean-Luc Reny, Anne Rossel, Christine Serratrice, Jacques Serratrice, Dina Zekry, Delphine S Courvoisier, Jérôme Stirnemann","doi":"10.57187/4893","DOIUrl":"https://doi.org/10.57187/4893","url":null,"abstract":"<p><strong>Study aims: </strong>The COVID-19 pandemic required healthcare systems to reorganise around patient surges. Previous evidence associated these reorganisations with worse clinical outcomes for non-COVID-19 patients, to varying degrees. This exploratory study aimed to quantify the effects of successive COVID-19 waves on mortality, length of stay and transfers to intermediate and intensive care units among non-COVID-19 patients by comparing COVID-19 and non-COVID-19 periods in a Swiss hospital.</p><p><strong>Methods: </strong>This retrospective monocentric cohort study extracted electronic health data of patients hospitalised in a Swiss tertiary hospital from 1 January 2019 to 1 March 2023, whose primary discharge diagnosis was non-COVID-19, excluding patients from psychiatry and women-mother-child departments. Patients were then classified into COVID-19 wave periods based on the weekly average number of COVID admissions. Multivariable regressions were performed to compare in-hospital mortality, transfer rates to intermediate and intensive care units, and length of stay, adjusting for sex, age, insurance class, region of residence, level of care, Charlson comorbidity index, hospital department and main diagnosis.</p><p><strong>Results: </strong>A total of 22,972 non-COVID-19 patients hospitalised during three COVID-19 waves were included and compared to 51,252 pre-COVID-19 patients, 46,753 patients in the inter-wave period and 39,844 post-COVID-19 patients. Compared to the pre-COVID-19 period, adjusted in-hospital mortality among non-COVID-19 patients increased significantly during all COVID-19 waves, peaking in the first wave (OR: 1.27, 95% CI: 1.07-1.51), and decreased during inter-wave periods (OR: 0.91, 95% CI: 0.85-0.97). Transfers to intermediate care units increased throughout the COVID-19 period and normalised post-COVID-19, whereas transfers to intensive care units decreased significantly from the second wave onwards. Compared to the pre-COVID-19 period, length of stay did not differ during the first wave but was shorter in subsequent periods.</p><p><strong>Conclusions: </strong>Worse outcomes among non-COVID-19 patients during COVID-19 waves highlight the need for protocols that ensure continuity and quality of care during future healthcare crises.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4893"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273027","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":"Potentially inappropriate medication: prevalence, risk of hospitalisation and associated healthcare costs in the general older population of Switzerland.","authors":"Renato Farcher, Sereina M Graber, Stefan Boes, Carola A Huber","doi":"10.57187/4613","DOIUrl":"10.57187/4613","url":null,"abstract":"<p><strong>Background: </strong>Potentially inappropriate medications (PIM) and their public health burden in the general older population in Switzerland remain largely unexplored. The aim of this study was to estimate the PIM prevalence and the association between the exposure to PIMs and the time to hospitalisation after PIMs as well as the total healthcare costs in the general older population of Switzerland.</p><p><strong>Methods: </strong>We performed an observational retrospective study using health insurance claims data from patients aged 65 years or older. PIMs were defined based on the Beers criteria and the PRISCUS list. A repeated cross-sectional design was used to assess PIM prevalence, defined as the proportion of patients with PIM prescription. In a separate matched case-control design, a time-dependent multiple Cox proportional hazards regression was applied to examine the association between PIM prescription and time to first hospitalisation. To examine the association between the exposure to PIM and healthcare costs, a negative binomial regression model was used.</p><p><strong>Results: </strong>In 2022, one-third of the population aged 65 years or older was prescribed at least one PIM. The highest risk of hospitalisation occurred within the first 15 days after the initial PIM prescription (hazard ratio [HR]: 2.72, 95% confidence interval [2.25-3.27]) and gradually decreased over time (after 30 days: HR: 2.16 [1.75-2.66]. 60 days: HR: 1.76 [1.50-2.05]. 90 days: HR: 1.67 [1.42-2.97]. 180 days: HR: 1.50 [1.37-1.66]. 365 days: HR: 1.34 [1.25-1.44]). Patients with PIM prescription showed on average CHF 3194 [3047.67-3341.10] higher costs than patients without PIM.</p><p><strong>Conclusion: </strong>This study showed a high PIM prevalence and associated public health burden in terms of hospitalisations and healthcare costs in the general older population of Switzerland. Our findings may indicate limited awareness in prescribing PIMs in primary care and the challenge associated with managing conflicting therapeutic recommendations in vulnerable patients. Given the ageing population and rising healthcare costs, the study highlights the urgent need for targeted strategies to reduce PIMs.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4613"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273058","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":"Retracted publications in medical journals: a cross-sectional, cross-disciplinary analysis.","authors":"Paul Sebo","doi":"10.57187/4685","DOIUrl":"https://doi.org/10.57187/4685","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the number and proportion of retracted publications across 131 high-impact medical journals spanning nine clinical disciplines and to compare retraction rates and the proportion of misconduct-related retractions across journals and disciplines.</p><p><strong>Methods: </strong>This cross-sectional study analysed all retracted publications in 131 top-ranked journals (15 per discipline) in anaesthesiology, dermatology, general internal medicine, gynaecology/obstetrics, neurology, oncology, paediatrics, psychiatry and radiology. Journals were selected using the 2023 Journal Impact Factor from Clarivate's Journal Citation Reports. Retractions were identified in the Retraction Watch Database (RWD), PubMed and the Web of Science from journal inception to 15 December 2024. Retraction rates per 1000 publications were calculated using total publication output indexed in PubMed. The proportion of misconduct-related retractions was determined based on the RWD classification.</p><p><strong>Results: </strong>878 retracted publications have been identified among 422,827 publications in total, corresponding to a retraction rate of 2.1 per 1000. Among the 811 retractions with available data on reasons, 542 (66.8%) were attributed to misconduct. Retraction rates and the proportion of misconduct-related retractions varied widely across disciplines. Anaesthesiology accounted for the highest retraction rate (7.0 per 1000) and the highest proportion of misconduct-related retractions (88.9%). All authors with ≥20 retracted articles were anaesthetists based in Japan or Germany.</p><p><strong>Conclusion: </strong>Retractions and misconduct-related retractions are unevenly distributed across disciplines. These findings underscore the importance of strengthening editorial oversight and promoting research integrity.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"156 ","pages":"4685"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273162","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}