{"title":"[Metatarsalgia].","authors":"Fabienne Inglin, Markus Knupp","doi":"10.23785/TU.2024.07.002","DOIUrl":"10.23785/TU.2024.07.002","url":null,"abstract":"<p><strong>Introduction: </strong>Metatarsalgia is a generic term for complaints in the forefoot and the metatarsophalangeal joints II-IV. However, it does not describe a specific clinical picture but rather a complex of symptoms, which can have different causes. There are mechanical causes, e.g. due congenital or acquired malformations of the foot. Splayfeet with a bunion malformation combined with transfer a common cause. Other examples include brachimetatarsalgia or an instability of the first ray. Other, non-mechanical causes are Morton's neuroma, stress fractures, systemic diseases (rheumatoid arthritis, gout) or infections and aseptic necrosis. Metatarsalgia is described as stress-dependent pain in the ball of the forefoot, which often has a burning or stabbing character. Sometimes a foreign body feeling is reported, as if one were walking on a «pebble». Wearing tight and hard shoes further provokes the symptoms. The therapy depends on the causes and should initially cover conservative options. This includes wearing proper shoes, foot gymnastic/stretching exercise, orthopedic insoles or even orthopedic shoes. Surgical options comprise of Morton's neuroma removal, deformity correction and ligament reconstruction.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 7","pages":"240-244"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Osteochondral lesions of the talus].","authors":"Doria Juric, Nicola Krähenbühl","doi":"10.23785/TU.2024.07.005","DOIUrl":"10.23785/TU.2024.07.005","url":null,"abstract":"<p><strong>Introduction: </strong>The talus has a comparatively high occurrence of osteochondral lesions (OCL), largely due to its unique anatomic characteristics. These lesions can occur post-traumatic or primary. Patients often present with non-specific symptoms, making a thorough clinical examination essential. This examination should include assessing hindfoot alignment, performing antero-lateral and antero-medial palpation with the ankle joint slightly plantar-flexed and evaluating stability. Beyond standard X-ray examinations, additional imaging modalities such as magnetic resonance imaging (MRI) and arthro-computed tomography (CT) are valuable diagnostic tools. Surgical intervention is recommended for symp-tomatic patients with unstable OCL. Besides cartilage reconstructive procedures, options like fusion or prosthetic treatments are available for managing recurring pain.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 7","pages":"254-257"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anja Hirschmüller, Kerstin Recktenwald, Roman Gähwiler, Lukas Weisskopf
{"title":"[Chronic exertional compartment syndrome - an overlooked diagnosis of exercise related leg pain].","authors":"Anja Hirschmüller, Kerstin Recktenwald, Roman Gähwiler, Lukas Weisskopf","doi":"10.23785/TU.2024.07.003","DOIUrl":"10.23785/TU.2024.07.003","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic exertional compartment syndrome (CECS) is an underdiagnosed clinical condition primarily affecting young, physically active people between the ages of 15 and 25. Pathophysiologically, there is an activity associated pressure increase in one or more muscle compartments of the lower leg, usually triggered by sports including running or jumping. The lower legs are most affected, but compartment syndromes of arms, thighs, feet and even the paravertebral muscles have also been described. Typically, CECS manifests as bilateral exercise related leg pain, quickly subsiding after the end of activity. Intracompartmental pressure measurement is required to make a definitive diagnosis. Vascular entrapments, spinal pathologies and myopathies should be considered in the differential diagnosis. Conservative therapy measures include activity modifications, detonation of the muscles, gait retraining, optimization of biomechanics, compression stockings, dry needling and Botulinum toxin injections. If symptoms persist, an endoscopically assisted fasciotomy is a surgical procedure with few complications and a high success rate.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 7","pages":"245-248"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Foot Ulcers in Orthopedics].","authors":"Felix Waibel, Madlaina Schöni","doi":"10.23785/TU.2024.07.004","DOIUrl":"10.23785/TU.2024.07.004","url":null,"abstract":"<p><strong>Introduction: </strong>Foot ulcers are most often vascular, pressure-related or diabetes-related. The presence of neuropathy with loss of protective sensation and/or peripheral arterial disease are essential risk factors for diabetic foot ulcers. Prevention aims at identifying the foot at risk, regularly checking the foot at risk, educating patients, relatives and healthcare professionals, ensuring the routine wearing of appropriate footwear and treating risk factors for ulceration. In the presence of a diabetic foot ulcer, therapy consists of a combination of mechanical relief (gold standard during the ulcer phase: total contact cast), treatment of peripheral arterial disease, treatment of infections, metabolic control and treatment of comorbidities, local ulcer control and education of patients and relatives. Infected ulcers must be examined for the presence of osteomyelitis. Without osteomyelitis, therapy consists of local debridement and 1-2 weeks of antibiotic therapy. If osteomyelitis is present, therapy consists either of a combination of surgical therapy (amputation vs. internal resection) with accompanying short antibiotic therapy or of purely conservative therapy with 6 weeks of antibiotics. After the ulcer has healed, orthopedic shoe care is indicated to prevent recurrence.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 7","pages":"249-253"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Flatfoot in Children - A Look at Myths and Their Evidence].","authors":"Bernhard Speth","doi":"10.23785/TU.2024.07.006","DOIUrl":"10.23785/TU.2024.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>In connection with children's flat feet, one encounters many general statements whose truthfulness is unknown. Some of these myths concerning epidemiology, natural history, long-term progression and non-surgical interventions are examined in more detail in this article with regard to their evidence.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 7","pages":"258-262"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[The knowledge of medical law among medical students and medical service providers in Switzerland].","authors":"Katja Meier, Thomas D Szucs","doi":"10.23785/TU.2024.06.003","DOIUrl":"https://doi.org/10.23785/TU.2024.06.003","url":null,"abstract":"<p><strong>Introduction: </strong>Legal aspects play an increasingly big role in everyday medical practice. This can lead to uncertainties when dealing with medicolegal issues, which could negatively impact the healthcare system and its involved parties. In this study, the medicolegal knowledge of medical students and physicians in Switzerland was examined to give recommendations for undergraduate, postgraduate and further education. A survey was conducted to assess how comfortable individuals feel when dealing with medicolegal issues, and their medicolegal knowledge was tested using case vignettes. Participants generally felt «rather uncomfortable» to be confronted with medicolegal issues. The results of the case vignettes suggest some medicolegal knowledge. However, there were indications of lack of knowledge or incorrect knowledge across almost the entire range of the topics surveyed. In undergraduate, postgraduate and further education, it seems appropriate to focus on the topics insurance and patient rights. Nevertheless, a generally more comprehensive medicolegal education can be considered important. In addition to medicolegal theory, its practical application should be taught as well. A more comprehensive medicolegal education should be seen as one of various approaches to address the uncertainty when facing medicolegal issues.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"195-202"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Medicine and Law: an Introduction - Part 2].","authors":"Thomas D Szucs","doi":"10.23785/TU.2024.06.002","DOIUrl":"10.23785/TU.2024.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>Swiss medical law is based on a clear distinction between substantive and procedural law. Substantive law defines the material rights and duties of persons and institutions, while procedural law regulates the procedures for enforcing these rights. In addition, Swiss law distinguishes between objective law, which represents the totality of legal norms, and subjective law, which defines individual rights and powers. Private regulations such as the FMH Code of Professional Conduct or the SAMS guidelines supplement state medical law and set ethical standards. In social insurance law, the definition of illness (Art. 3 para. 1 ATSG) plays a central role, which is substantiated by case law. The interplay of legal requirements, private-law regulations and clear procedural standards ensures high-quality and legally sound medical practice in Switzerland.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"188-194"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Pharmaceutical Products and Medical Devices: Authorization and Conformity Assessment Procedures, Regulatory Data Protection, Patent Protection and Supplementary Protection Certificate].","authors":"Claudia Seitz","doi":"10.23785/TU.2024.06.006","DOIUrl":"10.23785/TU.2024.06.006","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmaceutical products and medical devices can pose a potenzial risk to health. They may therefore only be placed on the market if their safety, efficacy and quality have been proven. The safety requirements are not to be understood as absolute. Rather, the safety assessment is based on a risk-benefit assessment. Pharmaceutical products and medical devices are subject to different requirements, whereby pharmaceutical products are subject to an authorization procedure, while medical devices have to undergo a conformity assessment procedure. This article first sets out the basic principles and the system of therapeutic products law and discusses the categorization of pharmaceutical products and medical devices as well as their differentiation from other products, in particular foodstuffs and cosmetics. The main features of placing pharmaceutical products on the market are then presented, with a focus on the authorization procedures for pharmaceutical products. This article also provides a brief overview of the protection rights for pharmaceutical products. In addition to the protection rights under the Therapeutic Products Act, the regulatory data protection, there are also protection rights under intellectual property law. In addition to the patent, intellectual property law grants another protection right for products that require an authorization in order to be placed on the market. The supplementary protection certificate, which is only granted to medicinal products and plant protection products as products that require an authorization, is intended to partially compensate for the lack of possibility of using the patented invention during the approval process. Due to the scope of the medicinal products and intellectual property law regulations mentioned, this article must limit itself to selected areas in an overview.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"214-222"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Criminal law aspects in the medical field].","authors":"Brigitte Tag","doi":"10.23785/TU.2024.06.008","DOIUrl":"10.23785/TU.2024.06.008","url":null,"abstract":"<p><strong>Introduction: </strong>The legal framework in Switzerland regarding medicine and health care is complex. Switzerland doesn't have a specific federal law on medicine or health care. Instead, numerous legal provisions apply to very different medical and health care situations. There are regulations located at different hierarchical legal levels with a variety of international, national and cantonal regulations, as well as the (soft) law of the medical profession. Under federalism and the principle of subsidiarity, the Swiss Federal Parliament is only responsible for the federal legal re-gulations where the Swiss Federal Constitution grants it the power to do so. The 26 cantons of Switzerland are responsible for all other matters. Therefore, the cantons have enacted specific health laws, patient laws and other regulations relevant to the medicine and health care sector. In addition, the Swiss Criminal Code is particularly relevant to medical treatments. The Swiss Criminal Code punishes, among others, assaults on life and physical integrity. Criminal liability is an individual responsibility and is determined by whether the requirements for criminal behavior are met in the individual case.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"231-238"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}