{"title":"[Digital health, telemedicine and law].","authors":"Nicolas Jordi","doi":"10.23785/TU.2024.06.007","DOIUrl":"https://doi.org/10.23785/TU.2024.06.007","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the development of digitalisation and information technology, medicine is subject to constant change. This development raises many new legal questions, most of which are still unanswered. This article first looks at the subarea of telemedicine and its regulation in federal and cantonal law and the question of the extent to which telemedicine is legally permissible. The particular focus here is on the doctor's perspective. Furthermore, this article deals with digital healthcare from the perspective of data protection law. Due to the central position of personal data in medicine, this area has become an integral part of everyday medical practice. This article provides a brief overview of this extensive field and highlights the most important key points of data protection law. Finally, this article uses a case study to address the question of the extent to which digital health applications should be considered medical devices. In practice, it is often very difficult to determine in advance whether such a digital health application is to be considered a medical device and is therefore subject to stricter regulations. The most important conditions in this regard are then presented and analysed.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"223-230"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814513","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":"[Medical liability and insurance].","authors":"Simon Schönenberger","doi":"10.23785/TU.2024.06.004","DOIUrl":"10.23785/TU.2024.06.004","url":null,"abstract":"<p><strong>Introduction: </strong>The basic principles of medical liability in Switzerland are the same regardless of whether a physician is self-employed or employed. The first part of this article provides an overview of the jurisdiction of the Federal Supreme Court on the requirements for medical liability under civil law and state liability law, which is aimed at financial compensation for damages suffered by patients. The second part describes the insurance cover and important obligations that the physician has in the event of a claim. The third part of the article contains recommendations developed from the practice of a hospital on what to do after a possible medical error.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"203-206"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814515","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":"[Medical reporting obligations and reporting rights].","authors":"Esther Schaffner","doi":"10.23785/TU.2024.06.005","DOIUrl":"10.23785/TU.2024.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>Medical confidentiality protects the patient's privacy and medical data with criminal consequences in the event of a breach. It continues to exist even after the end of professional practice. Exceptions apply with the patient's consent or official authorisation. This paper describes various reporting obligations, e.g. in the case of exceptional deaths, abortions, communicable diseases and significant injuries caused by dogs. There are also reporting rights, e.g. for children or adults who are at risk. Some reports must be made anonymously, others require full patient details to be provided. Violations of the reporting obligations are punishable by law.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"207-213"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814518","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 1].","authors":"Thomas D Szucs","doi":"10.23785/TU.2024.06.001","DOIUrl":"https://doi.org/10.23785/TU.2024.06.001","url":null,"abstract":"<p><strong>Introduction: </strong>The development of Swiss medical law is closely linked to social and medical development. In the early days and in the Middle Ages, healers and monasteries shaped medical care, with canon law playing an important role. In the early modern period, the first regional regulations for the medical profession emerged. With the founding of the federal state in 1848, the modernisation of medical law began; important laws such as the Factory Act (1877) and the first Health Insurance Act (1911) were introduced. In the 20th century, the introduction of the AHV/IV (1948) and the Health Insurance Act (KVG, 1996) marked the beginning of further professionalisation. Medical law is currently being adapted to meet modern ethical and legal challenges through laws such as the Human Research Act (2014) and remains a dynamic field.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 6","pages":"180-187"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814521","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":"[Gout and Nutrition].","authors":"Barbara Ankli","doi":"10.23785/TU.2024.05.005","DOIUrl":"https://doi.org/10.23785/TU.2024.05.005","url":null,"abstract":"<p><strong>Introduction: </strong>Gout, the most common arthritis worldwide, is closely linked to cardiovascular disease and metabolic syndrome. The most impor-tant risk factor for developing gout is hyperuricemia. Serum uric acid is the end product of purine metabolism and can be partially influenced by dietary changes. Since a quarter of serum uric acid is excreted via the intestine, there is also a connection with diet here - keyword microbiome. Recently, genetic predispositions and drug therapy for gout have come to the fore. However, since cardiovascular comorbidities exist in high frequency, a dietary adjustment also makes sense to improve the comorbidities. Recently, the focus has shifted away from simply reducing purine intake in favor of introducing a largely plant-based diet. Reducing alcohol consumption makes sense for many reasons but does not lead to a significant reduction in serum uric acid. In addition to drug therapy, however, all possibilities should be exploited to enable a rapid reduction in serum uric acid to the target range; a change in diet can contribute to this. A change in diet can also have a positive effect on the frequency of gout flares. Targeted, structured information for patients promotes their knowledge of the disease and motivation to achieve their serum uric acid (SUA) goal. The right diet may be the personal contribution to quickly reaching the SUA target level and freedom from gout flares.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"164-167"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606694","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":"[Therapy of gout in 2024].","authors":"Adrian Forster","doi":"10.23785/TU.2024.05.004","DOIUrl":"https://doi.org/10.23785/TU.2024.05.004","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of gout includes anti-inflammatory therapy and prophylaxis of flare-ups on the one hand and measures for long-term uric acid reduction on the other. Acute arthritis urica is best relieved by intra-articular steroids; systemic steroids, NSAIDs and, in exceptional cases, colchicine are also suitable. For the prophylaxis of relapses, long-term use of colchicine, NSAIDs or low-dose steroids is an option. However, the main pillar of gout therapy is pharmacological reduction of uric acid. The xanthine oxidase inhibitors allopurinol and febuxostat are best suited. The goal is a serum uric acid below 360 µmol/l (\"treat to target\"). The «start low, go slow» strategy reduces the risk of relapses and, in the case of allopurinol, the occurrence of hypersensitivity syndrome. Allopurinol is started at a maximum of 100 mg/d (less in renal insufficiency), followed by a slow upward titration to the required maintenance dose, which may largely exceed 300 mg/d (also in renal insufficiency). Febuxostat is started at a maximum of 40 mg/d and also titrated upwards. The most common cause of insufficient uric acid reduction is unreliable medication intake. In the management of gout, its comorbidities should also be sought and addressed.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"160-163"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606696","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":"Gicht im Wandel der Zeiten: von der Krankheit der Könige zur Hyperurikämie als Organ-Risikofaktor.","authors":"Marcel Weber","doi":"10.23785/TU.2024.05.001","DOIUrl":"10.23785/TU.2024.05.001","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"151-152"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606698","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":"[Imaging in crystal arthropathies].","authors":"Florian Alexander Huber, Roman Guggenberger","doi":"10.23785/TU.2024.05.007","DOIUrl":"https://doi.org/10.23785/TU.2024.05.007","url":null,"abstract":"<p><strong>Introduction: </strong>Crystal arthropathies present a complex entity for radiological diagnostics, often reflecting rheumatologic and other diseases. Over the past decades, the evidence and applicability of various radiological techniques, with and without the use of ionizing radiation, have significantly evolved. This article provides an overview of the current evidence on the use of different modalities and their advantages and disadvantages for the diagnosis and therapy monitoring of crystal arthropathies, based on the latest guidelines from relevant professional societies. In addition to established methods such as X-ray, ultrasound and MRI, this work also addresses newer methods such as dual-energy computed tomography (CT) and photon-counting CT.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"172-178"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606695","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":"Advances in treatment of hyperuricemia and gout.","authors":"Alexandre Dumusc, Alexander So","doi":"10.23785/TU.2024.05.006","DOIUrl":"https://doi.org/10.23785/TU.2024.05.006","url":null,"abstract":"<p><strong>Introduction: </strong>Gout is an inflammatory arthritis that is commonly associated with chronic diseases such as chronic kidney disease (CKD), hypertension, coronary vascular disease, and the metabolic syndrome. Therefore, the management of gout (treatment of the acute flare, lowering serum urate [sUA]) needs to take these co-morbid conditions in consideration. Recent advances in gout therapy showed the effectiveness of new and existing therapies in gout management and we will summarize those we consider to have the largest impact on our clinical practice in this article.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"168-171"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606697","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":"[Calcium pyrophosphate deposition (CPPD) disease - more than just \"pseudogout\"].","authors":"Tobias Manigold","doi":"10.23785/TU.2024.05.003","DOIUrl":"https://doi.org/10.23785/TU.2024.05.003","url":null,"abstract":"<p><strong>Introduction: </strong>Calcium pyrophosphate deposition (CPPD) disease plays an important - and sometimes underestimated - role in rheumatology practice. Clinically, CPP-arthritis is often indistinguishable from gout and is therefore commonly referred to as \"pseudogout\". In contrast to gout, CPPD cannot be cured but can only be treated symptomatically. The pathophysiology, diagnosis, therapy and new therapeutic approaches to CPPD are discussed below.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"81 5","pages":"156-159"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606691","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}
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