Praxis最新文献

Introduction:

Introduction: House calls are an important part of medical practice in Switzerland and help reducing the need for emergency room visits. To ensure quality service, the content of the doctor' s bag must be adapted to home practice: Enough to deal with a variety of clinical situations, while sufficiently limited to remain portable. We offer here an updated doctor' s bag content, focusing on the resources needed for diagnosis and treatment. We distinguish between basic items and additional resources that can be used for extended care, particularly in regions with no local health resources.

Introduction:

Introduction: The Frozen Shoulder is a frequently encountered pathology in clinical practice. This condition often coexists with various comorbidities and is characterized by severe pain and a significantly restricted motion of the affected shoulder. A limited passive external rotation with the arm in adduction, with no signs of any other pathology that could explain the finding, such as shoulder osteoarthritis or an undetected posterior dislocation, is pathognomonic. The course of the disease typically spans over one to two years and is usually self-limiting. In the vast majority of cases, this condition can be managed conservatively. Keywords: shoulder, shoulder stiffness, shoulder pain, conservative therapy.

Introduction: Drug use in a sexualised context provides unique challenges both in specialised clinics (psychiatric and sexual health clinics) as well as general practice. Layered onto this leads some inequalities in health care to poorer outcomes in specific groups. This article aims to provide evidence based harm reduction strategies that can easily be applied in primary care to reduce complications, identify those at higher risk and deploy appropriate treatments.

Introduction: Cardiovascular diseases (CVD) represent a significant health problem worldwide and in Switzerland. Despite preventive measures and advances in treatment, cardiovascular diseases still lead to a significant number of hospitalizations in Switzerland (133 000 in 2021) and are for responsible for almost 1/3 of all deaths (19 600 in 2021). Emergency care for acute cardiovascular events now has a very high standard in Switzerland compared to other countries. However, there is a large discrepancy between evidence and daily practice (evidence-performance gap) in cardiovascular risk factor control, because a large percentage of patients do not achieve the goals of the guideline recommendations: 55% of hypertensives, 81% of patients with elevated LDL cholesterol and 44% of diabetics. In addition, 21% of people in Switzerland currently smoke, 42% are considered obese and 24% of people are sedentary. Therefore, primary and secondary prevention offers great potential for reducing the morbidity and mortality of cardiovascular diseases. Sub-optimal control of cardiovascular risk factors leads to preventable cardiovascular events and associated economic costs. Thus, cardiovascular diseases not only affect life expectancy, but also influence the years with reduced quality of life (disability-adjusted life years, DALY). In Switzerland, the main risk factors of cardiovascular diseases lead to a loss of 311 332 DALYs in total, 45 454 DALYs lost by hypertension, 64 445 DALYs lost due to hyperlipidema, 24 283 DALYs due to diabetes mellitus, 47 639 DALYs due to smoking, 21 170 DALYs lost by obesity)and 4 669 DALYs lost due to a lack of exercise. Assuming that one DALY is associated with a socioeconomic burden of CHF 99 417, the total socioeconomic cost of all cardiovascular diseases is 4% of gross domestic product (GDP). Furthermore, cardiovascular diseases caused a cost burden of CHF 27,8 billion in direct and indirect healthcare costs in 2021. Keywords: Cardiovascular diseases, hypertension, risk factors, prevention, healthcare costs, DALY, mortality.

Introduction:

Introduction: Long QT syndrome (LQTS) is a congenital ion channel disorder causing prolonged ventricular repolarization and presents on surface ECG with a prolonged QTc interval. This condition predisposes to ventricular arrhythmias and also sudden cardiac death. LQTS without appropriate therapy during pregnancy and the postnatal phase poses an additionally increased risk of sudden cardiac death due to physiological changes associated with gestation. We present a case report of a 30-year-old pregnant woman with known long QT syndrome Type 2 (LQT2) and discuss the management in cardiological practice.

Introduction:

Introduction: The quality of care for the chronically ill is to be improved through interprofessional cooperation (IPC). To date, evaluation projects on IPC have mostly focused on the inpatient sector. The aim was to use a multiple case study design to investigate forms of IPC in primary care and to identify facilitating and inhibiting factors. Factors that facilitated the implementation of IPC included having a responsible person employed to provide the service, supportive training, and the introduction of evidence-based interventions. There appeared to be insufficient incentives to implement IPC and the needs of the chronically ill were poorly integrated. More systematic evaluation of IPC initiatives is needed to demonstrate their added value. Greater integration of patient needs is key.