Introduction: A 31-year-old farmer is being treated for suspected pneumonia. As the symptoms persist despite antibiotic treatment, the suspicion of hypersensitivity pneumonitis type Farmer´s lung arises after taking into account the patients occupational history. Information from various examination modalities and the clinical course confirm the suspected diagnosis. Thanks to the rapid diagnosis and the measures taken as a result, it was possible for the patient to remain in his profession.
{"title":"[Lifelong Mask Mandate].","authors":"Jörn Eggimann, Sara Eggimann, Philipp Grob-Blum","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A 31-year-old farmer is being treated for suspected pneumonia. As the symptoms persist despite antibiotic treatment, the suspicion of hypersensitivity pneumonitis type Farmer´s lung arises after taking into account the patients occupational history. Information from various examination modalities and the clinical course confirm the suspected diagnosis. Thanks to the rapid diagnosis and the measures taken as a result, it was possible for the patient to remain in his profession.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913286","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}
Nico Wiegand, Martin Geyer, Gianluca Lollo, Walter A Wuillemin, Patrick Aepli, Remus Frei, Sébastien Godat, Michael Manz, Stefan Seewald, Frans Olivier The, Reiner Wiest, Jan Borovicka, Stephan Brand, Sophie Buyse, Lukas Degen, Tobias Ehmann, Florian Riniker, Daniele Riva, David Semela, Kaspar Truninger, Ellen Utzinger, Alain Vonlaufen
Introduction:
介绍:
{"title":"Antithrombotic therapy and assessment for bleeding diathesis in elective gastrointestinal endoscopy - Expert Opinion Statement on behalf of the Swiss Society of Gastroenterology.","authors":"Nico Wiegand, Martin Geyer, Gianluca Lollo, Walter A Wuillemin, Patrick Aepli, Remus Frei, Sébastien Godat, Michael Manz, Stefan Seewald, Frans Olivier The, Reiner Wiest, Jan Borovicka, Stephan Brand, Sophie Buyse, Lukas Degen, Tobias Ehmann, Florian Riniker, Daniele Riva, David Semela, Kaspar Truninger, Ellen Utzinger, Alain Vonlaufen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404119","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}
Introduction: Measures restricting freedom include physical restraints restricting movement and treatment without consent according to the Swiss Civil Code. Patients incapable of consenting to treatments and other measures of care and who are somatically multimorbid in addition to their mental illness are frequently encountered in the geriatric psychiatry inpatient setting. In this group of patients, physical restraints are repeatedly used to prevent falling and to quarantine patients due to infectious diseases. Frequently, treatment is conducted with the apparent agreement of the patient but which are to be recorded as measures restricting freedom due to the inability to give informed consent. The National Association for Quality Development in Hospitals and Clinics (ANQ) has introduced geriatric psychiatry as a separate department category; this differentiation should also be seen as an opportunity and invitation to take a differentiated look at measures restricting freedom in geriatric psychiatry.
{"title":"[Measures restricting freedom in the geriatric psychiatry].","authors":"Stefan Klöppel, Dan Georgescu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Measures restricting freedom include physical restraints restricting movement and treatment without consent according to the Swiss Civil Code. Patients incapable of consenting to treatments and other measures of care and who are somatically multimorbid in addition to their mental illness are frequently encountered in the geriatric psychiatry inpatient setting. In this group of patients, physical restraints are repeatedly used to prevent falling and to quarantine patients due to infectious diseases. Frequently, treatment is conducted with the apparent agreement of the patient but which are to be recorded as measures restricting freedom due to the inability to give informed consent. The National Association for Quality Development in Hospitals and Clinics (ANQ) has introduced geriatric psychiatry as a separate department category; this differentiation should also be seen as an opportunity and invitation to take a differentiated look at measures restricting freedom in geriatric psychiatry.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404115","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}
Andrea Rosemann, Oliver Senn, Stefan Neuner-Jehle, Stefan Markun, Giuseppe Pichierri, Thomas Rosemann
Introduction: Due to their advantageous benefit-risk-profile, direct oral anticoagulants (DOACs) are preferred over vitamin-K-antagonists for stroke prevention in atrial fibrillation as well as therapy and secondary prevention of venous thromboembolism. This guideline provides information on the practical use of DOACs, their advantages and disadvantages and limitations. It is based on recommendations from international guidelines (ESC, EHRA, DGA) and adapts them for the general practitioner setting in Switzerland.
{"title":"[New/direct oral anticoagulants (DOAK)].","authors":"Andrea Rosemann, Oliver Senn, Stefan Neuner-Jehle, Stefan Markun, Giuseppe Pichierri, Thomas Rosemann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Due to their advantageous benefit-risk-profile, direct oral anticoagulants (DOACs) are preferred over vitamin-K-antagonists for stroke prevention in atrial fibrillation as well as therapy and secondary prevention of venous thromboembolism. This guideline provides information on the practical use of DOACs, their advantages and disadvantages and limitations. It is based on recommendations from international guidelines (ESC, EHRA, DGA) and adapts them for the general practitioner setting in Switzerland.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404116","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}
Désirée Abgottspon, René Hornung, Tanja Hülder, Larissa Greive
Introduction: This practice case describes a 28-year-old female patient suffering from unclear residual urine formation. Urogynecologic examination reveals a severely hypercapacitated bladder with atonic detrusor. After ruling out other gynecologic and neurologic differential diagnoses, the diagnosis of Fowler syndrome was made. This is a painless residual urine formation with typical pelvic floor EMG with detrusor sphincter dyscoordination. Causal therapies do not exist. Sacral neuromodulation, percutaneous tibial nerve stimulation, or intermittent self-catheterization.
{"title":"[Urinary retention in young female patients].","authors":"Désirée Abgottspon, René Hornung, Tanja Hülder, Larissa Greive","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This practice case describes a 28-year-old female patient suffering from unclear residual urine formation. Urogynecologic examination reveals a severely hypercapacitated bladder with atonic detrusor. After ruling out other gynecologic and neurologic differential diagnoses, the diagnosis of Fowler syndrome was made. This is a painless residual urine formation with typical pelvic floor EMG with detrusor sphincter dyscoordination. Causal therapies do not exist. Sacral neuromodulation, percutaneous tibial nerve stimulation, or intermittent self-catheterization.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404118","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}
Introduction: Locally advanced rectal cancer has a high risk of local recurrence which can be reduced by multimodal therapy. Neoadjuvant radiotherapy or radiochemotherapy has been established. Nevertheless, this has not proved to improve overall survival. The benefit of adjuvant chemotherapy after neoadjuvant radiotherapy or radiochemotherapy remains unclear. Current studies are investigating total neoadjuvant therapy with different sequences of radiotherapy and chemotherapy followed by rectal resection. This procedure shows high pathologic complete remissions up to 28 % as well as an improvement in disease-free and metastasis-free survival. Under study conditions, in case of clinical complete remission, watchful waiting with close follow-up and surgery can be considered only in case of local tumor recurrence.
{"title":"[Lipid Management in Practice].","authors":"Barbara Dehos, Stefan Bilz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Locally advanced rectal cancer has a high risk of local recurrence which can be reduced by multimodal therapy. Neoadjuvant radiotherapy or radiochemotherapy has been established. Nevertheless, this has not proved to improve overall survival. The benefit of adjuvant chemotherapy after neoadjuvant radiotherapy or radiochemotherapy remains unclear. Current studies are investigating total neoadjuvant therapy with different sequences of radiotherapy and chemotherapy followed by rectal resection. This procedure shows high pathologic complete remissions up to 28 % as well as an improvement in disease-free and metastasis-free survival. Under study conditions, in case of clinical complete remission, watchful waiting with close follow-up and surgery can be considered only in case of local tumor recurrence.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404114","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}
Introduction: Quality or quality development and the corresponding regulations are becoming increasingly important in the Swiss healthcare system, in particular due to the link with aspects of permission for the provision of services and financing. In doing so, the focus is directed to varying degrees on structural, processual or outcome criteria. Specific quality aspects of the specialist area consultation-liaison psychiatry and psychosomatics (CLPP) are compiled and the indicators derived from them are grouped according to the quality criteria mentioned. There are numerous requirements, the implementation of which requires considerable efforts from the service providers, not least because of the shortage of specialists and limited financial resources. The requirements listed should be continuously evaluated and developed as well as sensibly anchored in regulation. Linking quality requirements with corresponding financial aspects within the framework of national tanning structures as well as national and cantonal permission regulations should be sought.
{"title":"[Quality development in Consultation and Liaison Psychiatry and Psychosomatics].","authors":"Rafael Meyer, Dan Georgescu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Quality or quality development and the corresponding regulations are becoming increasingly important in the Swiss healthcare system, in particular due to the link with aspects of permission for the provision of services and financing. In doing so, the focus is directed to varying degrees on structural, processual or outcome criteria. Specific quality aspects of the specialist area consultation-liaison psychiatry and psychosomatics (CLPP) are compiled and the indicators derived from them are grouped according to the quality criteria mentioned. There are numerous requirements, the implementation of which requires considerable efforts from the service providers, not least because of the shortage of specialists and limited financial resources. The requirements listed should be continuously evaluated and developed as well as sensibly anchored in regulation. Linking quality requirements with corresponding financial aspects within the framework of national tanning structures as well as national and cantonal permission regulations should be sought.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404117","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}
Lukas Maager, Christian Lehmann, Katja Weiss, Beat Knechtle
Introduction: We report a 23-year-old patient who presented to the general practitioner due to persisting headache, fever, and vomiting. In the further course, a tetraparesis dominated on the right side, dysphagia and dysarthria occurred, and a general tonic-clonic seizure. Further examinations confirmed tick-borne encephalomyelitis as well as polyradiculitis. After two months of rehabilitation, neuropsychological as well as focal-neurological deficits persisted in the unvaccinated patient.
{"title":"[Small Tick - Big Danger].","authors":"Lukas Maager, Christian Lehmann, Katja Weiss, Beat Knechtle","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We report a 23-year-old patient who presented to the general practitioner due to persisting headache, fever, and vomiting. In the further course, a tetraparesis dominated on the right side, dysphagia and dysarthria occurred, and a general tonic-clonic seizure. Further examinations confirmed tick-borne encephalomyelitis as well as polyradiculitis. After two months of rehabilitation, neuropsychological as well as focal-neurological deficits persisted in the unvaccinated patient.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398917","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}
Introduction: The breast is essential to a woman's physical integrity. There are numerous techniques for breast reconstruction, so that the needs and limitations of each patient can be respected. The individual preferences of the patient play an important role in the decision of silicone implants vs. autologous tissue, size, and shape of the breast as well as the timing of the surgery. The only reasons not to perform a reconstruction are a locally incompletely removed tumor or the explicit wish of the patient against reconstruction. The costs for reconstruction are covered by the health insurance for all procedures, including symmetrizing the opposite breast, nipple reconstruction and autologous fat grafting.
{"title":"[Individual Needs of the Patient in Breast Reconstruction - Are There Limits to Plastic Surgery?]","authors":"Martina Schneider, Farid Rezaeian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The breast is essential to a woman's physical integrity. There are numerous techniques for breast reconstruction, so that the needs and limitations of each patient can be respected. The individual preferences of the patient play an important role in the decision of silicone implants vs. autologous tissue, size, and shape of the breast as well as the timing of the surgery. The only reasons not to perform a reconstruction are a locally incompletely removed tumor or the explicit wish of the patient against reconstruction. The costs for reconstruction are covered by the health insurance for all procedures, including symmetrizing the opposite breast, nipple reconstruction and autologous fat grafting.</p>","PeriodicalId":20494,"journal":{"name":"Praxis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398916","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}