Focal liver lesions are common, with a prevalence up to 20%. The lesions must be evaluated in context of risk factors associated with malignancy. Risk factors include age >40 years, known current or past malignancy, presence of liver cirrhosis or chronic liver disease (i.e. suspected by elevated liver elastography measurement ≥8 kPa or FIB-4 score ≥1.3), unintentional weight loss, fever or night sweats, newly detected focal liver lesions, documented growth of focal liver lesions, current or past use of androgens (e.g. testosterone, oxymetholone, danazol), increased serum tumour markers (i.e. alpha-fetoprotein, carbohydrate antigen 19-9 [CA19-9], carcinoembryonic antigen [CEA]) and family history of malignancy. In patients without risk factors of malignancy, regional (non-)fatty changes, simple liver cysts and typical haemangiomas can be diagnosed by conventional ultrasound (without contrast). Conventional ultrasound Doppler is recommended to rule out vascular malformations such as portosystemic shunts. In all other cases of focal liver lesions, contrast-enhanced imaging is indicated for differentiation in benign and malignant dignity. Contrast-enhanced ultrasound (CEUS) as a first diagnostic step and contrast-enhanced magnetic resonance imaging (MRI) are accurate tests to diagnose haemangioma and focal nodular hyperplasia. Hepatocellular adenoma is diagnosed by contrast-enhanced MRI and/or histology. “Wash out” on CEUS is highly suspicious for a malignant focal liver lesion. Additional investigations aimed at identifying the primary tumour, as well as staging-computed tomography, MRI and/or histology may be necessary and should be decided on a case-by-case basis. A biopsy of focal liver lesions is indicated in cases of unclear dignity, malignant aspect and focal liver lesions of unclear origin as well as for guiding surgical and oncological management.
{"title":"Assessment of focal liver lesions in non-cirrhotic liver – expert opinion statement by the Swiss Association for the Study of the Liver and the Swiss Society of Gastroenterology","authors":"Mikael Sawatzki, Daniela B. Husarik, David Semela","doi":"10.57187/smw.2023.40099","DOIUrl":"https://doi.org/10.57187/smw.2023.40099","url":null,"abstract":"Focal liver lesions are common, with a prevalence up to 20%. The lesions must be evaluated in context of risk factors associated with malignancy. Risk factors include age >40 years, known current or past malignancy, presence of liver cirrhosis or chronic liver disease (i.e. suspected by elevated liver elastography measurement ≥8 kPa or FIB-4 score ≥1.3), unintentional weight loss, fever or night sweats, newly detected focal liver lesions, documented growth of focal liver lesions, current or past use of androgens (e.g. testosterone, oxymetholone, danazol), increased serum tumour markers (i.e. alpha-fetoprotein, carbohydrate antigen 19-9 [CA19-9], carcinoembryonic antigen [CEA]) and family history of malignancy. In patients without risk factors of malignancy, regional (non-)fatty changes, simple liver cysts and typical haemangiomas can be diagnosed by conventional ultrasound (without contrast). Conventional ultrasound Doppler is recommended to rule out vascular malformations such as portosystemic shunts. In all other cases of focal liver lesions, contrast-enhanced imaging is indicated for differentiation in benign and malignant dignity. Contrast-enhanced ultrasound (CEUS) as a first diagnostic step and contrast-enhanced magnetic resonance imaging (MRI) are accurate tests to diagnose haemangioma and focal nodular hyperplasia. Hepatocellular adenoma is diagnosed by contrast-enhanced MRI and/or histology. “Wash out” on CEUS is highly suspicious for a malignant focal liver lesion. Additional investigations aimed at identifying the primary tumour, as well as staging-computed tomography, MRI and/or histology may be necessary and should be decided on a case-by-case basis. A biopsy of focal liver lesions is indicated in cases of unclear dignity, malignant aspect and focal liver lesions of unclear origin as well as for guiding surgical and oncological management.","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878588","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}
Pub Date : 2020-02-20DOI: 10.31525/ct1-nct04278456
S. Beriger
UNLABELLED We investigated whether informing first-time mothers about postpartum depression affects their experience and behaviour during the depression occurring in the first two weeks after birth. METHOD 138 first-time mothers who were participants in a longitudinal study sponsored by the Swiss National Fund were retrospectively surveyed concerning postpartum depression in the week after birth (response rate: 86.9%). RESULTS 90% of the new mothers were affected. One fourth reported severe to very severe symptoms. The most popular sources of information about postpartum depression were books (65.8%) and magazines (59.2%). 10% of the mothers received information from their gynaecologist. 33% of the mothers with severe to very severe symptoms reported that after the birth no member of the medical or paramedical professions had discussed postpartum depression with them. Among the mothers who knew about postpartum depression, 30% did not feel adequately prepared for the degree of depression. Comparisons between informed and non-informed mothers show that the informed mothers had fewer symptoms, a shorter duration, and suffered less. In addition, the following reactions were noted: the informed mothers complained less and were less likely to believe that they were alone in their suffering. Also, they tended to have less negative thought patterns, felt less powerless, and were better able to explain their feelings and behaviour. RECOMMENDATIONS Information about postpartum depression, especially to ensure that new mothers "feel prepared for it", has a positive influence on experience and behaviour in the week after birth. Therefore, it is useful to inform women about postpartum depression before the birth. This could be integrated into the neonatal care programme offered by the woman's gynaecologist. At the same time, training for nursing staff concerning postpartum depression is recommended.
{"title":"[Postpartum depression].","authors":"S. Beriger","doi":"10.31525/ct1-nct04278456","DOIUrl":"https://doi.org/10.31525/ct1-nct04278456","url":null,"abstract":"UNLABELLED\u0000We investigated whether informing first-time mothers about postpartum depression affects their experience and behaviour during the depression occurring in the first two weeks after birth.\u0000\u0000\u0000METHOD\u0000138 first-time mothers who were participants in a longitudinal study sponsored by the Swiss National Fund were retrospectively surveyed concerning postpartum depression in the week after birth (response rate: 86.9%).\u0000\u0000\u0000RESULTS\u000090% of the new mothers were affected. One fourth reported severe to very severe symptoms. The most popular sources of information about postpartum depression were books (65.8%) and magazines (59.2%). 10% of the mothers received information from their gynaecologist. 33% of the mothers with severe to very severe symptoms reported that after the birth no member of the medical or paramedical professions had discussed postpartum depression with them. Among the mothers who knew about postpartum depression, 30% did not feel adequately prepared for the degree of depression. Comparisons between informed and non-informed mothers show that the informed mothers had fewer symptoms, a shorter duration, and suffered less. In addition, the following reactions were noted: the informed mothers complained less and were less likely to believe that they were alone in their suffering. Also, they tended to have less negative thought patterns, felt less powerless, and were better able to explain their feelings and behaviour.\u0000\u0000\u0000RECOMMENDATIONS\u0000Information about postpartum depression, especially to ensure that new mothers \"feel prepared for it\", has a positive influence on experience and behaviour in the week after birth. Therefore, it is useful to inform women about postpartum depression before the birth. This could be integrated into the neonatal care programme offered by the woman's gynaecologist. At the same time, training for nursing staff concerning postpartum depression is recommended.","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81815401","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}
L. Heilmeyer, W. Keller, O. Vivell, K. Betke, F. Woehler, W. Keiderling
{"title":"[Congenital atransferrinemia].","authors":"L. Heilmeyer, W. Keller, O. Vivell, K. Betke, F. Woehler, W. Keiderling","doi":"10.32388/eyfwyl","DOIUrl":"https://doi.org/10.32388/eyfwyl","url":null,"abstract":"","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81962382","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}
Pub Date : 2020-02-07DOI: 10.1007/3-540-30683-8_1179
G. Kacl, C. Schubiger, U. Eriksson
{"title":"[Neuroendocrine carcinoma].","authors":"G. Kacl, C. Schubiger, U. Eriksson","doi":"10.1007/3-540-30683-8_1179","DOIUrl":"https://doi.org/10.1007/3-540-30683-8_1179","url":null,"abstract":"","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79673246","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}
Pub Date : 2011-05-02DOI: 10.1542/9781581106275-part06-ch22
P. Dür, R. Speich
Bronchial asthma is a chronic inflammatory disease of the airways which triggers bronchial hyperresponsiveness and reversible airflow obstruction. Today it is still a potentially fatal disease. The course and prognosis of bronchial asthma can be improved by adequate diagnosis, education of patients to develop a partnership in disease management, continuous monitoring of asthma severity, avoidance of asthma triggers, establishment of medication plans for chronic management as well as for managing exacerbation, and regular follow-up care. In the following 5 case reports each of these factors is discussed in detail.
{"title":"[Asthma attack].","authors":"P. Dür, R. Speich","doi":"10.1542/9781581106275-part06-ch22","DOIUrl":"https://doi.org/10.1542/9781581106275-part06-ch22","url":null,"abstract":"Bronchial asthma is a chronic inflammatory disease of the airways which triggers bronchial hyperresponsiveness and reversible airflow obstruction. Today it is still a potentially fatal disease. The course and prognosis of bronchial asthma can be improved by adequate diagnosis, education of patients to develop a partnership in disease management, continuous monitoring of asthma severity, avoidance of asthma triggers, establishment of medication plans for chronic management as well as for managing exacerbation, and regular follow-up care. In the following 5 case reports each of these factors is discussed in detail.","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80573030","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}
We report the case of a 63-year-old male hospitalised for chronic diarrhoea and weight loss of 11 kg within 2 years. The symptoms began after a trip to Thailand. Various investigations were negative and led to the assumption of tropical sprue, which was treated with tetracycline. Within 4 months the malabsorption deteriorated and the patient was readmitted with severe electrolyte imbalance. CT-scan of the abdomen revealed a thickened intestinal wall in the jejunum. Diagnostic laparotomy was performed and, surprisingly, revealed chylascites. Histology in a segment of the jejunum demonstrated intestinal lymphangiectasias as the cause of the malabsorption. These intestinal lymphangiectasias were most probably the sequela of radiotherapy 30 years earlier for testicular teratocarcinoma. Symptomatic therapy with middle chain triglycerides brought about substantially improvement.
{"title":"[Post-actinic jejunal lymphangiectasis: a rare case of malabsorption].","authors":"R Monasteri, B Werth, W Brunner, W H Reinhart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report the case of a 63-year-old male hospitalised for chronic diarrhoea and weight loss of 11 kg within 2 years. The symptoms began after a trip to Thailand. Various investigations were negative and led to the assumption of tropical sprue, which was treated with tetracycline. Within 4 months the malabsorption deteriorated and the patient was readmitted with severe electrolyte imbalance. CT-scan of the abdomen revealed a thickened intestinal wall in the jejunum. Diagnostic laparotomy was performed and, surprisingly, revealed chylascites. Histology in a segment of the jejunum demonstrated intestinal lymphangiectasias as the cause of the malabsorption. These intestinal lymphangiectasias were most probably the sequela of radiotherapy 30 years earlier for testicular teratocarcinoma. Symptomatic therapy with middle chain triglycerides brought about substantially improvement.</p>","PeriodicalId":21484,"journal":{"name":"Schweizerische medizinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2000-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21954325","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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