SWISS MEDICAL WEEKLY

Exploring the real-world management of catheter-associated urinary tract infections by Swiss general practitioners and urologists: insights from an online survey
Zünti I, Arbelaez E, Tschudin-Sutter S, Zeller A, Halbeisen FS, Seifert HH and Bausch K
To assess and compare the real-world management of catheters and catheter-associated urinary tract infections (CAUTI) among Swiss general practitioners and urologists, encompassing diagnosis, treatment and prophylaxis.
Prediction of electroconvulsive therapy response and remission in late-life depression: a review
Pozuelo Moyano B, Swierkosz Lenart K, Rosselet Amoussou J, Von Gunten A and Schuster JP
Electroconvulsive therapy is an effective and well-tolerated antidepressant treatment for the elderly population. The place of electroconvulsive therapy in the treatment sequence for depression in the elderly is currently not well established. This review aims to identify the factors that contribute to a positive response and remission in elderly patients with depression undergoing electroconvulsive therapy treatment. We searched five bibliographic databases (Medline ALL Ovid, Embase.com, APA PsycInfo Ovid, Cochrane Library Wiley and Web of Science Core Collection) for articles published between 1995 and June 2023. Of the 2149 articles screened, 19 were included in the review. No significant associations were found between remission and/or response and salivary cortisol, baseline hippocampal and white matter hyperintensities, total amyloid load or global cortical atrophy. The reviewed articles did not show a significant difference in remission between unilateral and bilateral electroconvulsive therapy treatment. Other interesting findings are that moderately elevated levels of CRP and S100B levels, lower retardation scores, poorer performance on the word reading task at baseline and longer post-ictal reorientation time may be associated with higher remission and/or response rates. Medial temporal atrophy can be associated with lower Montgomery-Åsberg Depression Rating Scale (MADRS) decrease after electroconvulsive therapy. Finally, elderly patients had higher rates of electroconvulsive therapy response; retardation and psychotic features may mediate this association. Incorporation of this data into clinical practice may facilitate a personalised approach to electroconvulsive therapy. However, research on this topic is scarce and there are few studies that focus specifically on older people.
Blood pressure control and antihypertensive treatment in Swiss general practice: a cross-sectional study using routine data
Di Gangi S, Brenner R, Grischott T, Burgstaller JM, Senn O, Rosemann T and Markun S
Arterial hypertension is a major global health risk. Global surveys indicate that only half of patients with arterial hypertension receive pharmacotherapy, and only a quarter achieve the primary blood pressure target recommended by guidelines. This study aimed to evaluate the achievement of the primary blood pressure target in Swiss general practice, provide insights into arterial hypertension treatment, and identify factors associated with achieving this goal.
Safety of oral immunotherapy for cashew nut and peanut allergy in children - a retrospective single-centre study
Breiding M, Soomann M, Roth M, Trück J and Bellutti Enders F
Oral immunotherapy (OIT) is increasingly used for the treatment of childhood food allergies, with limited data available on cashew nut OIT. This real-life study investigated the safety and feasibility of cashew nut OIT, comparing it with peanut OIT, with a focus on the up-dosing process.
Cardiac amyloidosis
Laptseva N, Benz DC, Schwotzer R and Flammer AJ
Cardiac amyloidosis is a disease characterised by the accumulation of amyloid protein in the heart tissue. There are several types of amyloidosis, but the most common types affecting the heart are ATTR amyloidosis (caused by transthyretin protein) and AL amyloidosis (caused by abnormal immunoglobulin light chains). Cardiac amyloidosis causes typical signs and symptoms of heart failure. Diagnosis involves a combination of imaging tests such as echocardiography and cardiac magnetic resonance imaging, as well as nuclear imaging scans and tissue biopsies to confirm the presence of amyloid deposits in the heart. Treatment of cardiac amyloidosis depends on the type and severity of the disease and includes medications to manage symptoms as well as treatments targeting the underlying cause of amyloidosis. Importantly, cardiac amyloidosis is a serious condition requiring specialised care from a multidisciplinary team including cardiologists and haematologists as well as other specialists familiar with the management of this rare disease. This is crucial, as early diagnosis and treatment are important for improving outcomes.
Severity of native pulmonary annular hypoplasia and late outcomes of tetralogy of Fallot: retrospective cohort study
Erdil T, Steigmiller K, Rampa JE, Christmann M, Held U and Dave H
Pulmonary annular hypoplasia and valvar dysplasia are key morphological features affecting long-term outcomes of tetralogy of Fallot. This retrospective study aimed to analyse factors affecting contemporary long-term outcomes with a focus on pulmonary annular growth and function over time.
Antipsychotic, benzodiazepine and Z-drug prescriptions in a Swiss hospital network in the Choosing Wisely and COVID-19 eras: a longitudinal study
Gagliano V, Salemme G, Ceschi A, Greco A, Grignoli N, Clivio L, Merler A, Feyling Benitez V, Gianini J, Zandonà M and Gabutti L
Physicians frequently prescribe antipsychotics off-label to treat, among others, insomnia and anxiety. The Swiss "smarter medicine - Choosing Wisely" campaign has tried to raise awareness about the risks and to limit benzodiazepine and Z-drug prescriptions. In the Italian-speaking part of Switzerland, our network of public hospitals joined the campaign with the aim of avoiding unnecessary benzodiazepine and Z-drug treatments, with prescription monitoring, benchmarking and educational contributions. Considering the risks of a possible shift towards the prescription of antipsychotics, and aware of the potential role of the COVID-19 pandemic, we decided to analyse the prescription trends of antipsychotics and benzodiazepines/Z-drugs before, during (2016-2017) and after the intervention.
Syphilis in pregnant women and congenital syphilis from 2012 to 2021 in Switzerland: a multicentre, retrospective study
Alberto C, Wagner N, Fougère Y, Meyer Sauteur PM, Scherler G, Aebbi-Popp K, Baumann M, Schöbi N, Catho G, Emonet S, Polli C, Kottanattu L, Kahlert C, Baud D, Coste A, Martinez De Tejada B, Posfay Barbe KM and Toutous Trellu L
Congenital syphilis is a rare complication of syphilis in pregnant women. Vertical transmission may occur at any time during pregnancy. The incidence of congenital syphilis has been increasing worldwide. Congenital syphilis has been a notifiable disease for many years in Switzerland but reporting does not include maternal features associated with syphilis in pregnancy or infant's subsequent development. We described syphilis cases among pregnant women screened over a 10-year period in Switzerland and subsequent cases of congenital syphilis, in order to identify maternal risk profiles and to optimise prevention. Second, we compared the characteristics of pregnant women screened early (1st trimester) vs late in pregnancy (2nd or 3rd trimester). Finally, we assessed the risk factors for premature birth among these women with syphilis.
Supplementum 284: Abstracts of the 56th Annual meeting of the Swiss Society of Nephrology
Swiss Society Of Nephrology
Supplementum 282: Abstracts Swiss Anaesthesia 2024, joint annual congress of the Swiss Society for Anaesthesiology and Perioperative Medicine and the Swiss Association for Anaesthesia Care
Swiss Society For Anaesthesiology And Perioperative Medicine and Swiss Association For Anaesthesia Care
Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study
Vock I, Aguilar-Bultet L, Khanna N, Egli A, Wehrle-Wieland E, Tamma PD and Tschudin Sutter S
Aminoglycoside resistance is frequently detected in extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE), questioning the appropriateness of aminoglycosides as empiric therapy in patients with suspected ESBL-PE infections. Therefore, we aimed to evaluate the frequency of aminoglycoside resistance in patients harbouring ESBL-PE and identify patient-related risk factors associated with aminoglycoside resistance to facilitate early detection of at-risk patients.
Pathologic findings of the placenta and clinical implications - recommendations for placental examination
Menter T, Bruder E, Hösli I, Lapaire O, Raio L, Schneider H, Höller S, Hentschel R, Brandt S, Bode P, Schultzke S, Drack G, , and
The placenta is a unique and complex organ that combines the circulatory systems of two or more individuals within a single dynamic organ with a set, short lifespan. A diverse spectrum of disorders, including infections as well as metabolic, genetic, circulatory, and maturation defects, may affect its function. Pathology investigation of the placenta is key for identifying several pathogenic processes in both the mother and the foetus. Aberrant placentation, maternal and foetal vascular compromise, infection, inflammatory immunologic conditions, and disorders of maturation are elements of newly proposed classification schemes. The clinical impact of placental examination consists of diagnosing maternal and foetal disease, identifying the potential for recurrence, correlating clinical pathological findings with distinct morphologic features, and identifying the aetiology responsible for growth restriction or foetal death. Gestational trophoblastic disease occurs more frequently in the first trimester; however, in very rare cases, it can affect the term or third-trimester placenta. The application of reproducible nomenclature is expected to facilitate progress in the diagnosis and treatment of obstetric and foetal disorders with placental manifestation. Therefore, this review aims to facilitate communication between obstetricians, neonatologists, and pathologists involved in this diagnostic process.
Transcatheter aortic valve implantation with SAPIEN 3 versus surgical aortic valve replacement in patients with symptomatic severe aortic stenosis at low risk of surgical mortality: a cost-utility analysis for Switzerland
Wyss CA, Corti R, Nestelberger T, Candolfi P, Delbaere A, Fischer B, Schwenkglenks M and Telser H
The 2021 European Society of Cardiology Guidelines on valvular heart disease recommend transcatheter aortic valve implantation (TAVI) for patients with symptomatic severe aortic stenosis at low surgical risk and age ≥75 years who are suitable for a transfemoral approach (recommendation class IA) based on two large randomised controlled trials (PARTNER 3 and Evolut Low Risk) comparing transcatheter aortic valve implantation with surgical aortic valve replacement (SAVR). Whether such an approach is cost-effective in Switzerland remains unclear. The aim of this cost-utility analysis was to compare transcatheter aortic valve implantation with SAPIEN 3 versus surgical aortic valve replacement in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of Swiss compulsory health insurance using data from the PARTNER 3 trial (reflecting specifically the safety and efficacy of the SAPIEN 3 TAVI device).
Primary care physician eHealth profile and care coordination: a cross-sectional study
Jendly M, Santschi V, Tancredi S and Chiolero A
Digital health holds promise for enhancing care coordination and supporting patient self-management. However, various barriers, including at the healthcare professional level, hinder its adoption. This cross-sectional study explored the eHealth profile of primary care physicians and its relationship with care coordination.
Inadequate health literacy and higher healthcare utilisation among older adults in Switzerland: cross-sectional evidence from a population-based study
Pigazzini G, Wieczorek M, Meier C and Maurer J
Population ageing in Switzerland poses significant challenges, including for the healthcare system. Inadequate health literacy can hinder individuals' ability to seek appropriate treatments and navigate the healthcare system efficiently. This study explores the associations between health literacy and the number of consultations with general practitioners and healthcare specialists in a population-based sample of adults aged 58+ in Switzerland.
Experimental assessment of the performance of artificial intelligence in solving multiple-choice board exams in cardiology
Huwiler J, Oechslin L, Biaggi P, Tanner FC and Wyss CA
The aim of the present study was to evaluate the performance of various artificial intelligence (AI)-powered chatbots (commercially available in Switzerland up to June 2023) in solving a theoretical cardiology board exam and to compare their accuracy with that of human cardiology fellows.
Reply to comment by Arber C, et al. on: Real-world expenditures and survival time after CAR-T treatment for large B-cell lymphoma in Switzerland
Trottmann M, Blozik E, Hilbig M, Pletscher M and Meier N
No abstract available.
Recommendations for early identification of heart failure in patients with diabetes: Consensus statement of the Swiss Society of Endocrinology and Diabetology and the Heart Failure Working Group of the Swiss Society of Cardiology
Paul M, Eggerschwiler A, Meyer G, Studer C, Hürlimann U, Brändle M, Wiesli P, Gastaldi G, Arrigo M, Meyer P, Mueller C, Zimmermann K and Lehmann R
Diabetes is a well-recognised risk factor for the development of heart failure, with a prevalence higher than 30% in patients with diabetes aged over 60 years. Heart failure often emerges as the primary cardiovascular manifestation in patients with type 2 diabetes and appears to be even more prevalent in type 1 diabetes. In Switzerland, there are approximately 500,000 individuals with diabetes, and the number of affected people has been steadily rising in recent years. Therefore, the consequences of heart failure will affect an increasing number of patients, further straining the Swiss healthcare system. Early lifestyle modification and initiation of appropriate treatment can prevent or at least significantly delay the onset of symptomatic heart failure by several years. These facts underscore the urgent need for early detection of individuals with subclinical heart failure, which often remains undiagnosed until the first episode of acute heart failure requiring hospital admission occurs. To address this issue, the European Society of Cardiology, the American Diabetes Association (ADA) and other international professional societies have published recommendations on heart failure screening, diagnosis and management. To address this issue in Switzerland, experts from the Swiss Society of Endocrinology and Diabetology, the Swiss Society of Cardiology and the General Internal Medicine specialty met and prepared a consensus report including a simple diagnostic algorithm for use in everyday practice.
Patients with refractory musculoskeletal pain syndromes undergoing a multimodal assessment and therapy programme: a cross-sectional study
Prétat T, Hügle T, Mettler J, Suter M, Jean Scherb S, Taily RL, Hans C, Hoarau M, Monod L, Frossard P, Turchi S, Marillier G, Delavignette N, Blanchard M, Le Thanh A and Ming Azevedo P
Chronic musculoskeletal pain syndromes, including fibromyalgia, are heterogeneous entities with a major socioeconomic burden. Multimodal treatment programmes have shown greater efficacy than conventional approaches for these patients, at least in the short term. A profound understanding of chronic musculoskeletal pain syndrome patients treated in multimodal treatment programmes is important for their development and to provide insight into these conditions.
Technical comment on: Trottmann M, et al. Real-world expenditures and survival time after CAR-T treatment for large B-cell lymphoma in Switzerland: a retrospective study using insurance claims data
Arber C, Baerlocher G, Chalandon Y, Daskalakis M, Duchosal M, Fehr M, Gerull S, Güngör T, Nair G, Pabst T, Passweg JR, Piccolruaz B, Renner C, Ruefer A, Schneidawind D, Stüssi G, Zeerleder S, Halter JP and
Participation in organised sports and longitudinal development of physical activity in Swiss youth: the population-based SOPHYA cohort
Hänggi J, Lovison G, Jeong A, Schaffner E, Njihuis E, Studer F, Taube W, Kayser B, Suggs SL, Bringolf-Isler B and Probst-Hensch N
Maintaining physical activity throughout life is crucial for overall health and wellbeing. Yet the age-related decline in average physical activity, a natural phenomenon also observed in animals, poses a challenge. This study aimed to investigate whether participation in organised sports supported by the Swiss Youth+Sports (Y+S) programme is associated with sustaining or enhancing physical activity among children and adolescents during 5 years of follow-up.