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The «Recommendations for the Diagnosis and Treatment of Behavioral and Psychological Symptoms of Dementia (BPSD)» were developed in parallel with the Swiss National Dementia Strategy 2014-2019 under the auspices of the Swiss Society for Geriatric Psychiatry and Psychotherapy (SGAP) and mark the beginning of a series of recommendations for geriatric psychiatric disorders. They depict the evidence-based state of knowledge about diagnostics and therapy, based on the clinical experience of the experts, and are designed for interprofessional and interdisciplinary use. The non-pharmacological intervention options and pharmacotherapy are discussed in detail. This paper is the revised version of the 2014 publication and compiles the development in this area for everyday clinical practice. [ABSTRACT FROM AUTHOR]

Violence and abuse in competitive sports, such as physical and emotional abuse, physical and emotional neglect and sexual abuse, affect children, adolescents and adults alike and lead to severe physical, psychological and social consequences. In current medical and educational care concepts of athletes, there is a lack of consistent integration of sports/psychiatric, clinical psychological and psychotherapeutic, developmental pediatric and developmental psychological expertise. Problem areas arise from fine lines between harassment, non-physical and physical violence. The present position paper includes recommendations for the development of a concept for the protection of mental health in competitive sports and for coping with mental stress and psychological disorders by qualified medical experts in mental health, i.e., child, adolescent and adult psychiatrists with specific expertise in competitive sports: sports psychiatrists. According to the recommendations, experts should also have and further develop competence in other fields, especially in ethics, child protection, protection against violence and abuse in competitive sports, awareness of and dealing with transgression of boundaries, knowledge about child development, and transparency in training structures and relationships. [ABSTRACT FROM AUTHOR]

Entrustable Professional Activities (EPAs) are competency-based learning goals derived from observable clinical activities. In undergraduate medical education, they have now been adopted throughout Switzerland as part of the so-called PROFILES catalog (Principal Relevant Objectives and Framework for Integrated Learning and Education in Switzerland). The nine core EPAs to be mastered in undergraduate medical education can serve as a basis for introducing EPAs in graduate medical education as well. We will discuss this approach in the context of graduate medical education in psychiatry and psychotherapy from the perspective of different training contexts and a pilot example. In this position paper, we describe a promising opportunity to improve graduate medical training through the implementation of EPAs, both in terms of the quality of training and thus of patient care, as well as in terms of the attractiveness of the specialty for future residents. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the hand and the fingers. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the foot including the ankle, midfoot and the toes. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the knee. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the hip. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

Despite a decreasing incidence of tuberculosis (TB) over the last decades in Switzerland, the frequency of newly diagnosed tuberculous spondylitis has remained stable. It occurs most frequently in old, immunocompromised persons and/or persons who have moved to Switzerland from TB endemic areas. It is a chronic manifestation of TB, which is characterized by 'cold abscesses', neurological deficits and kyphotic spinal deformity. Tuberculous spondylitis is often diagnosed with a delay, which can lead to higher morbidity and treatment complexity. Antibiotic therapy is essential in tuberculous spondylitis. Surgical interventions aim to obtain samples, decompress nervous structures, obtain pain control and, if necessary, deformity correction/stabilization. This paper provides an overview of the modern diagnostic and therapeutic management of tuberculous spondylitis in Switzerland. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the elbow. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

This review paper explains the simplified ultrasound anatomy of the shoulder. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies. [ABSTRACT FROM AUTHOR]

Geographic information on risk factors for health or disease is increasingly being used to understand the determinants of health. GeoLaus is a project initiated in 2015 that studies the impact of living spaces and socio-economic situation, on physical and mental health and on different lifestyle habits. This paper discusses and illustrates the use of spatial information in CoLaus to understand the determinants of obesity and daytime sleepiness. The first results of the GeoLaus study open new perspectives on population health. [ABSTRACT FROM AUTHOR]

The electronic health record (EHR) is a topic of high political relevancy particularly with regards to the launch of the ‘electronic patient's dossier' 2017. To investigate the current use of EHR under Swiss general practitioners, we analyzed data from the Work Force Study 2015 with respect to use of electronic, paper and mixed (electronic as well as paper) medical history patient administration. 39% of the participants used EHR, 34% paper and 27% mixed health records. The use of EHR was significantly larger in German-speaking Switzerland (44% ) as compared with French (30% ) and Italian speaking parts (12% ). Especially younger physicians and group practices preferred EHR. EHR users reported a higher number of hours spent for research and further training. The results are discussed with respect to the challenges on general practitioners' provision posed by the demographic change. [ABSTRACT FROM AUTHOR]

The subject ‘Ultrasound in Medicine', already introduced during the studies increases the m otivation of students by its practical character and combines basic medical knowledge (anatomy, physiology) and imaging w ith clinical applications in a unique way. This is done on the one hand as a point of care method (POCUS) at the point of decision-m aking, and on the other hand as a ‘radiological' method with intervention options. POCUS is the use of ultrasound by physicians to correctly identify problems and im plem ent solutions at the point of action. Both the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and the World Federation for Ultrasound in Medicine and Biology (WFUMB) have published position papers on the targeted application of ultrasound technology (point of care), the status of which is reported here. [ABSTRACT FROM AUTHOR]

Microscopic colitis (MC) is still an underestimated cause of chronic, non-bloody watery diarrhea. It is typically manifested in elderly patients with a female predominance. The incidence of microscopic colitis has been increasing. The aetiology and pathophysiology remain unclear. Conditions associated with it include autoimmune diseases. There may be a genetic predisposition, as familial cases have been described. As implicated by the name microscopic colitis, the diagnosis is found by histological examination. There are mainly two subtypes, the lymphocytic colitis (LC) and the collagenous colitis (CC). Even if the condition's long-term course is benign, a chronic recurrent course of the symptoms is frequent. Due to the symptoms, there is an impairment of patient's health-related quality of life. A correct diagnosis and therapy is therefore mandatory. The aim of this paper is to create awareness for microscopic colitis. [ABSTRACT FROM AUTHOR]

The electroencephalogram (EEG) is a non-invasive and cost-effective method to monitor spontaneous neuronal activity over time. Pathologies in EEG recordings indicate with high sensitivity but low specificity abnormal functional brain states.The main psychiatric indications for EEG recordings include atypical clinical symptoms of a neuropsychiatric syndrome or atypical reactions to medication as well as a baseline diagnostic before starting treatment with specific drugs or stimulation modalities. In recent research the EEG continues to be a valuable tool not only in diagnostics but also for the prediction of treatment success.The following paper focuses on basic electrophysiological understanding of EEG recordings, the diagnostic value of EEG recordings in different clinical entities, and new research attempts in diagnostic and treatment prediction. [ABSTRACT FROM AUTHOR]

Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data. Digititizing processes intend to increase efficiency, but also to enhance clinical and administrative decision support and quality assurance. The introduction of the electronic patient record in Switzerland in 2020 is expected to provide cross-company, more complete documentation of patient care. Multimorbid patients, often treated in different institutions and by different specialists, should benefit from this in particular. Advances in artificial intelligence offer new opportunities in medicine. Challenges include ensuring reliable data protection, and better interoperability of the systems involved. Semantically structured, machine-readable data exchange is a necessity for both networked services and internationally competitive research. [ABSTRACT FROM AUTHOR]

This paper deals with corticoid alternatives such as calcineurin inhibitors, sulfonated shale oils, ultraviolet light and climatotherapy which are discussed in detail.Topical calcineurin inhibitors can be understood as immunosuppressants which inhibit T-lymphocyte activation and prevent the release of pro-inflammatory cytokines. The inflammation inhibition of sulfonated shale oils is to be based on an inhibition of 5-lipoxygenase as well as 5-hydroxyeicosatetraenoic acid and leukotriene B4. The rationale for the use o~ a UV light treatment is its anti-inflammatory effect on antigen-presenting Langerhans cells, infiltratingT cells, and proinflammatory cytokines. A climatherapy in the high mountain range above 1500 meters above sea level is - amorgotherthings - a freedom from house dust mites allergens. Other potent allergens (e.g., birch and grass pollen, mold spores) are significantly reduced in concentration as well as in the duration of their occurrence. [ABSTRACT FROM AUTHOR]

Acute and chronic infections are a serious complication after implantation of a joint prosthesis and are difficult to diagnose due to the biofilm mode of the microorganism. Microbiological cultures can remain negative, so that additional tests such as a puncture of the synovial fluid with determining the leukocytes, or histopathological examination of the periprosthetic tissue are important. It is recommended to take multiple tissue samples intraoperatively from areas with presumably high bacterial density (interphase membranes or capsule). Newer biomarkers such as alpha-defensin or a multiplex PCR have been developed in recent years, but they are not yet part of the standard diagnostics. The following paper summarizes the strength and limits of the various diagnostic options in suspected PJL [ABSTRACT FROM AUTHOR]

After 1945, Western medicine was influenced mostly by investigations from Britain and the USA. This paper deals with the presentation of German medicine in the German weekly «Der Spiegel» between 1947 and 1955, when German society changed from a postwar community focussed on survival to a modern western society. The paper will particularly focus on medicine as a service, dealing not with diagnostic and therapeutic innovations, but with troublesome every-day problems of body and soul at the border of health and disease. The paper argues that »service medicine« was an important tool for German medicine to achieve social acceptance and to integrate itself into the new German democratic society with its private market economy. [ABSTRACT FROM AUTHOR]

The author presents his personal choice of practical relevant papers of pancreatic diseases from 2014 to 2015. Nutritional factors and hypertriglycidemia are discussed as causes of acute pancreatitis. Tools to avoid post-ERCP(endoscopic retrograde cholangiopancreatography) pancreatitis are described and the natural course of fluid collections and pseudocysts is demonstrated. The value of secretin-MRCP(magnetic resonance cholangiopancreatography) for diagnosis of chronic pancreatitis is illustrated. Data help to choose the minimally effective prednisolone dose in autoimmune pancreatitis. The increased prevalence of fractures in patients with chronic pancreatitis highlights the necessity of screening for bone density loss. The association of vitamin D intake with pancreatic cancer is described. The probability of cancer in IPNM is shown and innovative surgical concepts to reduce the loss of pancreatic function are presented. Finally neoadjuvant concepts for the treatment of pancreatic cancer are highlighted. [ABSTRACT FROM AUTHOR]

Background and objectives: Both France and Switzerland face a general practitioner (GP) shortage. What differences or parallels exist between the two countries with regard to the causes for this shortage? What conclusions might be drawn from a systematic comparison? Methods: Literature review with qualitative and semi-quantitative content analysis. Results: Parallels exist in the comparing categories work contents, working structure, income and social status, medical school formation, private life, psychological motives. Differences are found in the categories biography and social selection, medical socialisation, residency. In Switzerland, residency is not uniformly structured, rarely institutionally organised and contains only few elements specific to general medicine. In France, medical socialisation not only exalts the specialists, but also strongly devaluates the GPs. Conclusions: By systematic analysis and comparison of both countries' pertinent literature, France and Switzerland can deepen their understanding of GP shortage.This paper identifies possible fields of action from medical school through residency up to workplace conditions that are pivotal in addressing the shortage of GPs. [ABSTRACT FROM AUTHOR]

The issue of personality disorders addresses fundamental questions of psychiatry: Is there a clear boundary between normal behaviour and the state of mental illness? Which criteria are defining this boundary? Is a personality disorder really a mental illness or «just» a special variation of an individual lifestyle? This paper reviews the development of the terms psychopathy/personality disorder from the early 19"' century to the present-day diagnostic manuals ICD-10 and DSM-5. This debate spreads out - as it does with regard to any other mental disorder - between psychopathological, neurobiological and social sciences approaches. It is of high practical relevance to realize that nowadays effective therapeutic options for patients with personality disorders are available. Therefore, the therapeutic nihilism of earlier times is no longer justified. [ABSTRACT FROM AUTHOR]

In the last decade the indication of antipsychotics has been expanded from the treatment of psychoses to the treatment of impulsive-aggressive behaviors in mentally retarded children and adolescents with conduct disorder or autism spectrum disorders. As a consequence the use of antipsychotics in children and adolescents has increased worldwide. This increase of prescriptions is under critical discussion. In this paper the indication and the potential side-effects of antipsychotics in children and adolescents are described. The risks of antipsychotic medication are contrasted with the potential benefits to arrive at rational treatment recommendations. [ABSTRACT FROM AUTHOR]

It is not uncommon for patients with an advanced disease to express a desire to their physician to hasten their death. Recent studies show that the motivation of such a desire is multifactorial and multidimensional, including depression, physical, psycho-social and spiritual suffering, fears about the process of dying and/or misunderstandings about the options for end-of-life care. The objective of this paper is to propose to the physician how to explore the dimensions of this request and some elements to answer it. [ABSTRACT FROM AUTHOR]

The aim of a clinical trial is to judge the efficacy of a new therapy or drug. In the planning phase of the study, the calculation of the necessary sample size is crucial in order to obtain a meaningful result. The study design, the expected treatment effect in outcome and its variability, power and level of significance are factors which determine the sample size. It is often difficult to fix these parameters prior to the start of the study, but related papers from the literature can be helpful sources for the unknown quantities. For scientific as well as ethical reasons it is necessary to calculate the sample size in advance in order to be able to answer the study question. [ABSTRACT FROM AUTHOR]

It is not clear whether the right to end one's life is one of our rights to live an autonomous life. This paper tries to show why we should think this to be the case.The right to life is in certain situations waivable.This follows from a plausible conception of rights. The exercise of this right, however, does not create any obligations, only permissions. [ABSTRACT FROM AUTHOR]

Cutaneous pruritus can be caused by systemic as well as skin diseases. This paper focuses on differential diagnosis of pruritus and covers therapeutic options. [ABSTRACT FROM AUTHOR]

The origins of obesity tan be traced back at least 25000 years. In the Stone Age, in the Middle Ages, and in the 17th century overweight indicated prosperty, power, and fertility, but already Hippocrates described obesity as a disease in the Antique. The first academic papers dealing with adiposity were published in the times of the Industrial Revolution. In the 19th century a pharmaceutical treatment boom against overweight emerged- people had to deal with quackery and dangerous remedies like amphetamines that flooded the market. Bariatric surgery was introduced in the 20th century- todays goldstandard is the RYGB operation. Dealing with morbid obesity and its comorbidities is nowadays one of the serious problems in the field of public health. [ABSTRACT FROM AUTHOR]

According to the international guidelines of COPD (GOLD) and asthma (GINA) diagnosis and treatment of both diseases necessitate spirometry in the private practice as well as in hospital setting. However today, spirometry is not sufficiently used in Switzerland. This paper intends to give an easy overview how spirometry is performed and spirometric values can be interpreted. [ABSTRACT FROM AUTHOR]

According to the international guidelines of COPD (GOLD) and asthma (GINA) diagnosis and treatment of both diseases necessitate spirometry in the private practice as well as in hospital setting. However today, spirometry is not sufficiently used in Switzerland. This paper intends to give an easy overview how spirometry is performed and spirometric values can be interpreted. [ABSTRACT FROM AUTHOR]

Recently the „EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): Update 2012 on non-hepatic applications" have been published. In the following paper a short summary and comments on the guidelines are given. [ABSTRACT FROM AUTHOR]

Digitization is found everywhere in sonography. Printing of ultrasound images using the videoprinter with special paper will be done in single cases. The documentation of sonography procedures is more and more done by saving image sequences instead of still frames. Echocardiography is routinely recorded in between with so called R-R-loops. Doing contrast enhanced ultrasound recording of sequences is necessary to get a deep impression of the vascular structure of interest. Working with this data flood in daily practice a specialized software is required. Comparison in follow up of stored and recent images/sequences is very helpful. Nevertheless quality control of the ultrasound system and the transducers is simple and safe - using a phantom for detail resolution and general image quality the stored images/ sequences are comparable over the life cycle of the system. The comparison in follow up is showing decreased image quality and transducer defects immediately. [ABSTRACT FROM AUTHOR]

Osteoporosis is a disease of older people with preference for the female sex. A bilateral fracture of the sacrum in a premenopausal woman with osteoporosis is very rare. We describe the case of a 34-year-old premenopausal woman suffering a bilateral sacral fracture after lifting a bundle of paper. The reason for these fractures was a primary osteoporosis with the risk factors vitamin D insufficiency, smoking, decreased alimentary calcium intake, physical inactivity and nulliparity. [ABSTRACT FROM AUTHOR]

Osteoporosis is a disease of older people with preference for the female sex. A bilateral fracture of the sacrum in a premenopausal woman with osteoporosis is very rare. We describe the case of a 34-year-old premenopausal woman suffering a bilateral sacral fracture after lifting a bundle of paper. The reason for these fractures was a primary osteoporosis with the risk factors vitamin D insufficiency, smoking, decreased alimentary calcium intake, physical inactivity and nulliparity. [ABSTRACT FROM AUTHOR]

Heritable thrombophilia as a concept in hemostasis has been continuously discovered parallel to the knowledge on physiology of bleeding disorders. Since the 1980s it has become increasingly popular to search for thrombophilia in patients with thromboembolism and their relatives. Although initially no direct evidence existed for any advantage for the patients, successive clinical studies have helped to understand the risk of thrombosis and to stratify the patients in relation to the thrombophilic defect. In the meantime national and international guidelines have been published, suggesting which candidates should be examined and what tests should be performed. In the present paper we summarise and explain the rationale of these guidelines from the european point of view. [ABSTRACT FROM AUTHOR]

Heritable thrombophilia as a concept in hemostasis has been continuously discovered parallel to the knowledge on physiology of bleeding disorders. Since the 1980s it has become increasingly popular to search for thrombophilia in patients with thromboembolism and their relatives. Although initially no direct evidence existed for any advantage for the patients, successive clinical studies have helped to understand the risk of thrombosis and to stratify the patients in relation to the thrombophilic defect. In the meantime national and international guidelines have been published, suggesting which candidates should be examined and what tests should be performed. In the present paper we summarise and explain the rationale of these guidelines from the european point of view. [ABSTRACT FROM AUTHOR]

In the last years, obesity has become one of the main problems of health care systems in Western countries. Among morbid obese patients, four out of five will develop comorbidities doubling the mortality risk in women and increase the numbers in men at a threefold risk. According to evidence based guidelines, nowadays surgery is the best and most effective treatment resulting in excellent long-term weight loss, reduction of comorbidities while extending expectation of life. A sound indication is the most important step for successful surgery. In this paper we focus on Swiss regulations and some special indications which have to be taken into consideration. After bariatric surgery clinical follow up on a regular basis is also of great importance. Furthermore, we explain typical mechanical and nutritional complications after different types of surgery and give some recommendations. [ABSTRACT FROM AUTHOR]

Until recently metastatic renal cell carcinoma was considered refractory to the available therapies. A better understanding of the molecular biology and the introduction of targeted agents led to a significant improvement in the prognosis of patients with metastatic renal cell carcinoma, In this paper the molecular pathology, specifically the deregulation of the oxygen adaption mechanisms leading to tumorangiognesis will be presented. Based on these fundamental mechanisms the targeted agents will be introduced. These agents have been tested in randomized phase IlI trials in different clinical and prognostic situations. The results and the side-effects of sunitinib, sorafenib, temsirolimus, everolimus and bevacizumab treatment will be presented leading to a possible treatment algorithm. [ABSTRACT FROM AUTHOR]

The decline and fall of the Roman Empire and the dramatic change of the Mediterranean world in late antiquity have ever been discussed in history. The present paper outlines, from the point of view of medical history, some recent tendencies of research, including those which bring in scientific evidence. [ABSTRACT FROM AUTHOR]

Communication about risk, e.g. cardiovascular risk, is a central task of physicians in their daily practice. In this paper we summarize the different methods of risk communication published in the literature. The different methods and their particular advantages and shortcomings are described and some recommendations are formulated. The most significant of them are: verbal qualifiers like, your risk for a cardiovascular event is moderate, is imprecise and difficult to interpret. Information about risk in numerical form is more comprehensible when delivered in natural frequencies compared to percentages, pictorial representations contribute to a better understanding. Probably not one single mode of representation is the most effective way to convey information about risk, but a combination of methods. [ABSTRACT FROM AUTHOR]

Communication about risk, e.g. cardiovascular risk, is a central task of physicians in their daily practice. In this paper we summarize the different methods of risk communication published in the literature. The different methods and their particular advantages and shortcomings are described and some recommendations are formulated. The most significant of them are: verbal qualifiers like, your risk for a cardiovascular event is moderate, is imprecise and difficult to interpret. Information about risk in numerical form is more comprehensible when delivered in natural frequencies compared to percentages, pictorial representations contribute to a better understanding. Probably not one single mode of representation is the most effective way to convey information about risk, but a combination of methods. [ABSTRACT FROM AUTHOR]