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La Societe suisse de pediatrie et la Societe suisse de medecine interne generale (SSMIG), se fondant sur les resultats d’une enquete menee aupres des membres en mars 2021, se voient encouragees a maintenir la plateforme CIRS dans le cadre actuel du Forum de la medecine de premier recours. Les commentaires en retour des membres ont ete precieux pour les membres des Comites afin de definir de nouvelles lignes directrices pour la poursuite du developpement. La Societe suisse de pediatrie et la SSMIG remercient tous les membres qui ont participe activement a ce sondage.

padiatrie schweiz und die Schweizerische Gesellschaft fur Allgemeine Innere Medizin (SGAIM) sehen sich aufgrund der Ergebnisse einer Mitgliederumfrage vom Marz 2021 bestarkt darin, die CIRS-Plattform des Forums fur Hausarztmedizin im bisherigen Rahmen fortzufuhren. Die Ruckmeldungen der Mitglieder waren fur die Vorstande wertvoll, um weitere Leitplanken fur die Weiterentwicklung zu setzen. padiatrie schweiz und die SGAIM danken allen Mitgliedern, die sich aktiv an der Umfrage beteiligt haben.

Le Forum de la medicine de permier recours existe depuis 15 ans. Il s´agit d´un organe de discussion officiel de Medecins de famille et de l´enfance Suisse (mfe) et de la Societe Suisse de Medecine Interne Generale (SSMIG). A partir de juin 2020, il sera possible de se connecter par HIN.

Seit 15 Jahren gibt es das Forum fur Hausarztmedizin. Es ist ein offzielles Diskussionsorgan von Haus- und Kinderarzte Schweiz (mfe) sowie der Schweizerischen Gesellschaft fur Allgemeine Innere Medizin (SGAIM). Ab Juni 2020 ist neu ein Einloggen per HIN moglich.

Es ist davon auszugehen, dass ein relevanter Teil in der Fachinformation erwähnten Nebenwirkungen nichts mit der getesteten Substanz zu tun hat, sondern als «Hintergrundrauschen» zu interpretieren ist, und dass auch heute noch wichtige Nebenwirkungen weiterhin systematisch verpasst werden und somit nicht in der Fachinformation auftauchen.

Le CIRS a ete introduit en Suisse en 2002. Ou en est le systeme de recensement des incidents critiques en 2017? Bilan.

A quoi pouvons-nous vraiment nous fier: aux resultats du laboratoire ou a notre regard clinique?

Objectives To provide estimates of the prevalence of chronic conditions in Swiss primary care. Methods In total, 175 general practitioners (GP) or pediatricians (PED) reporting to the Swiss Sentinel Surveillance Network collected morbidity data. Results In 26,853 patient contacts, mean (± SD) age was 55.8 ± 21.6 or 6.1 ± 5.7 years (in GPs vs. PEDs, respectively) and 47% were males. In GP patients, median Thurgau Morbidity Index was 2 (IQR 1–3). The median numbers of chronic conditions and permanently used prescribed drugs were 2 (0–5) and 2 (1–4), respectively; in PEDs medians were 0. Out of all patients, 16.7 and 7.0% of the PED patients were hospitalized during the previous year; patients cared by family/proxies or community nurses were hospitalized significantly more often than patients living in homes (50.1 vs. 35.4%, OR 1.41, p

During a two-year study, all spider bites recorded by Swiss primary care physicians were reported to the Swiss Toxicological Information Centre and all collected spiders were identified. A total of 14 verified spider bites were recorded, involving five species from four families: Zoropsis spinimana (five cases), Cheiracanthium punctorium (four cases), Tegenaria atrica (three cases) and one case of Malthonica ferruginea (= Tegenaria ferruginea) (both Agelenidae), and one case of Amaurobius ferox (Amaurobiidae). The bites of all spider species produced relatively mild symptoms. Local symptoms such as moderate to severe pain, circumscribed swelling and redness were the only effects in most cases. Systemic symptoms were rare. There was complete recovery in all cases and all lesions healed completely without further damage or secondary disorders. Following a review of the European spider bite literature, the number of spider species capable of biting humans in Europe is considered to be much larger than could be concluded from this study. Most spider bites are restricted to species living synanthropically, thus promoted by climate and habitat change. The annual frequency of spider bites in Switzerland is estimated at 10-100 bites per million inhabitants, but this is predicted to increase due to the continuous arrival of new alien species, many of which have a high potential to establish in urban areas.

2002 wurde CIRS in der Schweiz eingefuhrt. Wie steht es um das System zur Erfassung kritischer Zwischenfalle 2017? Eine Bilanz.

Objectives To describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Design Prospective surveillance study. Setting Swiss primary healthcare, Swiss Sentinel Surveillance Network. Participants Patients with drug treatment who experienced any erroneous event related to the medication process and interfering with normal treatment course, as judged by their physician. The 180 physicians in the study were general practitioners or paediatricians participating in the Swiss Federal Sentinel reporting system in 2015. Outcomes Primary: medication incidents; secondary: potential risk factors like age, gender, polymedication, morbidity, care-dependency, previous hospitalisation. Results The mean rates of detected medication incidents were 2.07 per general practitioner per year (46.5 per 1 00 000 contacts) and 0.15 per paediatrician per year (2.8 per 1 00 000 contacts), respectively. The following factors were associated with medication incidents (OR, 95% CI): higher age 1.004 per year (1.001; 1.006), care by community nurse 1.458 (1.025; 2.073) and care by an institution 1.802 (1.399; 2.323), chronic conditions 1.052 (1.029; 1.075) per condition, medications 1.052 (1.030; 1.074) per medication, as well as Thurgau Morbidity Index for stage 4: 1.292 (1.004; 1.662), stage 5: 1.420 (1.078; 1.868) and stage 6: 1.680 (1.178; 2.396), respectively. Most cases were linked to an incorrect dosage for a given patient, while prescription of an erroneous medication was the second most common error. Conclusions Medication incidents are common in adult primary care, whereas they rarely occur in paediatrics. Older and multimorbid patients are at a particularly high risk for medication incidents. Reasons for medication incidents are diverse but often seem to be linked to communication problems.

Die Blutdruckmessung ist, obwohl alltaglich, keineswegs trivial. Die richtige Durchfuhrung der Messungen, die Verwendung zuverlassiger und validierter Gerate, regelmassige Wartung und eine ausfuhrliche Instruktion der Patienten, Pflegenden und der Arzte sind das A und O fur brauchbare Werte.

La mesure de la pression arterielle, bien que quotidienne, n’est en aucun cas anodine. La realisation correcte des mesures, l’utilisation d’appareils fiables et valides, l’entretien regulier des appareils, ainsi que l’instruction detaillee des patients, soignants et medecins constituent les conditions sine qua non pour obtenir des valeurs exploitables.

The purposes of this study were (i) to determine the prevalence of exercise-associated hyponatremia (EAH) in multi-stage ultra-marathoners and (ii) to gain more insight into fluid and electrolyte regulation during a multi-stage race. Body mass, sodium concentration ([Na⁺]), potassium concentration ([K⁺]), creatinine, urea, specific gravity, and osmolality in urine were measured in 25 male ultra-marathoners in the 'Swiss Jura Marathon' 2008 with 11,000 m gain of altitude over 7 stages covering 350 km, before and after each stage. Haemoglobin, haematocrit, creatinine, urea, [Na⁺], [K⁺], and osmolality were measured in plasma before stage 1 and after stages 1, 3, 5, and 7. Two athletes (8%) showed plasma [Na⁺]135 mmol/l. Body mass, plasma [Na⁺], and plasma [K⁺] remained unchanged (p0.05). Urine specific gravity (p0.001) and osmolality in both plasma (p0.01) and urine (p0.001) were increased and haematocrit (p0.0001), haemoglobin (p0.0001) and plasma albumin were decreased (p0.001). Plasma volume (p0.01) and plasma urea (p0.001) were increased. The K⁺/Na⁺ ratio in urine increased1.0 after each stage and returned to1.0 the morning of the next stage (p0.001). To summarize, more sodium than potassium was excreted during rest. The increased urinary sodium losses during rest are compatible with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) or the cerebral salt-wasting syndrome (CSWS). Further studies are needed to determine the antidiuretic hormone (ADH) and both the atrial natriuretic peptide (ANP) and the brain natriuretic peptide (BNP) during multi-stage races.

An increase in body mass due to oedema has been previously described. The aim of this study was to investigate a potential association between both fluid and electrolyte intake and the formation of peripheral oedemas. Fluid and electrolyte intakes and the changes in limb volumes in 50 male 100-km ultra-marathoners were measured. Pre- and post-race serum sodium concentration ([Na(+)]), serum aldosterone concentration, serum copeptin concentration, serum and urine osmolality and body mass were determined. Fluid intake, renal function parameters and urinary output, as well as the changes of volume in the extremities, were measured. The changes of volume in the limbs were measured using plethysmography. Serum [Na(+)] increased by 1.6%; body mass decreased by 1.9 kg. Serum copeptin and aldosterone concentrations were increased. The change in serum copeptin concentration and the change in serum [Na(+)] correlated positively; the change in serum [Na(+)] and body mass correlated negatively. A mean fluid intake of 0.58 L/h was positively related to running speed and negatively to post-race serum [Na(+)]. Total fluid intake was positively related to the changes in both arm and lower leg volumes. Running speed was positively associated with the changes in arm and lower leg volumes; race time was related to the changes in serum copeptin or aldosterone concentrations. To conclude, fluid intake was related to the changes in limb volumes, where athletes with an increased fluid intake developed an increase in limb volumes.