Hepatitis C micro-elimination among people on opioid agonist therapy is a low-hanging fruit

People who use drugs are badly affected by chronic hepatitis C. As a result of the pragmatic national drug policy in Switzerland, the majority of persons with an opioid dependency are on opioid agonist therapy (OAT) and therefore in the healthcare system. For years, national guidelines have recommended that all OAT patients be regularly tested for hepatitis C and, if tested positive, referred for treatment.

Patiromer and medication optimisation in heart failure with reduced ejection fraction: a Swiss perspective

Despite medical advances, heart failure remains a major public health issue and is associated with considerable morbidity and mortality. Suboptimal use of evidence-based therapies and lack of medication up-titration play important roles in this regard. Hyperkalaemia is a frequent and potentially harmful finding which hinders treatment optimisation in patients with heart failure. In this review, heart failure experts from two Swiss academic hospitals discuss the principles of general pharmacological therapy in heart failure with reduced ejection fraction and the different treatment options for chronic hyperkalaemia, focusing on patiromer, a recently available potassium binder. 

Communication challenges in end-of-life decisions

With the progress in healthcare over recent decades and a growing life expectancy, discussions and decisions regarding end-of-life issues have become increasingly important. Especially in intensive care and emergency medicine there is a growing need of decision making for optimised end-of-life care. Prolonging life and preventing death is considered to be the highest principle of healthcare professionals; however, in some cases alleviation of suffering is a more appropriate goal. This article discusses communication challenges in end-of-life decision making and outlines strategies from an area of growing interest and research.

2020 recommendations for osteoporosis treatment according to fracture risk from the Swiss Association against Osteoporosis (SVGO)

No specific treatment recommendations have been made so far in our country to guide therapy according to the baseline level of risk. The authors define four risk subgroup categories and propose an algorithm for osteoporosis therapy according to the level of fracture risk.

Candida auris – recommendations on infection prevention and control measures in Switzerland

Candida auris, a globally emerging pathogen, has been repeatedly introduced into European healthcare settings, leading to large and long-lasting nosocomial outbreaks. The pathogen has already been isolated in Switzerland, requiring clinicians and microbiologists to become alert.

Including adolescents of childbearing potential in clinical trials with possible exposure to teratogenic medication: a challenge for paediatricians and researchers

This article reviews how to address practical and ethical questions regarding minor adolescents of childbearing potential enrolled in a clinical trial that may involve teratogenic medication and offers a series of concrete advice and tools for dealing with problematic situations.

Use of the wearable cardioverter-defibrillator – the Swiss experience

The use of wearable cardioverter defibrillators has increased in Switzerland over the years for a variety of indications. There is high therapy adherence to the WCD, and a treatment rate comparable to previously published registry data.

Long-term evaluation of the distal transverse plantar approach for Morton’s neuroma excision

The transverse plantar approach results in good objective outcome scores, including scar healing, in the long term. It offers optimal visualisation of the nerve, does not require deep dissection and allows the exposure of two adjacent web spaces of the foot through a single incision.

Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

The combination of ultrasound-guided regional anaesthesia and ultrasound-guided reduction of distal radius fractures is feasible.  Effectiveness regarding the necessity of subsequent operation was comparable to usual care.

Outcomes after spinal stenosis surgery by type of surgery in adults aged 60 years and older