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Mortality prediction in acute heart failure: scores or biomarkers?

Review article: Biomedical intelligence
Wussler D, Michou E, Belkin M, Kozhuharov N, Diebold M, Gualandro DM, Breidthardt T, Mueller C
Swiss Med Wkly. 2020;150:w20320

Acute heart failure is a complex and heterogeneous syndrome not only associated with a concerning rise in incidence, but also with still unacceptably high rates of mortality and morbidity. As this dismal outcome is at least in part due to a mismatch between the severity of acute heart failure and the intensity of its management, both in-hospital and immediately after discharge, early and accurate risk prediction could contribute to more effective, risk-adjusted management.

Iron overload associated symptoms and laboratory changes in the Swiss Haemochromatosis Cohort – when a clinician should become attentive

Original article
Kölmel S, Nowak A, Krayenbuehl PA
Swiss Med Wkly. 2020;150:w20294

Elevated ALT levels and metacarpophalangeal arthropathy remained independently associated with elevated ferritin levels in patients with haemochromatosis and should prompt clinicians to consider iron overload in patients with hereditary haemochromatosis.

Characteristics, predictors and outcomes among 99 patients hospitalised with COVID-19 in a tertiary care centre in Switzerland: an observational analysis

Original article
Gregoriano C, Koch D, Haubitz S, Conen A, Fux CA, Mueller B, Bernasconi L, Hammerer-Lercher A, Oberle M, Burgermeister S, Reiter H, Kutz A, Schuetz P
Swiss Med Wkly. 2020;150:w20316

This analysis provides insights into the first consecutively hospitalised patients with confirmed COVID-19 at a Swiss tertiary care hospital during the initial period of the pandemic. Markers of disease progression such as inflammatory markers, markers for shock and impaired respiratory function provided the most prognostic information regarding severe COVID-19 progression in this sample.

Characteristics, comorbidities, 30-day outcome and in-hospital mortality of patients hospitalised with COVID-19 in a Swiss area – a retrospective cohort study

Original article
Pellaud C, Grandmaison G, Pham Huu Thien HP, Baumberger M, Carrel G, Ksouri H, Erard V, Chuard C, Hayoz D, Sridharan G
Swiss Med Wkly. 2020;150:w20314

The authors report the first cohort of Swiss patients hospitalised with COVID-19. Thirty days after onset of the symptoms, 60% had returned home. Among them, 63% still presented symptoms.

Effect of guideline revisions by the Swiss Society of Hypertension on blood pressure control in hypertensive patients from primary care

Original article
Giezendanner S, Tschudi P, Leuppi J, Dieterle T, Zeller A
Swiss Med Wkly. 2020;150:w20279

The 2009 guideline change in high-risk patients was associated with a reduction in systolic office blood pressure together with an increase in pharmacological combination therapy. These results highlight primary care physicians’ efforts to implement blood pressure guidelines. Further, blood pressure goal attainment was more likely to be achieved in later follow-up visits.

Supporting health professionals after an adverse event in Swiss hospitals: a cross-sectional study

Original article
Reiser Crelier F, Schwappach D, Schwendimann R
Swiss Med Wkly. 2020;150:w20278

In Swiss hospitals, second victim support is generally prevalent, but often in an unstructured way. This lack of methodology increases the risk that, following adverse events, both the quantity and quality of support provided to health professionals will be insufficient. A firm commitment on the part of institutional leaders to implement related policies could foster the adoption of high-quality second victim guidelines in Swiss hospitals.

Oral antibiotic therapy in people who inject drugs (PWID) with bacteraemia

Review article: Biomedical intelligence
Martinez AE, Scheidegger C, Bättig V, Erb S
Swiss Med Wkly. 2020;150:w20259

Treatment of bacteraemia in people who inject drugs remains very complex, and an interdisciplinary approach is essential in order to select the best therapy for this vulnerable group of patients.

What interventions do general practitioners recommend avoiding? A nationwide survey from Switzerland

Original article
Neuner-Jehle S, Grischott T, Markun S, Rosemann T, Senn O, Maeder M
Swiss Med Wkly. 2020;150:w20283

Most suggestions from GPs were concordant with previously published recommendations of interventions to avoid, independently of GPs knowledge of these and reflecting their high clinical relevance. In addition, our study revealed some more relevant topics and may help to develop future “Choosing Wisely” recommendations, with the final goal to reduce low-value care.

The well-being of Swiss general internal medicine residents

Original article
Zumbrunn B, Stalder O, Limacher A, Ballmer PE, Bassetti S, Battegay E, Beer JH, Brändle M, Genné D, Hayoz D, Henzen C, Huber LC, Petignat PA, Reny JL, Vollenweider P, Aujesky D
Swiss Med Wkly. 2020;150:w20255

Approximately 20% of Swiss general internal medicine residents appear to have a reduced well-being and many show signs of distress or have career choice regret. Having few hours of rewarding work and a high number of working hours were the most important modifiable predictors of reduced well-being. Healthcare organisations have an ethical responsibility to implement interventions to improve physician well-being.

D-dimer and mortality in COVID-19: a self-fulfilling prophecy or a pathophysiological clue?

Original article
Breakey N, Escher R
Swiss Med Wkly. 2020;150:w20293

The authors present the case of a patient who was diagnosed with a pulmonary thrombotic complication during inpatient care for COVID-19. The haemostasis parameters, including increased levels of von Willebrand factor and factor VIII, point towards a relevant involvement of endothelial cells in patients with severe COVID-19.

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