Abstract:
:Pulmonary arterial hypertension (PAH) is a vascular disease of unknown aetiology, characterised by an abnormal thickening of the arterial wall that is responsible for an increase in pulmonary vascular resistance. The haemodynamic consequence of PAH is an increased afterload for the right ventricle and, eventually, right heart failure. When untreated, PAH has a grim prognosis with a median survival of about 2 to 4 years from diagnosis. In the last 10 years new orally administered compounds have demonstrated clinical efficacy in controlled trials using various surrogate endpoints to survival. Although the disease remains without cure until now, the available phase III trials have allowed evidence-based recommendations for the medical management of these patients to be established. It appears, however, that none of the compounds from the three main therapeutic classes, endothelin receptor antagonists, agents acting on the nitric oxide-cyclic guanosine monophosphate pathway (including phosphodiesterase type 5 inhibitors and guanylate cyclase stimulator), and prostanoid receptor agonists are able alone to control disease progression in every patient. Therefore combination therapy with two or three drugs may be necessary in a significant number of patients in order to maintain patients in, or bring them to, a low risk profile. Several recent studies have now validated this approach for specific double or triple drug regimens. It remains, however, unclear whether an upfront combination is preferable to a sequential step-up approach based on clinical response. In addition, some specific combination therapies have failed to demonstrate superiority to single drug alone in randomised controlled trials. Besides PAH-specific treatment, the place of nonspecific pharmaceutical and nonpharmaceutical treatment has been also recently clarified.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Yerly P,Prella M,Aubert JDdoi
10.4414/smw.2016.14305subject
Has Abstractpub_date
2016-05-31 00:00:00pages
w14305eissn
1424-7860issn
1424-3997pii
smw-14305journal_volume
146pub_type
杂志文章abstract:BACKGROUND:The transition from undergraduate to postgraduate training is a crucial career step for physicians. Several international studies have shown that graduates feel insufficiently prepared to perform various aspects of clinical practice. The publication of a national framework for undergraduate medical education...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20370
更新日期:2020-11-24 00:00:00
abstract:THEORETICAL BACKGROUND:Mental disorders emerge in childhood and adolescence and are important risk factors for mental disorders in adolescence and adulthood. Since paediatricians are typically the first to see children with psychological problems, the aim of this study was to obtain a survey of mental disorders of chil...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13092
更新日期:2010-08-27 00:00:00
abstract::Increased survival rates after orthotopic liver transplantation (OLT) in patients with end-stage liver disease have become possible due to an advanced understanding of the pathophysiology of liver disease, the establishment of multiorgan procurement and preservation techniques, and the development of safer and more po...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2007/13/smw-11681
更新日期:2007-04-07 00:00:00
abstract:OBJECTIVES:First, to test whether current injury is more closely related to acute intake than to usual consumption patterns, and second, to test whether repeated injury is more closely related to general consumption patterns than to acute intake. METHODS:Screening of alcohol consumption of 7,872 patients enrolling bet...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2007/45/smw-11697
更新日期:2007-11-17 00:00:00
abstract:OBJECTIVES:Women are still underrepresented in the senior ranks of medical school faculties. Thus far information has been lacking on gendersensitive career paths for professorial and nonprofessorial staff of Swiss medical schools. The aim of this study was to survey faculty members of all Swiss medical schools on soci...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2003/21/smw-10230
更新日期:2003-05-31 00:00:00
abstract::Metallothioneins (MTs) are a family of small proteins containing 61-68 amino acids with an unusually high concentration of cysteine. MT-1, the most functional and active MT in humans, has the ability to react with and enhance the detoxification of a number of metals including zinc, mercury, copper and cadmium. MT dysf...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:
更新日期:2008-02-09 00:00:00
abstract::Apart from the degree of stenosis, plaque morphology has emerged in recent years as an important contributory factor in stroke risk. Ultrasound studies have shown that hypo- or anechogenic plaques carry a higher risk of cerebrovascular events than echogenic ones. Similarly, heterogeneous plaques presenting a complex p...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2005/43/smw-11038
更新日期:2005-10-29 00:00:00
abstract:QUESTIONS UNDER STUDY:Measuring the patient safety climate in the organisation of healthcare can help to identify problematic issues with a view to improving patient safety. We aimed (1) to describe the nurse-reported engagement in safety behaviours, (2) to describe the prevailing nurse-reported patient safety climate ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,多中心研究
doi:10.4414/smw.2012.13501
更新日期:2012-01-20 00:00:00
abstract:INTRODUCTION:In general practice, the diagnosis of dementia is often delayed. Therefore, the Swiss National Dementia Strategy 2014 concluded that action was needed to improve patient care. Little is known about GPs’ confidence in and approach to the diagnosis, disclosure and post-diagnostic management of individu...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14695
更新日期:2018-12-21 00:00:00
abstract::We report a case series of 11 patients with severe E. faecium infections treated with daptomycin. All strains were resistant to ampicillin (MIC >8 mg/l), but susceptible to vancomycin. Seven out of 11 strains were also highly resistant to gentamicin (MIC >500 mg/l). All patients were treated with multiple broad-spectr...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2012.13603
更新日期:2012-06-26 00:00:00
abstract:AIMS:We aimed to identify familial hypercholesterolaemia mutation carriers among participants to the Lausanne Institutional Biobank (BIL). Our experimental workflow was designed as a proof-of-concept demonstration of the resources and services provided by our integrated institutional clinical research support platform....
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2016.14326
更新日期:2016-08-06 00:00:00
abstract:OBJECTIVE:The methods used to diagnose and classify ovarian cancer have changed over the past decade. We used hospital registry data to assess the incidence, treatment durations and hospital costs of ovarian cancer in Switzerland. METHODS:We carried out a retrospective analysis of a hospital registry covering all inpa...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14647
更新日期:2018-07-29 00:00:00
abstract::In Switzerland, voluntary termination of pregnancy (VTP) can be performed in all public and private hospitals with an obstetrics/gynaecology department. For various reasons, many Italian women use the Swiss healthcare system, in particular in Canton Ticino, a border region adjacent to Italy in the southern part of Swi...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14636
更新日期:2018-07-09 00:00:00
abstract:OBJECTIVE:To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD:Between September 2015 and May 2017 30 patients (20 males, mean ± standa...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14591
更新日期:2018-02-09 00:00:00
abstract::A prominent 2014 series by The Lancet on "Increasing value, reducing waste in biomedical research" provided recommendations on how to optimise precious resources, including in clinical research. Despite being ideally placed to lead the movement in patient-oriented clinical research, academia struggles to take correspo...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2018.14615
更新日期:2018-04-26 00:00:00
abstract::The WHO recommends screening of Latin American migrants for Chagas disease to reduce morbidity and mortality and increase the likelihood of eradicating the disease. The objective was to assess the feasibility and acceptability of a screening strategy in one Swiss canton. From February 2011 to September 2012, people at...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20050
更新日期:2019-04-04 00:00:00
abstract::Congenital tuberculosis was first suspected in a premature infant with patent ductus arteriosus (PDA), progressive respiratory distress and septic shock, when an enlarged mediastinal lymph node was noted intraoperatively at the time of PDA ligature. Culture revealed Mycobacterium tuberculosis. The asymptomatic mother ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2002/41/smw-10101
更新日期:2002-11-23 00:00:00
abstract::The current situation of the biomedical sciences is critically discussed. It can be summarized as follows: 1. We have to acknowledge the presence of a serious credibility problem, which might undermine the foundations of medical science. ("Sliding on a slippery slope") 2. Multiple forces going beyond simple conflicts ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2015.14120
更新日期:2015-03-13 00:00:00
abstract:QUESTION UNDER STUDY:Domestic accidents are an important problem in paediatric medicine. This study was designed to gain a better understanding of burn mechanisms and target prevention. METHODS:Children treated for burn lesions in the Department of Paediatric Surgery between August 2004 and August 2005 were included i...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12605
更新日期:2009-09-19 00:00:00
abstract:QUESTIONS UNDER STUDY:In this work we wanted to evaluate the effect of intra-articular injection (IAI) at the knee joint of 1 ml of Diprospan on the hypothalamic-pituitary-adrenal (HPA) axis. METHODS:Consecutive patients attending the rheumatology or orthopaedic clinic with osteoarthritic knee pain not responding sati...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2015.14134
更新日期:2015-05-21 00:00:00
abstract::According to World Health Organisation estimates 1.1 billion people were overweight or obese worldwide in the year 2000 with the prevalence rapidly increasing. Compelling evidence suggests that excess body weight is a risk factor for several cancer types including cancer of the colon, breast, endometrium, kidney, oeso...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2007/03/smw-11435
更新日期:2007-01-27 00:00:00
abstract::After the health catastrophe resulting from the widespread use of asbestos which was once hailed as a new miracle material, the increasing use of carbon nanotubes (CNTs) has spawned major concern due to their similarities in terms of size, shape and poor solubility. Assessment of genotoxicity has shown that CNTs can d...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2012.13698
更新日期:2012-11-05 00:00:00
abstract:BACKGROUND:Sarcoidosis is a disorder of unknown aetiology. Most patients have steroid-responsive disease, but side effects and steroid resistance may necessitate alternative treatments. Endothelin has in-vitro fibrogenic activity and the endothelin system is activated in sarcoidosis. OBJECTIVES:We studied the efficacy...
journal_title:Swiss medical weekly
pub_type: 杂志文章,随机对照试验
doi:10.4414/smw.2018.14677
更新日期:2018-10-28 00:00:00
abstract:BACKGROUND:In recent years, several treatment modalities have proved to be effective in the treatment of neuroendocrine tumours (NETs). However, there is currently no consensus on the sequence in which these options are best used. METHODS:In this observational study, we analysed the treatment modalities and sequences ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20176
更新日期:2020-01-15 00:00:00
abstract::Cartilage hair hypoplasia (CHH) is a rare autosomal recessive ribosomopathy characterised by skeletal and integumentary system manifestations. It may also present with varied forms and intensities of haematopoietic and/or immune disorders. We report a 27-year-old female who presented a picture of combined immunodefici...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14606
更新日期:2018-04-24 00:00:00
abstract::More than seventy years after their initial characterisation, the aetiology of inflammatory bowel diseases remains elusive. A recent review evaluating the incidence trends of the last 25 years concluded that an increasing incidence has been observed almost worldwide. A north-south gradient is still found in Europe. Ge...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:smw-12549
更新日期:2009-05-16 00:00:00
abstract:OBJECTIVE:To analyze the immediate and midterm angiographic and clinical results of stent placement in the endovascular treatment of intracranial cerebral aneurysms. METHODS:Out of 330 cerebral aneurysms treated by endovascular approach in our neurovascular centre, stents have been used in 18 patients. Twelve aneurysm...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2008/43/smw-12396
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:To compare the efficacy of two different regimens in treatment of brucellosis. METHODS:This randomised clinical trial study was conducted on 280 patients with brucellosis in Babol, Iran, from April 1999 to January 2002. One of the following two regimens was randomly prescribed for two months: co-trimoxazole...
journal_title:Swiss medical weekly
pub_type: 临床试验,杂志文章,随机对照试验
doi:2004/37/smw-10665
更新日期:2004-09-18 00:00:00
abstract:BACKGROUND:The past 25 years have seen the increased use of minimally invasive surgery. The development of these techniques has impacted the domain of liver surgery. This study aimed to describe the safety, feasibility, benefits and results of laparoscopic liver resection in a single tertiary care centre. METHODS:We r...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2021.20391
更新日期:2021-01-20 00:00:00
abstract:QUESTION UNDER STUDY:To investigate the change over time in the number of ED admissions with positive blood alcohol concentration (BAC) and to evaluate predictors of BAC level. METHODS:We conducted a single site retrospective study at the ED of a tertiary referral hospital (western part of Switzerland) and obtained al...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.13982
更新日期:2014-08-07 00:00:00