[Scientific raisins from 125 year SMW (Swiss Medical Weekly) Q fever (Queensland fever) in Switzerland (endemic pneumonia caused by Rickettsia burneti). 1948].
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Biomedical subjects
Publications and source records attributed to O Gsell.
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Fifty years ago the first author of this paper described the entity known as idiopathic medial necrosis of the aorta. The present report describes two cases of ruptured aneurysm of the main pulmonary artery. The histologic alterations of the arterial wall were the same as in the much more common aneurysms of the aorta, viz. severe medial necrosis and mucoid degeneration. The findings are discussed and compared with 20 cases documented in the literature. Physical (hypertension) as well as biochemical factors appear to play an essential role in the pathogenesis of medial necrosis.
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Based on the new statistics of diagnoses from over 7 700 000 cases each year of the Swiss Hospital Association it can be demonstrated that all infectious diseases can also occur in the older age up of 65 years. Statistical data are given for each single infection. The morbidity of old people is rarely seized in contrary to mortality. The Swiss morbidity statistic shows that older persons are concerned in over 50% by pneumonia and herpes zoster, in 25-45% by septicemias, erysipelas and pulmonary tuberculosis, in only 1 until few percent by the classical children infections. The morbidity shows yearly considerable fluctuations depending on local epidemics (p.e. influenza), on the preexistent immunity (p.x. vaccinations) and the lesser resistance by risk factors of the individuals.
The longevity of a Swiss family with 867 descendants during 200 years from 1778-1980 is given in detail. The lifetime of 65 years or more was reached by 178 members, whilst in the years from 0-64 years 125 died and 564 are just today on life. 49% of the family members reached 70 years or more, all these born before 1910, in which period the average life-time at birth was between 49-52 years. The causes of death of the drop-out-cases (died before 65 years) are analyzed, happening mostly by infectious diseases, misfortune or exogenous risk factors. Essential is that no hereditary hypertension, metabolism or biochemical diseases, epilepsy was seen. Of the factors of longevity could be excluded climate of habitation occupation, had social or educational position. The hereditary longevity is broken only for some individuals by exogenous damage and can be seen as a privilege of this large family.
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The guidelines of medical ethic are recommendations of the Swiss Academy of Medical Sciences to the medical doctors to overcome the difficulties of medicine and modern technics and social problems. In an introduction the duties of the physician and his behaviour in the hippocratic mind are exposed, without asking for an oath. The recommendations give I. essential rules of international health organisations and II. Medical-ethic guidelines regarding different questions: 1. research examinations on men 2. euthanasia 3. transplantation 4. artificial insemination 5. sterilisation, especially the operative sterilisation of mentally handicapped persons, without acceptation of the so-called forced sterilisation 6. medical-ethical committees. The newly founded medical-ethical commission of the Swiss Academy of Medical Sciences and its organisation with physicians and laymen is explained. Its different functions are: a) answers to inquiries of international or national organisations and of individual persons b) formulation of principal ideas for medical-ethical questions, which will arise also in the future, not only on research, but also on diagnostic, therapeutic or prophylactic problems. These medical-ethical guidelines are formulated in few words to help the medical doctor for a quick consultation. They give a legal ethic. The Swiss Academy of Medical Sciences considers this as one of her tasks: to guard and to guard and to advance ethical devices in medicine.
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A prospective mortality study of tobacco smoking of Swiss physicians is reported over a period of 18 years (1955-1973). The mortality rate increases with the intensity of the daily smoking quantity, going till to the double of non-smokers. This elevation is not seen in late smokers. Contrary to the habits of English doctors, who smoke mostly cigarettes, in Switzerland the death rates of cigars (mostly Stumpen) and pipe smokers are as much elevated as for cigarette smokers. In intensive smokers the mortality reached for all 3 the same rate (2,4-2,6). Under the various causes of death lung cancer was only seen in smokers (92,5% intensive smokers). Heart infarctions death has in smokers the highest rate in the age of 35-54 years, going back till 75 years where the death rate is nearly the same as in non-smokers. The passover in mortality of the intensive smokers in full activity of life is documentated by the statistic of Swiss Doctors. Therefore it is a positive factor that in the last 18 years the number of cigarette-smokers in physicians declined from 37% to 21% and the number of past-smokers has gone up from 17 to 38%, but the number of only cigars and pipesmokers is always the same.