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Biomedical subjects

S Tschudin

Publications and source records attributed to S Tschudin.

9 recordsLinked to original sources
PubMed2006

[Dangerous fever].

Fever is a frequent symptom which can arise as a consequence of bacterial, viral and parasitic infections. Additionally, fever is a frequent symptom in non-infectious diseases, e.g. autoimmune diseases or lymphomas. The term dangerous fever describes febrile conditions which are associated with high mortality and, in most cases, mandate hospitalization, and even monitoring in an intensive care unit. As a rule, infections (bacterial infections in particular) may begin harmlessly; however, they can instantaneously change into life-threatening conditions even a few days later. In the following report we focus on some critical syndromes which must be recognized quickly, such as severe sepsis, septic shock, fever in neutropenia, and fever in the immunocompromised patient.

AIDS-Related Opportunistic Infections↗
PubMed2005

[Antidepressants and pregnancy].

Depressive disorders in women are not uncommon during the reproductive period. Identifying women at risk for the development of depression, early detection of depressive symptoms and an adequate treatment are important issues in preventing severe chronic depressive disorders. Do psychotherapeutic interventions not show any sufficient benefits, the use of antidepressants is indicated. In the meantime sufficient data are available concerning the use of anti-depressants during pregnancy to exclude any serious damage to the fetus or newborn. As a basic principle, a monotherapy should be favoured and the drug applicated in the lowest efficient dose. Due to the SSRI's side effect profile the choice of the antidepressant should be done in favour of serotonin reuptake inhibitors rather than tri- and tetracyclic antidepressants. For both substance groups there is no hint for any teratogenic potential. Benzodiazepine should be prescribed with caution. Negative long term effects to the newborn cannot be excluded. Based on few available data, indeed, there exists no reservation against the use of St. John's wort during pregnancy and breastfeeding. A profound ultrasound screening of the organs should be performed in case of lithium exposition, whereas newer studies showed no increase in risk for Ebstein anomaly. A multidisciplinary approach, including psychiatry, obstetrics and neonatology should be always aimed at in case of depressive disorders during pregnancy.

Antidepressive Agents↗
PubMed2005

[Immediate care for women after sexual and physical assault].

The management of recent sexual and physical assault in women has two aims: to provide medical and psychological care for the victim and to prevent possible health consequences of the trauma on one hand, and to facilitate the forensic assessment with regard to the perpetrator's prosecution on the other. The victim should always be encouraged to report an offence to the police and forensic medicine should be called in to assist in the victim's examination, whenever possible. In addition, emergency contraception and prophylactic measures against sexually transmitted infections (STI), especially HIV, must be offered. The profound emotional impact of sexual and physical assault requires knowledgeable and sensitive crisis intervention on the part of the counsellor and referral for ongoing counselling and support must be made available. A well trained and competent sexual assault care team with a sympathetic and non-judgemental attitude can contribute profoundly to the assaulted woman's regaining control over her life and being able to overcome the experienced trauma.

Crime Victims↗
PubMed2005

[Menstruation and its impact on women's health].

The impact of menstruation on women's health manifests itself on different levels. The sociocultural dimension shows the influence of societal and cultural norm, which regulate the way of dealing with menstruating women. These rules are at first glance in most cultures characterized by rather expulsion, rejection and submission of women. At a closer look many traditions however reflect the fascination and the power which is associated with the "blood of women", which means that throughout history menstruation is conceived in an ambivalent manner. This ambivalence is still present in the subjective experience of modern women, who experience the biological process of menstruation but finally attribute emotional and cognitive meaning to it. This means that women finally decide when menstruation becomes a "disease" for them. Many empirical studies show that although a majority of women declare menstruation as something negative and disturbing, only a much smaller percentage would want to get rid of it, because menstruation seems to be associated with feelings of connectedness with nature and with other women. The biomedical view on menstruation is historically new and quite different: uterine bleeding can either be a sign of disease (uterus, ovaries) or it can lead to anemia, pain, anxiety, frustration in women consulting. Menstrual disorders are in fact one of the most frequent reasons for consultation. Modern medicine has developed a large range of interventions which modify or abolish menstruation. From a medical standpoint menstruation is not necessary and may be obsolete. The transition from "healthy menstruation" to "menstruation related diminution of quality of life", to "Menstrual Disease" is continuous and has to be elaborated in the physician patient interaction, the patient being expert for her values, aims and health objectives and the physician being the expert for knowledge and information. The patient has to use this to come to a personal and individual solution of her menstruation problem.

Female↗
PubMed2004

Acceptability and side-effects of Implanon in Switzerland: a retrospective study by the Implanon Swiss Study Group.

DESIGN: A multicenter, retrospective study of the single-rod contraceptive implant, Implanon (NV Organon, Oss, The Netherlands), was carried out in Switzerland in 1183 women. METHODS: Assessments included duration of use, bleeding pattern, side-effects and subjective acceptability and satisfaction with the method. RESULTS: A total of 991 women (84%) had at least one follow-up visit and 306 (26%) had two visits with a mean duration between insertion and follow-up of 224 days (7.4 months) and 347 days (11.4 months), respectively. Implanon was removed prematurely in 235 women (24%), primarily because of side-effects (20%) and for family planning reasons (4%). Side-effects leading to discontinuation were mainly bleeding disturbances (45%), acne (12%) and other reasons (15%). The mean duration between insertion and removal for discontinuers was 280 days (9.2 months). Side-effects related to bleeding (visit 1) included infrequent bleeding (28%), amenorrhea (33%), prolonged bleeding (15%), and metromenorrhagia (frequent and heavy bleeding) (16%). Other reported side-effects at visit 1 included dizziness (12%), acne (11%), mood swings (8%) and headache (5%). The incidence of side-effects reported at visit 2 was generally comparable to that at visit 1. CONCLUSIONS: The results of this study show that early discontinuation of implant use is primarily due to bleeding problems. Extensive counseling before implant insertion may help to prevent this. It is also important to develop an easy solution to successfully treating progestogen-induced bleeding disturbances.

Adult↗
PubMed2003

[Effects on the quality of life of a new oral contraceptive containing 30 mcg EE and 3 mg drospirenone (Yasmin)].

In a clinical multicenter observational study including 584 women attended by 99 participating gynaecologists the quality of life changes after 3 month use of an oral contraceptive preparation containing 30 mcg ethinylestradiol (EE) and 3 mg drospirenone was evaluated through the use of a self developed questionnaire using 20 items with a 5 scale answer scheme. We found a mean positive change of life quality of 7.3%. Significant changes were observed regarding subjective experiences of weight, skin, hair, cycle, attractivity, libido and mental wellbeing.

Adult↗
PubMed2001

[Psychosocial and psychosomatic basic competence of the gynecologist--from intrinsic conviction to a learnable curriculum].

The gynecologist is confronted with many tasks for which she/he needs psychosocial competence: patient education and health promotion, counselling, and management of psychosocial problems during the various phases of a woman's life cycle, care for patients with chronic diseases. To obtain this competence, a curriculum is needed which comprises elements of psychology, psychosocial medicine, and psychiatry adapted to the specific needs in women's health care. Knowledge and skills derived from communications theory and practice include the semiotic and pragmatic model of communication, physician- and patient-centered communication, counselling for health behavior changes, breaking bad and sad news, coping, and supportive counselling.

Communication↗
PubMed2001

[Psychosocial and psychosomatic basic competence of the gynecologist--from intrinsic conviction to a learnable curriculum. (2. Biosychosocial model and basic psychiatric therapy].

Besides the communicative skills and medical interviewing techniques (part 1 in Gynäkol Geburtshilfliche Rundsch 2001;41:158-165), it is the biopsychosocial model of health and disease which constitutes the second important element of the basic psychosomatic and psychosocial competence of the gynecologist. According to this model biological-somatic and psychosocial factors are concomitantly and equally taken into account during the diagnostic and therapeutic process. To conceptualize the possible pathology of psychosocial factors, the following categories have proven helpful in everyday work: behavior, stress, conflicts and developmental defects and disturbances. These categories are not objectively measurable, but they are accessible for the gynecologist in the consultation by means of the three following functions: assessment and monitoring of the patient's problems (somatic, psychological, social) by patient-centered communication; establishment, maintenance and termination of a therapeutic helpful relationship by perception of and response to emotions; development of a problem-solving plan and help for its realization by means of information giving and influencing behavioral changes.

Adult↗