[Sudden death following bypass surgery].
Explore the source record for details and available documents.
Coronary Artery Bypass↗
Biomedical subjects
T Ritschard
Publications and source records attributed to T Ritschard.
[Imported tsutsugamushi fever].
Scrub typhus rarely figures among the imported tropical diseases in western Europe. Rickettsia tsutsugamushi is transmitted by larval mites. A typical eschar develops at the site of the mite bite during the incubation period, after which systemic symptoms (remittent or continuous high fever, severe headache, tender lymphatic glands and symptoms of bronchitis) develop with sudden onset. Antibodies appear during the second week and can be shown by a positive and increasing titer against Prot. OXK (Weil-Felix) or by specific rickettsial agglutination. The Weil-Felix reaction is neither very sensitive nor very specific. Therefore, treatment should be started as soon as suspicion arises whether a positive serology is available or not. Tetracycline drugs are effective treatment and fever subsides in less than 24 hours in most patients. - We report the rare observation of a tourist who imported tsutsugamushi fever from India.
Animals↗
[The prevention of atherosclerosis].
Factors indicative of an increased risk for atherosclerotic disease comprise hereditary factors, male sex, abuse of tobacco, elevated total and LDL-cholesterol, hypertension, obesity and diabetes. Effective prevention is possible along two strategies: 1. population-oriented, using guidelines for life style, and 2. individual-oriented by identifying and treating those at significant risk. Changes in life style like to dispense with smoking, dieting and reducing cholesterol intake have to be tried before pharmacotherapy is attempted. Preventive measures should be encouraged as early as possible, ideally as health-conscience education of children. Efficient drugs are available but not very cost-efficient. They are useful as adjunct in selected cases.
Arteriosclerosis↗
[Thrombolysis in acute myocardial infarct. Initial experiences in a Swiss university hospital].
Preliminary experience with thrombolytic therapy in patients with acute myocardial infarction and its practicability in a CCU of a Swiss university hospital are presented. Out of 674 patients with a transmural or non-transmural infarction, 72 (11%) have been treated with thrombolytic agents since March 1986. 53 of these patients were included in the "European Cooperative Study Group" multicenter trial and treated with recombinant tissue plasminogen activator (rt-PA) or placebo; the other 19 patients received streptokinase i.v. with the same inclusion/exclusion criteria. The results corresponded to the well known effects of early thrombolysis with improvement in infarct size reduction, cardiac performance and early mortality.--The importance of the time factor and the implications regarding information of potential patients and practitioners and organization of rapid hospitalization are outlined. Follow-up (after a mean of 14 months) of our 72 thrombolysis patients revealed a high percentage of patients still dependent on medical care, reduced physical capacity in almost half of the patients and (a favourable result) a large number of patients who stopped smoking after the infarction. --In view of the slight additional stress caused by this therapy for patients, physicians and nursing staff, the use of thrombolytic agents in acute myocardial infarction should (with strict inclusion/exclusion criteria) be rapidly generalized in the hospitals of Switzerland.
Clinical Trials as Topic↗
[Mitral annular calcification in dialysis patients].
Degenerative mitral anular calcifications (MAC) are most often found between the posterior mitral anulus and the left ventricular posterior wall. In advanced stages they may encircle the mitral valve and thus involve the insertion of the anterior mitral leaflet and the posterior part of the aortic root. They are usually found only after the age of 70. Among 33 patients on chronic dialysis for renal failure who were investigated by echocardiography (2-D and m-mode) we found an MAC incidence of 55% but no cases among a control population of the same age and sex (p less than 0.001). The diameter of the calcification exceeded 5 mm in 9 cases out of 18. Four of these calcifications extended in a circular fashion around the mitral valve. Additional significantly associated echocardiographic features included dilatation of the left atrium and sclerosis of the aortic root and valve. Furthermore, 12 patients with MAC had dysfunction of the mitral valve (p less than 0.05), viz. 10 isolated mitral valve regurgitations and 2 mitral stenosis, combined with regurgitation. The patients with MAC were older than those without MAC, their mean duration of dialysis was longer and parathormone level higher. The incidence of mitral anular calcifications is much higher among patients on chronic dialysis. The clinical significance of these calcifications lies primarily in the consequent dysfunction of the mitral valve.
Adult↗
[Side effects of non-steroidal antirheumatic agents on the lower intestinal tract].
Two women, aged 21 and 44 years, developed ileocolitis and proctocolitis, respectively, lasting for several weeks after taking non-steroidal anti-inflammatory drugs (Diclofenac; Pyrazinebutazone). This relatively little known side effect of these drugs on the lower intestinal tract is apparently not rare.
Adult↗
[Inflammatory bowel disease and hormonal contraception].
Case reports and controlled studies show a definite relationship between the use of oral contraceptives and chronic inflammatory bowel disease. Based on a review of the literature, the clinical, radiological and endoscopic features of bowel disease associated with the use of oral contraceptives are described and the pathogenesis is discussed. The use of contraceptives should be inquired into in any women presenting with chronic enteritis or colitis, since this could be of decisive prognostic and therapeutic importance.
Adult↗
[Acute pseudo-obstruction of the colon (Ogilvie's syndrome). Internal medicine aspects].
Four patients with acute colonic pseudo-obstruction are described. The clinical and radiological picture is suggestive of colonic obstruction, without detectable organic obstruction. The syndrome usually occurs after surgery or trauma, or is related to severe preexisting systemic illness; its association with alcohol intake is frequently overlooked. The most severe complication is cecal rupture, which may occur at a diameter of 12 cm or more and which has a lethality rate of 40%. The primary management of colonic pseudo-obstruction is conservative, and includes an attempt at colonoscopic decompression; in most cases cecostomy can be avoided.
Adult↗
[Influencing factors related to narcotic consumption and leisure sports in juveniles].
This report presents some results of a survey of 2872 men and women of 17 to 18 years of age. A multivariate analysis shows a strong association of consumption of illegal drugs with that of tobacco and alcohol, as well as with absence of spare time sports activities (men) and excessive use of medicaments (women). The results favour a multifactorial model of prevention of drug abuse.
Adolescent↗