In autosomal dominant polycystic kidney disease (ADPKD), aberrant activation of the mammalian target rapamycin (mTOR) pathway is associated with progressive enlargement. The drug sirolimus suppresses mTOR signaling.In this 18-month, open-label, randomized, controlled trial, we sought to determine whether halts growth in volume among patients ADPKD. We randomly assigned 100 between ages 18 and 40 years receive either (target dose, 2 mg daily) or standard care. All had an estimated creatinine...

Rationale: To establish a new approach to investigate the physiological effects of obstructive sleep apnea (OSA), and evaluate novel treatments, during period continuous positive airway pressure (CPAP) withdrawal.Objectives: determine CPAP withdrawal.Methods: Forty-one patients with OSA receiving were randomized either withdrawal (subtherapeutic CPAP), or continued CPAP, for 2 weeks. Polysomnography, sleepiness, psychomotor performance, endothelial function, blood (BP), heart rate (HR),...

Objectives To describe the prevalence and determinants of potentially inappropriate medication (PIM) use association with hospitalizations in an elderly managed care population Switzerland. Methods Using health claims data four insurers for a sample patients 65 years age older to compare persons on PIM not PIM. Beers' 2012 PRISCUS criteria were used determine potential inappropriateness prescribed medications. The included 16′490 33′178 time period January 1, 2008 through December 31, 2012....

Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular mortality. Endothelial dysfunction may underpin this association. This cross-sectional study aimed to determine the impact of airflow obstruction, systemic inflammation, oxidative stress, sympathetic activation, hypoxaemia and physical activity on endothelial function in COPD. In stable COPD patients, assessments by flow-mediated dilatation (FMD), risk (Pocock score), obstruction (forced expiratory...

Abstract Background General practitioners often care for patients with several concurrent chronic medical conditions (multimorbidity). Recent data suggest that multimorbidity might be observed more than isolated diseases in primary care. We explored the age- and gender-related prevalence of compared these estimates to other common specific found Swiss Methods analyzed from FIRE (Family Medicine ICPC Research using Electronic Medical Record) project database, representing a total 509,656...

Patients with severe thrombocytopenia are at risk for bleeding during insertion of central venous catheters (CVCs). Although most guidelines recommend preprocedural platelet (PLT) transfusions a threshold less than 50 × 10(9) /L, there is only weak evidence supporting such recommendations.The current study aimed to establish safe PLT transfusion trigger in patients CVC placements. We performed retrospective single-center analysis 604 insertions 193 acute leukemia receiving intensive...

Traditionally, single-unit red blood cell transfusions were believed to be insufficient treat anemia, but recent data suggest that they may lead a safe reduction of transfusion requirements. We tested this hypothesis by changing from double- policy.We performed retrospective cohort study in patients with hematologic malignancies receiving intensive chemotherapy or hematopoietic stem transplantation. The major end-points the total number units per therapy cycle and day aplasia. comprised 139...

Detecting elder abuse is challenging because it a taboo, and many cases remain unreported. This study aimed to identify types of investigate its associated risk factors.Retrospective analyses 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton Zurich, Switzerland, from January 1, 2008 October 31, 2012. Characteristics victims perpetrators, abuse, factors related victim or perpetrator were assessed. Bi- multivariate analysis used neglect determinants.A total...

Tackling antibiotic resistance represents one of the major challenges in modern medicine, and limiting antibiotics' overuse first step this fight. Most antibiotics are prescribed primary care settings, lower respiratory tract infections (LRTIs) most common indications for their prescription. An expert panel conducted an extensive report on C-reactive protein point-of-care (CRP POC) testing evaluation LRTIs its usefulness to limit prescriptions. The stated that CRP POC is a potentially useful...

Potentially inappropriate medication (PIM) exposes patients to an increased risk of adverse outcomes. Many lists explicit criteria provide guidance on identifying PIM and recommend alternative prescribing, but the complexity available limits their applicability amount data prescribing.

Bloch, Konrad E., Alexander J. Turk, Marco Maggiorini, Thomas Hess, Tobias Merz, Martina M. Bosch, Daniel Barthelmes, Urs Hefti, Jacqueline Pichler, Oliver Senn, and Otto D. Schoch. Effect of ascent protocol on acute mountain sickness success at Muztagh Ata, 7546 m. High Alt. Med. Biol. 10:25-32, 2009.-Data acclimatization during expedition-style climbing to > 5000 m are scant. We evaluated the hypothesis that minor differences in influence (AMS) symptoms mountaineering climbers Ata (7546...

Abstract Background: Individuals with severe deficiency in serum α1-antitrypsin (AAT) concentrations are at high risk for developing chronic obstructive pulmonary disease (COPD), whereas those carrying the PI*MZ genotype slightly increased risk. Testing appropriate subgroups of population AAT (AATD) is therefore an important aspect COPD prevention and timely treatment. We decided to perform exhaustive investigation SERPINA1 gene variants individuals from general a moderately reduced...

Abstract Background Understanding the environmental and genetic risk factors of accelerated lung function decline in general population is a first step prevention strategy against worldwide increasing respiratory pathology chronic obstructive pulmonary disease (COPD). Deficiency antioxidative detoxifying Glutathione S-transferase (GST) gene has been associated with poorer children, smokers patients diseases. In present study, we assessed whether low activity variants GST genes are also adult...

Research is scarce where most patients are found. One of the main reasons difficulty in extracting data from traditionally conducted paper-based medical records. Thus, until now existing patient records have originated invoicing-tools. Endeavours to truly reflect a doctor's consultation been rare. FIRE (Family Medicine ICPC-Research using Electronic Medical Records) an ambitious project establish proper knowledge base primary care by ongoing implementation EPR (electronic records). will...

Abstract The increasing pervasiveness of urban systems and networks utilizing digital technologies for their operation generates enormous amounts traces capable reflecting in real-time how people make use space infrastructures the city. This is not only transforming we study, design, manage cities but opens up new possibilities tools that give access to up-to-date information about dynamics, allowing them take decisions are more sync with environment. paper documents ongoing LIVE Singapore!...

We investigated the associations of anthropometry, training, and pre-race experience with race time in 93 recreational male ultra-marathoners (mean age 44.6 years, s = 10.0; body mass 74.0 kg, 9.0; height 1.77 m, 0.06; index 23.4 kg · m(-2), 2.0) a 100-km ultra-marathon using bivariate multivariate analysis. In analysis, (r 0.24), sum eight skinfolds 0.55), percent fat 0.57), weekly running hours -0.29), kilometres -0.49), speed during training -0.50), personal best marathon 0.72) were...

Abstract Background and objective Both comorbidities physical inactivity have been shown to impair quality of life contribute hospital admissions mortality in chronic obstructive pulmonary disease ( COPD ) patients. We hypothesized that the comorbid status predicts level daily activity PA . Methods In 228 patients with (76% men; median (quartiles) age: 64 (59/69) years; percentage predicted forced expiratory volume 1 s FEV % pred): 44 (31/63)), were assessed by medical history, clinical...

Polypharmacy is an increasing problem, leading to increased morbidity and mortality, especially in older, multimorbid patients. Consequently, there a need for reduction of polypharmacy. The aim this study was explore attitudes, beliefs, concerns towards deprescribing among patients with polypharmacy who chose not pursue at least one their GP's offers deprescribe. Exploratory using telephone interviews cluster-randomized Northern Switzerland. interview included qualitative part consisting...

Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates use varied due to different definitions study populations.We aimed measure population-based incidence time trends PPI potentially prescriptions (PIPPI) with novel method, continuously assessing excessive cumulative doses based on clinical practice guidelines. We also assessed association patient characteristics PIPPI.This...