INTRODUCTION:A 71-year-old patient with known metastatic melanoma undergoing treatment with the immune checkpoint inhibitors Ipilimumab/Nivolumab presented with a rapid deterioration in general condition over the past 24 hours. Approximately three weeks after starting ICI-the-rapy, thyroiditis was diagnosed, which progressed to a substitution-requiring hypothyroidism. Currently, laboratory tests revealed severe keto-acidosis with acute blood sugar derangement (51 mmol/l) despite only a mildly elevated HbA1c (6.3 %). We hereby diagnosed fulminant ICI- associated type 1 diabetes mellitus. Symptoms improved under insulin therapy.
INTRODUCTION:A 77-year-old patient presents with acute back pain. Due to elevated CRP and other lab abnormalities, bacterial spondylodiscitis is initially suspected, and blood cultures are obtained early. However, a biopsy reveals uric acid crystals and cultures remain negative, leading to the diagnosis of gout spondylodiscitis. Treatment includes renal-adjusted anti-inflammatory therapy, urate-lowering therapy and flare prophylaxis.
INTRODUCTION:This guideline (GL) provides an overview of the management of dyslipidaemia based on international guidelines and new evidence from studies published up to June 2026. The GL focuses on primary care and takes into account the specific characteristics of the Swiss healthcare system. Lipid-lowering therapy should be risk-adapted, with the current 2025/2026 AGLA, ESC/EAS, and ACC/AHA dyslipidaemia GLs recommending a target-based treatment strategy. Our GL presents a structured approach to cardiovascular risk stratification and supports clinicians in selecting the most appropriate risk prediction model for individual patients. Risk modifiers - including family history, ethnicity, comorbidities, biomarkers, and lipoprotein(a) - should be considered in addition to traditional cardiovascular risk factors. In addition to lifestyle optimization, statins remain the first-line treatment. If the required LDL-C reduction is not achieved with statins alone, Ezetimibe, bempedoic acid, and PCSK9 inhibitors should be added sequentially.
INTRODUCTION:A 93-year-old woman presented herself with subacute exertional dyspnea in our primary care setting. Imaging revealed a large pericardial cyst without echocardiographic evidence of hemodynamic compromise. Instead, findings were consistent with heart failure with preserved ejection fraction (HFpEF) in the context of hypertensive and valvular heart disease. Optimization of heart failure therapy, including initiation of an SGLT-2 inhibitor, led to clinical improvement. This case highlights the importance of integrating imaging findings into the overall clinical context in primary care.
INTRODUCTION:Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure, arrhythmias, and conduction disease. After exclusion of light-chain amyloidosis, diagnosis can often be established non-invasively by bone scintigraphy with SPECT. Disease-modifying therapies are now available in Switzerland and are most effective when initiated early. Management should also address heart failure, atrial fibrillation, thromboembolic risk, conduction disorders, and concomitant aortic stenosis. Early recognition and multidisciplinary treatment are therefore essential to improve outcomes.
INTRODUCTION:We report the case of an 88-year-old female patient presenting with progressive, severely pruritic skin lesions and scattered blisters on the trunk and extremities. Histological examination revealed subepidermal blister formation with a neutrophil-rich infiltrate. Differentiation from other autoimmune blistering diseases was initially challenging. The diagnosis was ultimately guided by the linear IgA deposition pattern along the dermoepidermal junction on direct immunofluorescence. This case highlights the diagnostic difficulties of this rare condition and the rapid clinical improvement following appropriate therapy.
INTRODUCTION:Case report of a young immunocompetent patient presenting with aseptic meningitis due to varicella-zoster virus (VZV) infection. Reactivation of VZV manifesting as meningitis is an uncommon clinical presentation compared to herpes zoster. While a concomitant vesicular rash is frequently observed, it may be absent in some cases. With antiviral therapy initiated promptly, the clinical outcome is generally favorable.
INTRODUCTION:We present a case of recurrent international normalised ratio (INR) derailment during treatment with phenprocoumon for sinus vein thrombosis. During the course of the illness, the patient developed signs of bleeding, such as epistaxis, gross haematuria and vaginal bleeding, as well as elevated liver enzyme levels. This ultimately led to hospitalisation, where a diagnosis of acute hepatitis associated with drug-induced liver injury (DILI) was made. Following the discontinuation of phenprocoumon and a switch to apixaban for anticoagulation therapy, as well as repeated administration of vitamin K, the patient's condition stabilised. The laboratory findings, liver biopsy and clinical course are most consistent with toxic hepatitis caused by phenprocoumon.
INTRODUCTION:A 48-year-old man was diagnosed with IgG4-related disease (IgG4-RD) during an evaluation for exophthalmos and unexplained pain on the left side of his face. The diagnosis was made by ruling out all other possible conditions and was based on histopathological findings. After initiating immunosuppressive therapy with corticosteroids (GC), most of the symptoms resolved. As the GC-dose was gradually reduced, a relapse occurred, leading to two courses of Rituximab. Reflecting the success of the therapy, long-term follow-up revealed a marked radiological reduction in the retrobulbar mass and a significant clinical improvement in pain.
INTRODUCTION:Chronic wounds remain a major problem despite advances in wound care. Around 1 % of the population is affected and experiences a significant reduction in quality of life as a result. General practices are often the first port of call for impaired wound healing and chronic wounds. They are responsible for the comprehensive assessment and management of wounds and their underlying causes. This article summarises the current state of knowledge and recommendations, taking into account a cost-effective approach.
INTRODUCTION:Measles is a highly contagious viral disease whose incidence has declined significantly since the introduction of vaccination in the mid-1970s. However, local outbreaks continue to occur due to insufficient vaccination rates. Adults are at higher risk of complications. The present case of a patient with acute post-infectious measles encephalitis despite a history of presumed measles vaccination underscores the critical importance of vaccination as a preventive measure. In everyday general practice, there is an opportunity to identify individuals who have not been vaccinated against measles and to guide them toward achieving full vaccination coverage.
Este trabajo examina los antecedentes intelectuales que propiciaron el surgimiento de la Revolución Científica, centrándose en la influencia de William Gilbert como precursor de esta transformación. Se explora cómo sus hipótesis y descubrimientos, particularmente el modelo heliocéntrico magnético, articularon un debate fundamental en el que figuras como Cabeo, Kepler y Descartes posicionaron la evidencia y la razón en el centro de debate para entender el cosmos. Asimismo, se analiza el papel de Galileo Galilei en la consolidación del método científico mediante la experimentación y el formalismo matemático. Finalmente, el artículo aborda la creación de la Royal Society de Londres como el hito de institucionalización del conocimiento. Si bien el estudio revisa pocos descubrimientos, establece el marco histórico e intelectual necesario para comprender el desarrollo de la teoría electromagnética.
El presente artículo describe el diseño, construcción y caracterización experimental de un prototipo de telescopio refractor tipo kepleriano, desarrollado como una propuesta para la enseñanza de la óptica geométrica. El sistema óptico se construyó con un lente objetivo convergente de 75 mm de diámetro y distancia focal aproximada de 54 cm, junto con un ocular compuesto por cuatro lentes convergentes con distancia focal efectiva cercana a 3 cm. El prototipo se ensambló utilizando materiales accesibles, principalmente tubos de polivinilcloruro (PVC), incorporando un mecanismo de enfoque deslizante y un acoplador para captura digital mediante cámara web. A partir de pruebas de observación terrestre y lunar se calibraron rangos de enfoque entre 2 m e infinito, y se verificó una magnificación aproximada de 18×, coherente con el modelo teórico de lentes delgadas. Las observaciones permitieron identificar aberraciones cromáticas propias del uso de lentes simples, así como limitaciones en la captura digital a distancias superiores a 40 m. Se concluye que es posible construir un telescopio funcional de bajo costo (52,00 USD) con potencial para ser utilizado como recurso en la enseñanza experimental de la óptica y la astronomía
En el presente trabajo se analiza el papel del lenguaje científico en el aprendizaje de la Física desde una perspectiva epistemológica y cognitiva. A partir de una revisión narrativa de la literatura en didáctica de las ciencias y alfabetización disciplinar, se evidencia que el lenguaje no solo cumple una función comunicativa, sino que constituye una herramienta fundamental para la construcción del conocimiento, al permitir comprender conceptos abstractos, establecer relaciones causales entre variables y explicar fenómenos físicos. En este marco, se examina cómo la escritura y la oralidad científica favorecen el desarrollo de procesos cognitivos de orden superior, tales como la argumentación, la explicación y la regulación del pensamiento. En particular, se propone una clasificación de los niveles de escritura en función de su impacto cognitivo, diferenciando entre formas reproductivas, organizativas y epistémicas. Se concluye que la escritura epistémica, en articulación con la oralidad disciplinar, promueve la transformación del conocimiento y el desarrollo del pensamiento científico. Por ello, en el contexto universitario, resulta imprescindible fomentar el uso intencional del lenguaje científico como eje articulador del aprendizaje en Física.
La pregunta sobre si la Inteligencia Artificial (IA) nos reemplazará ha pasado de ser ciencia ficción a estar hoy en el centro del debate científico, económico y ético. A lo largo de la historia, cada revolución industrial transformó el trabajo: el vapor desplazó oficios artesanales y consolidó la fábrica; la electrificación y el motor de combustión impulsaron la producción en masa; la digitalización automatizó tareas administrativas y expandió el sector tecnológico. La actual Cuarta Revolución Industrial, basada en IA, extiende la automatización hacia funciones cognitivas complejas, acelerando la reconfiguración laboral. Este artículo desarrolla una revisión histórica entre las revoluciones industriales, identificando qué empleos desaparecieron, cuáles emergieron y cómo se reorganizó el mercado laboral en cada etapa. La evidencia sugiere que la IA no elimina el trabajo humano, sino que redefine sus competencias y su valor productivo
La medición precisa del tiempo representó durante siglos un desafío científico y tecnológico. En 1656, el matemático y físico neerlandés Christiaan Huygens desarrolló el primer reloj de péndulo preciso, basado en el principio del isocronismo del péndulo observado previamente por Galileo Galilei. Este trabajo analiza el contexto científico en el que surgió este invento, las limitaciones de los relojes mecánicos anteriores y el funcionamiento del mecanismo que permitió mejorar notablemente la exactitud en la medición del tiempo. Asimismo, se analiza el perfeccionamiento del reloj de péndulo, destacando su versión de mayor precisión.
INTRODUCTION:A 58-year-old patient presented with progressive cerebellar ataxia and lymphocytic pleocytosis with normal MRI findings. Detection of Anti-TR(DNER) antibodies led to the diagnosis of paraneoplastic encephalitis. Tumor workup revealed anaplastic large cell lymphoma. Combined immunotherapy and chemotherapy resulted in clinical stabilization.
