Fractures are a frequent complication of osteoporosis, often leading to chronic pain, reduced mobility and a lower quality of life. Early detection of osteoporosis is vital, with diagnostic tools such as dual-energy X-ray absorptiometry (DEXA) and the Fracture Risk Assessment Tool (FRAX) providing accurate assessments of bone health and fracture risk. Treatment options continue to evolve, targeting various facets of bone metabolism. Anabolic therapies, such as parathyroid hormone analogs, promote new bone formation, while antiresorptive treatments, including bisphosphonates and monoclonal antibodies, help prevent further bone loss. Emerging combination therapies, such as romosozumab combined with denosumab, show enhanced efficacy in reducing fracture risk. For patients with vertebral fractures, minimally invasive procedures such as vertebroplasty and kyphoplasty can provide pain relief and restore spinal stability. Additionally, specific surgical techniques address special cases, such as sacral fatigue fractures and spinopelvic dissociation. For example, sacroplasty is effective for stabilizing sacral fractures, while spinopelvic triangular stabilization can restore function in complex spinopelvic injuries. Through a comprehensive approach that integrates prevention, advanced diagnostics, personalized treatments and precise surgical interventions, osteoporosis management can significantly improve patient outcomes and quality of life. PEER REVIEWED ARTICLE **Peer reviewers:** Prof. Dr Pedro L. Berjano, MD, PhD, Division of Spine Surgery (GSpine4), IRCCS Ospedale Galeazzi – Sant’Ambrogio, Milan, Italy Prof. Dr Pau Heini, Spine Surgery Department, Klinik Sonnenhof, Bern, Switzerland Prof. Dr Kan Min, Swiss Scoliosis – Centre for Spinal and Scoliosis Surgery, Hirslanden Klinik Im Park, Zurich, Switzerland Critical review by Prof. emer. Dr Max Aebi, University of Bern, Switzerland, and McGill University, Montreal, Canada Received on October 10, 2025; accepted after peer review on November 20, 2025; published on December 12, 2025.
Vasopressin is a non-catecholaminergic vasopressor with proven advantages in the treatment of vasodilatory states such as septic shock. Its clinical utility in this context is supported by its ability to stabilize blood pressure and tissue perfusion, reduce the norepinephrine dose and mitigate adrenergic side effects. While norepinephrine remains the first-line drug in septic shock, vasopressin serves as an adjunct therapy, typically added when norepinephrine fails to achieve the target mean arterial pressure (MAP) despite adequate fluid resuscitation. This 2^nd^ Swiss Vasopressin Consensus Report provides updated, evidence-based and practice-oriented guidance on the use of vasopressin in septic shock and selected vasodilatory states. Building upon the 1^st^ Swiss Consensus Report from 2021, this document integrates recent clinical data and expert insights and addresses practical gaps in the 2021 Surviving Sepsis Campaign (SSC) guidelines, such as vasopressin dosing, vasopressor weaning and hemodynamic monitoring. A structured treatment algorithm for the early use of vasopressin -- before the onset of catecholamine-refractory shock -- is presented. Beyond its established role in septic shock, the expert panel reviewed additional potential indications for vasopressin, including vasoplegic syndrome following cardiac surgery with cardiopulmonary bypass (CPB), acute right ventricular (RV) failure or cardiogenic shock and acute liver failure. This consensus report is intended to support anesthesiologists, intensivists and cardiovascular specialists caring for critically ill surgical and medical patients by providing clear and structured recommendations to optimize the use of vasopressin in the management of vasoplegia. PEER REVIEWED ARTICLE **Peer reviewers:** Prof. Dr med Dominique Bettex, Institute of Anesthesiology and Perioperative Medicine, University Hospital Zurich Prof. Dr med Reto Stocker, Head of Research, Teaching and Medical Quality Programmes, Hirslanden Klinik, Zurich Received on May 23, 2025; accepted after peer review on June 10, 2015; published online on June 30, 2025.
Die Bedeutung, Diagnostik und Therapie von subsyndromalen Angstzuständen (SSA) war Thema eines Expertengremiums. Dabei wurde auch deutlich, dass die Hausärzte meist die ersten Ansprechpartner für die Betroffenen sind und deren Einbindung und Befähigung zur Erstversorgung der Patienten daher eine wichtige Rolle im Management der SSA spielt. Nachfolgend soll dem Hausarzt eine praktische Anleitung für den Umgang mit SSA-Patienten an die Hand gegeben werden. The significance, diagnosis and treatment of subsyndromal anxiety disorders was the topic of an expert panel. It also became clear that GPs are usually the first point of contact for those affected and that their involvement and ability to provide primary care for patients therefore plays an important role in the management of subsyndromal anxiety (SSA). The following is intended to provide GPs with practical instructions for dealing with SSA patients. PEER REVIEWED ARTICLE **Peer reviewers:** Prof. Dr. Rainer Rupprecht, Universität Regensburg, Lehrstuhl für Psychiatrie und Psychotherapie, Universitätsstrasse 84, 93053 Regensburg, Deutschland Ein anonymer Peer-Reviewer Artikel erhalten am 22. April 2025; artikel akzeptiert am 22. Juni 2025, artikel veröffentlicht am 30. Juni 2025.
Die Behandlung der beiden chronisch-entzündlichen Darmerkrankungen (IBD) Colitis ulcerosa und Morbus Crohn hat dank der Einführung von Biologika und niedermolekularer Substanzen (small molecules) bedeutende Fortschritte gemacht. Neben klassischen Immunsuppressiva sind gezielte Modulatoren inflammatorischer Signalwege etabliert, darunter TNF-α-Inhibitoren, Interleukin-Hemmer, Integrin-Antagonisten, JAK-Inhibitoren und S1P-Rezeptormodulatoren. Klinische Studien zeigen, dass Biologika wie Adalimumab, Infliximab und Vedolizumab die Remissionsraten signifikant erhöhen, während neuere IL-23- und JAK-Inhibitoren vielversprechende Optionen für therapierefraktäre Patienten bieten. Neue Wirkstoffklassen wie Anti-TL1A-Antikörper und MiR124-Modulatoren erweitern das therapeutische Spektrum. The treatment of the chronic inflammatory bowel diseases (IBD) ulcerative colitis and Crohn’s disease has made significant progress with the introduction of biologics and small molecules. In addition to conventional immunosuppressants, targeted modulators of inflammatory pathways – such as TNF-α inhibitors, interleukin inhibitors, integrin antagonists, JAK inhibitors, and S1P receptor modulators – have become integral components of therapy. Clinical studies demonstrate that biologics like adalimumab, infliximab, and vedolizumab significantly improve remission rates, while newer IL-23 and JAK inhibitors offer promising options for therapy-refractory patients. New drug classes such as anti-TL1A antibodies and MiR124 modulators are further expanding the therapeutic spectrum. PEER REVIEWED ARTICLE **Peer Reviewers:** PD Dr. med. Jonas Zeitz Dr. med. Samuel Truninger Gastroenterologie und Hepatologie, HOCH Health Ostschweiz, Kantonsspital St. Gallen, St. Gallen, Schweiz PD. Dr. med. Jonas Zeitz, Schweizer Zöliakie Zentrum, GastroZentrum Hirslanden Zürich, Zürich, Schweiz Ein anonymer Peer Reviewer Artikel erhalten am 28.04.2025; artikel akzeptiert nach Peer Review am 12. Juni 2025; artikel veröffentlicht am 30. Juni 2025.
Nontuberculous mycobacteria (NTM) can cause pulmonary disease or lymphadenitis, the latter being more common in pediatric patients, among other sites of infection. The detection of nontuberculous mycobacteria does not necessarily indicate a clinically relevant infection requiring treatment, as NTM may be contaminants (e.g., from water sources) or cause asymptomatic infections. We describe the case of a 58-year-old male patient with granulomatous mediastinal and hilar lymphadenopathy, who had repeated detection of *Mycobacterium avium (M. avium)* without clear indications for NTM lung disease. Initial antibiotic treatment had to be discontinued due to severe adverse effects. Clinically and radiologically, there was no sign of disease progression over a short monitoring period. However, one year later, after the diagnosis of hairy cell leukemia, the disease progressed to disseminated NTM infection. Mediastinal tuberculous lymphadenitis is common and can be diagnosed using EBUS-TBNA samples. Isolated NTM mediastinal lymphadenitis is rarely described in the literature, and no recommendations exist regarding potential management for immunocompetent or immunocompromised patients. This case illustrates the diagnostic and therapeutic challenges of isolated NTM lymphadenitis in adults and highlights the importance of evaluating for underlying immunodeficiency. PEER REVIEWED ARTICLE **Peer reviewers:** PD Dr Stefan Zimmerli, Institute of Infectiology, University of Berne, Switzerland Dr Marisa Kälin, Clinic for Infectious Diseases and Hospital Hygiene, University Hospital Zurich, Switzerland This article was received on April 4, 2025; accepted after peer review on May 22, 2025; published on June 30, 2025.
In den letzten Jahren haben sich das konzeptionelle Verständnis der Multiplen Sklerose (MS) und damit auch die diagnostischen und therapeutischen Möglichkeiten weiterentwickelt. Die nachfolgende Übersichtsarbeit beleuchtet die Fortschritte in der Diagnostik und Therapie der MS. Zentrale Themen sind dabei die Biomarker-basierte Diagnostik und die bildgebende Diagnostik mittels Magnetresonanztomographie als Voraussetzung für die Diagnosestellung einer MS sowie zum Monitoring des Erkrankungsverlaufs. Therapiekonzepte werden in Abhängigkeit von der jeweiligen Verlaufsform der MS diskutiert und innovative, zukünftige Ansatzpunkte vorgestellt. PEER REVIEWED ARTICLE Peer reviewers: Dr. med. Sebastian Finkener, Leiter Neuroimmunologie, Kantonsspital Aarau, Aarau, Schweiz PD Dr. med. Oliver Findling, Zentrum für Neurologie Aarau im Kernareal, Aarau, Schweiz Erhalten am 7. Februar 2025; akzeptiert am 3. März 2025; veröffentlicht am 17. März 2025.
# Background Vitamin D plays a crucial role in numerous metabolic processes and is essential for overall health. Clinical conditions, ideal threshold values and optimal dose of supplementation remain a topic of discussion. This study presents a real-world analysis of Vitamin D optimization in a diverse patient population. # Aim The primary objectives of our real-world study in primary care patients supplemented with vitamin D were to assess the effectiveness of different strategies in achieving optimal serum vitamin D levels and to identify factors that influence changes in vitamin D levels in patients with different clinical conditions. # Results Among the 22 patients receiving only a maintenance dose, 59% exhibited an inadequate response (either low or high), and in 36.3% of cases, this remained unexplained even after analyzing risk factors for vitamin D deficiency. Notably, one patient showed no increase in vitamin D levels three months after a controlled depot dose of 100,000 units. Despite supplementation, a significant subset of patients failed to reach optimal levels, suggesting potential resistance to conventional approaches or poor adherence. # Conclusion We suggest that adherence to supplementation was one of the critical factors in achieving target levels, but there must be other factors. Starting with supervised “depots” of vitamin D and improved patient education for maintenance dose helps to exclude the probably very high adherence problems. This real-world analysis highlights the complexities of vitamin D optimization and suggests the need for more complex research studies, when to supplement and how to do it. Our study shows the importance of monitoring Vitamin D levels 2–3 months after the first substitution for finding the optimal dose. PEER REVIEWED ARTICLE Peer reviewers: Dr Stefan Zechmann, Stoffwechselzentrum St. Gallen, friendly Docs AG, St. Gallen Prof. Dr Reto Krapf, Chief Medical Officer at Medisyn SA, Kriens Received on January 31, 2025; accepted after peer review on March 12, 2025; published on March 17, 2025.
Paraneoplastic neurological syndromes can affect any part of the nervous system, often have a stereotypical presentation, occur in association with a tumor, and have an antibody-mediated pathogenesis. We describe the case of a 65-year-old previously healthy crane operator who presented to the emergency department due to symmetrical, gradually progressive gait instability and leg weakness. Due to evidence of a pulmonary mass in combination with polyneuroradiculopathy, a thoracoscopic upper lobe resection was performed with histological findings of an adenocarcinoma. Postoperatively, there was a marked improvement in gait and distal paraparesis. Despite an extensive search, no paraneoplastic autoantibodies could be detected in our patient. According to the 2021 consensus criteria, both the clinical phenotype and the presence of a tumor, as well as the determination of anti-neuronal antibodies in serum and cerebrospinal fluid, are essential for diagnosis. This enables a diagnosis to be made in four categories (definite, probable, possible, non-paraneoplastic neurological syndrome [PNS]). PEER REVIEWED ARTICLE Peer Reviewers: Prof. Dr Uwe Schlegel, Klinik für Neurologie Hirslanden, Zurich, und Neurozentrum Bellevue, Zurich One anonymous peer reviewer Received on January 25, 2025; accepted after peer review on February 27, 2025; published on March 17, 2025.
Optimizing vitamin D levels poses a significant challenge in healthcare, characterized by varying guidelines, recent changes in testing coverage and widespread vitamin D deficiency. In Switzerland, where 59% of primary care patients have insufficient vitamin D levels and 12% are deficient, the complexity is heightened by the discontinuation of health insurance coverage for vitamin D testing without risk factors, as of July 1, 2022. This article explores the multifaceted landscape of vitamin D management, addressing the intricacies of testing, supplementation and guideline implementation. Through an analysis of the current guidelines and the pathophysiology of vitamin D, we aim to equip clinicians with the insights needed to navigate these complexities, optimize patient care and improve outcomes. PEER REVIEWED ARTICLE Dr Joël Capraro, Kantonsspital, Aarau, Endokrinologie, Diabetologie und Metabolismus Dr Stefan Zechmann, Stoffwechselzentrum, St. Gallen, friendlyDocs AG Received on November 19, 2024; accepted after peer review on December 20, 2024; published online on December 23, 2024.
Menopause and the symptoms often associated with it are still a taboo subject. However, around two thirds of all women suffer from more or less severe symptoms during the peri- and postmenopause. Hormonal and non-hormonal therapies are available to treat them. Zusammenfassung Wechseljahre und die oft damit verbundenen Symptome sind häufig immer noch ein Tabuthema. Dabei leiden rund zwei Drittel aller Frauen in der Peri- und Postmenopause unter mehr oder weniger starken Beschwerden. Zu deren Behandlung stehen hormonelle und nicht-hormonelle Therapien zur Verfügung. PEER REVIEWED ARTICLE Peer reviewers: Dr. med. Lea Köchli, Frauengesundheits-Zentrum (FGZR), Rämistrasse 35, 8001 Zürich Ein anonymer Peer-Reviewer Erhalten am 19. August 2024; akzeptiert am 31. Oktober 2024; veröffentlicht am 1. November 2024.
We report a case of late onset primary lymphedema (lymphedema tarda) where edema is managed with high levels of B vitamins. This is the first successful treatment of lymphedema where a patient's function is fully restored without the limitation of compressive garments. This restored mobility is of significant benefit to the patient, as it allowed them to reengage in the activities of daily life. Similar to the edema seen in retinal veins in those with elevated endothelin levels, we speculate that the edema in primary lymphedema is related to diseased lymphatic vascular health. In our case, following 12 months of high dose B vitamins. similar results were seen as in retinal cases, with elimination of edema and restoration of an active quality of life for the patient, an outcome that was sustained a year later. Given the proven absence of toxicity or side effects, we suggest employment of such vitamin therapy as the standard tool in management of primary lymphedema. PEER REVIEWED ARTICLE Peer reviewers: Dr Alexandru Grigorean, Universitätsspital Zurich, Klinik für Angiologie One anonymous peer reviewer Received on July 28, 2024; accepted after peer review on September 19, 2024; published on October 30, 2024.
Headaches can have many causes. The causes can be very common but can also have a rare etiology. Therapy is the treatment of the respective etiology. Certain symptoms, so-called red flags, can prompt the general practitioner to act more quickly. The case report is about a 67-year-old patient who suffered from headaches, fatigue and nausea. The symptoms disappeared when lying down and only occurred when standing. An magnetic resonance imaging (MRI) of the skull was ordered. This showed hygromas of the cerebral hemispheres, which were caused by cerebrospinal fluid loss. A MR - myelography was performed, which showed cerebrospinal fluid loss at the level of thoracic vertebrae 11 and 12. The clinical symptoms and the imaging findings led to the diagnosis of spontaneous cerebrospinal fluid loss syndrome. Treatment was carried out by neurosurgical leak closure. The patient became symptom-free after the therapy. Intracranial hypotension is usually caused by loss of cerebrospinal fluid. Early detection is important for treatment and reduction of further complications. PEER REVIEWED ARTICLE Peer Reviewers: Prof. Dr Andreas Gantenbein, Rehaclinic Bad Zurzach One anonymous peer reviewer Received on August 19, 2024; accepted after peer review on September 19, 2024; published on October 30, 2024.
Die thorakale Sonographie ist von breitem Nutzen bei der Diagnostik und Therapie pleuraler, pulmonaler und anderweitiger thorakaler Erkrankungen. Da immer mehr Ultraschallgeräte in der Hausarztpraxis im Einsatz sind, sind Grundkenntnisse in der thorakalen Sonographie essentiell. Die thorakale Sonographie erlaubt in Echtzeit eine rasche Analyse thorakaler Pathologien. Neben der Diagnose von Pleuraergüssen können auch Zwerchfellfunktionsstörungen, pulmonale Konsolidationen, Tumore, Empyeme, Abszesse, Rippenfrakturen und thorakale Lymphadenopathien ohne Strahlenbelastung nachgewiesen und weiter spezifiziert werden. Zudem macht die Thoraxsonographie thorakale Interventionen sicherer (insb. Pleuraergusspunktionen) und kann postinterventionelle Röntgenuntersuchungen vermeiden. Thoracic sonography is widely beneficial in the diagnosis and treatment of pleural, pulmonary, and other thoracic diseases. With an increasing number of ultrasound devices being used in general practitioner offices, basic knowledge in thoracic sonography is essential. Thoracic sonography allows for a fast real-time analysis of thoracic pathologies. In addition to diagnosing pleural effusions, it can also identify diaphragmatic dysfunction, pulmonary consolidations, tumors, empyema, abscesses, rib fractures, and thoracic lymphadenopathies without radiation exposure and further specification. Moreover, thoracic sonography makes thoracic interventions safer (especially pleural effusion punctures) and can avoid post-interventional X-ray examinations. **Peer reviewers:** Prof. Dr. Robert Thurnheer, Kantonsspital Münsterlingen, Münsterlingen, Schweiz Dr. Rudolf Horn, Center da sandà Val Müstair, Sta. Maria, Schweiz Artikel erhalten am 8. Januar, 2024. Artikel veröffentlicht am 15. April, 2024.
Cryptococcosis represents the third most frequent invasive fungal infection in solid organ transplant (SOT) recipients and is associated with high mortality rates. Its clinical presentation is often insidious making the diagnosis difficult. Treatment guidelines are mainly derived from the population affected by human immunodeficiency virus (HIV) and trials specific to the SOT population are lacking. Here, we present the case of a 67-year-old lung transplant recipient with acute-on-chronic kidney failure and disseminated cryptococcosis successfully treated with a regimen of two single high doses of intravenous (IV) liposomal amphotericin B (10 mg/kg) on day 1 and day 7 in association with IV flucytosine and high doses of oral fluconazole, hence limiting the nephrotoxicity of amphotericin B. Treatment approaches for cryptococcosis in SOT limiting the nephrotoxicity of amphotericin B need to be further studied. PEER REVIEWED ARTICLE Peer reviewers: Two anonymous peer reviewers. Received: November 21, 2023; Accepted after peer review: January 9, 2024
# Introduction In Europe, mucormycosis is predominantly observed in patients with underlying hematological disorders and physicians are accustomed to considering invasive fungal diseases as a potential complication in these patients. However, on a global scale, the most common predisposing condition for mucormycosis is diabetes mellitus, particularly in India. # Case and management A 57-year-old diabetic patient with a history of tobacco use presented with coughing, hemoptysis and weight loss. A computed tomography (CT) scan of the chest showed a cavitating lesion in the right lower lobe with concomitant lymphadenopathy. Pulmonary malignancy was suspected and a bronchoscopy with transbronchial biopsy was performed. Histology revealed invasive fungal disease confirmed as pulmonary mucormycosis by a positive Mucorales-specific and panfungal polymerase chain reaction (PCR). Species identification via sequence analysis demonstrated Rhizopus arrhizus as the causative organism. Treatment with liposomal amphotericin B was initiated and surgical resection was performed. This comprehensive approach resulted in a complete and sustained recovery. # Discussion Mucormycosis is an aggressive and often fatal disease that necessitates fast diagnosis and treatment. We aim to increase awareness among European physicians to consider pulmonary mucormycosis as a possible differential diagnosis in patients with lung lesions and diabetes mellitus. A rapid and interdisciplinary approach may affect the outcome positively. PEER REVIEWED ARTICLE Peer reviewers: Two anonymous peer reviewers. Received: December 16, 2024; Accepted after peer review: January 8, 2024
Mit dem wachsenden Anteil älterer Menschen an der Bevölkerung und der steigenden Lebenserwartung in der Schweiz gewinnt auch die Diagnose «Depression im Alter» zunehmend an Bedeutung. Da die Erkrankung für die Patienten oft mit einem hohen Leidensdruck verbunden ist, müssen Depressionen beim älteren Menschen frühzeitig erkannt und behandelt werden. Diagnose und Therapie erfolgen grundsätzlich in gleicher Weise wie bei jüngeren Patienten. Allerdings sind bei älteren Menschen einige Besonderheiten zu beachten. With the growing proportion of older people in the population and increasing life expectancy in Switzerland, the diagnosis of "depression in later life" is also becoming increasingly important. As the illness is often associated with a high level of suffering for patients, depression in older people must be recognised and treated at an early stage. Diagnosis and treatment are basically the same as for younger patients. However, there are some special features to consider in older people. PEER REVIEWED ARTICLE Peer reviewers: PD Dr. Thorsten Mikoteit, Solothurner Spitäler, Solothurn, Schweiz Dr. Dan Georgescu, Psychiatrische Dienste Aargau AG, Windisch, Schweiz Received: January 17, 2024; Accepted after peer review: April 8, 2024
This study aimed to investigate the impact of posture on retinal venous pressure (RVP) in a diverse cohort. The research delves into determining the percentage distribution of normal and increased RVP among healthy volunteers across various positions. Additionally, it sought to quantify the range of RVP in patients with known ocular pathology compared to healthy individuals in different postures. Utilizing an Ophthalmo-Dynamometer, a comparative analysis was conducted on RVP in both healthy volunteers and patients with ocular pathology. Prior to participation, the subjects provided informed consent. Notably, a significant absence of empirical data on the influence of postural changes on RVP currently exists, underlining the novelty of this investigation. The findings of this study hold potential implications for comprehending retinal blood flow dynamics. The insights gained could significantly contribute to the understanding of glaucoma pathogenesis, thereby shedding light on the critical aspects of ocular health. PEER REVIEWED ARTICLE Peer reviewers: PD Dr Karl-Georg Schmidt, Augenzentrum Höfe, Freienbach, Switzerlan One anonymous peer reviewers Received: February 15, 2024; Accepted after peer review: March 28, 2024
The treatment paradigm for individuals living with human immunodeficiency virus (HIV) has evolved beyond solely focusing on viral load suppression to encompass a comprehensive approach that prioritizes health-related quality of life (HRQoL). Biktarvy (BIC/FTC/TAF) has emerged as a promising therapeutic option for achieving this treatment goal. During the 11th German-Austrian AIDS Congress (DÖAK), eight healthcare professionals from Germany, Austria, and Switzerland convened at a non-public, industry-sponsored meeting to discuss how treatment with BIC/FTC/TAF supports a holistic, long-term, and patient-centered treatment approach to optimize HRQoL for people living with HIV (PwH). The experts were invited to share their experience with BIC/FTC/TAF and examine relevant real-world data presented during the DÖAK congress. The industry-sponsored and expert-led meeting was initiated to provide valuable perceptions from the eight experts practicing in different clinical and practical settings. This paper highlights the key findings from the expert meeting discussion. The experts agreed that the BIC/FTC/TAF regimen is highly suitable for everyday use, showing efficacy and tolerability across various patient groups, including those with unclear prior therapies, hepatitis B virus status, low CD4 counts, opportunistic infections, and individuals engaged in chemsex. Moreover, adherence to the BIC/FTC/TAF regimen is crucial for successful therapy, requiring personalized patient care and a structured, regular questioning process. Various factors, such as substance abuse or changes in life circumstances, can affect adherence; hence, open discussions about the patient's life situations and needs are important. In conclusion, the BIC/FTC/TAF regimen supports the achievement of new therapeutic goals beyond virological suppression by effectively catering to different patient groups. It also fosters personalized patient care by leniency towards suboptimal adherence. The regimen's versatility and practicality make it an integral tool in achieving broader health objectives in HIV management. PEER REVIEWED ARTICLE Peer reviewers: Dr Rein Jan Piso, Kantonsspital Olten, Olten, Switzerland One anonymous peer reviewer Received: September 1, 2023; Accepted after peer review: January 15, 2024
Rhino-orbital-cerebral mucormycosis (ROCM) is a rare angioinvasive fungal infection known to be associated with high morbidity and mortality rates of over 50%. Its incidence has increased lately due to the increasing number of patients with predisposing immunocompromising conditions, as well as COVID-19. In addition to the common acute disease progression, chronic, less aggressive courses have rarely been described. In this paper, we report the case of a 39-year-old man with recurrent diabetic ketoacidosis who initially presented with acute sinonasal symptoms, was positive for SARS-COV-2 and was later diagnosed with acute ROCM. He had mutilating but not complete surgical removal of infected tissue and was given high-dose liposomal amphotericin B followed by long-term oral antifungal therapy. One year after being lost to follow-up because of repatriation to his home country he sent us a holiday picture of himself having recovered from the disease. Despite the incomplete and mutilating resection, coupled with long-term antifungal treatment, we conclude that survival is possible in cases of Rhino- orbito- cerebral Mucormycosis (ROCM). However, it is important to note that there is still a scientific gap in evidence regarding follow-up procedures and the optimal duration of therapy. PEER REVIEWED ARTICLE Peer reviewers: Three anonymous peer reviewers Received: December 6, 2023; Accepted after peer review: January 8, 2024
By Ellen Heitlinger, Ulrich Keller. Übergewichtige Patienten haben mitunter ein deutlich erhöhtes Risiko für Krankheiten wie Diabetes mellitus, Herz-Kreislauf-Erkrankungen und einige Krebsarten. GLP1-Rezeptor-Agonisten haben kürzlich ihre guten gewichtsreduzierenden Eigenschaften unter Beweis gestellt.
