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.
