Internal medicine has recently undergone major changes, which have created--among others--4 feeli... more Internal medicine has recently undergone major changes, which have created--among others--4 feelings of alienation among physicians: first, the internist--initially an observer of clinical signs, and later laboratory-assisted--has now become operator-assisted with modern technology in imaging and other technologies assisting him by giving him not the essence, but the interpretation of the gathered information; second, the dialogue between basic biomedical research and the bedside clinician has been interrupted by the creation of a new language in molecular genetics, to which he has no access any more; third, modern biotechnology is rapidly creating an unlimited number of new biological therapeutic modalities, giving the internist too many therapeutic options which he can no longer master. Fourth, the formerly direct, bipolar relationship between patient and physician has been extended to a triangular relationship between patient, physician and an institution (hospital administration...
Une experience originale en Suisse: l'unite de traitement integre medico-psychiatrique. - Le ... more Une experience originale en Suisse: l'unite de traitement integre medico-psychiatrique. - Le fonctionnement de l'unite de traitement integre medico-psychiatrique ouverte a Geneve en 1992 est presente, avec un bilan intermediaire positif: la prise en charge de l'anorexie et des somatisations a ete amelioree, et les collaborateurs se montrent satisfaits. Il s'agit d'un progres notable, compte tenu de l'etat actuel de la collaboration entre la medecine et la psychiatrie en Suisse. Cette cooperation aboutira prochainement a une formation en medecine psychosociale pour les internistes.
In this clinical-pathological conference the case of a patient with aplastic anemia is presented ... more In this clinical-pathological conference the case of a patient with aplastic anemia is presented who recovered after treatment with prednisone and antilymphocyte serum. The patient's clinical course was however complicated by persistent fever and panuveitis. This was followed by acute mitral insufficiency and left ventricular failure, leading to the patient's death.
Between 1983 and 1987, 19 patients presenting with encephalic involvement of AIDS had an EEG reco... more Between 1983 and 1987, 19 patients presenting with encephalic involvement of AIDS had an EEG recording during the early neurological examination. In 8 patients, EEGs were repeated 1 to 11 times during the course of the disease. All recordings were abnormal. A good EEG correlation existed with clinical, virological and bacteriological (SF), radiological, and histological data (10 cases). EEG recordings are useful to study the encephalic pathology of AIDS, not only for its secondary, but even more for its primary involvement.
L'adaptation a un environnement hostile est l'un des moyens de survie les plus efficaces ... more L'adaptation a un environnement hostile est l'un des moyens de survie les plus efficaces du monde microbien. La capacite des staphylocoques dores (S. aureus) de resister aux antibiotiques en est l'un des exemples les plus etonnants et les plus effrayants. Apres l'acquisition de la resistance a la meticilline actuellement largement repandue, des souches cliniques de S. aureus de sensibilite diminuee a la vancomycine en particulier (« vancomycin-intermediate S. aureus, VISA»), et plus generalement aux glycopeptides («glycopeptides-intermediate S. aureus, GISA»), ont ete identifiees recemment au niveau de quatre continents au moins. Les glycopeptides demeurant la seule alternative therapeutique disponible en cas de S. aureus multiresistant, la mesure et la comprehension du «phenomene GISA» sont des priorites absolues compte tenu de l'importance epidemiologique de S. aureus en tant que germe pathogene, tant hospitalier que communautaire. Cette revue fait etat de la s...
We investigated complement fractions in patients after extracorporeal circulation for coronary by... more We investigated complement fractions in patients after extracorporeal circulation for coronary bypass operations or cardiac valve replacement, and in two cases developing an adult respiratory distress syndrome (ARDS) after this type of intervention. The patients presenting an ARDS had significantly increased levels of C3d (p less than 0.001), the small molecular breakdown product of C3, associated with decreased levels of total classic haemolytic activity (p less than 0.05) and of the complement component C1q (p less than 0.001) when compared to a group of 10 patients who had uneventful evolution after bypass. However, all patients undergoing cardiopulmonary bypass had significantly increased levels of C3d (p less than 0.005 or less) associated with significant decrease of various complement components within 24 h after bypass, when compared to a control group of 5 patients investigated after aorto-iliac bypass graft surgery. We conclude that significant complement activation can pe...
We report the case of a 27 year old man admitted to hospital for investigation of radiological op... more We report the case of a 27 year old man admitted to hospital for investigation of radiological opacities of recent origin. A diagnosis of mycotic aneurysms was made on a surgical biopsy. Although a right sided endocarditis could not be detected clinically, a trial of antibiotic therapy was instituted. However, no improvement occurred. The patient died, following a massive pulmonary haemorrhage. The necropsy revealed an active right sided endocarditis with multiple aneurysms of the intra-pulmonary arteries.
Internal medicine has recently undergone major changes, which have created--among others--4 feeli... more Internal medicine has recently undergone major changes, which have created--among others--4 feelings of alienation among physicians: first, the internist--initially an observer of clinical signs, and later laboratory-assisted--has now become operator-assisted with modern technology in imaging and other technologies assisting him by giving him not the essence, but the interpretation of the gathered information; second, the dialogue between basic biomedical research and the bedside clinician has been interrupted by the creation of a new language in molecular genetics, to which he has no access any more; third, modern biotechnology is rapidly creating an unlimited number of new biological therapeutic modalities, giving the internist too many therapeutic options which he can no longer master. Fourth, the formerly direct, bipolar relationship between patient and physician has been extended to a triangular relationship between patient, physician and an institution (hospital administration...
Une experience originale en Suisse: l'unite de traitement integre medico-psychiatrique. - Le ... more Une experience originale en Suisse: l'unite de traitement integre medico-psychiatrique. - Le fonctionnement de l'unite de traitement integre medico-psychiatrique ouverte a Geneve en 1992 est presente, avec un bilan intermediaire positif: la prise en charge de l'anorexie et des somatisations a ete amelioree, et les collaborateurs se montrent satisfaits. Il s'agit d'un progres notable, compte tenu de l'etat actuel de la collaboration entre la medecine et la psychiatrie en Suisse. Cette cooperation aboutira prochainement a une formation en medecine psychosociale pour les internistes.
In this clinical-pathological conference the case of a patient with aplastic anemia is presented ... more In this clinical-pathological conference the case of a patient with aplastic anemia is presented who recovered after treatment with prednisone and antilymphocyte serum. The patient's clinical course was however complicated by persistent fever and panuveitis. This was followed by acute mitral insufficiency and left ventricular failure, leading to the patient's death.
Between 1983 and 1987, 19 patients presenting with encephalic involvement of AIDS had an EEG reco... more Between 1983 and 1987, 19 patients presenting with encephalic involvement of AIDS had an EEG recording during the early neurological examination. In 8 patients, EEGs were repeated 1 to 11 times during the course of the disease. All recordings were abnormal. A good EEG correlation existed with clinical, virological and bacteriological (SF), radiological, and histological data (10 cases). EEG recordings are useful to study the encephalic pathology of AIDS, not only for its secondary, but even more for its primary involvement.
L'adaptation a un environnement hostile est l'un des moyens de survie les plus efficaces ... more L'adaptation a un environnement hostile est l'un des moyens de survie les plus efficaces du monde microbien. La capacite des staphylocoques dores (S. aureus) de resister aux antibiotiques en est l'un des exemples les plus etonnants et les plus effrayants. Apres l'acquisition de la resistance a la meticilline actuellement largement repandue, des souches cliniques de S. aureus de sensibilite diminuee a la vancomycine en particulier (« vancomycin-intermediate S. aureus, VISA»), et plus generalement aux glycopeptides («glycopeptides-intermediate S. aureus, GISA»), ont ete identifiees recemment au niveau de quatre continents au moins. Les glycopeptides demeurant la seule alternative therapeutique disponible en cas de S. aureus multiresistant, la mesure et la comprehension du «phenomene GISA» sont des priorites absolues compte tenu de l'importance epidemiologique de S. aureus en tant que germe pathogene, tant hospitalier que communautaire. Cette revue fait etat de la s...
We investigated complement fractions in patients after extracorporeal circulation for coronary by... more We investigated complement fractions in patients after extracorporeal circulation for coronary bypass operations or cardiac valve replacement, and in two cases developing an adult respiratory distress syndrome (ARDS) after this type of intervention. The patients presenting an ARDS had significantly increased levels of C3d (p less than 0.001), the small molecular breakdown product of C3, associated with decreased levels of total classic haemolytic activity (p less than 0.05) and of the complement component C1q (p less than 0.001) when compared to a group of 10 patients who had uneventful evolution after bypass. However, all patients undergoing cardiopulmonary bypass had significantly increased levels of C3d (p less than 0.005 or less) associated with significant decrease of various complement components within 24 h after bypass, when compared to a control group of 5 patients investigated after aorto-iliac bypass graft surgery. We conclude that significant complement activation can pe...
We report the case of a 27 year old man admitted to hospital for investigation of radiological op... more We report the case of a 27 year old man admitted to hospital for investigation of radiological opacities of recent origin. A diagnosis of mycotic aneurysms was made on a surgical biopsy. Although a right sided endocarditis could not be detected clinically, a trial of antibiotic therapy was instituted. However, no improvement occurred. The patient died, following a massive pulmonary haemorrhage. The necropsy revealed an active right sided endocarditis with multiple aneurysms of the intra-pulmonary arteries.
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Papers by F. Waldvogel