[Multidisciplinary treatment of chronic pain--opportunities and challenges for collaboration between psychosomatic medicine and physiotherapy]. / Multimodale Behandlung bei chronischen Schmerzen--Chance und Herausforderung für die Zusammenarbeit von Psychosomatik und Physiotherapie.

Chronic pain is often associated with inefficient treatments attempts and a significant impairment of quality of life. The treatment of patients with chronic pain has been a major challenge for all disciplines concerned; none has convincingly shown that their approach achieves the goal of a pain free life. Multimodal pain management programs are characterised by a joint effort of somatic medicine, physiotherapy, and psychology or psychotherapy to cooperate in a shared model of diagnosis and treatment for chronic pain patients. We present the model that is in practice since eight years at the Division of Psychosomatic Medicine at the University Hospital Basel, combining elements of cognitive behaviour therapy and physiotherapeutic exercises. The presence of physiotherapists in therapeutic group sessions is essential because physical activation helps to improve body awareness; it yields bodily sensations that are often interpreted in a catastrophic way that can then be dealt with in a cognitive-behavioural approach. Such a close collaboration between different departments and between representatives of different professions takes time to develop, it needs open minded psychologists and physiotherapists who are willing to cooperate and share responsibility. On the other hand, having achieved a good working relationship leads to mutual support in working with these patient who sometimes induce intense feelings of helplessness in the professional, it provides patients with two different 'battlefields' to tackle chronic pain, thus allowing for a broader set of experiences from which patients can feed their motivation.

[Altitude edema in the Swiss Alps. Observations on the incidence and clinical course in 50 patients 1980-1984]. / Das Höhenödem in den Schweizer Alpen. Beobachtungen über Inzidenz, Klinik und Verlauf bei 50 Patienten der Jahre 1980-1984.

In the Swiss Alps 50 patients with high altitude edema (high altitude pulmonary edema and/or high altitude cerebral edema) had to be rescued by helicopter during the period 1980-1984. The development, clinical picture and clinical course have been analyzed retrospectively. The patients were 49 men and one woman, generally in good health and well trained. They had ascended from the low-lands to an altitude above 2500 m and subsequently climbed higher. The climbers developed symptoms of acute mountain sickness on the second to third day of high altitude exposure and had to be evacuated by air on the fourth to fifth day. 70% of the cases occurred in the Valais Alps and the rest in the region of the Bernese Alps and the Bernina. The highest incidence of high altitude edema was observed in the Capanna Margherita (4559 m), where one of 588 climbers who stayed overnight had to be air-rescued. This ratio was about one in 4000 mountaineers at the Finsteraarhorn hut (3050 m) and the Monte Rosa hut (2795 m). Evacuation by air was the most successful therapeutic measure and resulted in immediate amelioration of clinical symptoms in 16 patients. 34 climbers had to be admitted to local hospitals due to severe high altitude pulmonary and/or cerebral edema. The pulmonary edema was bilateral in two thirds of these patients and unilateral in one third. Arterial blood gases showed moderate to severe limitation of oxygen diffusion capacity. All patients recovered completely within a few days.

[The value of walking exercise in treatment of intermittent claudication]. / Der Stellenwert des Gehtrainings in der Behandlung der Claudicatio intermittens.

Physical training is one of the basic measures for all patients suffering from a generalized atherosclerosis. Specific training forms for PAD patients include home-based and structured, organized physical training programs; these are discussed and the results of meta-analyses presented. Whereas the published materials available for a home-based training is non-conclusive, structured training programs will lead to a statistically significant and clinically relevant improvement of a PAD patients' functional capacity.

Collaborative clinical laboratory evaluation of an individual MIC strip system.

Susceptibility results obtained with individualized MIC strips (MICRO-MIC) agreed with the standard microdilution broth method at a level of 96% or greater for each of the 10 antimicrobial agents tested.