Health information given by Swiss travel agencies.

BACKGROUND: Many of the 1 million Swiss traveling to tropical or subtropical countries book their trip through travel agencies every year. These agencies are thus an important source of information about malaria and other important health risks and little is known about the appropriate health information provided by these. METHOD: A study was conducted to assess health-related information in members of the Swiss Federation of Travel Agencies in the metropolitan area of Zurich, Switzerland. A covert investigator (F.M.S.) visited these agencies and requested information on a package holiday for 2 or 3 weeks to Kenya. Following an in-person interview, the investigator recorded any health-related information provided on a pretested form. If none was mentioned, the agent was prompted using a standardized procedure. RESULTS: A total of 88 agencies were visited. Spontaneous health advice was given in 44% of all visits. After prompting, 99% of all travel agents mentioned preventive measures against malaria, but only 69% indicated the need for vaccinations against other diseases. Spontaneous advice on malaria risk and vaccinations was better than advice given upon prompting. One fifth of all travel agents neither mentioned malaria prevention measures spontaneously nor recommended seeing a health specialist. CONCLUSIONS: Overall, travel medicine knowledge of travel agents in the Zurich area needs improvement as many tended to draw attention to health risks only when prompted. Attitude, personal knowledge, and experience of individual travel agents were key to the health information given. Up-to-date and readily available information on health risks should be provided to travel agencies and structured training given in collaboration with health professionals.

Facial appearance after operations for oral and oropharyngeal cancer: a comparison of casenotes and patient-completed questionnaire.

Disfigurement after operations for oral and oropharyngeal cancer is an important issue. Our aim was to review the casenotes of patients who reported distress in the appearance domain of the University of Washington Quality of Life Scale (UWQOL) and to find out what help they were given. Of 278 patients with previously untreated oral and oropharyngeal squamous cell carcinoma treated between 1995 and 1999, 114 (41%) were concerned about their appearance. Factors that correlated with these concerns included tumours more than 2cm in size, T2 or worse stage, free tissue reconstruction, segmental mandibular resection, and neck dissection. In only 7 of the 114 was there any mention of the patient's appearance in the clinic notes, of whom 4 were given help (2 scar revisions and 2 oral rehabilitations). This study suggests that patients' concerns about disfigurement are poorly recognised in routine clinical practice and supports the principle of using the UWQOL scale to discuss problems of appearance with patients.

A clinical and histologic comparison of electrosurgical and carbon dioxide laser peels.

BACKGROUND: A radiofrequency-controlled electrosurgical device (ESD) has been adapted for skin peeling. A high-voltage, low-amperage current converts an irrigant into an ionized vapor, causing molecular dissociation and superficial damage in adjacent tissue. OBJECTIVE: We compared the clinical and histologic effects of a scanning carbon dioxide (CO(2)) laser (ESC/Sharplan 40C) and the ESD (Visage Cosmetic Surgery System, Arthrocare). METHODS: This study was a matched clinical trial involving 9 subjects. Two strips (2 x 1 cm) of skin on the temple were alternately assigned to receive 2 passes with either the CO(2) laser (Silktouch mode, 260 handpiece, fluence 15 J/cm(2), 10 mm(2)) or the ESD (125 V = setting 4, 5 mm handpiece). Strips were wiped with moist gauze after the first pass, and 4-mm punch biopsy specimens were taken immediately and after 3 months. Clinical assessment of re-epithelialization, erythema, and hyperpigmentation was made at 1, 2, 4, and 12 weeks. RESULTS: Median erythema scores were significantly greater in skin treated with the CO(2) laser. Histologic examination showed greater epidermal loss and a significantly thicker zone of underlying thermal damage (average difference, 63 microm; 95% confidence interval, 40-87; P =.0002) in skin treated with the CO(2) laser compared with skin treated with the ESD. After 3 months, a band of superficial dermal fibrosis was thicker in skin treated with the CO(2) laser (average difference, 170 microm; 95% confidence interval, 69-271; P =.0075). CONCLUSION: Two passes with the ESD elicited a more superficial skin peel than the CO(2) laser. Despite minimal thermal damage, superficial dermal fibrosis was seen at 3 months in skin treated with the ESD.

Reevaluation of some double-blind, randomized studies of dexibuprofen (Seractil): a state-of-the-art overview. Studies in patients with lumbar vertebral column syndrome, rheumatoid arthritis, distortion of the ankle joint, gonarthrosis, ankylosing spondylitis, and activated coxarthrosis.

This article presents a reevaluation of studies previously performed regarding the efficacy and safety of dexibuprofen (Seractil; S(+)-ibuprofen) for use in patients with inflammatory or degenerative diseases. Using appropriate standardized measures (univariate and multivariate analysis with the Mann-Whitney statistic with confidence intervals), the authors were able to compare the effects of treatment in different diseases. For the primary criterion and for the combined analysis of all efficacy criteria, one-sided equivalence was proved in all six studies reviewed.