[Polytrauma on the way. Simple measures for efficient life-saving care!]. / Polytrauma unterwegs. Einfache Massnahmen effizient einsetzen--Leben retten!

The General Practitioner (GP) doesn't usually treat polytrauma often. However in Switzerland there are many remote areas where he is first on the scene of the accident. Thus it is important that he knows basic treatment principles in this situation such as the ABC according to the ATLS guidelines. We give a short overview of these important principles.

[Is iodination of cooking salt still necessary? Current studies on iodine supply in Switzerland]. / Ist die Kochsalzjodierung noch nötig? Neuere Untersuchungen über die Jodversorgung in der Schweiz.

Salt with 3.75 mg iodide per kg was introduced in Switzerland stepwise in the individual cantons between 1922 and 1952. The iodide content was raised to 7.5 mg in 1962 and to 15 mg per kg in 1980. 92% of retail salt and 78% of all salt for human consumption (including salt used in industrial food processing) was iodized in 1989. Under this measure, prevalence of grade 1b or larger goiter dropped continuously to a present value of 1.3% in school-children and 0.3% in male army recruits. Endemic cretinism has disappeared completely. Urinary iodine has reached the desired range of 150 +/- 77 (SD) micrograms per g creatinine. The following facts prove that iodization of salt (and not other changes of food habits) have corrected the iodine deficiency in Switzerland: 1. Urinary iodine is highly correlated with urinary sodium. Backward extrapolation yields a theoretical urinary iodine of 30 micrograms per g creatinine in the absence of iodized salt, a value typical of severe deficiency. 2. Goiter prevalence declined later in those cantons which introduced iodized salt last. 3. Surrounding countries without iodized salt (France, Italy, Federal Republic of Germany, Spain) suffer from considerable iodine deficiency with areas of high goiter prevalence and even endemic cretinism. The new data underscore the absolute and continued need for iodized salt in Switzerland.

Iodine deficiency diseases in Switzerland one hundred years after Theodor Kocher's survey: a historical review with some new goitre prevalence data.

In certain regions of Switzerland, before prophylaxis, 0.5% of the inhabitants were cretins, almost 100% of schoolchildren had large goitres and up to 30% of young men were unfit for military service owing to a large goitre. Iodization of salt was introduced in 1922 at 3.75 mg I per kg and the iodine content was doubled twice, in 1962 and 1980, to the present 15 mg I per kg. In 1988, 92% of retail salt and 76% of all salt for human consumption (including food industry) was iodized, even though its use is voluntary. Urinary iodine excretion, previously between 18 and 64 micrograms per per day, has now risen to 150 micrograms per day. No new endemic cretins born after 1930 have been identified. Goitre disappeared rapidly in newborns and schoolchildren, more slowly in army recruits, and incompletely in elderly adults. In some Cantons (by constitution in charge of health matters and the salt monopoly) which allowed iodized salt only in 1952, disappearance of goitre lagged behind accordingly, proof that iodized salt was the cause of regression. The Swiss data provide evidence that isolated deafness, mental deficiency, and short stature, each without the other attributes of cretinism have also decreased. Adverse effects of iodized salt were minimal, possibly because the initial iodine content of salt was chosen very low. Iodization of salt has proved a highly cost-effective preventive measure in Switzerland.