Surgical indications for pituitary tumors during pregnancy: a literature review.

PURPOSE: Surgical indications for pituitary tumors during pregnancy are rare, and are derived from a balance between expected benefits, particularly for maternal benefits, and anesthetic/surgical risks. METHODS: A literature review was performed to define the optimal surgical indications for pituitary adenomas (PA) and other pituitary tumors during pregnancy. RESULTS: Main benefits are expected in case of critical visual impairment and/or life-threatening endocrine disturbances. Multidisciplinary patient management is systematically required although nonobstetric surgery presents a reasonable risk during pregnancy. The risks of congenital malformation during the first trimester and those of premature birth during the third trimester make the second trimester the optimal period for surgery. In prolactin-secreting, nonsecreting, GH- and TSH-secreting PAs, transsphenoidal surgery (TS) is recommended in cases involving severe visual impairment, characterized by severe visual field deficit, visual acuity impairment, and abnormal optical coherence tomography findings, and when no other medical alternatives are possible and/or sufficient. Uncontrolled and severe Cushing's disease (CD) during pregnancy increases both maternal and fetal morbimortality, thus justifying TS or sometimes dopamine agonist therapy as a safer alternative. Finally, metyrapone, ketoconazole, or bilateral adrenalectomy could be recommended in certain cases after the failure of medical therapies and/or TS. Surgery is also required for suprasellar meningiomas, craniopharyngiomas, and pituitary cysts in the case of severe visual deficit. CONCLUSION: Surgical indications for pituitary tumors are rare during pregnancy; therefore, surgery should be avoided when possible. Further, the second trimester should be considered as the optimal surgical period. Severe visual disturbance and uncontrolled CD are the main surgical indications during pregnancy.

Control of Staphylococcus aureus in dairy herds in a region with raw milk cheese production: farmers' attitudes, knowledge, behaviour and belief in self-efficacy.

BACKGROUND: Contagious mastitis is an important disease in dairy cattle, and the causative agent S. aureus can also impair raw milk cheese quality. In a confined region in eastern Switzerland attitude, knowledge and behaviour towards S. aureus und S. aureus control was assessed in 90 dairy farmers with communal alpine pasturing including raw milk cheese production with the aid of a questionnaire. RESULTS: Forty-three out of 90 questionnaires were returned (48% return rate). Farmers perceived reproductive problems as most important in their dairy herds followed by respiratory disease and diarrhoea in young stock. Most frequently stated as important motivating factors to participate in S. aureus control were "avoiding negative news about cheese quality in the press" followed by "I want to be proud of my somatic cell counts again". Most frequently chosen and identified as important constraining factors were "I fear that the authorities dictate and the farmers are not heard" followed by "costs to control S. aureus are too high because of premature culling" and "I am afraid to be forced to cull genetically valuable cows". Farmers with an experience of a S. aureus problem in their dairy herds had a significantly better knowledge about contagiosity and clinical manifestation of different S. aureus genotypes than farmers with no self-reported experience of a S. aureus problem. Veterinarians were indicated as the most important experts, farmers seek advice in case of mastitis and most farmers suggested subsidising bacteriological milk analysis as an incentive to motivate farmers towards S. aureus control. CONCLUSION: According to the results an improved knowledge transfer on S. aureus to dairy producers and an integrative approach to a S. aureus control program with subsidising milk analysis will be most promising to improve the S. aureus situation in this confinded region of eastern Switzerland. Veterinarians should cover a key role in consulting farmers during the control program.

"The Dose Makes the Poison": Informing Consumers About the Scientific Risk Assessment of Food Additives.

Intensive risk assessment is required before the approval of food additives. During this process, based on the toxicological principle of "the dose makes the poison,Ë® maximum usage doses are assessed. However, most consumers are not aware of these efforts to ensure the safety of food additives and are therefore sceptical, even though food additives bring certain benefits to consumers. This study investigated the effect of a short video, which explains the scientific risk assessment and regulation of food additives, on consumers' perceptions and acceptance of food additives. The primary goal of this study was to inform consumers and enable them to construct their own risk-benefit assessment and make informed decisions about food additives. The secondary goal was to investigate whether people have different perceptions of food additives of artificial (i.e., aspartame) or natural origin (i.e., steviolglycoside). To attain these research goals, an online experiment was conducted on 185 Swiss consumers. Participants were randomly assigned to either the experimental group, which was shown a video about the scientific risk assessment of food additives, or the control group, which was shown a video about a topic irrelevant to the study. After watching the video, the respondents knew significantly more, expressed more positive thoughts and feelings, had less risk perception, and more acceptance than prior to watching the video. Thus, it appears that informing consumers about complex food safety topics, such as the scientific risk assessment of food additives, is possible, and using a carefully developed information video is a successful strategy for informing consumers.

Intestinal permeability and fecal eosinophil-derived neurotoxin are the best diagnosis tools for digestive non-IgE-mediated cow's milk allergy in toddlers.

BACKGROUND: Food allergy is a common problem in France involving 4%-6% of toddlers. As opposed to IgE-mediated cow's milk allergy (CMA), delayed-onset CMA, mostly, non-IgE-mediated, remains difficult to diagnose in toddlers. Our study assessed the diagnostic performances of intestinal permeability and of fecal markers, in comparison with the standard allergic work-up in children referred for CMA diagnosis. METHODS: Twenty-five consecutive children, mean age (standard deviation) 6.3 months (4.8) with digestive and/or extra-digestive manifestations suggesting CMA, were prospectively studied based on a standardized allergic work-up (specific cow's protein IgE and IgG, skin prick test, atopy patch test and oral open cow's milk challenge) and digestive work-up including fecal microbiota analysis, intestinal permeability determination (urinary lactitol/mannitol ratio) and fecal markers measurement, i.e., α(1)-antitrypsin, tumor necrosis factor-α, calprotectin, ß-defensin2, secretory IgA and eosinophil-derived neurotoxin (EDN). Receiver operating characteristic (ROC) curves were calculated for all markers in order to define cut-off levels. RESULTS: The cow's milk challenge was positive in 11 children and negative in 14. The global test performances, i.e., the number of true positive+negative cases/the total number of cases, were 76% for intestinal permeability; 72% for fecal EDN; contrasting with atopy patch test, 68%; IgE, 60%; skin prick test, 55% and IgG, 52%. CONCLUSIONS: In this routine diagnosis allergy work-up for CMA in toddlers, the best efficacy was seen for intestinal permeability compared to IgE, IgG, skin prick test and atopy patch test. Moreover, fecal EDN in a single spot sample displayed a similar performance.

Cell phones and health concerns: impact of knowledge and voluntary precautionary recommendations.

The article explores how voluntary precautionary recommendations for cell phone usage influence people's health concerns and behavior. An experimental study using a sample of Swiss citizens (N=408) was conducted. Three different versions of a newly developed booklet, which focused on common misconceptions in regard to mobile communication, and an existing booklet were tested. The experimental design addressed questions of the potential effects of knowledge, precautionary recommendations, and sender identity on health concerns and transfer of the proposed recommendations. Participants' perceptions were measured three times: immediately before and after reading the booklet, and two weeks later. The reading of the booklets increased participants' knowledge considerably and led to perceptual changes. In regard to cell phones, health concerns increased after the reading and stayed at a higher level even after two weeks. The negative perception of base stations, in contrast, tended to decrease. Neither the identity of the sender nor the omission of precautionary recommendations had significant effects on health concerns. Provision of specific recommendations enhanced readers' behavioral changes. Confrontation with information per se, and not precautionary recommendations, influenced the public's health concerns. These changes should not prevent the provision of precautionary recommendations because, in the face of scientific uncertainty, these are the only means through which to enable users to make informed decisions.

Knowledge, attitude and practices of Swiss dairy farmers towards intramammary antimicrobial use and antimicrobial resistance: A latent class analysis.

Understanding farmers' mindsets is important to improve antimicrobial stewardship in the dairy industry. This cross-sectional study aimed to determine farmers' knowledge, attitude, and practices with respect to lactational intramammary antimicrobial use (AMU) and antimicrobial resistance (AMR) in Swiss dairy herds. Based on their approach towards subclinical mastitis (SCM) and non-severe cases of clinical mastitis (CM), subgroups of farmers were identified and compared regarding their knowledge, attitude and practices towards AMU and AMR. After conducting qualitative interviews to develop a questionnaire, an online survey was sent to 1296 randomly selected Swiss dairy farmers. Information was gathered on demographic data and farmers' knowledge, attitude, and practices towards AMU and AMR. A latent class analysis was performed to identify subgroups of farmers based on management of SCM and non-severe CM cases. Based on the results of 542 completed questionnaires, poor knowledge with respect to AMU and AMR was identified, as well as discrepancies between farmers' perceptions and their actual practices. Farmers approached cows with SCM and non-severe CM similarly, indicating they perceived both mastitis states as the same disease. Intramammary antimicrobial products containing cefquinome, which is a highest priority critically important antimicrobial, were among the 3 most commonly applied intramammary antimicrobials. Five latent classes of farmers were identified based on their management towards SCM and non-severe CM. One group of farmers (18.5% of respondents) indicated that they did not treat those mastitis cases, one group only treated SCM cases (13.8% of respondents), one group only treated non-severe CM cases (28.6% of respondents) and the largest group treated both mastitis states (39.1% of respondents). The latter group was subdivided into a latent class of farmers following guidelines for AMU/AMR (25.5% of respondents) and a group of farmers that were not strictly following these guidelines (13.7% of respondents). Regional differences between farmers, according to altitude and language region, explained some of the variation in latent class membership. Latent class membership was associated with farmers' attitude to use antimicrobials as little as possible and with using antimicrobials only after performing bacteriological and susceptibility testing. This study gave detailed insight into Swiss farmers' knowledge, attitude, and practices regarding AMU and AMR and provides opportunities to improve antimicrobial stewardship in Swiss dairy herds. The identified groups of farmers, based on their management practices regarding SCM and non-severe CM, may help to design tailored intervention strategies for improving prudent AMU in the heterogeneous population of dairy farmers in Switzerland.

Expectations influence sensory experience in a wine tasting.

Information about a product may shape consumers' taste experience. In a wine tasting experiment, participants received (positive or negative) information about the wine prior to or after the tasting. When the information was given prior to the tasting, negative information about the wine resulted in lower ratings compared to the group that received positive information. No such effect was observed when participants received the information after the tasting but before they evaluated the wine. Results suggest that the information about the wine affected the experience itself and not only participants' overall assessment of the wine after the tasting.

Factors and markers of growth hormone secretion and gonadal function in Fanconi anemia.

UNLABELLED: Many factors may be involved in the growth and gonadal dysfunction of Fanconi anemia (FA). OBJECTIVE: To evaluate the (1) relationship between FA presentation, including genital abnormalities and pituitary stalk interruption syndrome (PSIS), (2) markers of growth hormone (GH) deficiency and gonadal function, and (3) factors influencing final height and gonadal function. PATIENTS: Twenty five patients with FA were included, 17 of them were given bone marrow transplantation. RESULTS: Six patients were diagnosed with GH deficiency and PSIS (group A), whereas 19 had no evidence of GH deficiency (group B). In group A, all patients had more than 3 FA malformations and all 5 boys had cryptorchidism associated with microphallus in 4. All patients had heights and plasma insulin-like growth factor I < -3SD. Final height was reached in 15 patients and was < or = -2SD in 12 of them, all but 3 were born small for gestational age and/or given norethandrolone and/or corticosteroids. Gonadal function was abnormal in 5/7 boys and 4/5 girls evaluated at pubertal age. The plasma concentrations were low in 4/9 for antimüllerian hormone and in 3/9 for inhibin B, 3 of them had been given bone marrow transplantation. CONCLUSIONS: PSIS can be part of a severe FA phenotype. It seems to occur mainly in boys, with more than 3 malformations, microphallus and cryptorchidism. This phenotype is associated with normal blood counts, defining a new clinical subgroup of patients.

Expert Opinion on the Perceived Effectiveness and Importance of On-Farm Biosecurity Measures for Cattle and Swine Farms in Switzerland.

Biosecurity is crucial for safeguarding livestock from infectious diseases. Despite the plethora of biosecurity recommendations, published scientific evidence on the effectiveness of individual biosecurity measures is limited. The objective of this study was to assess the perception of Swiss experts about the effectiveness and importance of individual on-farm biosecurity measures for cattle and swine farms (31 and 30 measures, respectively). Using a modified Delphi method, 16 Swiss livestock disease specialists (8 for each species) were interviewed. The experts were asked to rank biosecurity measures that were written on cards, by allocating a score from 0 (lowest) to 5 (highest). Experts ranked biosecurity measures based on their importance related to Swiss legislation, feasibility, as well as the effort required for implementation and the benefit of each biosecurity measure. The experts also ranked biosecurity measures based on their effectiveness in preventing an infectious agent from entering and spreading on a farm, solely based on transmission characteristics of specific pathogens. The pathogens considered by cattle experts were those causing Bluetongue (BT), Bovine Viral Diarrhea (BVD), Foot and Mouth Disease (FMD) and Infectious Bovine Rhinotracheitis (IBR). Swine experts expressed their opinion on the pathogens causing African Swine Fever (ASF), Enzootic Pneumonia (EP), Porcine Reproductive and Respiratory Syndrome (PRRS), as well as FMD. For cattle farms, biosecurity measures that improve disease awareness of farmers were ranked as both most important and most effective. For swine farms, the most important and effective measures identified were those related to animal movements. Among all single measures evaluated, education of farmers was perceived by the experts to be the most important and effective for protecting both Swiss cattle and swine farms from disease. The findings of this study provide an important basis for recommendation to farmers and policy makers.

When memorized instances compete with rules: the case of number-noun agreement in written French.

It is claimed by Totereau, Thévenin & Fayol (1997) that French children understand the rule for spelling the plural inflection very early on. However, no evidence contradicts the alternative that they learn the spelling of a word's singular and plural forms by treating the two forms as entirely different words. We tested this by asking French first and second graders (85 six-year-old and 89 seven-year-old children, respectively) to read and write rare words, either in just the singular or in just the plural, and then testing their spelling. The children tended to attach plural inflections to words which they had encountered only as plural and to omit them from words encountered before only as singular.

Public acceptance of nanotechnology foods and food packaging: the influence of affect and trust.

Nanotechnology is increasingly being employed in the areas of food production and packaging. Public perception will be crucial to the realization of these technological advances. We examined how lay people (N=153) perceive nanotechnology foods and nanotechnology food packaging, and we examined the factors that influence willingness to buy these products. Participants received some general information about nanotechnology, and specific information about four nanotechnology applications. Overall, participants were hesitant to buy nanotechnology foods or food with nanotechnology packaging. Results suggest, however, that nanotechnology packaging is perceived as being more beneficial than nanotechnology foods. Results further suggest that social trust in the food industry is an important factor directly influencing the affect evoked by these new products. As suggested by the affect heuristic, affect had an impact on perceived benefits and perceived risks. Perceived benefit seems to be the most important predictor for willingness to buy.

Implicit attitudes toward nuclear power and mobile phone base stations: support for the affect heuristic.

The implicit association test (IAT) measures automatic associations. In the present research, the IAT was adapted to measure implicit attitudes toward technological hazards. In Study 1, implicit and explicit attitudes toward nuclear power were examined. Implicit measures (i.e., the IAT) revealed negative attitudes toward nuclear power that were not detected by explicit measures (i.e., a questionnaire). In Study 2, implicit attitudes toward EMF (electro-magnetic field) hazards were examined. Results showed that cell phone base stations and power lines are judged to be similarly risky and, further, that base stations are more closely related to risk concepts than home appliances are. No differences between experts and lay people were observed. Results of the present studies are in line with the affect heuristic proposed by Slovic and colleagues. Affect seems to be an important factor in risk perception.