Emergence of four cases of KPC-2 and KPC-3-carrying Klebsiella pneumoniae introduced to Switzerland, 2009-10.

We report four epidemiologically unrelated cases of KPC-carrying Klebsiella pneumoniae identified in Switzerland between May 2009 and November 2010. Three cases were transferred from Italy (two KPC-3, one KPC-2) and one from Greece (KPC-2). Resistance to colistin and doxycycline emerged in one KPC-3-carrying K. pneumoniae strain during therapy. These results demonstrate ongoing dissemination of KPC throughout Europe. Rapid and reliable identification of KPC and implementation of control measures is essential to limit spread.

Determination of biogenic halogenated methyl-phenyl ethers (halogenated anisoles) in the picogram m(-3) range in air.

Halogenated anisoles (methyl-phenyl ethers) appear to be ubiquitous organic trace compounds in the environment. An analytical method is presented for analyzing the altogether 134 congeners of chloro-, bromo- and mixed bromochloro-anisoles on an isomer-specific basis in air. High volume sampling (20 m(3) per hour) is carried out by adsorption, using a mixture of silica gel 60 and ENVI-Carb. The preseparation of the anisoles is achieved by NP-LC on Florisil (a magnesium silicate). The interference by volatile n-alkyl nitrates in the electron-capture detection can be avoided by a LC-preseparation on a carboneous phase. The isomer-specific separation and detection is performed by HRGC-ECD and HRGC-MS-SIM. A structure-specific systematic numbering of the 134 congeners of the chloro-, bromo- and bromochloro-anisoles is suggested. The retention data are given of 16 chloroanisoles, 10 bromoanisoles and 27 bromo-chloroanisoles on three stationary phases with different polarity.

Are we any closer to understanding divided attention?

The present paper reports a replication of work by Hirst, Neisser, and Spelke, which requires extensive practice on two coupled tasks (reading and writing) at once. The results highlight the importance of individual differences in any consideration of divided attention.

[Hospital physicians in the light of letters of complaint]. / Spitalärzte im Lichte von Beschwerdebriefen.

In a competitive health-care system the quality of services and, closely related, customer satisfaction are significant success factors. Some patients or their relatives who are dissatisfied with the provided service express this in letters of complaint. Using the critical incident technique based on a sample of 54 letters of complaint regarding doctors' performance sent to the administration of the Inselspital of Berne we examined information such feedback contains. A total of 133 critical occurrences have been described. Seventy percent of the occurrences were related to medical treatment and 6% to the medical education and research process. The remaining 26% of the complaints concerned accommodation, care, administration or other areas. In the sphere of medical service procedures the dissatisfaction of patients centered on information provided to patients and their families (38%), followed by criticism concerning clinic organization (23%), interaction with the doctor (14%), his professional competence (13%) as well as the management of clinical data (12%). On average, 3 out of 10 letters allude to possible criminal or liability proceedings or seemed to have a potential for escalation in other areas. The situations as presented in these complaints is to be considered as objective and relevant. To continue the process of optimization and quality improvement it is therefore recommendable to take these signals seriously.

[Evaluation of social status and hemodynamic results four to six years after prosthetic valve replacement (author's transl)]. / Sozialanamnestische und hämodynamische Untersuchungen 4 bis 6 Jahre nach prothetischem Klappenersatz.

In 72 patients the professional and social status before and after prosthetic valve replacement was examined. In 60 of these patients the hemodynamic data (cardiac index, stroke volume index, pulmonary arterial pressure at rest and during exercise) were measured. The patients were classified according to their professional training, their last occupation, and their social status before operation. Postoperative changes in professional life and the daily work load were correlated to the hemodynamic results. The study shows that the social status plays a more important role in regaining the professional position postoperatively than the hemodynamic parameter.