Complete sequence-based pathway analysis by differential on-chip DNA and RNA extraction from a single cell.

We demonstrate on-chip, differential DNA and RNA extraction from a single cell using a microfluidic chip and a two-stage lysis protocol. This method enables direct use of the whole extract, without additional washing steps, reducing sample loss. Using this method, the tumor driving pathway in individual cells from a colorectal cancer cell line was determined by applying a Bayesian computational pathway model to sequences obtained from the RNA fraction of a single cell and, the mutations driving the pathway were determined by analyzing sequences obtained from the DNA fraction of the same single cell. This combined functional and mutational pathway assessment of a single cell could be of significant value for dissecting cellular heterogeneity in tumors and analyzing single circulating tumor cells.

Influence of occupational exposure to latex on the prevalence of sensitization and allergy to latex in a Swiss hospital.

BACKGROUND: Replacement of powdered latex gloves has been recommended in order to prevent the development of latex allergy in health care workers. The conclusion that occupational exposure to latex gloves represents a risk factor for latex allergy is mainly based on studies without exposure controls. Atopy is also thought to be a risk factor for the development of latex allergy. OBJECTIVE: To determine the prevalence of atopy, sensitization to latex, and symptoms following latex exposure in professionally exposed and nonexposed hospital personnel by means of a cross-sectional study. METHODS: Six hundred randomly sampled individuals working in medicine and surgery departments and in surgery theaters and 300 sex- and age-matched individuals classified as administrative personnel were selected from the employee data base of the Geneva University Hospital. A questionnaire about exposure to latex and symptoms following this exposure was sent to all individuals. Skin prick test reactions and serum IgE to latex as well as standard environmental allergens were determined in both groups. RESULTS: Respiratory and skin (local) symptoms but not objective tests of latex sensitization (positive skin prick test and specific IgE to latex) were significantly associated with occupational exposure to latex (p < 0.001). Only among atopics subjects was 15 years or more of occupational exposure associated with a significantly higher prevalence of local symptoms than among those who were exposed from 1 to 9 years (odds ratio: 3.2; 95% confidence interval: 1.6-6.5). Atopy was significantly associated with sensitization to latex (odds ratio: 10.3; 95% confidence interval: 4.0-26.6) but not with local symptoms. Tests of latex sensitization were both frequently positive, less frequently negative, resulting in low kappa values. CONCLUSION: These results support the current preventive health care recommendation to replace powdered latex gloves. In atopics, increasing years of occupational exposure increase the risk of developing latex allergy. In contrast to questionnaires about local symptoms, skin prick tests and specific serum IgE to latex are of limited value in epidemiologic studies of latex allergy.

Influenza immunization: improving compliance of healthcare workers.

OBJECTIVE: In spite of yearly recalls, influenza immunization rates of healthcare workers (HCWs) remained low (10%) at the University Hospitals of Geneva. This study was conducted to identify HCWs' reasons for rejection of immunization, to design specific intervention methods based on these reasons, and to evaluate the impact of such interventions. METHODS: Three departments with high-risk patients (geriatrics, obstetrics, and pediatrics) were selected as main targets. Questionnaires were distributed in these units. Based on HCWs' perceptions, different intervention methods were designed and used either in these departments only (educational conferences, on-site availability of a vaccination nurse) or in the whole institution (posters, personal letters). Immunization rates were collected throughout the institution. RESULTS: 797 completed questionnaires from 1,092 HCWs (73%) were returned. Major reasons for immunization rejection were confidence that their bodies' self-defense mechanisms would ward off infection (32%), perception of low exposure risk (23%), and doubts concerning vaccine efficacy (19%). The use of intervention methods designed to address these factors increased influenza immunization rates in the three targeted departments from 13% (95% confidence interval [CI95], 11.4-15.6) in 1995 and 1996 to 37% (CI95, 34.5-40.3) in the following season (P<.001). In all other departments, immunization rates rose from 9% (CI95, 8.5-10.3) to 23% (CI95, 21.6-24.1; P<.001). Nurses were, and remained, more reluctant to be immunized compared to other HCWs. CONCLUSIONS: Influenza immunization rates can be increased significantly by specific interventions based on local concerns of HCWs, among which educational conferences and the on-site availability of a vaccination nurse appeared important.

[Vaccination against influenza in Switzerland]. / Vaccination contre la grippe en Suisse.

Influenza is still an important cause of morbidity and mortality in our country. The yearly vaccination of the population at risk is always the best method of prevention and for the limitation of health care costs. Today the protection of elderly people and health care professionals by vaccination is not sufficient. Development of information programs, sensibilisation and motivation of the community on a national basis and in line with the health care insurers are necessary. The vaccine's reimbursement since 1996 following the respective legal change will certainly help to promote vaccination against influenza. On the other hand, the competition of different vaccines introduced in Switzerland in the last years will additionally support the penetration of information and vaccination.

[Demonstration of gram-negative bacteria and endotoxins in the air surrounding a sewage treatment plant: effect of contaminated aerosols on the health status of the staff]. / Mise en évidence de bactéries gram-négatives et d'endotoxines dans l'air ambiant d'une station d'épuration des eaux usées: influence des aérosols contaminés sur l'état de santé du personnel.

Data on airborne gram-negative bacteria and endotoxin contamination in a sewage treatment plant are reported and compared with data from similar plants in Scandinavia. Respiratory, digestive, and cutaneous symptoms were investigated on the basis of medical files. The contamination levels which can be considered safe are discussed in the light of the actual exposure of workers.

[Measurements of blood citrates in neoplasms with bone metastases]. / Dosage de la citratémie dans les cancers avec métastases osseuses.

Blood citrate was measured in 49 patients with cancer, with or without bone metastases, and in 53 normal subjects. It is significantly higher (p less than 0.001) in patients with bone metastases than in normal subjects or patients without bone metastases. In normal subjects, blood citrate is higher in summer than in winter and higher in older people. The theoretical and practical interest of these observations is discussed.