Long-term projections and acclimatization scenarios of temperature-related mortality in Europe.

The steady increase in greenhouse gas concentrations is inducing a detectable rise in global temperatures. The sensitivity of human societies to warming temperatures is, however, a transcendental question not comprehensively addressed to date. Here we show the link between temperature, humidity and daily numbers of deaths in nearly 200 European regions, which are subsequently used to infer transient projections of mortality under state-of-the-art high-resolution greenhouse gas scenario simulations. Our analyses point to a change in the seasonality of mortality, with maximum monthly incidence progressively shifting from winter to summer. The results also show that the rise in heat-related mortality will start to completely compensate the reduction of deaths from cold during the second half of the century, amounting to an average drop in human lifespan of up 3-4 months in 2070-2100. Nevertheless, projections suggest that human lifespan might indeed increase if a substantial degree of adaptation to warm temperatures takes place.

The FIM instrument to identify patients at risk of falling in geriatric wards: a 10-year retrospective study.

OBJECTIVES: the main objective was to evaluate if the admission functional independence measure (FIM) score could be used to predict the risk of falls in geriatric inpatients. DESIGN: a 10-year retrospective study was performed. SETTING: the study was conducted in a 298-bed geriatric teaching hospital in Geneva, Switzerland. SUBJECTS: all patients discharged from the hospital from 1 January 1997 to 31 December 2006 were selected. MAIN OUTCOME MEASURES: measures used were FIM scores at admission using the FIM instrument and number of falls extracted from the institution's fall report forms. RESULTS: during the study period, there were 23,966 hospital stays. A total of 8,254 falls occurred. Of these, 7,995 falls were linked to 4,651 stays. Falls were recorded in 19.4% of hospital stays, with a mean incidence of 7.84 falls per 1,000 patients-days. Although there was a statistically significant relationship between total FIM score, its subscales, and the risk of falling, the sensitivity, specificity, positive predictive value and negative predictive value obtained with receiver operating characteristic curves were insufficient to permit fall prediction. This might be due in part to a non-linear relationship between FIM score and fall risk. CONCLUSION: in this study, the FIM instrument was found to be unable to predict risk of falls in general geriatric wards.

Death toll exceeded 70,000 in Europe during the summer of 2003.

Daily numbers of deaths at a regional level were collected in 16 European countries. Summer mortality was analyzed for the reference period 1998-2002 and for 2003. More than 70,000 additional deaths occurred in Europe during the summer 2003. Major distortions occurred in the age distribution of the deaths, but no harvesting effect was observed in the months following August 2003. Global warming constitutes a new health threat in an aged Europe that may be difficult to detect at the country level, depending on its size. Centralizing the count of daily deaths on an operational geographical scale constitutes a priority for Public Health in Europe.

A new preservation solution increases islet yield and reduces graft immunogenicity in pancreatic islet transplantation.

The aim of the study was to test a new preservation solution containing polyethylene glycol (S.C.O.T. solution) as pancreatic islet isolation medium both to increase the islet yield and to prolong the allograft survival. In a model of islet transplantation in diabetic mouse, islets were isolated with S.C.O.T. in experimental groups and with Hank's balanced salt solution (HBSS) in control groups. The use of S.C.O.T. solution improved the islet yield (596+/-27 IEQ/pancreas) as compared to HBSS (456+/-11 IEQ/pancreas) (P<0.001). Allograft survival was prolonged in experimental group (17.3+/-4.3 days) versus controls (7.3+/-3.6 days) in a full mismatch combination (P<0.001) and in absence of recipient immunosuppression. The same prolongation (10 days) was also found in a strongly alloreactive transgenic combination. It is hypothesized that a transitory phenomenon of immunocamouflage of the graft surface antigens occurs, as shown by immunofluorescence studies. The use of this new solution could improve the results of islet transplantation in humans.

Immunohistochemical expression of p63, p53 and MIB-1 in urinary bladder carcinoma. A tissue microarray study of 158 cases.

P63 is a member of the p53 family, which plays a role in the differentiation of urothelium and is supposed to play a role in urothelial carcinogenesis. P53 and MIB-1 are recognised in many studies as predictive markers of progression, but few studies in the literature have examined p63. The aims of our study were to explore the expression of p63 in bladder carcinomas and to compare this expression to p53 and MIB-1, as well as to stage and grade. Tissue microarrays were performed on 158 urothelial carcinomas (56 pTa, 45 pT1 and 57>or=pT2). Immunohistochemical studies were performed with p63, p53 and MIB-1 antibodies. In our study we observed that p63 immunostaining is present in all cell layers in papillary urothelial neoplasm of low malignant potential (PUNLMP), but partially lost in non-invasive papillary urothelial carcinoma low grade (NILGC) and in pT1/>or=pT2 bladder cancers. P53 and MIB-1 displayed lower expression in PUNLMP/NILGC vs non-invasive papillary urothelial carcinoma high grade (NIHGC)/pT1, but there was no correlation between the expression of p63, p53 and MIB-1. Our study demonstrates that p63 expression distinguishes between PUNLMP/NILGC and NIHGC/pT1 (p=4.10(5)). A statistical difference disserving pTa and pT1/>or=pT2 with a statistical significance (p<10(-6)) could also be observed. P63 should be considered as an additional biomarker that might help pathologists to classify their patients.