[Relevance of traditional hospitalizations in an ophthalmology department]. / Pertinence de l'hospitalisation traditionnelle dans un service d'ophtalmologie.

INTRODUCTION: Ophthalmological indications for traditional hospitalizations are not clearly established and should be updated with respect to both healthcare quality and economic considerations. We therefore analyzed the data of patients hospitalized in an ophthalmology department. PATIENTS AND METHOD: We prospectively analyzed the medical and socioeconomic charts of all patients hospitalized during a 2-month period (December 2006 and January 2007) in a single ophthalmology department. RESULTS: Over the 2 months, 349 patients were admitted (mean stay, 3 days), 324 of whom were operated. The main causes of admission were retinal detachments (n=103), injuries (n=33), endothelial cell failure (n=27), cataract (n=27), high ocular pressure (n=23), and corneal abscess (n=17). Admission was mainly guided by the surgeon's habits (n=135, 39%) and was not medically relevant but was generally motivated by financial considerations. Other hospital admissions were medically justified (intravenous injections, head positioning) but the hospitalization of patients living far from the hospital (n=46; 13%) could be limited by the development of housing made available to patients. CONCLUSION: Ophthalmological hospitalization is not always medically relevant and often is based on financial or housing constraints. More than half of the classical admissions should be switched to ambulatory patient care by adapting financial compensations to surgical costs or providing outpatient housing.

Bacterial diversity and community composition in the chemocline of the meromictic alpine Lake Cadagno as revealed by 16S rDNA analysis.

Using different techniques of molecular biology we investigated the bacterial diversity of the chemocline of the meromictic Lake Cadagno. Cloning of a total community 16S rDNA PCR product and subsequent screening with a combination of amplified ribosomal DNA restriction analysis and temporal temperature gradient gel electrophoresis (TTGE) analysis revealed that 30 of 47 randomly selected clones were unique. Partial sequencing and comparative analysis indicated a high bacterial diversity dominated by the gamma-Proteobacteria (33.3%). Most of these rDNA clone sequences were not closely related to any 16S rDNA sequence in the database. In a second approach, the TTGE pattern from an environmental sample was compared with the migration of the cloned 16S rDNA fragments. Four clone types were identified on the environmental pattern by excising and sequencing comigrating bands, three of which were well represented in the library: two Chromatiaceae species and one sequence affiliated with the Desulfobulbus assemblage. Using the fluorescent in situ hybridization technique we essentially confirmed the results of the cloning experiments and the TTGE analysis.