Factors during training which predict future use of minimally invasive thoracic surgery.

BACKGROUND: While minimally invasive thoracic surgery (MIS) has increased nationwide over the years, most patients undergoing lung and esophageal resections still undergo an open approach. We performed a national survey to analyze factors associated with a propensity to perform MIS after completing a cardiothoracic training program. MATERIALS AND METHODS: Cardiothoracic surgery trainees in 2 or 3-year programs from 2010 to 2016 were sent an online survey regarding the numbers and types of cases performed during training and current practice patterns as attending surgeons. Comfort level with MIS was also assessed. Responses were recorded and analyzed using SPSS. RESULTS: One hundred thirty-six trainees responded, with a mean of 121 lobectomies (30-250) and 40 esophagectomies (8-110) performed during training. Mean minimally invasive lobectomy and esophagectomy rates during training were 53% and 30% respectively. A greater ratio of MIS procedures performed during training correlated with a higher rate performed as an attending (lobectomies, p = 0.04; esophagectomies, p = 0.01) and a greater comfort level with performing these procedures (lobectomies, p = 0.01 and esophagectomies, p < 0.01). CONCLUSIONS: Based on these results, performing a greater ratio of minimally invasive lobectomies and esophagectomies during fellowship training increases the likelihood of performing them as an attending.

Reviving post-mortem diagnostics as a tool to increase porcine herd health and strengthen early detection of pig diseases - the PathoPig project 2014-2016.

INTRODUCTION: Post-mortem diagnostics are an important tool for disease diagnosis and therefore early detection of (re-)emerging animal diseases and zoonoses as well as nationwide disease surveillance programs. To counteract the decline of porcine necropsies in Switzerland over the last ten years, the Federal Food Safety and Veterinary Office (FSVO) launched a national project in 2014 called PathoPig. Post-mortem examinations of pigs from herds with health problems were financially supported by the FSVO. During the first 3 years of the project, the number of pig necropsies increased by 195% (mean). An underlying cause of disease was identified in 74% of the cases. These findings resulted in specific recommendations by the attending veterinarians or by the Swiss Porcine Health Service. A follow-up survey revealed that herd health had improved in 90% of the farms implementing the recommendations.

INTRODUCTION: Les diagnostics post-mortem constituent un outil important pour le diagnostic des maladies et, partant, la détection précoce des maladies animales et des zoonoses (ré)-émergentes ainsi que pour les programmes nationaux de surveillance des maladies. Pour contrer le déclin des nécropsies porcines en Suisse au cours des dix dernières années, l'Office fédéral de la sécurité alimentaire et vétérinaire (OSAV) a lancé en 2014 un projet national baptisé PathoPig. Les examens post-mortem des porcs provenant d'exploitations avec des problèmes de santé ont été soutenus financièrement par l'OSAV. Au cours des trois premières années du projet, le nombre de nécropsies porcines a augmenté de 195% (moyenne). Une cause sous-jacente de maladie a été identifiée dans 74% des cas. Ces constatations ont abouti à des recommandations spécifiques des vétérinaires participants ou du Service sanitaire porcin suisse. Une enquête de suivi a révélé que la santé des troupeaux s'était améliorée dans 90% des exploitations appliquant les recommandations.

Estimating healthcare costs of acute gastroenteritis and human campylobacteriosis in Switzerland.

Rising numbers of campylobacteriosis case notifications in Switzerland resulted in an increased attention to acute gastroenteritis (AG) in general. Patients with a laboratory-confirmed Campylobacter infection perceive their disease as severe and around 15% of these patients are hospitalized. This study aimed at estimating healthcare costs due to AG and campylobacteriosis in Switzerland. We used official health statistics, data from different studies and expert opinion for estimating individual treatment costs for patients with different illness severity and for extrapolating overall costs due to AG and campylobacteriosis. We estimated that total Swiss healthcare costs resulting from these diseases amount to €29-45 million annually. Data suggest that patients with AG consulting a physician without a stool diagnostic test account for €9·0-24·2 million, patients with a negative stool test result for Campylobacter spp. for €12·3 million, patients testing positive for Campylobacter spp. for €1·8 million and hospitalized campylobacteriosis patients for €6·5 million/year. Healthcare costs of campylobacteriosis are high and most likely increasing in Switzerland considering that campylobacteriosis case notifications steadily increased in the past decade. Costs and potential cost savings for the healthcare system should be considered when designing sectorial and cross-sectorial interventions to reduce the burden of human campylobacteriosis in Switzerland.