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1.
Anticancer Res ; 39(12): 6859-6862, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810953

RESUMO

BACKGROUND/AIM: Hodgkin's lymphoma (HL) accounts for 1% of cancers and is of largely unknown pathogenesis. This study intended to find clues about potential causes (etiology) of HL through observations on patients and their families. PATIENTS AND METHODS: In 37 years of a medical oncology practice in Basel, Switzerland, 36 out of 2201 patients (1.6%) had HL. Etiological information has been obtained from the patients with the help of a German translation of the NCI Medical History Questionnaire for Cancer Etiology, and through the study of their medical charts. RESULTS: Findings of etiological interest were observed in the medical history of 26 out of the 36 patients with HL; these findings were grouped as follows: benign tumors (25%), carcinogenic exposures (19%), immunologic disorders (19%), secondary malignancies (14%), infections (11%), congenital disorders (8%) and tonsillectomies (6%). Twenty-two out of 36 patients had one or more relatives with cancer. CONCLUSION: Personal and family history of patients with HL is a readily available useful tool for etiology research. The fact that HL is frequently associated with other cancers in patients and their relatives points to causal genetic factors.


Assuntos
Doença de Hodgkin/etiologia , Doença de Hodgkin/mortalidade , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Anamnese , Pessoa de Meia-Idade , Fatores de Risco , Suíça/epidemiologia , Adulto Jovem
2.
Environ Health Perspect ; 127(11): 117007, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31769300

RESUMO

BACKGROUND: Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multi-country study has explored the shape of the association and the role of moderate and extreme heat across different locations. OBJECTIVES: We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y. METHODS: We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country. RESULTS: A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain. DISCUSSION: Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed. https://doi.org/10.1289/EHP4898.


Assuntos
Temperatura Alta/efeitos adversos , Suicídio/estatística & dados numéricos , Brasil/epidemiologia , Canadá/epidemiologia , Cidades , Humanos , Japão/epidemiologia , Filipinas/epidemiologia , República da Coreia/epidemiologia , Risco , África do Sul/epidemiologia , Espanha/epidemiologia , Suíça/epidemiologia , Taiwan/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia , Vietnã/epidemiologia
3.
Rev Med Suisse ; 15(670): 2046-2051, 2019 Nov 06.
Artigo em Francês | MEDLINE | ID: mdl-31696680

RESUMO

Stroke is the most common acute neurological disease in the world. Approximately 16 000 strokes occur each year in Switzerland. In the older population, the stroke outcomes are related to high risk of malnutrition due to neurological deficits impacting oral feeding. Therefore, systematic screening of malnutrition is required upon admission to hospital. Then, assessment of the nutritional status by a specialist should be initiated before deciding on individualised nutritional strategy. Rehabilitation is complex and must be done in multidisciplinary team to provide optimal care to the patients.


Assuntos
Desnutrição/etiologia , Desnutrição/terapia , Avaliação Nutricional , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/complicações , Idoso , Hospitalização , Humanos , Desnutrição/diagnóstico , Estado Nutricional , Acidente Vascular Cerebral/epidemiologia , Suíça/epidemiologia
4.
Parasit Vectors ; 12(1): 521, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690337

RESUMO

BACKGROUND: Sarcoptic mange is a contagious skin disease of wild and domestic mammals caused by the mite Sarcoptes scabiei. Reports of sarcoptic mange in wildlife increased worldwide in the second half of the 20th century, especially since the 1990s. The aim of this study was to provide new insights into the epidemiology of mange by (i) documenting the emergence of sarcoptic mange in the red fox (Vulpes vulpes) in the last decades in Switzerland; and (ii) describing its spatiotemporal spread combining data obtained through different surveillance methods. METHODS: Retrospective analysis of archived material together with prospective data collection delivered a large dataset from the 19th century to 2018. Methods included: (i) a review of historical literature; (ii) screening of necropsy reports from general health surveillance (1958-2018); (iii) screening of data on mange (1968-1992) collected during the sylvatic rabies eradication campaign; (iv) a questionnaire survey (<1980-2017) and (v) evaluation of camera-trap bycatch data (2005-2018). RESULTS: Sarcoptic mange in red foxes was reported as early as 1835 in Switzerland. The first case diagnosed in the framework of the general health surveillance was in 1959. Prior to 1980, sarcoptic mange occurred in non-adjacent surveillance districts scattered all over the country. During the period of the rabies epidemic (1970s-early 1990s), the percentage of foxes tested for rabies with sarcoptic mange significantly decreased in subregions with rabies, whereas it remained high in the few rabies-free subregions. Sarcoptic mange re-emerged in the mid-1990s and continuously spread during the 2000-2010s, to finally extend to the whole country in 2017. The yearly prevalence of mange in foxes estimated by camera-trapping ranged from 0.1-12%. CONCLUSIONS: Sarcoptic mange has likely been endemic in Switzerland as well as in other European countries at least since the mid-19th century. The rabies epidemics seem to have influenced the pattern of spread of mange in several locations, revealing an interesting example of disease interaction in free-ranging wildlife populations. The combination of multiple surveillance tools to study the long-term dynamics of sarcoptic mange in red foxes in Switzerland proved to be a successful strategy, which underlined the usefulness of questionnaire surveys.


Assuntos
Doenças Transmissíveis Emergentes/veterinária , Raposas/parasitologia , Escabiose/veterinária , Animais , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/parasitologia , Conjuntos de Dados como Assunto , Feminino , Masculino , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Escabiose/epidemiologia , Escabiose/parasitologia , Análise Espaço-Temporal , Inquéritos e Questionários , Suíça/epidemiologia
5.
Rev Med Suisse ; 15(672): 2159-2163, 2019 Nov 20.
Artigo em Francês | MEDLINE | ID: mdl-31746573

RESUMO

The main aims of the CoLaus/PsyCoLaus cohort study are to better understand: 1) the personal, biologic, genetic end environmental determinants of cardiovascular risk factors and diseases, and 2) the existing association of mental disorders with cardiovascular diseases. The study was initiated in 2003 and over 6700 participants from the city of Lausanne were include and very rich phenotypic data were collected making the study unique worldwide. Numerous scientific articles were published in various fields such as epidemiology, public health, genetic, social and environmental determinants of cardiovascular diseases and their association with mental health. We briefly present here some key results obtained over the last 16 years.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/genética , Transtornos Mentais/complicações , Doenças Cardiovasculares/epidemiologia , Seguimentos , Humanos , Transtornos Mentais/epidemiologia , Fatores de Risco , Suíça/epidemiologia
6.
Rev Med Suisse ; 15(668): 1926-1931, 2019 Oct 23.
Artigo em Francês | MEDLINE | ID: mdl-31643153

RESUMO

Chlamydia trachomatis (CT) infection is the most frequent notifiable sexually transmitted infection (STI) in Switzerland. The infection is most frequently observed in 15 to 24 year-old-women and in 25 to 34 year-old-men. 50-75 % of the Chlamydia trachomatis carriage are asymptomatic, making the infection difficult to diagnose and increasing the untreated specimen, leading to complications like infertility, ectopic pregnancy or pelvic inflammatory disease. Despite having a sexual prevention at school, the youths seem to have a lack of knowledge about CT, her transmission and her complications. We performed a survey, which showed that 60.5 % of the participants ignored that this bacteria is mostly asymptomatic. We also found that 11 % of the participants believed that there is no possible relapse of the infection. The prevention must be strengthened, mostly because there is no program in Switzerland, letting every physician to his own beliefs. The medical consultation is an ideal opportunity for this prevention and the youths shared their wish to discuss more about it with health professionals.


Assuntos
Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis , Metas , Educação em Saúde , Adolescente , Adulto , Doenças Assintomáticas/epidemiologia , Erradicação de Doenças , Feminino , Humanos , Infertilidade/epidemiologia , Infertilidade/microbiologia , Masculino , Doença Inflamatória Pélvica/epidemiologia , Doença Inflamatória Pélvica/microbiologia , Gravidez , Suíça/epidemiologia , Adulto Jovem
7.
Rev Med Suisse ; 15(669): 1987-1990, 2019 Oct 30.
Artigo em Francês | MEDLINE | ID: mdl-31663699

RESUMO

This article addresses the issue of health inequalities and the measures allowing to reduce them. Starting from the observation that, in Switzerland like in the rest of the world, health gaps between the riches and the poorest are still very marked, this article questions the role that health promotion and prevention can play in the fight against this phenomenon. The main approaches allowing to reduce inequalities are presented and illustrated with examples : the universal approach, the targeted approach and proportionate universalism. This last approach appears as the ideal towards which all health promotion and prevention actions should converge in order to reduce health inequalities all along the social gradient. However, its translation into prevention measures remains subject to interpretation. Therefore, the article ends with a set of recommendations for the elaboration of measures aiming to reduce health inequalities.


Assuntos
Promoção da Saúde , Disparidades nos Níveis de Saúde , Fatores Socioeconômicos , Humanos , Pobreza , Suíça/epidemiologia
8.
Rev Med Suisse ; 15(666): 1807-1811, 2019 Oct 09.
Artigo em Francês | MEDLINE | ID: mdl-31599522

RESUMO

Measles is a disease that was considered as relegated to medical history, since an extremely efficient vaccine had been developed. However, in Switzerland and elsewhere there has been an increasing number of epidemics in the past years, and the highest number of new cases this year. Based on two clinical cases showing very different outcomes, we discuss the disease, its clinic, complications, management, and the challenges remaining in obtaining a sufficient vaccination coverage worldwide as well as in our country.


Assuntos
Exantema/etiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Evolução Fatal , Humanos , Sarampo/complicações , Sarampo/terapia , Vacina contra Sarampo , Suíça/epidemiologia , Vacinação/estatística & dados numéricos
9.
BMC Health Serv Res ; 19(1): 708, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623664

RESUMO

BACKGROUND: Multimorbidity is associated with higher healthcare resource utilization, but we lack data on the association of specific combinations of comorbidities with healthcare resource utilization. We aimed to identify the combinations of comorbidities associated with high healthcare resource utilization among multimorbid medical inpatients. METHODS: We performed a multicentre retrospective cohort study including 33,871 multimorbid (≥2 chronic diseases) medical inpatients discharged from three Swiss hospitals in 2010-2011. Healthcare resource utilization was measured as 30-day potentially avoidable readmission (PAR), prolonged length of stay (LOS) and difference in median LOS. We identified the combinations of chronic comorbidities associated with the highest healthcare resource utilization and quantified this association using regression techniques. RESULTS: Three-fourths of the combinations with the strongest association with PAR included chronic kidney disease. Acute and unspecified renal failure combined with solid malignancy was most strongly associated with PAR (OR 2.64, 95%CI 1.79;3.90). Miscellaneous mental health disorders combined with mood disorders was the most strongly associated with LOS (difference in median LOS: 17 days) and prolonged LOS (OR 10.77, 95%CI 8.38;13.84). The number of chronic diseases was strongly associated with prolonged LOS (OR 9.07, 95%CI 8.04;10.24 for ≥10 chronic diseases), and to a lesser extent with PAR (OR 2.16, 95%CI 1.75;2.65 for ≥10 chronic diseases). CONCLUSIONS: Multimorbidity appears to have a higher impact on LOS than on PAR. Combinations of comorbidities most strongly associated with healthcare utilization included kidney disorders for PAR, and mental health disorders for LOS.


Assuntos
Doença Crônica/epidemiologia , Doença Crônica/terapia , Multimorbidade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Suíça/epidemiologia
10.
Artigo em Alemão | MEDLINE | ID: mdl-31578620

RESUMO

As of 2019, Germany has still not been able to provide a national poisoning register and toxicovigilance for sufficient and reliable information on human exposure for the purpose of identification and assessment of toxic risk to the public. In particular, the USA acts as a special model, but France, the Netherlands, Switzerland, and Sweden also have efficient poisoning registers and toxicovigilance systems that deliver representative human exposure data as early warning systems for risk minimization and prevention. This contribution presents an overview of national poisoning registers and systems of toxicovigilance in different countries and describes the present situation in Germany where, from a public health point of view, insufficient political development in this area has so far been supplied.In Germany, the database for poisoning analysis is still insufficient because poisonings as an important medical entity does not find sufficient medical-statistical correspondence in the ICD Code. Cooperation between the Federal Institute for Risk Assessment (BfR) and the German Poison Centres (GIZ) has already led to significant progress and results in risk minimization, but due to the lack of representative data and the non-implementation of a national monitoring and toxicovigilance system, false estimations of poisoning situations can not be excluded.yIn the future, acute poisoning, and when appropriate chronic poisoning, can be competently assessed via human exposure in the German Poison Centres and through medical reports on poisoning at the BfR. This requires an effective national monitoring and toxicovigilance system supported and financed by government across the borders of the German federal states.


Assuntos
Envenenamento , Sistema de Registros , Bases de Dados Factuais , Alemanha/epidemiologia , Humanos , Envenenamento/epidemiologia , Sistema de Registros/estatística & dados numéricos , Medição de Risco , Suécia/epidemiologia , Suíça/epidemiologia
11.
Lancet ; 394(10209): 1619-1628, 2019 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-31570258

RESUMO

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is the preferred treatment option for older patients with symptomatic severe aortic stenosis. Differences in the properties of available TAVR systems can affect clinical outcomes. Among patients undergoing TAVR, we compared the self-expanding ACURATE neo TAVR system with the balloon-expandable SAPIEN 3 TAVR system with regard to early safety and efficacy. METHODS: In this randomised non-inferiority trial, patients (aged ≥75 years) undergoing transfemoral TAVR for treatment of symptomatic severe aortic stenosis, and who were deemed to be at increased surgical risk, were recruited at 20 tertiary heart valve centres in Germany, the Netherlands, Switzerland, and the UK. Participants were randomly assigned (1:1) to receive treatment with the ACURATE neo or the SAPIEN 3 with a computer-based randomly permuted block scheme, stratified by study centre and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) category. The primary composite safety and efficacy endpoint comprised all-cause death, any stroke, life-threatening or disabling bleeding, major vascular complications, coronary artery obstruction requiring intervention, acute kidney injury (stage 2 or 3), rehospitalisation for valve-related symptoms or congestive heart failure, valve-related dysfunction requiring repeat procedure, moderate or severe prosthetic valve regurgitation, or prosthetic valve stenosis within 30 days of the procedure. Endpoint assessors were masked to treatment allocation. Non-inferiority of ACURATE neo compared with SAPIEN 3 was assessed in the intention-to-treat population on the basis of a risk-difference margin of 7·7% for the primary composite endpoint, with a one-sided α of 0·05. This trial is registered with ClinicalTrials.gov (number NCT03011346) and is ongoing but not recruiting. FINDINGS: Between Feb 8, 2017, and Feb 2, 2019, up to 5132 patients were screened and 739 (mean age 82·8 years [SD 4·1]; median STS-PROM score 3·5% [IQR 2·6-5·0]) were enrolled. 30-day follow-up was available for 367 (99%) of 372 patients allocated to the ACURATE neo group, and 364 (99%) of 367 allocated to the SAPIEN 3 group. Within 30 days, the primary endpoint occurred in 87 (24%) patients in the ACURATE neo and in 60 (16%) in the SAPIEN 3 group; thus, non-inferiority of the ACURATE neo was not met (absolute risk difference 7·1% [upper 95% confidence limit 12·0%], p=0·42). Secondary analysis of the primary endpoint suggested superiority of the SAPIEN 3 device over the ACURATE neo device (95% CI for risk difference -1·3 to -12·9, p=0·0156). The ACURATE neo and SAPIEN 3 groups did not differ in incidence of all-cause death (nine patients [2%] vs three [1%]) and stroke (seven [2%] vs 11 [3%]); whereas acute kidney injury (11 [3%] vs three [1%]) and moderate or severe prosthetic aortic regurgitation (34 [9%] vs ten [3%]) were more common in the ACURATE neo group. INTERPRETATION: TAVR with the self-expanding ACURATE neo did not meet non-inferiority compared to the balloon-expandable SAPIEN 3 device in terms of early safety and clinical efficacy outcomes. An early composite safety and efficacy endpoint was useful in discriminating the performance of different TAVR systems. FUNDING: Boston Scientific (USA).


Assuntos
Estenose da Valva Aórtica/cirurgia , Bioprótese/efeitos adversos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/instrumentação , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/epidemiologia , Estenose da Valva Aórtica/mortalidade , Causas de Morte/tendências , Feminino , Alemanha/epidemiologia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Masculino , Países Baixos/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Desenho de Prótese , Índice de Gravidade de Doença , Suíça/epidemiologia , Substituição da Valva Aórtica Transcateter/métodos , Substituição da Valva Aórtica Transcateter/mortalidade , Resultado do Tratamento , Reino Unido/epidemiologia
12.
Schweiz Arch Tierheilkd ; 161(9): 533-544, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31488394

RESUMO

INTRODUCTION: The aim of the present study was to determine the effects of selective dry cow treatment (SDCT) on udder health in Swiss dairy farms compared to a blanket dry cow treatment (BDCT). Cows with a somatic cell count (SCC) of less than 250'000 cells/ml and after BDCT in the previous dry period were selected. These animals received a SDCT in the subsequent dry period. Cows with less than 150,000 cells/ml or a negative California mastitis test (CMT) received either no treatment (group oB) or an internal teat sealant (group ZV) in all teats. Cows with more than 150,000 cells/ml or a positive CMT were treated with antibiotics and teat sealants (group ZV+AB). The SCC before and after the dry period were determined. In addition, the incidence of mastitis treatments in the dry period and the first 100 days of the following lactation as well as rates of new intramammary inflammations and healing thereof were determined. Data from 115 cows were available for evaluation. The SCC postpartum of all cows after SDCT did not differ from those after BDCT in the previous year. In the group oB the SCC was significantly higher than in the previous year. While the group ZV+AB showed a significant decrease of SCC during the dry period, the other two groups showed an increase (p < 0.0001). In the group oB, the proportion of mastitis treatments increased from 0% after BDCT to 28% after SDCT without any udder treatment (p < 0.05). Due to the increasing problem of antimicrobial resistance, SDCT is a valuable alternative to the BDCT. In the present study the antibiotic consumption could be reduced by 63%, while the udder health after SDCT did not deteriorate. If cows with low SCC are dried off without antibiotics the end of lactation, it is beneficial to protect the udder during the dry period with a teat sealant.


Assuntos
Indústria de Laticínios/métodos , Glândulas Mamárias Animais , Mastite Bovina/prevenção & controle , Animais , Antibacterianos/administração & dosagem , Bovinos , Contagem de Células/veterinária , Feminino , Incidência , Glândulas Mamárias Animais/microbiologia , Mastite Bovina/tratamento farmacológico , Mastite Bovina/epidemiologia , Suíça/epidemiologia
13.
Praxis (Bern 1994) ; 108(10): 665-672, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31387504

RESUMO

Accidents Caused by Gardening - Trivial or Serious? 5-Year Retrospective Analysis at the University Emergency Department Berne Abstract. Gardening is a popular leisure activity in Switzerland. Approximately 1 million non-occupational accidents are recorded each year; 600,000 of these occur at home or in pursuit of a hobby, including approx. 16,000 accidents while gardening. The aim of this study is to investigate gardening-related accidents. The data for this study were generated from the database of the management system of Berne University Hospital, Switzerland, and retrospectively analyzed. Patients were enrolled who were at least 16 years old - since younger patients in Switzerland are normally treated in specialised Emergency Departments for Paediatrics. The study was restricted to patients who suffered an accident that resulted in physical impairment while working in their own garden. The data were then analysed based on age, sex, triage category, mechanism, causing object, lesion site, diagnoses, severity of injury (monotraumatic or combined with more than one region or polytrauma), in-patient or out-patient treatment. Gardening-related accidents were mainly suffered by middle aged adults (40-69 years). Men were more often affected than women. At consultation, the injury was mostly monotraumatic and could be treated in an out-patient setting. Patients mainly complained of eye injuries and lacerations. The exposed areas of the eyes, fingers and the head or face were the most affected body regions. Falls and stumbling often led to accidents. Injuries were mainly caused by organic material or by the improper use of gardening tools. The data analysis showed that many injuries could have been avoided by simple preventive measures.


Assuntos
Serviço Hospitalar de Emergência , Jardinagem , Ferimentos e Lesões , Acidentes por Quedas , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Suíça/epidemiologia , Ferimentos e Lesões/epidemiologia
14.
Dermatology ; 235(5): 434-439, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31295740

RESUMO

BACKGROUND: Trichophyton violaceumis an anthropophilic dermatophyte, endemic in Africa and recently an emerging pathogen in Europe. OBJECTIVE: To perform a retrospective analysis of dermatophytoses due to T. violaceum between 2007 and 2018, in order to evaluate epidemiological trends in Southern Switzerland (Ticino). METHODS: We reviewed all medical records of patients affected by dermatophytosis due to T. violaceum between January 2007 and December 2018 in Bellinzona (Ticino, Switzerland). RESULTS: Dermatophytoses due to T. violaceumwas diagnosed in 44 patients, 33 of which were in the last 4 years. The most affected sex was female (25/44) and the most frequent diagnosis was tinea capitis (30/44). The majority of tinea capitis patients were children younger than 13 years of age (27/30). The main source of contagion were people from endemic areas, especially from Eritrea. CONCLUSION: In Southern Switzerland T. violaceumhas been rarely diagnosed before 2014. Its increased occurrence seems linked to increased migratory flows from Eritrea. Since it is responsible mainly for tinea capitis, with most of the time no clearly defined alopecia patches, it is important to consider it as a possible diagnosis when facing scalp scaling. Tinea capitis due to T. violaceum is a benign affection, but if left untreated it can spread epidemically, especially among children in schools and kindergartens. Mycological examination is then required, not only for a correct diagnosis and epidemiological data, but also for planning the appropriate treatment.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Tinha/epidemiologia , Trichophyton/isolamento & purificação , Adolescente , Adulto , Idoso , Antifúngicos , Criança , Pré-Escolar , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Suíça/epidemiologia , Tinha/microbiologia , Tinha/transmissão , Tinha do Couro Cabeludo/terapia , Tinha do Couro Cabeludo/transmissão , Adulto Jovem
15.
Schweiz Arch Tierheilkd ; 161(7): 465-472, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31298215

RESUMO

INTRODUCTION: Ovine footrot caused by Dichelobacter nodosus is a highly contagious and painful disease representing an economic as well as an animal welfare problem. In order to get more information on the infection dynamics, 26 lambs and 4 ewes enrolled in an in-contact infection trial were monitored over two weeks for the presence of D. nodosus-specific DNA. Two D. nodosus-positive ewes were housed together with 13 confirmed negative lambs. The control group consisted of another 13 lamb siblings and two confirmed D. nodosus-negative ewes. Every foot of all sheep was sampled seven times over the two weeks experiment period and subsequently analyzed for the presence of D. nodosus by quantitative real-time PCR. The control group was negative at the beginning and the end of the experiment and showed no clinical symptoms of footrot. The two positive ewes showed a high, but hundred fold differing level of virulent D. nodosus that remained constant over time with one of the ewes being also weakly positive for benign D. nodosus. All lambs of the infection group were positive for virulent D. nodosus at 14 days post infection (dpi). The first positive animals were observed on 3 dpi. The D. nodosus load remained at a low level and only increased in a few lambs at the end of the trial. Five of the contact lambs showed suspicious clincal signs (score 1-2) at 14 dpi corroborating the PCR results and indicating that the disease starts as early as two weeks after contact with positive sheep.


Assuntos
Infecções por Bactérias Gram-Negativas/veterinária , Animais , Carga Bacteriana , Dichelobacter nodosus/fisiologia , Feminino , Pododermatite Necrótica dos Ovinos/diagnóstico , Pododermatite Necrótica dos Ovinos/epidemiologia , Pododermatite Necrótica dos Ovinos/microbiologia , Pododermatite Necrótica dos Ovinos/transmissão , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/transmissão , Reação em Cadeia da Polimerase , Ovinos , Doenças dos Ovinos/diagnóstico , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/microbiologia , Doenças dos Ovinos/transmissão , Suíça/epidemiologia
16.
Anthropol Anz ; 76(5): 433-443, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31348484

RESUMO

Background: Recent research reported height biased migration of taller individuals and a Monte Carlo simulation showed that such preferential migration of taller individuals into network hubs can induce a secular trend of height. In the simulation model taller agents in the hubs raise the overall height of all individuals in the network by a community effect. However, it could be seen that the actual network structure influences the strength of this effect. In this paper the background and the influence of the network structure on the strength of the secular trend by migration is investigated. Material and methods: Three principal network types are analyzed: networks derived from street connections in Switzerland, more regular fishing net like networks and randomly generated ones. Our networks have between 10 and 152 nodes and between 20 and 307 edges connecting the nodes. Depending on the network size between 5.000 and 90.000 agents with an average height of 170cm (SD 6.5cm) are initially released into the network. In each iteration new agents are regenerated based on the actual average body height of the previous iteration and, to a certain proportion, corrected by body heights in the neighboring nodes. After generating new agents, a certain number of them migrated into neighbor nodes, the model let preferentially taller agents migrate into network hubs. Migration is balanced by back migration of the same number of agents from nodes with high centrality measures to less connected nodes. The latter is random as well, but not biased by the agents height. Furthermore the distribution of agents per node and their correlation to the centrality of the nodes is varied in a systematic manner. After 100 iterations, the secular trend, i.e. the gain in body height for the different networks, is investigated in relation to the network properties. Results: We observe an increase of average agent body height after 100 iterations if height biased migration is enabled. The increase rate depends on the height of the neighboring factor, the population distribution, the relationship between population in the nodes and their centrality as well as on the network topology. Networks with uniform like distributions of the agents in the nodes, uncorrelated associations between node centrality and agent number per node, as well as very heterogeneous networks with very different node centralities lead to biggest gains in average body height. Conclusion: Our simulations show, that height biased migration into network hubs can possibly contribute to the secular trend of height increase in the human population. The strength of this "tall by migration" event depends on the actual properties of the underlying network. There is a possible significance of this mechanism for social networks, when hubs are represented by individuals and edges as their personal relationships. However, the required high number of iterations to achieve significant effects in more natural network structures in our models requires further studies to test the relevance and real effect sizes in real world scenarios.


Assuntos
Estatura , Emigração e Imigração , Humanos , Método de Monte Carlo , Suíça/epidemiologia
17.
Nutrients ; 11(7)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31336862

RESUMO

Socioeconomically disadvantaged people are disproportionally more likely to develop obesity and obesity-related diseases. However, it remains unclear to what extent diet quality contributes to socioeconomic inequalities in obesity. We aimed to assess the role of diet quality in the association between socioeconomic status (SES) and obesity. Data originated from the national nutrition survey, a cross-sectional sample of the adult Swiss population (N = 1860). We used education and income as proxies for SES; calculated the Alternate Healthy Eating Index (AHEI) as a measure of diet quality; and used body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) as obesity markers. We applied counterfactual mediation modelling to generate odds ratios, 95% confidence intervals, and the proportion mediated by diet quality. Individuals with less than a tertiary education were two to three times more likely to be obese, regardless of the marker (OR (95% CI): 3.36 (2.01, 5.66) using BMI; 2.44 (1.58, 3.75) using WC; 2.48 (1.63, 3.78) using WHR; and 2.04 (1.43, 2.96) using WHtR). The proportion of the association between educational level and obesity that was mediated by diet quality was 22.1% using BMI, 26.6% using WC, 31.4% using WHtR, and 35.8% using WHR. Similar findings were observed for income. Our findings suggest that diet quality substantially contributes to socioeconomic inequalities in obesity while it does not fully explain them. Focusing efforts on improving the diet quality of disadvantaged groups could help reduce social inequalities in obesity.


Assuntos
Dieta/normas , Inquéritos Nutricionais , Obesidade/epidemiologia , Obesidade/etiologia , Classe Social , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suíça/epidemiologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
18.
Mycoses ; 62(10): 928-931, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31271679

RESUMO

Onychomycoses in temperate climates are most commonly due to dermatophytes, particularly Trichophyton rubrum. Non-dermatophyte nail infections are much less frequent, and their diagnosis requires a careful and repeated search for a potential dermatophyte that may have been overgrown in culture. A series of histological slides of suspected onychomycoses with uncommon fungal morphology prompted us to search for non-dermatophytic moulds causing dermatophytosis-like nail infections. Thirty cases were identified by culture as F solani, F oxysporum, F dimerum or F spp, and two more were only diagnosed histopathologically. None of these patients was immunocompromised. Treatment was mostly unsuccessful with terbinafine whereas itraconazole showed a moderately better treatment result; in all cases, a topical ciclopirox nail varnish in a hydroxychitosan base was added.


Assuntos
Fusariose/epidemiologia , Fusarium/isolamento & purificação , Onicomicose/epidemiologia , Antifúngicos/uso terapêutico , Fusariose/tratamento farmacológico , Fusariose/microbiologia , Fusariose/patologia , Histocitoquímica , Humanos , Técnicas Microbiológicas , Onicomicose/tratamento farmacológico , Onicomicose/microbiologia , Onicomicose/patologia , Suíça/epidemiologia
19.
BMC Urol ; 19(1): 64, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291913

RESUMO

BACKGROUND: This paper describes the testicular cancer trends for incidence, survival, socio-economic status (SES) disparities and second cancer occurrence in Geneva, Switzerland, a high-risk population. METHODS: We included all testicular germ-cell tumors recorded in the population-based Geneva cancer registry during the period 1970-2012. Changes in incidence trends were assessed using Joinpoint regression to calculate the annual percentage change (APC). Overall and cancer-specific survivals (OS, CSS) were estimated by Kaplan Meyer methods. To evaluate the risk of a second cancer we calculated the Standardized Incidence Ratios (SIR) using the Geneva population incidence rates. RESULTS: The average annual testicular cancer rate was 7.32/100 000 men, with a non-significant increasing trend during the study period. The highest rates were observed among men younger than 39 years. Despite a trend toward earlier diagnosis, 14% of patients were diagnosed at a late stage. Patients with non-seminoma tumours and patients with low SES were more often diagnosed with an advanced stage. Both OS and CSS improved during the study period but with strong differences by age, stage, morphology and SES. The risk for developing a second cancer was more than doubled. This risk was particularly high for a contralateral testicular cancer, bladder cancer and pancreatic cancer. CONCLUSIONS: Overall, there was no substantial increase in the incidence of testicular cancer in Geneva in recent decades, however the prognosis has improved. The high risk of developing a second cancer, the differences in stage at diagnosis and survival by SES, require enhanced awareness and surveillance by clinicians, patients and men in general.


Assuntos
Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/mortalidade , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/mortalidade , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/mortalidade , Adulto , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Taxa de Sobrevida/tendências , Suíça/epidemiologia , Neoplasias Testiculares/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-31357581

RESUMO

High temperatures lead to heat-related human stress and an increased mortality risk. To quantify heat discomfort and the relevant dangers, heat stress indices combine different meteorological variables such as temperature, relative humidity, radiation and wind speed. In this paper, a set of widely-used heat stress indices is analyzed and compared to the heat index currently used to issue official heat warnings in Switzerland, considering 28 Swiss weather stations for the years 1981-2017. We investigate how well warnings based on the heat index match warning days and warning periods that are calculated from alternative heat stress indices. The latter might allow for more flexibility in terms of specific warning demands and impact-based warnings. It is shown that the percentage of alternative warnings that match the official warnings varies among indices. Considering the heat index as reference, the simplified wet bulb globe temperature performs well and has some further advantages such as no lower bound and allowing for the calculation of climatological values. Yet, other indices (e.g., with higher dependencies on humidity) can have some added value, too. Thus, regardless of the performance in terms of matches, the optimal index to use strongly depends on the purpose of the warning.


Assuntos
Transtornos de Estresse por Calor/epidemiologia , Temperatura Alta , Tempo (Meteorologia) , Algoritmos , Resposta ao Choque Térmico , Humanos , Suíça/epidemiologia
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