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1.
Arq Bras Cir Dig ; 34(4): e1642, 2022.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35107504

RESUMO

AIM: Three surgical techniques for inguinal hernia repair are currently validated. Few studies have compared results among Lichtenstein and transabdominal preperitoneal (TAPP) laparoscopic approach obtained at an early step of the learning curve. This study aims to compare the early treatment results between the Liechtenstein technique and the laparoscopic TAPP approach to provide a basis for the surgeon's decision-making. METHODS: Patients were divided into two groups: those who underwent laparoscopic TAPP approach (114 patients), and those who underwent open Lichtenstein repair (35 patients). Data were collected from the medical records during the evolution of the immediate postoperative period and by telephone contact after hospital discharge. For the analysis of the variables, the chi-square test of independence was implemented, with a level of significance set at a p-value of 0.05. RESULTS: There was a strong association between laparoscopy, less postoperative pain, and longer operative time. In addition, a preference for the technique in cases of recurrence, bilaterality, associated umbilical hernia, or obesity was noticed. In this study, the Lichtenstein technique was associated with a shorter time to return to work and was the treatment of choice for elderly patients. CONCLUSION: TAPP laparoscopic herniorrhaphy should be the first choice in cases of bilaterality, associated umbilical hernia, obesity, and recurrence to a previous anterior repair. The surgical risk is adequate for the procedure, even at early stages of the learning curve.


OBJETIVO: Três técnicas cirúrgicas para correção de hérnia inguinal estão atualmente validadas. Poucos estudos compararam os resultados entre Lichtenstein e a abordagem laparoscópica transabdominal pré-peritoneal obtidos em uma etapa inicial da curva de aprendizado. Comparar os resultados iniciais do tratamento entre a técnica de Liechtenstein e a abordagem pré-peritoneal transabdominal laparoscópica para fornecer uma base para a tomada de decisão do cirurgião. MÉTODO: Os pacientes foram divididos em grupo 1: aborgadem laparoscópica transabdominal pré-peritoneal (114 pacientes), e grupo 2: reparo aberto de Lichtenstein (35 pacientes). Os dados foram coletados em prontuários médicos durante a evolução do pós-operatório imediato e por contato telefônico após a alta hospitalar. Para a análise das variáveis, foi implementado o teste de independência Qui-Quadrado, com nível de significância estabelecido em p-valor = 0,05. RESULTADOS: Houve forte associação entre laparoscopia, menos dor pós-operatória e maior tempo operatório. Além disso, notou-se preferência pela técnica nos casos de recorrência, bilateralidade, hérnia umbilical associada ou obesidade. Neste estudo, a técnica de Lichtenstein foi associada a um menor tempo de retorno ao trabalho e foi o tratamento de escolha para pacientes idosos. CONCLUSÃO: A herniorrafia laparoscópica transabdominal pré-peritoneal deve ser a primeira escolha em casos de bilateralidade, hérnia umbilical associada, obesidade e recorrência para reparo anterior. O risco cirúrgico é adequado para o procedimento, mesmo nos estágios iniciais da curva de aprendizado.


Assuntos
Herniorrafia , Laparoscopia , Idoso , Humanos , Liechtenstein , Período Pós-Operatório , Estudos Prospectivos , Telas Cirúrgicas
2.
J Water Health ; 20(1): 114-125, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35100159

RESUMO

The new coronavirus 2 (SARS-CoV-2) is known to be also shed through feces, which makes wastewater-based surveillance possible, independent of symptomatic cases and unbiased by any testing strategies and frequencies. We investigated the entire population of the Principality of Liechtenstein with samples from the wastewater treatment plant Bendern (serving all 39,000 inhabitants). Twenty-four-hour composite samples were taken once or twice a week over a period of 6 months from September 2020 to March 2021. Viral RNA was concentrated using the PEG centrifugation method followed by reverse transcription quantitative PCR. The aim of this research was to assess the suitability of SARS-CoV-2 fragments to relate the viral wastewater signal to the incidences and assess the impact of the emerging B.1.1.7. variant. The viral load in the wastewater peaked at almost 9 × 108 viral fragments per person equivalent (PE) and day on October 25, and showed a second peak on December 22 reaching a viral load of approximately 2 × 108 PE-1d-1. Individual testing showed a lag of 4 days and a distinct underestimation of cases at the first peak when testing frequency was low. The wastewater signal showed an immediate response to the implementation of non-pharmaceutical interventions. The new virus variant B.1.1.7. was first detected in wastewater on December 23, while it was first observed with individual testing on January 13, 2021. Further, our data indicate that the emergence of new virus variant may change the wastewater signal, probably due to different shedding patterns, which should be considered in future models.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Liechtenstein , Prevalência , Águas Residuárias
3.
Swiss Med Wkly ; 151: w30032, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34495607

RESUMO

OBJECTIVE: To describe the epidemiology of tuberculosis in Switzerland from 2009 to 2019.METHODS: Analysis of Swiss notification data. RESULTS: Tuberculosis cases declined from 553 (7.1/100,000) in 2009 to 437 (5.1/100,000) in 2019. The male-to-female ratio was 3:2. Although the number of tuberculosis cases of Swiss origin has steadily declined, the number of tuberculosis cases of foreign origin was rather stable but peaked in 2016. Overall, three quarters of tuberculosis cases were among people of foreign origin; of these, around half were from East Africa, Southern East Europe, and Southern Asia. Forty-nine percent had extrapulmonary manifestations. Every year, with little variation, 7-16 cases with rifampicin resistance were reported (2.9% overall). Independent risk factors for rifampicin resistance were prior anti-tuberculosis treatment, with an adjusted odds ratio (aOR) of 5.5 and a 95% confidence interval (CI) from 3.7 to 8.1, and foreign origin (aOR 3.6, 95% CI 2.0-7.0), particularly Georgia (aOR 10.0, 95% CI 4.0-23.1), Ethiopia (aOR 9.4, 95% CI 3.5-24.2), Tibet (aOR 6.9; 95% CI 2.9-16.6) and Somalia (aOR 8.1, 95% CI 4.0-17.2), together with Eritrea (aOR 2.6, 95% CI 1.1-5.9), accounting for more than half of all 134 cases . From 2016 to 2018, applying the World Health Organization definitions, overall treatment success in culture-confirmed pulmonary cases was 78%, and thus below the target of 85%. Since most cases with unsuccessful outcome are due to missing information, the proportion of unsuccessful outcome are overestimated. CONCLUSION: Autochthonous tuberculosis has become rare in Switzerland and the new diagnoses are increasingly attributable to immigration. Rifampicin resistance remains rare. Switzerland currently fails to achieve international targets for treatment success.


Assuntos
Antituberculosos , Tuberculose , Antituberculosos/uso terapêutico , Feminino , Humanos , Liechtenstein , Masculino , Rifampina/uso terapêutico , Suíça/epidemiologia , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia
4.
Schweiz Arch Tierheilkd ; 163(4): 281-290, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-33821800

RESUMO

INTRODUCTION: One of the varied tasks of the Large Animal Rescue Service Switzerland and Liechtenstein (GTRD CH/FL)® is the recovery of animals from manure and cesspools. The aim of the present retrospective study was the evaluation of the rescue protocols of the GTRD CH/FL from such operations and the documentation of a rescue procedure. In the past 25 years, a total of 176 animals have been rescued from manure and cesspools. These included 113 cattle, 51 horses and 12 pigs. All animals could be safely rescued with the animal rescue and transport net (TBTN) or the large animal vertical rescue set (GTVBS). The TBTN is used when the opening of the cesspool is large enough to recover the animal in a horizontal position. The GTVBS is particularly suitable for narrow openings, as the recovery in a -vertical position does not require any constructional modification or the enlargement of the cesspool opening. Both rescue harnesses are characterized by reliable handling and allow gentle recovery.


INTRODUCTION: L'une des multiples tâches du Service de sauvetage des grands animaux de Suisse et du Liechtenstein (GTRD CH/FL)® est de sortir des animaux de fosses à fumier ou à lisier. Le but de la présente étude rétrospective était l'évaluation des protocoles de sauvetage du GTRD CH/FL sur la base de ces opérations et la documentation d'un processus de sauvetage. Au cours des 25 dernières années, 176 animaux au total ont été tirés de fosses à fumier ou à lisier. Il s'agissait de 113 bovins, 51 chevaux et 12 porcs. Tous les animaux ont pu être secourus en toute sécurité grâce au filet de sauvetage et de transport des animaux (TBTN) ou à l'équipement de sauvetage vertical pour grands animaux (GTVBS). Le TBTN est utilisé lorsque l'ouverture de la fosse à lisier est suffisamment grande pour récupérer l'animal en position horizontale. Le GTVBS est particulièrement adapté aux ouvertures étroites, car la récupération en position verticale permet de ne pas devoir ou modifier modifiées par d'autres mesures structurelles les ouvertures des fosses. Les deux harnais de sauvetage se caractérisent par une manipulation fiable et permettent une récupération en douceur.


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Esterco , Macas (Leitos)/veterinária , Animais , Bovinos , Emergências/veterinária , Cavalos , Liechtenstein , Suínos , Suíça
5.
ABCD arq. bras. cir. dig ; 34(4): e1642, 2021. tab
Artigo em Inglês, Português | LILACS | ID: biblio-1360003

RESUMO

RESUMO - RACIONAL: Três técnicas cirúrgicas para correção de hérnia inguinal estão atualmente validadas. Poucos estudos compararam os resultados entre Lichtenstein e a abordagem laparoscópica transabdominal pré-peritoneal obtidos em uma etapa inicial da curva de aprendizado. OBJETIVO: Comparar os resultados iniciais do tratamento entre a técnica de Liechtenstein e a abordagem pré-peritoneal transabdominal laparoscópica para fornecer uma base para a tomada de decisão do cirurgião. MÉTODO: Os pacientes foram divididos em grupo 1: aborgadem laparoscópica transabdominal pré-peritoneal (114 pacientes), e grupo 2: reparo aberto de Lichtenstein (35 pacientes). Os dados foram coletados em prontuários médicos durante a evolução do pós-operatório imediato e por contato telefônico após a alta hospitalar. Para a análise das variáveis, foi implementado o teste de independência Qui-Quadrado, com nível de significância estabelecido em p-valor = 0,05. RESULTADOS: Houve forte associação entre laparoscopia, menos dor pós-operatória e maior tempo operatório. Além disso, notou-se preferência pela técnica nos casos de recorrência, bilateralidade, hérnia umbilical associada ou obesidade. Neste estudo, a técnica de Lichtenstein foi associada a um menor tempo de retorno ao trabalho e foi o tratamento de escolha para pacientes idosos. CONCLUSÃO: A herniorrafia laparoscópica transabdominal pré-peritoneal deve ser a primeira escolha em casos de bilateralidade, hérnia umbilical associada, obesidade e recorrência para reparo anterior. O risco cirúrgico é adequado para o procedimento, mesmo nos estágios iniciais da curva de aprendizado.


ABSTRACT - BACKGROUND: Three surgical techniques for inguinal hernia repair are currently validated. Few studies have compared results among Lichtenstein and transabdominal preperitoneal (TAPP) laparoscopic approach obtained at an early step of the learning curve. AIM: This study aims to compare the early treatment results between the Liechtenstein technique and the laparoscopic TAPP approach to provide a basis for the surgeon's decision-making. METHODS: Patients were divided into two groups: those who underwent laparoscopic TAPP approach (114 patients), and those who underwent open Lichtenstein repair (35 patients). Data were collected from the medical records during the evolution of the immediate postoperative period and by telephone contact after hospital discharge. For the analysis of the variables, the chi-square test of independence was implemented, with a level of significance set at a p-value of 0.05. RESULTS: There was a strong association between laparoscopy, less postoperative pain, and longer operative time. In addition, a preference for the technique in cases of recurrence, bilaterality, associated umbilical hernia, or obesity was noticed. In this study, the Lichtenstein technique was associated with a shorter time to return to work and was the treatment of choice for elderly patients. CONCLUSION: TAPP laparoscopic herniorrhaphy should be the first choice in cases of bilaterality, associated umbilical hernia, obesity, and recurrence to a previous anterior repair. The surgical risk is adequate for the procedure, even at early stages of the learning curve.


Assuntos
Humanos , Idoso , Laparoscopia , Herniorrafia , Período Pós-Operatório , Telas Cirúrgicas , Estudos Prospectivos , Liechtenstein
6.
Artigo em Inglês | MEDLINE | ID: mdl-33291659

RESUMO

The aim of this observational cross-sectional study was to gain information on the awareness; protective measures and economic effects of dentists in Switzerland during the global COVID-19 pandemic. All dentist were members of the Swiss Dental Association SSO from all over Switzerland-including all Swiss cantons and Liechtenstein-and received a previously calibrated questionnaire as an ad hoc online version. The questionnaire was divided into four parts: personal data; precautionary measures; awareness; perception. In total, 1324 questionnaires were analyzed; the response rate was 30.59% (ntotal = 4328). Participants stated in less than 2% common symptoms/signs of COVID-19; of which only fatigue was statistically significant (p < 0.01). A small number of dentists reported a positive test (0.91%; n = 12) or having one or more symptoms (2.65%; n = 35) of COVID-19 during the pandemic; whereas only 6.71% (n = 87) of the participants reported having treated SARS-CoV-2 infected patients. High prevalence areas were only medium-large and large Swiss cantons (p < 0.01). Face filter (FFP2/FFP3) masks were used by about half of the dentists, while disposable visor was rarely used. The majority of dentists had to reduce the dental practice activity to a minimum of 0-10% (n = 923; 69.98%) due to the lockdown. This economic impact forced 1.4% (n = 18) to close their practice permanently or by the end of 2020 due to the economic situation. These results can be helpful to better prepare dental practices for future outbreaks of infection (e.g., prophylactic storage of additional protective measures), define the best strategy and organize the dental workforce. Political decision-makers should consider drastic economic effects when deciding on drastic measures such as "lockdown", which can lead to practice closures and unemployment of dental staff after only a few weeks. This should be taken into account, especially with regard to possible financial assistance to severely impaired dental practices to maintain a high level of dental care.


Assuntos
COVID-19/prevenção & controle , Odontólogos , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Humanos , Controle de Infecções , Liechtenstein/epidemiologia , Pandemias , Inquéritos e Questionários , Suíça/epidemiologia
7.
Swiss Med Wkly ; 150: w20361, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33105020

RESUMO

BACKGROUND: The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence. AIM: To characterise the COVID-19 pandemic in Liechtenstein. METHODS: All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised. RESULTS: During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns. CONCLUSION: The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Monitorização Fisiológica/métodos , Pandemias , Pneumonia Viral , Adulto , Doenças Assintomáticas/epidemiologia , Betacoronavirus/isolamento & purificação , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Incidência , Liechtenstein/epidemiologia , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , SARS-CoV-2
8.
Am J Hypertens ; 31(7): 784-791, 2018 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-29481641

RESUMO

BACKGROUND: While the positive relationship between urinary sodium excretion and blood pressure (BP) is well established for middle-aged to elderly individuals using office BP, data are limited for younger individuals and ambulatory BP measurements. METHODS: Our analysis included 2,899 individuals aged 18 to 90 years from 2 population-based studies (GAPP, Swiss Kidney Project on Genes in Hypertension [SKIPOGH]). Participants with prevalent cardiovascular disease, diabetes, or on BP-lowering treatment were excluded. In SKIPOGH, 24-hour urinary sodium excretion was used as a measure of sodium intake, while in GAPP it was calculated from fasting morning urinary samples using the Kawasaki formula. Multivariable linear regression models were used to assess the relationships of 24-hour urinary salt excretion with office and ambulatory BP measurements. RESULTS: Mean age, ambulatory BP, sodium excretion, and estimated glomerular filtration rate in GAPP and SKIPOGH were 35 and 44 years, 123/78 and 118/77 mm Hg, 4.2 and 3.3 g/d, and 110 and 99 ml/min/1.73 m2, respectively. A weak linear association was observed between 24-hour ambulatory systolic BP and urinary sodium excretion (ß (95% confidence interval [CI]) per 1 g increase in sodium excretion (0.33 % (0.09; 0.57); P = 0.008). No significant relationships were observed for 24-hour ambulatory diastolic BP (ß (95% CI) (0.13 % (-0.15; 0.40) P = 0.37). When repeating the analyses in different age groups, all BP indices appeared to have stronger relationships in the older age groups (>40 years). CONCLUSIONS: In these large cohorts of healthy adults, urinary sodium excretion was only weakly associated with systolic 24-hour ambulatory BP.


Assuntos
Pressão Sanguínea , Ritmo Circadiano , Natriurese , Eliminação Renal , Sódio/urina , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Monitorização Ambulatorial da Pressão Arterial , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Liechtenstein , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Suíça , Fatores de Tempo , Adulto Jovem
9.
Adm Policy Ment Health ; 45(2): 245-253, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28756572

RESUMO

People suffering from schizophrenia-spectrum disorders often endorse a reduced quality of life (QoL) as compared to the general population. There appears to be a lack of studies for rural catchment areas for this patient population. We conducted a cross-sectional study with 94 people with schizophrenia-spectrum disorders in a mainly rural alpine area. We used multilevel models controlled for covariates to analyze the data. Total service satisfaction was associated with psychological aspects of subjective QoL and physical well-being in our model. Variables characterizing autonomy and empowerment of the person seem crucial concerning the QoL in this population.


Assuntos
Serviços de Saúde Mental/estatística & dados numéricos , Satisfação do Paciente , Qualidade de Vida/psicologia , Serviços de Saúde Rural/estatística & dados numéricos , População Rural/estatística & dados numéricos , Esquizofrenia/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Liechtenstein/epidemiologia , Masculino , Serviços de Saúde Mental/organização & administração , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Suíça/epidemiologia
11.
Swiss Med Wkly ; 147: w14510, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29063526

RESUMO

Reporting cases of malaria to the Federal Office of Public Health has been mandatory in Switzerland since 1974. We analysed notifications of imported confirmed malaria cases between 2005 and 2015 in Switzerland or Liechtenstein. Data for previously visited countries, nationality and reason for travelling were analysed. In contrast with the impressive drop of malaria cases reported worldwide since 2000, we found that the number of malaria cases imported yearly in Switzerland doubled in 2014 and 2015 compared to the average for the preceding decade. Since 2014, Plasmodium vivax infection represented 36% of all diagnosed malaria cases in Switzerland, compared to 11% in the decade leading to 2013. Most of the vivax malaria patients originated from the Horn of Africa, especially from Eritrea. This rise in cases was a consequence not only of an increase in the number of Eritrean refugees, but also their vivax malaria incidence rate, which jumped from 1-3‰ previously to 12‰ in 2014. This is a trend that is not matched by national statistics in Eritrea. An unreported increased incidence in the country of origin (Eritrea) might be the cause of the rise of Pv cases imported into Switzerland, but infections are also likely to occur along the harsh and long migration journey. This epidemiology highlights the need to register and use primaquine for the treatment of latent-phase P. vivax malaria in Switzerland, a medicine currently neither marketed nor systematically reimbursed. Moreover, general practitioners should be aware of this specific epidemiological situation in order to avoid misdiagnosis of febrile Eritreans even months after they reach Switzerland.


Assuntos
Malária Vivax/diagnóstico , Plasmodium vivax/isolamento & purificação , Primaquina/uso terapêutico , Refugiados/estatística & dados numéricos , Eritreia/etnologia , Humanos , Incidência , Liechtenstein/epidemiologia , Malária Vivax/epidemiologia , Malária Vivax/terapia , Plasmodium vivax/virologia , Suíça/epidemiologia
13.
Heart ; 103(9): 702-707, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27798051

RESUMO

BACKGROUND: Premature ventricular contractions (PVCs) are associated with an increased risk of morbidity and mortality. Therefore, it was aimed to assess risk factors for the frequency of PVCs in young and healthy adults. METHODS: Our population-based study included 2048 healthy adults from the general population aged 25-41 years. PVC frequency was determined by 24-hour Holter ECG. We performed multivariable regression analysis using stepwise backward selection to identify factors independently associated with PVC frequency. RESULTS: Median age was 37 years, 953 (46.5%) were male. At least one PVC during the 24-hour monitoring period was observed in 69% of participants. Median number of detected PVCs was 2, the 95th percentile was 193. In multivariable regression analyses, we found 17 significant risk factors for PVC frequency. Low educational status (risk ratio (RR) 3.33; 95% CI 1.98 to 5.60), body height>median (1.58, 95% CI 1.11 to 2.24) and increasing levels of waist:hip ratio (2.15, 95% CI 1.77 to 2.61), N-terminal pro brain natriuretic peptide (1.52, 95% CI 1.30 to 1.76) and Sokolow-Lyon Index (1.38, 95% CI 1.15 to 1.66) (all p≤0.01) were associated with a higher PVC frequency. Physical activity (RR fourth vs first quartile 0.51, 95% CI 0.34 to 0.76) and increasing levels of haemoglobin (0.58, 95% CI 0.47 to 0.70) and glucagon-like peptide-1 (0.72, 95% CI 0.64 to 0.82) (all p<0.001) were related to a lower PVC frequency. CONCLUSIONS: PVC occurrence is common even in healthy low-risk individuals, and its frequency is associated with several covariates mainly related to cardiovascular risk factors, markers of cardiac structure and function and socioeconomic status.


Assuntos
Complexos Ventriculares Prematuros/epidemiologia , Adulto , Fatores Etários , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Comorbidade , Escolaridade , Eletrocardiografia Ambulatorial , Feminino , Nível de Saúde , Voluntários Saudáveis , Humanos , Liechtenstein/epidemiologia , Estilo de Vida , Modelos Lineares , Masculino , Análise Multivariada , Razão de Chances , Prognóstico , Fatores de Risco , Complexos Ventriculares Prematuros/sangue , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/fisiopatologia
14.
Parasit Vectors ; 9(1): 356, 2016 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-27343074

RESUMO

BACKGROUND: The Asian bush mosquito, Aedes (Hulecoeteomyia) japonicus japonicus (Theobald, 1901) (Diptera: Culicidae), was first identified in Austria in August 2011 in the federal state of Styria at the border to Slovenia. METHODS: Between 2011 and 2015 the spread of Ae. j. japonicus was monitored in southern, eastern and western Austrian provinces as well as in neighbouring countries by checking natural and man-made container habitats for the aquatic stages. The search concentrated around the most recent occurrence of Ae. j. japonicus and extended up to several kilometres until the subspecies could not be found anymore. RESULTS: Between May and July 2012 the distribution area of Ae. j. japonicus was found to be extended westwards into Carinthia, and eastwards towards the federal state of Burgenland. In August 2012, the subspecies was found in Hungary, representing the first record of an invasive mosquito species in this country. In 2013 its expansion was confirmed at several sites in Austria. Additionally, between April and July 2015, the subspecies was detected in all districts of the westernmost Austrian state Vorarlberg reaching the alpine Montafon valley at the end of October 2015, at all three examined sites in southern Bavaria bordering Vorarlberg, and in the adjacent Principality of Liechtenstein, for which it also represents the first record of an invasive mosquito species. One remarkable finding of the subspecies was located close to the city of Kufstein in the lower Inn valley of the Tyrol in September 2015, which is an isolated occurrence without spatial connection to any known established population. CONCLUSIONS: Our findings demonstrate the ongoing spread of Ae. j. japonicus towards all directions within Austria and beyond. Together with the absence of supposed natural barriers, e.g. high mountain chains, at the borders of the current subspecies' distribution area in south-eastern Austria, these findings suggest a further spread to the Austrian capital Vienna and the Hungarian tourist region of Lake Balaton within the upcoming few years. The observed intrusions in western Austria represent most probably extensions of the population established and spreading in eastern Switzerland and southern Germany. The putative role of the subspecies in pathogen transmission together with its rapid spread observed argues for the implementation of comprehensive nation-wide surveillance and response preparedness.


Assuntos
Aedes/classificação , Aedes/fisiologia , Distribuição Animal , Espécies Introduzidas , Animais , Áustria , Hungria , Liechtenstein , Especificidade da Espécie
15.
Br J Sports Med ; 50(10): 631-6, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26884224

RESUMO

BACKGROUND: The prevention of injury and illness remains an important issue among young elite athletes. Systematic surveillance of injuries and illnesses during multi-sport events might provide a valuable basis to develop preventive measures, focusing especially on adequate information for youth athletes. AIM: To analyse the frequencies and characteristics of injuries and illnesses during the 2015 Winter European Youth Olympic Festival (W-EYOF). METHODS: All National Olympic Committees were asked to report daily the occurrence or non-occurrence of newly sustained injuries and illnesses on a standardised reporting form. RESULTS: Among the 899 registered athletes (37% female) with a mean age of 17.1±0.8 years, a total of 38 injuries and 34 illnesses during the 5 competition days of the W-EYOF were reported, resulting in an incidence of 42.3 injuries and 37.8 illnesses per 1000 athletes, respectively. Injury frequency was highest in snowboard cross (11%), Nordic combined (9%), alpine skiing (6%), and ice hockey (6%), taking into account the respective number of registered athletes. In snowboard cross, females showed a significant higher injury frequency compared to males (22% vs 4%, p=0.033). The lower back (16%), the pelvis (13%), the knee (11%), and the face (11%) were the most common injury locations. About 58% of injuries occurred in competition and about 42% in training. In total, 42% of injuries resulted in an absence of training or competition. The prevalence of illness was highest in figure skating (10%) and Nordic combined (9%), and the respiratory system was affected most often (53%). CONCLUSIONS: Four per cent of the athletes suffered from an injury and 4% from illnesses during the 2015 W-EYOF, which is about twofold lower compared to the first Winter Youth Olympic Games in 2012.


Assuntos
Esportes na Neve/lesões , Adolescente , Traumatismos em Atletas/epidemiologia , Áustria/epidemiologia , Feminino , Humanos , Incidência , Liechtenstein/epidemiologia , Masculino , Estações do Ano , Medicina Esportiva/estatística & dados numéricos
16.
Vet Microbiol ; 182: 202-12, 2016 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-26711049

RESUMO

Feline calicivirus (FCV) infections are associated with oral ulceration, chronic stomatitis and a limping syndrome. Epizootic outbreaks of virulent systemic disease (VSD) have been reported in the USA and Europe. Here, the molecular characterization and neutralization patterns of FCV isolates from cases of severe, non-epizootic infection associated with skin ulceration and edema are presented. Samples from eleven symptomatic cats, four in-contact cats and 27 cats with no contact with symptomatic cats were collected and tested for FCV, feline herpesvirus-1 (FHV-1), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV). Phylogenetic analyses based on the capsid (VP1) gene of FCV and virus neutralization with antisera raised against four FCV vaccine strains were performed. Nine kittens and two adult cats in two shelters and two veterinary clinics in four geographically distinct locations in Switzerland and Liechtenstein were affected. The cats showed fever, tongue and skin ulceration, head and paw edema, and occasionally jaundice, generalized edema and dyspnea. All symptomatic cats tested FCV-positive but were negative for FHV-1, FeLV and FIV, with the exception of one FIV-positive kitten. All kittens of one litter and both adult cats died. The disease did not spread to cats in the environment. Cats in the environment displayed phylogenetically distinct, but related, FCV strains. Virus neutralization patterns suggested that some cases might have been potentially prevented by vaccination with the optimal vaccine strain. In conclusion, clinicians should be aware of severe, non-epizootic forms of FCV infections with initial clinical presentations similar to VSD.


Assuntos
Infecções por Caliciviridae/virologia , Calicivirus Felino/genética , Doenças do Gato/epidemiologia , Surtos de Doenças/veterinária , Animais , Infecções por Caliciviridae/diagnóstico , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/genética , Calicivirus Felino/isolamento & purificação , Doenças do Gato/diagnóstico , Doenças do Gato/genética , Doenças do Gato/virologia , Gatos , Feminino , Liechtenstein/epidemiologia , Masculino , Filogenia , Suíça/epidemiologia
17.
J Dairy Sci ; 98(8): 5241-51, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26051316

RESUMO

The onset of lactation marks a significant turning point in a heifer's life, and prior experience with the milking routine could have positive effects on animal welfare and productivity. The objectives of this multifarm (n=5) study were to investigate (1) whether prelactation training sessions affected behavior during milking, cardiac activity, human avoidance distance, and milk yield, and (2) whether these responses would be modified by the heifer's initial level of fear of humans. Trained heifers (TH, n=30) experienced the routine in the milking parlor on at least 10 d prepartum, whereas untrained heifers (UH, n=29) entered the parlor for the first time after calving. Behavior and cardiac activity were recorded on d 1 and 7 after calving, and an avoidance test was carried out on the day of integration into the dairy herd as well as on d 1, 7, and 28 postpartum. Each animal's initial level of fear of humans was classified as high or low based on the first human avoidance distance measured toward an unknown person. Results showed that TH showed less stepping and kicking during the udder preparation phase in the parlor and UH had higher probabilities to put their ears flat on the head, clamp their tail between the hind legs, and have their eyes wide open throughout the different phases in the milking parlor. Heart rate decreased from d 1 to 7, increased from before to during and to after milking and was slightly elevated in TH compared with UH. Milk yield did not differ between TH and UH. Human avoidance distance was not influenced by training, but distance decreased in heifers with a high initial level of fear of humans across repetitions of the test, whereas heifers with a low initial level of fear of humans had generally short avoidance distances. However, initial level of fear of humans neither determined behavior and heart rate during milking nor milk yield of TH and UH. The results indicate that the training regimen applied in the present study habituated heifers, to some extent, to the milking routine.


Assuntos
Bovinos/fisiologia , Indústria de Laticínios , Habituação Psicofisiológica , Animais , Aprendizagem da Esquiva , Feminino , Frequência Cardíaca , Humanos , Lactação , Liechtenstein , Leite/metabolismo , Atividade Motora , Postura , Estações do Ano , Estresse Fisiológico , Suíça
18.
Atherosclerosis ; 239(1): 186-91, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25617859

RESUMO

OBJECTIVES: Endothelial dysfunction is a major precursor of atherosclerosis. The aim of this study was to assess the interrelationships between plasma endothelin-1 (ET-1) levels and cardiovascular risk among young and healthy individuals. METHODS: We performed a population-based study among 2160 healthy adults aged between 25 and 41 years in the Principality of Liechtenstein. Individuals with prevalent cardiovascular disease, diabetes or a body mass index >35 kg/m(2) were excluded. Plasma ET-1 was measured using a novel high-sensitive, single-molecule counting technology. The relationships between plasma levels of ET-1 and various cardiovascular risk factors were assessed by multivariable regression analyses. RESULTS: Median age of our population was 37 years. Median ET-1 levels across ET-1 quartiles were 1.86, 2.33, 2.76 and 3.48 pg/mL. After multivariable adjustment, there were significant correlations of ET-1 with systolic blood pressure (ß per 1-unit increase in log transformed ET-1 2.30 (95% confidence interval (CI) 1.03; 3.58, p = 0.0004), C-reactive protein (ß 0.19 (95% CI 0.03; 0.34, p = 0.021), glomerular filtration rate (ß -1.73 (95% CI -3.17; -0.29, p = 0.019), and current smoking (Odds ratio 1.94 (95% CI 1.39; 2.71, p < 0.0001). We also found a highly significant association between ET-1 levels and overall cardiovascular risk estimated by the "Prospective Cardiovascular Münster" (PROCAM) and the Framingham score (ß 0.18 (95% CI 0.06; 0.31, p = 0.004, and ß 0.11 (95% CI 0.05; 0.16), p < 0.0001, respectively). CONCLUSIONS: Plasma ET-1 levels are easily measurable in healthy adults and correlate with major cardiovascular risk factors and global cardiovascular risk.


Assuntos
Doenças Cardiovasculares/epidemiologia , Endotelina-1/sangue , Adulto , Estudos de Coortes , Feminino , Taxa de Filtração Glomerular , Voluntários Saudáveis , Humanos , Inflamação , Liechtenstein , Masculino , Análise Multivariada , Fenótipo , Fatores de Risco , Fumar , Inquéritos e Questionários , Sístole , Adulto Jovem
19.
Swiss Med Wkly ; 144: w14019, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25295968

RESUMO

INTRODUCTION: Several studies have shown an increased risk of type 2 diabetes among smokers. Therefore, the aim of this analysis was to assess the relationship between smoking, cumulative smoking exposure and nicotine dependence with pre-diabetes. METHODS: We performed a cross-sectional analysis of healthy adults aged 25-41 in the Principality of Liechtenstein. Individuals with known diabetes, Body Mass Index (BMI) >35 kg/m² and prevalent cardiovascular disease were excluded. Smoking behaviour was assessed by self-report. Pre-diabetes was defined as glycosylated haemoglobin between 5.7% and 6.4%. Multivariable logistic regression models were done. RESULTS: Of the 2142 participants (median age 37 years), 499 (23.3%) had pre-diabetes. There were 1,168 (55%) never smokers, 503 (23%) past smokers and 471 (22%) current smokers, with a prevalence of pre-diabetes of 21.2%, 20.9% and 31.2%, respectively (p <0.0001). In multivariable regression models, current smokers had an odds ratio (OR) of pre-diabetes of 1.82 (95% confidential interval (CI) 1.39; 2.38, p <0.0001). Individuals with a smoking exposure of <5, 5-10 and >10 pack-years had an OR (95% CI) for pre-diabetes of 1.34 (0.90; 2.00), 1.80 (1.07; 3.01) and 2.51 (1.80; 3.59) (p linear trend <0.0001) compared with never smokers. A Fagerström score of 2, 3-5 and >5 among current smokers was associated with an OR (95% CI) for pre-diabetes of 1.27 (0.89; 1.82), 2.15 (1.48; 3.13) and 3.35 (1.73; 6.48) (p linear trend <0.0001). DISCUSSION: Smoking is strongly associated with pre-diabetes in young adults with a low burden of smoking exposure. Nicotine dependence could be a potential mechanism of this relationship.


Assuntos
Estado Pré-Diabético/epidemiologia , Fumar/epidemiologia , Tabagismo/epidemiologia , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Estudos Transversais , Feminino , Hemoglobina A Glicada , Comportamentos Relacionados com a Saúde , Humanos , Liechtenstein/epidemiologia , Lipídeos/sangue , Masculino , Fatores de Risco , Fatores Socioeconômicos
20.
Public Health Nutr ; 17(2): 241-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23237337

RESUMO

OBJECTIVE: Data about vitamin B(12) (B(12)) deficiency in the general population are scarce. The present study was performed to determine the prevalence of B(12) deficiency in the general population of the Principality of Liechtenstein, as well as to identify sub-populations potentially at high risk. DESIGN: Retrospective study. SETTING: Ambulatory setting, population of the Principality of Liechtenstein. SUBJECTS: Seven thousand four hundred and twenty-four patients seeking medical attention whose serum samples were referred for routine work-up in an ambulatory setting were consecutively enrolled. Serum total B(12) was determined in all patients in this cohort. In addition, for a subgroup of 1328 patients, serum holotranscobalamin was also measured. Prevalence of B(12) deficiency was calculated. Further, multivariate logistical regression models were applied to identify covariates independently associated with B(12) deficiency and depletion. RESULTS: Nearly 8% of the general population was suffering from either B(12) depletion or deficiency. The ratio between B(12) depletion and deficiency was 2:1 for all age ranges. Pathological changes were detected predominantly in older people. Female gender was a significant predictor of B(12) depletion. In the cohort, nearly 40% exhibited either depletion or deficiency of B(12). CONCLUSIONS: B(12) depletion and deficiency are common in Liechtenstein, a Central European country. The measurement of biochemical markers represents a cost-efficient and valid assessment of the B(12) state. When a deficiency of B(12) is diagnosed at an early stage, many cases can be treated or prevented, with beneficial effects on individual outcomes and subsequent potential reductions in health-care costs.


Assuntos
Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/epidemiologia , Vitamina B 12/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Liechtenstein/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto Jovem
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