Application of phosphatidylethanol (PEth) in whole blood in comparison to ethyl glucuronide in hair (hEtG) in driving aptitude assessment (DAA)

For driving aptitude assessment (DAA), the analysis of several alcohol biomarkers is essential for the detection of alcohol intake besides psycho-medical exploration. In Switzerland, EtG in hair (hEtG) is often the only direct marker for abstinence monitoring in DAA. Therefore, the suitability of phosphatidylethanol (PEth) was investigated as additional biomarker. PEth 16:0/18:1 and 16:0/18:2 were determined by online-SPE-LC-MS/MS in 136 blood samples of persons undergoing DAA and compared to hEtG, determined in hair segments taken at the same time. With a PEth 16:0/18:1 threshold of 210��ng/mL for excessive alcohol consumption, all (n���=���30) but one tested person also had hEtG values ���30��pg/mg. In 54 cases, results are not in contradiction to an abstinence as neither PEth (<20��ng/mL) nor hEtG (<7��pg/mg) was detected. In eight cases, both markers showed moderate consumption. Altogether, PEth and hEtG were in accordance in 68��% of the samples, although covering different time periods of alcohol consumption. With receiver operating characteristic analysis, PEth was evaluated to differentiate abstinence, moderate, and excessive alcohol consumption in accordance with hEtG limits. A PEth 16:0/18:1 threshold of 150��ng/mL resulted in the best sensitivity (70.6��%) and specificity (98.8��%) for excessive consumption. Values between 20 and 150��ng/mL passed for moderate consumption, values <20��ng/mL passed for abstinence. As PEth mostly has a shorter detection window (2-4��weeks) than hEtG (up to 6��months depending on hair length), changes in drinking behavior can be detected earlier by PEth than by hEtG analysis alone. Therefore, PEth helps to improve the diagnostic information and is a valuable additional alcohol marker for DAA.

Survey of aspergillosis in non-neutropenic patients in Swiss teaching hospitals

Clin Microbiol Infect ABSTRACT: Invasive aspergillosis (IA) is a live-threatening opportunistic infection that is best described in haematological patients with prolonged neutropenia or graft-versus-host disease. Data on IA in non-neutropenic patients are limited. The aim of this study was to establish the incidence, disease manifestations and outcome of IA in non-neutropenic patients diagnosed in five Swiss university hospitals during a 2-year period. Case identification was based on a comprehensive screening of hospital records. All cases of proven and probable IA were retrospectively analysed. Sixty-seven patients were analysed (median age 60��years; 76% male). Sixty-three per��cent of cases were invasive pulmonary aspergillosis (IPA), and 17% of these were disseminated aspergillosis. The incidence of IPA was 1.2/10?000 admissions. Six of ten cases of extrapulmonary IA affected the brain. There were six cases of invasive rhinosinusitis, six cases of chronic pulmonary aspergillosis, and cases three of subacute pulmonary aspergillosis. The most frequent underlying condition of IA was corticosteroid treatment (57%), followed by chronic lung disease (48%), and intensive-care unit stays (43%). In 38% of patients with IPA, the diagnosis was established at autopsy. Old age was the only risk factor for post-mortem diagnosis, whereas previous solid organ transplantation and chronic lung disease were associated with lower odds of post-mortem diagnosis. The mortality rate was 57%.

Design, conduct, and analysis of a multicenter, pharmacogenomic, biomarker study in matched patients with severe sepsis treated with or without drotrecogin Alfa (activated)

A genomic biomarker identifying patients likely to benefit from drotrecogin alfa (activated) (DAA) may be clinically useful as a companion diagnostic. This trial was designed to validate biomarkers (improved response polymorphisms (IRPs)). Each IRP (A and B) contains two single nucleotide polymorphisms that were associated with a differential DAA treatment effect.

[Dosis sola facit venenum: outcome of intoxications in a Swiss university hospital]

Poisoning is a frequent disease in an emergency division. During four years we observed patients with poisoning related to there reason of intoxication, the degree of severity, age group and sex, and tried to make conclusions about lethal outcome on behalf of our data. The severity was defined by the ��poison severity scale�� (PSS). 1515 patients with intoxication in four years were documented. 152 (10%) of them had a severe intoxication or lethal outcome. In women suicide predominated as reason of severe intoxication, whereas in men an abuse of alcool and drugs was mostly seen. A multidisciplinary approach is important for handling intoxicated patients. Our investigation showed a good somatical outcome of patients with severe intoxication. Mortality was 5% (7/152 patients).

Perception of critical situations involving football fans: dynamics of conflict escalation and de-escalation

Title: The perception of critical situations involving football fans ��� how conflicts escalate or de-escalate Authors: Brechb��hl, A.1, Schumacher, A.1 & Seiler, R.1 1Institute of Sport Science, University of Bern, Switzerland Abstract: Introduction: Fan violence in the context of football matches is a prominent issue in today���s western societies and Switzerland presents no exception. A lot of research has been conducted on reasons for fan violence, mostly with fans of national teams. A prominent model is the Elaborated Social Identity Model (ESIM; Drury & Reicher, 2000): ESIM highlights the importance of interactions between the involved groups and their effect on the development of social identities. Another model is the aggravation mitigation model (AM model; Hylander & Guv��, 2010) which illustrates factors that can contribute towards an escalation or non-escalation of group violence, such as the ���categorization��� of the opponent group. Despite these models, research about the individual perceptions, and in particular, what factors distinguish between an escalation versus a non-escalation of a potentially violent situation in domestic football, is as yet scarce. This explorative study examines perceptions of critical situations in the domestic football fan context in Switzerland. Methods: An explorative qualitative design was employed to gather data about critical situations (CS) around football matches of two clubs of the Raiffeisen Super League. A CS is defined as a setting in or around the football stadium where violence between football fans and another group could occur. Eight CS were identified and analysed. Fifty-nine narrative interviews with individuals involved in a CS, e.g. fans, police officers or security personnel, were conducted. Interviews were analysed using interpretative phenomenological analysis (IPA). Results: The involved opposing groups expressed group-specific perceptions. Furthermore a strong tendency to negatively stereotype the opponent group was observed. Provocative symbols, such as balaclavas or riot-gear uniforms, were considered as highly relevant for the interpretation of the situation. Successful communication and sufficient distance between opponent groups supported the appeasement of a CS. These findings also underline the importance of knowledge about the local fan culture. This culture serves as basis for the perception of legitimacy, which was assessed to be essential for a de-escalation of a CS by fans. Discussion/Conclusion: This study improves the understanding of fan violence in the domestic football context in Switzerland. Based on the results it is suggested to deploy security or police forces without riot gear but with the goal of seeking dialogue with the fans to increase the likelihood of a peaceful ending in a CS. The findings also support the applicability of the ESIM (Drury & Reicher, 2000) and the AM model (Hylander & Guv��, 2010) in the context of domestic fan violence. Due to possible differences in the local fan cultures in Switzerland, research in this area should be continued. References: Drury, J., & Reicher, S. (2000). Collective action and psychological change: The emergence of new social identities. British Journal of Social Psychology, 39, 579-604. Hylander, I., & Guv��, G. (2010). Misunderstanding of out-group behaviour: Different interpretations of the same crowd events among police officers and demonstrators. Nordic Psychology, 62, 25-47.

The use of electromyography interference pattern analysis to determine muscle force of the deep digital flexor muscle in healthy and laminitic horses

BACKGROUND: In equine laminitis, the deep digital flexor muscle (DDFM) appears to have increased muscle force, but evidence-based confirmation is lacking. OBJECTIVES: The purpose of this study was to test if the DDFM of laminitic equines has an increased muscle force detectable by needle electromyography interference pattern analysis (IPA). ANIMALS AND METHODS: The control group included six Royal Dutch Sport horses, three Shetland ponies and one Welsh pony [10 healthy, sound adults weighing 411 �� 217 kg (mean �� SD) and aged 10 �� 5 years]. The laminitic group included three Royal Dutch Sport horses, one Friesian, one Haflinger, one Icelandic horse, one Welsh pony, one miniature Appaloosa and six Shetland ponies (14 adults, weight 310 �� 178 kg, aged 13 �� 6 years) with acute/chronic laminitis. The electromyography IPA measurements included firing rate, turns/second (T), amplitude/turn (M) and M/T ratio. Statistical analysis used a general linear model with outcomes transformed to geometric means. RESULTS: The firing rate of the total laminitic group was higher than the total control group. This difference was smaller for the ponies compared to the horses; in the horses, the geometric mean difference of the laminitic group was 1.73 [geometric 95% confidence interval (CI) 1.29-2.32], and in the ponies this value was 1.09 (geometric 95% CI 0.82-1.45). CONCLUSION AND CLINICAL RELEVANCE: In human medicine, an increased firing rate is characteristic of increased muscle force. Thus, the increased firing rate of the DDFM in the context of laminitis suggests an elevated muscle force. However, this seems to be only a partial effect as in this study, the unchanged turns/second and amplitude/turn failed to prove the recruitment of larger motor units with larger amplitude motor unit potentials in laminitic equids.

Update chronische Hepatitis B und C

Der nat��rliche Verlauf einer HepatitisB-Virus(HBV)-Infektion ist komplex und wird einerseits durch das Alter zum Zeitpunkt der Infektion, anderseits durch Komorbidit��ten bzw. Koinfektionen und zum Teil noch nicht identifizierte Faktoren bestimmt. Das HBV wird nie komplett eliminiert. Das Erreichen des inaktiven Tr��gerstatus ist aber ein realistisches Therapieziel. Zur Therapie stehen Nukleosid/NukleotidAnaloga sowie pegyliertes Interferonalpha zur Verf��gung. Screening von bestimmten Patientengruppen und eine generelle Impfung sind wichtige prophylaktische Massnahmen. Die chronische Hepatitis-C-Virus(HCV) -Infektion f��hrt in circa einem Drittel der F��lle zur Leberzirrhose. Eine Therapie ist generell ab Fibrosestadium Metavir 2 indiziert. Neue DAA (directly acting antivirals) erlauben kurzfristige, hochpotente und nebenwirkungsarme Therapieschemata.