Epidemiology of uveitis in Switzerland.

During the period from January 1990 to December 1993, 558 new patients (250 female and 308 male, mean age 44 years; range 5-92) were seen at the Uveitis Clinic of the Hopital Jules Gonin. These 558 patients (740 eyes) were subdivided into anterior uveitis (343 patients-61%), intermediate uveitis (57 patients-10%), posterior uveitis (118 patients-21 %) and panuveitis (40 patients-7%). The incidence of uveitis for the referral area considered was calculated to be 17.5 per 100,000 inhabitants per year. A specific diagnosis was found in 386 cases (69%). The most frequently diagnosed entities were HLA-B27-associated acute anterior uveitis (89 cases-15.9%), uveitis associated with acute herpes zoster ophthalmicus (54 cases-9.7%), toxoplasmosis (53 cases-9.5%), sarcoidosis (33 cases-5.9%), typical pars planitis (31 cases-5.6%), Fuchs' heterochromic cyclitis (30 cases-5.4%), herpetic anterior uveitis (23 cases-4.1 %) and acute retinal necrosis (13 cases-2.3%). Incidence and distribution of most disease entities correspond to those of other European and American series.

Descriptive epidemiology of Cornelia de Lange syndrome in Europe.

Cornelia de Lange syndrome (CdLS) is a multiple congenital anomaly/mental retardation syndrome consisting of characteristic dysmorphic features, microcephaly, hypertrichosis, upper limb defects, growth retardation, developmental delay, and a variety of associated malformations. We present a population-based epidemiological study of the classical form of CdLS. The data were extracted from the database of European Surveillance of Congenital Anomalies (EUROCAT) database, a European network of birth defect registries which follow a standard methodology. Based on 23 years of epidemiologic monitoring (8,558,346 births in the 1980-2002 period), we found the prevalence of the classical form of CdLS to be 1.24/100,000 births or 1:81,000 births and estimated the overall CdLS prevalence at 1.6-2.2/100,000. Live born children accounted for 91.5% (97/106) of cases, fetal deaths 2.8% (3/106), and terminations of pregnancy following prenatal diagnosis 5.7% (6/106). The most frequent associated congenital malformations were limb defects (73.1%), congenital heart defects (45.6%), central nervous system malformations (40.2%), and cleft palate (21.7%). In the last 11 years, as much as 68% of cases with major malformations were not detected by routine prenatal US. Live born infants with CdLS have a high first week survival (91.4%). All patients were sporadic. Maternal and paternal age did not seem to be risk factors for CdLS. Almost 70% of patients, born after the 37th week of gestation, weighed <or=2,500 g. Low birth weight correlated with a more severe phenotype. Severe limb anomalies were significantly more often present in males.

CO2, CH4 and N2O fluxes in an Ultisol treated with sewage sludge and cultivated with castor bean

Organic residue application into soil alter the emission of gases to atmosphere and CO2, CH4, N2O may contribute to increase the greenhouse effect. This experiment was carried out in a restoration area on a dystrophic Ultisol (PVAd) to quantify greenhouse gas (GHG) emissions from soil under castor bean cultivation, treated with sewage sludge (SS) or mineral fertilizer. The following treatments were tested: control without N; FertMin = mineral fertilizer; SS5 = 5 t ha-1 SS (37.5 kg ha-1 N); SS10 = 10 t ha-1 SS (75 kg ha-1 N); and SS20 = 20 t ha-1 SS (150 kg ha-1 N). The amount of sludge was based on the recommended rate of N for castor bean (75 kg ha-1), the N level of SS and the mineralization fraction of N from SS. Soil gas emission was measured for 21 days. Sewage sludge and mineral fertilizers altered the CO2, CH4 and N2O fluxes. Soil moisture had no effect on GHG emissions and the gas fluxes was statistically equivalent after the application of FertMin and of 5 t ha-1 SS. The application of the entire crop N requirement in the form of SS practically doubled the Global Warming Potential (GWP) and the C equivalent emissions in comparison with FertMin treatments.

Sewage sludge as nitrogen and phosphorus source for cane-plant and first ratoon crops

The use of sewage sludge in Brazilian agriculture was regulated by the resolution no. 375 Conama, in 2006. However, there is a lack of research to adequate the mineral N and P fertilizer doses to be applied in agricultural fields treated with this residue. In a field experiment, the effects of application rates of sewage sludge and mineral N and P fertilizers on the productivity and technical characteristics of the cane-plant and first ratoon (residual effect) crops were evaluated. Four doses of sewage sludge (0, 3.6, 7.2 and 10.8 t ha-1, dry base), of N (0, 30, 60 and 90 kg ha-1) and of P2O5 (0, 60, 120 and 180 kg ha-1) were combined in a factorial and laid out on randomized block design, a with two replications. To evaluate the residual effect of the sludge, 120 kg ha-1 N and 140 kg ha-1 of K2O were applied in all plots. Sludge application at cane planting, with or without N and/or P fertilizer increased the stalk yield from 84 up to 118 t ha-1, with no alteration in the sugarcane quality, compared with the application of NPK fertilizer alone, resulting in a stalk yield of 91 t ha-1. The study of the response surface for stalk yield on lowfertility soil was the basis for a recommendation of mineral N and P fertilizer doses for sugarcane implantation as related to sewage sludge application rates. It was also concluded that a sludge application of 10.8 t ha-1, which is the sludge dose established based on the N criterion according to the resolution Conama nº 375, could a) reduce the use of mineral N by 100 % and of P2O5 by 30 %, with increments of 22 % in stalk yield, as a direct effect of sludge application to cane plant crop, and b) increase the stalk yield in the second harvest (first ratoon) by up to 12 % and sugar yield by up to 11 %, by the residual effect of sludge application to sugar cane.

Sewage sludge application to agricultural land as soil physical conditioner

Water resource quality is a concern of today's society and, as a consequence, low pollutant wastewaters and sludges are being increasingly treated, resulting in continuous production of sewage sludge. Sewage sludge (SS) can be used as soil physical conditioner of agricultural or degraded lands, due to its organic C component. The objective of this research was to evaluate the long-term SS effects on soil physical quality of properties such as bulk density, porosity, permeability and water retention of degraded soils treated with annual SS applications. The SS rates were calculated according to the crop N demand. The field experiment consisted of three treatments: mineral fertilization, 10 and 20 Mg ha-1 of SS (once and twice the SS quantity to meet the maize N demand, respectively), in annual applications to the surface layer of a eutroferric Red Latosol. SS reduced bulk density, increased macroporosity and decreased microporosity after the third application, but did not significantly alter the soil permeability and physical quality as measured by the S index in the surface layer.

Water-dispersible clay in soils treated with sewage sludge

A by-product of Wastewater Treatment Stations is sewage sludge. By treatment and processing, the sludge is made suitable for rational and environmentally safe use in agriculture. The aim of this study was to assess the influence of different doses of limed sewage sludge (50 %) on clay dispersion in soil samples with different textures (clayey and medium). The study was conducted with soil samples collected from native forest, on a Red Latosol (Brazilian classification: Latossolo Vermelho distroférrico) loamy soil in Londrina (PR) and a Red-Yellow Latosol (BC: Latossolo Vermelho-Amarelo distrófico) medium texture soil in Jaguapitã (PR). Pots were filled with 3 kg of air-dried fine earth and kept in greenhouse. The experiment was arranged in a randomized block design with six treatments: T1 control, and treatments with limed sewage sludge (50 %) as follows: T2 (3 t ha-1), T3 (6 t ha-1), T4 (12 t ha-1), T5 (24 t ha-1) and T6 (48 t ha-1) and five replications. The incubation time was 180 days. At the end of this period, the pots were opened and two sub-samples per treatment collected to determine pH-H2O, pH KCl (1 mol L-1), organic matter content, water-dispersible clay, ΔpH (pH KCl - pH-H2O) and estimated PZC (point of zero charge): PZC = 2 pH KCl - pH-H2O, as well as the mineralogy of the clay fraction, determined by X ray diffraction. The results showed no significant difference in the average values for water-dispersible clay between the control and the other treatments for the two soil samples studied and ΔpH was the variable that correlated best with water-dispersible clay in both soils.

Plant availability of trace elements in sewage sludge-treated soils: methodology¹

Synthetic root exudates were formulated based on the organic acid composition of root exudates derived from the rhizosphere of aseptically grown corn plants, pH of the rhizosphere, and the background chemical matrices of the soil solutions. The synthetic root exudates, which mimic the chemical conditions of the rhizosphere environment where soil-borne metals are dissolved and absorbed by plants, were used to extract metals from sewage-sludge treated soils 16 successive times. The concentrations of Zn, Cd, Ni, Cr, and Cu of the sludge-treated soil were 71.74, 0.21, 15.90, 58.12, and 37.44 mg kg-1, respectively. The composition of synthetic root exudates consisted of acetic, butyric, glutaric, lactic, maleic, propionic, pyruvic, succinic, tartaric, and valeric acids. The organic acid mixtures had concentrations of 0.05 and 0.1 mol L-1 -COOH. The trace elements removed by successive extractions may be considered representative for the availability of these metals to plants in these soils. The chemical speciation of the metals in the liquid phase was calculated; results showed that metals in sludge-treated soils were dissolved and formed soluble complexes with the different organic acid-based root exudates. The most reactive organic acid ligands were lactate, maleate, tartarate, and acetate. The inorganic ligands of chloride and sulfate played insignificant roles in metal dissolution. Except for Cd, free ions did not represent an important chemical species of the metals in the soil rhizosphere. As different metals formed soluble complexes with different ligands in the rhizosphere, no extractor, based on a single reagent would be able to recover all of the potentially plant-available metals from soils; the root exudate-derived organic acid mixtures tested in this study may be better suited to recover potentially plant-available metals from soils than the conventional extractors.

Chemical and microbiological attributes of an oxisol treated with successive applications of sewage sludge¹

Studies on sewage sludge (SS) have confirmed the possibilities of using this waste as fertilizer and/or soil conditioner in crop production areas. Despite restrictions with regard to the levels of potentially toxic elements (PTE) and pathogens, it is believed that properly treated SS with low PTE levels, applied to soil at adequate rates, may improve the soil chemical and microbiological properties. This study consisted of a long-term field experiment conducted on a Typic Haplorthox (eutroferric Red Latosol) treated with SS for seven successive years for maize production, to evaluate changes in the soil chemical and microbiological properties. The treatments consisted of two SS rates (single and double dose of the crop N requirement) and a mineral fertilizer treatment. Soil was sampled in the 0-0.20 m layer and analyzed for chemical properties (organic C, pH, P, K, Ca, Mg, CEC, B, Cu, Fe, Mn, Zn, Cd, Ni, and Pb) and microbiological properties (basal respiration, microbial biomass activity, microbial biomass C, metabolic quotient, microbial quotient, and protease and dehydrogenase enzyme activities). Successive SS applications to soil increased the macro- and micronutrient availability, but the highest SS dose reduced the soil pH significantly, indicating a need for periodic corrections. The SS treatments also affected soil microbial activity and biomass negatively. There were no significant differences among treatments for maize grain yield. After seven annual applications of the recommended sludge rate, the heavy metal levels in the soil had not reached toxic levels.

Hydraulic conductivity and soil-sewage sludge interactions

One of the main problems faced by humanity is pollution caused by residues resulting from the production and use of goods, e.g, sewage sludge. Among the various alternatives for its disposal, the agricultural use seems promising. The purpose of this study was to evaluate the hydraulic conductivity and interaction of soil with sandy-silty texture, classified as Spodosols, from the Experimental Station Itapirema - IPA, in Goiana, state of Pernambuco, in mixtures with sewage sludge from the Mangueira Sewage Treatment Station, in the city of Recife, Pernambuco at rates of 25, 50 and 75 Mg ha-1. Tests were conducted to let water percolate the natural saturated soil and soil-sludge mixtures to characterize their physical, chemical, and microstructural properties as well as hydraulic conductivity. Statistical data analysis showed that the presence of sewage sludge in soils leads to an increase of the < 0.005 mm fraction, reduction in real specific weight and variation in optimum moisture content from 11.60 to 12.90 % and apparent specific dry weight from 17.10 and 17.50 kN m-3. In the sludge-soil mixture, the quartz grains were covered by sludge and filling of the empty soil macropores between grains. There were changes in the chemical characteristics of soil and effluent due to sewage sludge addition and a small decrease in hydraulic conductivity. The results indicate the possibility that soil acidity influenced the concentrations of the elements found in the leachate, showing higher levels at higher sludge doses. It can be concluded that the leaching degree of potentially toxic elements from the sewage sludge treatments does not harm the environment.

Microbiological and biochemical properties of an agricultural Mexican soil amended with sewage sludge

The application of sewage sludge is a concern because it may affect the quality of organic matter and microbiological and biochemical soil properties. The effects of surface application of sewage sludge to an agricultural soil (at 18 and 36 t ha-1 dry basis) were assessed in one maize (Zea mays L.) growing season. The study evaluated microbial biomass, basal respiration and selected enzymatic activities (catalase, urease, acid and alkaline phosphatase, and β-glucosidase) 230 days after sewage sludge application and infrared spectroscopy was used to assess the quality of dissolved organic matter and humic acids. Sewage sludge applications increased the band intensity assigned to polysaccharides, carboxylic acids, amides and lignin groups in the soil. The organic matter from the sewage sludge had a significant influence on the soil microbial biomass; nevertheless, at the end of the experiment the equilibrium of the soil microbial biomass (defined as microbial metabolic quotient, qCO2) was recovered. Soil urease, acid and alkaline phosphatase activity were strongly influenced by sewage sludge applications.

Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Switzerland: sampling only invasive isolates does not allow a representative description of the local diversity of clones.

We conducted a molecular study of MRSA isolated in Swiss hospitals, including the first five consecutive isolates recovered from blood cultures and the first ten isolates recovered from other sites in newly identified carriers. Among 73 MRSA isolates, 44 different double locus sequence typing (DLST) types and 32 spa types were observed. Most isolates belonged to the NewYork/Japan, the UK-EMRSA-15, the South German and the Berlin clones. In a country with a low to moderate MRSA incidence, inclusion of non-invasive isolates allowed a more accurate description of the diversity.

Epidemiologie und Prävention des Hautmelanoms in der Schweiz: Update 2010. [Epidemiology and prevention of melanoma in Switzerland: 2010 update]

Zusammenfassung] Die Inzidenz des malignen Melanoms steigt seit über 50 Jahren bei der weißen Bevölkerung stark an. Die Schweiz ist mit ungefähr 1900 neu diagnostizierten Fällen pro Jahr das am stärksten betroffene Land Europas (16/100 000 Welt-standardisierte Rate). In letzter Zeit sind regionale Unterschiede mit höherer Inzidenz in den Westschweizer Kantonen festzustellen. Änderungen in Wissen und Verhalten der Schweizer Bevölkerung gegenüber dem Schutz vor Sonnenexposition bestehen noch zu wenig lange und sind zu bescheiden, als dass sie schon einen Einfluss auf die Inzidenz hätten haben können. Dank der seit 20 Jahren betriebenen Früherfassung sind Überlebensrate und Anteil an dünnen Melanomen gestiegen, allerdings bei gleichbleibender Inzidenz dicker Läsionen. Die Mortalität aufgrund des malignen Melanoms ist neuerdings rückläufig, vor allem bei den Frauen. Werden die gegenwärtigen Präventionsbemühungen weitergeführt, dürften sich bald noch mehr Erfolge zeigen. [Abstract] The incidence of cutaneous malignant melanoma has steadily increased in Caucasian populations over the last decades. With around 1900 new cases each year, Switzerland has one of the highest melanoma rates in Europe (16/100 000 world-standardised rate). Regional differences are emerging within Switzerland, with a higher incidence in the western (French-speaking) region. Observed changes in sun protection attitudes and knowledge in the Swiss population have yet no impact on the incidence trend. Early detection, carried out since the mid 1980s in Switzerland, has led to a substantial increase in survival and rates of thin melanoma, without material change in rates of thick melanoma. Mortality from melanoma has recently decreased, earlier in women than men. The efficacy of prevention campaigns should soon become more blatant if current efforts persist.

Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.

Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide. METHODS: Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders. RESULTS: Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%. CONCLUSION: This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.