Obesity in Switzerland: a critical assessment of prevalence in children and adults.

The objective was to analyze the situation in Switzerland regarding the prevalence of overweight or obesity in children, adolescents and adults. The data were compared with France, an adjacent much larger country. The results showed that there is a definitive lack of objective information in Switzerland on the prevalence of obesity at different ages. As in other European studies, the fact that many national surveys are classically based on subject interviews (self-reported weights and heights rather than measured values) implies that the overweight/obesity prevalence is largely underestimated in adulthood. For example, in a recent Swiss epidemiological study, the prevalence of obesity (BMI greater than 30 kg/m(2)) averaged 6-7% in young men and women (25-34 y), the prevalence being underestimated by a factor of two to three when body weight was self-reported rather than measured. This phenomenon has already been observed in previous European studies. It is concluded that National Surveys based on telephone interviews generally produce biased obesity prevalence results, although the direction of the changes in prevalence of obesity and its evolution with repeated surveys using strict standardized methodology may be evaluated correctly. Therefore, these surveys should be complemented by large-scale epidemiological studies (based on measured anthropomeric variables rather than declared) covering the different linguistic areas of Switzerland. An epidemiological body weight (BMI) monitoring surveillance system, using a harmonized methodology among European countries, would help to accurately assess differences in obesity prevalence across Europe without methodological bias. It will permit monitoring of the dynamic evolution of obesity prevalence as well as the development of appropriate strategies (taking into account the specificity of each country) for obesity prevention and treatment.

Renal tumor ablation using radiofrequency: results in 28 patient. Exposition scientifique: Radiologie interventionnelle

Objectifs: To describe the technique and results of radiofrequency ablation (RFA) of small renal tumors.Matériels et méthodes: 28 patients with median age 79 years were treated with RFA for small renal exophytic tumor (median size 20 mm). Most patients were poor operative candidatesbecause of associated morbidity. Four patients were treated for biopsy proven papillary tumor, 7 for clear cell carcinoma, 2 for oncocytoma and one for renalhepatocellular metastasis. No biopsy sample was obtained for the others because of a typical radiological aspect of RCC.Résultats: All patients but one were treated successfully in one session under combined ultrasound and CT guidance using either Radionics 2000 cool-tip or Bostonscientific expandable needles, one was treated in two sessions. One Splenic, 3 colic and 1 pancreatic displacement with CO2 injection and one injection of G5%solution in the costo-phrenic recessus were done in order to protect adjacent organs. Two complications were observed, one splenic iatrogenic lesion treated byembolization and one renal pelvis stenosis treated with JJ stent. After a mean follow-up of 20 months, no patient developped local recurrence on MRI follow-up.Conclusion: RFA is a simple and efficient technique pending on strict selected criteria (small size < 3 cm and exophytic lesion). Long local control is obtained with minimalmorbidity.

Reservoir compensation releases : impact on the macroinvertebrate community of the Derwent River, Northumberland, UK-A longitudinal

River regulation for the purposes of public water supply causes the flow regime downstream of a dam to change. Traditionally, in the UK, such regulation was accompanied by requirements for reservoir releases to compensate downstream water users (e.g. industry) for the loss of natural flow (compensation flows). In this article, we compare a unique pre-impoundment macroinvertebrate data set for a regulated upland river with survey data post-impoundment. This allows a longitudinal assessment of the response of the system to regulation. The Derwent River, Northumberland, was impounded in 1966. Impacts on the hydrological regime were quantified by comparing long-term hydrographs, flow duration curves, flow ranges and flashiness indices for the pre-impoundment and post-impoundment periods. The comparison of changes in macroinvertebrate richness and diversity post-impoundment showed that the change in flow regime has had limited effect on the ecological community structure. The flow regime of the Derwent River has become less flashy with fewer extreme events, and the richness and the diversity of macroinvertebrates have, in some cases, increased and at worst have not deteriorated. We suggest that this reflects the strict compensation regime, which has guaranteed minimum flows at all times. Copyright (c) 2012 John Wiley & Sons, Ltd.

Epidemiology of foodborne Norovirus outbreaks in Catalonia, Spain

Background: Noroviruses are one of the principal biological agents associated with the consumption of contaminated food. The objective of this study was to analyse the size and epidemiological characteristics of foodborne outbreaks of gastroenteritis in Catalonia, a region in the northeast of Spain.Methods: In all reported outbreaks of gastroenteritis associated with food consumption, faecal samples of persons affected were analysed for bacteria and viruses and selectively for parasites. Study variables included the setting, the number of people exposed, age, sex, clinical signs and hospital admissions. The study was carried out from October 2004 to October 2005.Results: Of the 181 outbreaks reported during the study period, 72 were caused by Salmonella and 30 by norovirus (NoV); the incidence rates were 14.5 and 9.9 per 100,000 person-years, respectively. In 50% of the NoV outbreaks and 27% of the bacterial outbreaks (p = 0.03) the number of persons affected was ¿10; 66.7% of NoV outbreaks occurred in restaurants; no differences in the attack rates were observed according to the etiology. Hospitalizations were more common (p = 0.03) in bacterial outbreaks (8.6%) than in NoV outbreaks (0.15%). Secondary cases accounted for 4% of cases in NoV outbreaks compared with 0.3% of cases in bacterial outbreaks (p < 0.001)Conclusion: Norovirus outbreaks were larger but less frequent than bacterial outbreaks, suggesting that underreporting is greater for NoV outbreaks. Food handlers should receive training on the transmission of infections in diverse situations. Very strict control measures on handwashing and environmental disinfection should be adopted in closed or partially-closed institutions.

Characterization of PhlG, a hydrolase that specifically degrades the antifungal compound 2,4-diacetylphloroglucinol in the biocontrol agent Pseudomonas fluorescens CHA0.

The potent antimicrobial compound 2,4-diacetylphloroglucinol (DAPG) is a major determinant of biocontrol activity of plant-beneficial Pseudomonas fluorescens CHA0 against root diseases caused by fungal pathogens. The DAPG biosynthetic locus harbors the phlG gene, the function of which has not been elucidated thus far. The phlG gene is located upstream of the phlACBD biosynthetic operon, between the phlF and phlH genes which encode pathway-specific regulators. In this study, we assigned a function to PhlG as a hydrolase specifically degrades DAPG to equimolar amounts of mildly toxic monoacetylphloroglucinol (MAPG) and acetate. DAPG added to cultures of a DAPG-negative DeltaphlA mutant of strain CHA0 was completely degraded, and MAPG was temporarily accumulated. In contrast, DAPG was not degraded in cultures of a DeltaphlA DeltaphlG double mutant. To confirm the enzymatic nature of PhlG in vitro, the protein was histidine tagged, overexpressed in Escherichia coli, and purified by affinity chromatography. Purified PhlG had a molecular mass of about 40 kDa and catalyzed the degradation of DAPG to MAPG. The enzyme had a kcat of 33 s(-1) and a Km of 140 microM at 30 degrees C and pH 7. The PhlG enzyme did not degrade other compounds with structures similar to DAPG, such as MAPG and triacetylphloroglucinol, suggesting strict substrate specificity. Interestingly, PhlG activity was strongly reduced by pyoluteorin, a further antifungal compound produced by the bacterium. Expression of phlG was not influenced by the substrate DAPG or the degradation product MAPG but was subject to positive control by the GacS/GacA two-component system and to negative control by the pathway-specific regulators PhlF and PhlH.

Surface-dependent strategies and energy flux in benthic marine communities or, why corals do not exist in the Mediterranean

Most structure-building organisms in rocky benthic communities are surface-dependent because their energy inputs depend mainly on the surface they expose to water. Two photosynthetic strategies, divided into calcareous and non calcareous algae, strict suspension-feeders and photosynthetic suspension feeders (e.g. hermatypic corals) are the four main strategies evolutively acquired by benthic organisms. Competition between those strategies occur in relation to productivity of the different species, in such a way that, for given environmental conditions, species with a higher growth (P/B ratio) would dominate. At a worldwide scale, littoral marine benthos can he considered to fit into the four fields defined by two main axes: the first, relates to productivity and relies atrophic and oligotrophic waters and the second is defined by the degree of environmental variability or seasonality (from high to low). Coral reefs (marine ecosystems dominated by photosynthetic suspension feeders) develop in the space of oligotrophic areas with low variability, while kelp beds (marine ecosystem dominated by large, non calcareous algae) are to be found only in eutrophic places with a high variability. The space of eutrophic waters with a low variability do not has specially adapted, high structured, benthic marine ecosystems, and in these conditions opportunistic algae and animals predominate. Finally, photophilic mediterranean benthos -devoid of kelps and without hermatypic corals- typifies the field of oligotrophic areas with high variability; in its more genuine aspect, Mediterranean benthos is represented by small algae with a high percentage of calcareous thallii. In all cases strict suspension-feeders compete successfully with photosynthetic organisms only in situations of low irradiances or very high inputs of POM. In its turn, Mediterranean rocky benthos, in spite of its relative uniformity, is geographically organized along the same axes. The Gulf of Lions and the insular bottoms (Balearic Islands, for example) would correspond to the extremes of eutrophic-high variability areas and oligotrophic-low variability areas, respectively. Irradiance, nutrient and POM concentration, and hydrodynamism are the three variables which mainly affect the distribution of the different surface-dependent strategies, and thus, these parameters are of paramount interest for understanding the trophic structure of Mediterranean benthic communities. In environments non limited by light, nutrient availability, defined as the product between nutrient -POM concentration and hydrodynamism, states the dominance of calcareous versus non calcareous algae. Calcareous algae dominate in oligotrophic waters while non-calcareous algae dominate in moderately eutrophic waters. In light-limited environments, passive suspension feeders (octocorallaria, gorgonians) become dominant species if POM availability is enhanced by a high hydrodynamism (strong currents); in waters with a low charge of POM organisms of other groups, mainly active suspension feeders, predominate (sponges, bryozoans, scleractiniarians). In any case, there always exists a very variable bathymetric zone, depending on light attenuation and nutrient-POM availability, where encrusting calcareous algae strongly compete with suspension feeders (coralligenous).

EORTC topics in neurooncology: The long path from a focus on neurological complications of cancer towards molecularly defined trials and therapies in neurooncology

Over the past decade a series of trials of the EORTC Brain Tumor Group (BTG) has substantially influenced and shaped the standard-of-care of primary brain tumors. All these trials were coupled with biological research that has allowed for better understanding of the biology of these tumors. In glioblastoma, EORTC trial 26981/22981 conducted jointly with the National Cancer Institute of Canada Clinical Trials Group showed superiority of concomitant radiochemotherapy with temozolomide over radiotherapy alone. It also identified the first predictive marker for benefit from alkylating agent chemotherapy in glioblastoma, the methylation of the O6-methyl-guanyl-methly-transferase (MGMT) gene promoter. In another large randomized trial, EORTC 26951, adjuvant chemotherapy in anaplastic oligodendroglial tumors was investigated. Despite an improvement in progression-free survival this did not translate into a survival benefit. The third example of a landmark trial is the EORTC 22845 trial. This trial led by the EORTC Radiation Oncology Group forms the basis for an expectative approach to patients with low-grade glioma, as early radiotherapy indeed prolongs time to tumor progression but with no benefit in overall survival. This trial is the key reference in deciding at what time in their disease adult patients with low-grade glioma should be irradiated. Future initiatives will continue to focus on the conduct of controlled trials, rational academic drug development as well as systematic evaluation of tumor tissue including biomarker development for personalized therapy. Important lessons learned in neurooncology are to dare to ask real questions rather than merely rapidly testing new compounds, and the value of well designed trials, including the presence of controls, central pathology review, strict radiology protocols and biobanking. Structurally, the EORTC BTG has evolved into a multidisciplinary group with strong transatlantic alliances. It has contributed to the maturation of neurooncology within the oncological sciences.

Percutaneous endoscopic gastrostomy in head and neck cancer patients: indications, techniques, complications and results.

The aim of this study was to review our experience in percutaneous endoscopic gastrostomy (PEG) performed in patients with cancer of the upper aerodigestive tract. Descriptive retrospective study of 142 patients (115 males, 27 females), mean age 62.4 years (25-84 years), with head and neck or esophageal cancer, who underwent PEG tube insertion between January 2006 and December 2008. The studied parameters were indications, success rate, rate and type of complications, and their management. Percutaneous endoscopic gastrostomy was inserted before chemoradiation therapy in 80% and during or after cancer treatment in 20% of the patients. PEG placement was possible in 137 patients (96%). Major complications were observed in 9 (7%) and minor complications in 22 (17%) of the 137 patients. Seven of the 9 patients with a major complication needed revision surgery. The mortality directly related to the procedure was 0.7%. Percutaneous endoscopic gastrostomy tube insertion has a high success rate. In patients with upper aerodigestive tract cancer, PEG should be the first choice for enteral nutrition when sufficient oral intake is not possible. Although apparently easy, the procedure may occasionally lead to severe complications. Therefore, a strict technique and knowledge of clinical signs of possible complications are mandatory.

The IL-4 rapidly produced in BALB/c mice after infection with Leishmania major down-regulates IL-12 receptor beta 2-chain expression on CD4+ T cells resulting in a state of unresponsiveness to IL-12.

Within 1 day of infection with Leishmania major, susceptible BALB/c mice produce a burst of IL-4 in their draining lymph nodes, resulting in a state of unresponsiveness to IL-12 in parasite-specific CD4+ T cells within 48 h. In this report we examined the molecular mechanism underlying this IL-12 unresponsiveness. Extinction of IL-12 signaling in BALB/c mice is due to a rapid down-regulation of IL-12R beta2-chain mRNA expression in CD4+ T cells. In contrast, IL-12R beta2-chain mRNA expression was maintained on CD4+ T cells from resistant C57BL/6 mice. The down-regulation of the IL-12R beta2-chain mRNA expression in BALB/c CD4+ T cells is a consequence of the early IL-4 production. In this murine model of infection, a strict correlation is shown in vivo between expression of the IL-12R beta2-chain in CD4+ T cells and the development of a Th1 response and down-regulation of the mRNA beta2-chain expression and the maturation of a Th2 response. Treatment of BALB/c mice with IFN-gamma, even when IL-4 has been produced for 48 h, resulted in maintenance of IL-12R beta2-chain mRNA expression and IL-12 responsiveness. The data presented here support the hypothesis that the genetically determined susceptibility of BALB/c mice to infection with L. major is primarily based on an up-regulation of IL-4 production, which secondarily induces extinction of IL-12 signaling.

Abundance and diversity of soil mites of fragmented habitats in a biosphere reserve in Southern Nigeria

Soil samples were collected from the top 7.5 cm of soil in a Strict Natural Reserve (SNR), a surrounding buffer zone, a cassava farm and matured plantations of Gmelina, teak, and pine, so as to determine if plantation establishment and intensive cultivation affect the density and diversity of soil mites. Altogether, 41 taxonomic groups of mites were identified. The diversity and densities of mites in within the SNR, the buffer zone and the Gmelina were more than the diversity and densities in the cassava farm, teak and pine plantations. Each plantation had its own unique community structure which was different from the community structure in the SNR plot. The SNR plot and Gmelina were dominated by detritivorous cryptostigmatid mites unlike teak and pine which were dominated by predatory mesostigmatid and prostigmatid mites respectively. Low cryptostigmatid mite densities in the plantations and cassava farm were seen as a consequence of low fertility status of the soil, the evidence of which was revealed by soil pH and organic matter data.

The importance of environmental exposures to physical, mental and social well-being

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" states the WHO. However, the current focus in this important area seems to be on reducing diseases, while less attention is paid on aspects how to increase the well-being of populations. This paper reviews three examples where well-being has drawn attention of the public and policy makers, and compares the policies of two wealthy countries. The first example is noise. Noise can reduce sleep quality and cause physiological, mental, and social effects. In Switzerland, noise receives a lot of attention by the public. Swiss laws are extensive, e.g., they prohibit trucks and planes from traveling at night. In the USA, there is little public attention and no national strategy against environmental noise. The second example is aesthetics and recreation. Many humans seek contact with the beauty of nature. The USA and Switzerland have similar strategies for achieving clear waters, while the protection of scenic views is approached very differently. Lifestyle is the last example. In the USA, the desire for individual freedom is a leading cause for suburban sprawl, a car-dependent sedentary lifestyle resulting in obesity, asthma and loss of community spirit. In Switzerland, a strict land use planning seeks to balance individual and public interests and stresses public transportation, which seems to be a more promising approach. Paying attention to aspects of well-being while developing political strategies might be a promising model to tackle environmental problems. Successful strategies employed so far seem to include the public, local authorities, politicians and scientists in this process, which might have been a key for their success. [Authors]

Central line sepsis in intensive care units : overview and update

Catheter-related infection remains a leading cause of nosocomial infections, particularly in intensive care units. It includes colonization of the device, skin exit-site infection and device- or catheter-related bloodstream infection. The latter represents the most frequent life-threatening associated complication of central venous catheter use and is associated with significant patient morbidity, mortality and extra hospital costs. The incidence of catheter-related bloodstream infection ranges from 2 to 14 episodes per 1000 catheter-days. On average, microbiologically-documented device-related bloodstream infections complicate from three to five per 100 central venous line uses, but they only represent the visible part of the iceberg and most clinical sepsis are nowadays considered to be catheter-related. We briefly review the pathophysiology of infection, highlighting the importance of the skin insertion site and of intravenous line hub as principal sources of colonization. Principles of therapy are reviewed. Several preventive approaches are also discussed, in particular the possible benefit of recently developed impregnated catheters. Finally, the potential positive impact of a multimodal global preventive strategy based on strict application of hygienic rules is presented.

Copy number variation modifies expression profiles over developmental time

Abstract : A preliminary understanding of the phenotypic effect of copy number variation (CNV) of DNA segments is emerging. These rearrangements were shown to influence, in a somewhat dose-dependent manner, the expression of genes mapping within them. They were also shown to modify the expression of genes located on their Hanks, sometimes at great distance. Here, we demonstrate by monitoring these effects at multiple life stages, that these controls over expression are effective throughout mouse development. Similarly, we observe that the more specific spatial expression patterns of CNV genes are maintained through life. However, 'we find that some brain- expressed genes mapping within CNVS appear to be under compensatory loops only at specific time-points, indicating that the effect of CNVS on these genes is modulated during development. Notably, we also observe that CNV genes are significantly enriched within transcripts that show variable time-course expression between strains. Thus, modifying the copy number of a gene may potentially alter not only its expression level, but its timing of expression as well. Résume : Nous commençons à comprendre les effets phénotypiques liés aux séquences d'ADN qui changent de nombre de copies d'un individu a l'autre. Des travaux précédents ont montré que ces variante de nombre de copies (CNVS) avaient une influence sur l'expression non seulement des gènes se trouvant dans le réarrangement, mais aussi sur ceux se trouvant à une certaine distance. Le présent travail étudie ces effets à différents stades du développement de la souris allant d'un embryon de deux semaines à la souris adulte. Nous avons observé que certains gènes exprimés dans le cerveau semblent soumis à un contrôle plus strict a certaines étapes du développement suggèrent que l'effet des CNVs est modulé différemment au cours de la vie. Notre travail sur trois souches différentes de souris a permis de montrer que les gènes ayant un profil d'expression différent dans le temps entre souches sont enrichis en gènes se trouvant dans des CNVs. Ceci nous amène à penser que les CNVs ont, non seulement une influence sur le niveau d'expression des gènes, mais aussi sur les moments durant lesquels ils seront exprimés. Résumé pour un large public : De nombreuses maladies sont dues soit a un gain (on parle alors de duplication) soit à une perte de matériel génétique (il s'agit dune délétion). Bien que les recherches visant à identifier les mécanismes moléculaires liés à ces réarrangements de notre génome progressent continuellement, la plupart des causes des maladies génétiques restent à élucider. Certaines parties de notre génome sont présentes en un nombre de copies qui diffère d'un individu à l'autre sans pour autant provoquer une ou des maladies. Ces segments d'ADN qui varient en nombre sont appelés Copy Number Variant (CNVs). Ils couvrent environ 12% de notre matériel génétique. Des études menées sur différents modèles animaux ont montré que les CNVs avaient une influence aussi bien sur les gènes qui sont a l'intérieur des CNVs que sur ceux qui sont dans leur voisinage. Ce travail étudie l'effet des CNVs à travers différents stades du développement de la souris. Nous avons démontré que les segments d'ADN qui varient en nombre de copies ont des effets variables selon le stade auxquels ils sont mesurés. Ainsi, les CNVs ont non seulement un impact sur l'expression des gènes présents dans ces régions et dans leur voisinage, mais influencent également leurs profils d'expression au cours du temps.