Hospital for joint diseases participates in international spine registry Spine Tango after successful pilot study

Spine Tango is currently the only international spine registry in existence. It was developed under the auspices of Eurospine, the Spine Society of Europe, and is hosted at the University of Bern, Switzerland. The HJD Spine Center successfully tested Spine Tango during a 3-month pilot study and has since expanded documentation activities to more surgeons. Workflow integration and dedicated research staff are key factors for such an endeavor. Participation enables benchmarking against national and international peers and outcome research and quality assurance of surgical and non-surgical treatments.

Patent foramen ovale screening by ear oximetry in divers

The aim of this study was to test the hypothesis that ear oximetry immediately after the release of a sustained Valsalva maneuver accurately detects patent foramen ovale (PFO). One hundred sixty-five scuba divers underwent transesophageal echocardiography (TEE; reference method) for PFO assessment. Ear oximetry of the right earlobe was performed in a different room within a time frame of 2 hours before or after TEE. The subject and the oximetry operator were unaware of the results of TEE. Oxygen saturation (SO(2)) measurements were obtained at baseline and during the release phase of 4 Valsalva maneuvers within 10 minutes, and the average SO(2) change (SO(2) at baseline minus SO(2) at Valsalva release) was determined as the primary study end point. One hundred seventeen divers had no PFO, and 48 (29%) had PFO by TEE (mean age 39 ± 8 years). The average SO(2) change was 0.79 ± 1.13% (i.e., a slight absolute SO(2) decrease in response to the Valsalva maneuver) in the group without PFO and 1.67 ± 1.19% in the PFO group (p <0.0001). Using receiver-operating characteristic curve analysis, a PFO as defined by TEE could be detected at a threshold of a Valsalva-induced decrease in SO(2) of ≥0.825 percentage points in comparison to baseline (sensitivity 0.756, specificity 0.706, area under the receiver-operating characteristic curve 0.763, p <0.0001, negative predictive value 0.882). In conclusion, the entirely noninvasive method of ear oximetry in response to repetitive Valsalva maneuvers is accurate and useful as a screening method for the detection of a PFO, as shown in this study of divers.

Robotics in ear, nose and throat (ENT) surgery

The three main classes of robotics in ear, nose and throat (ENT) surgery (telemanipulation, image-guided functional servoing, and computer numerical control) are discussed and important examples of applications are described to show both technological and clinical developments. As access to many anatomical features of the head requires very small and compact tools to accurately perform procedures, examples are give in ear surgery where manipulation of the minute ossicles requires fine, dexterous movements.

NADPH P450 oxidoreductase: structure, function, and pathology of diseases

Cytochrome P450 oxidoreductase (POR) is an enzyme that is essential for multiple metabolic processes, chiefly among them are reactions catalyzed by cytochrome P450 proteins for metabolism of steroid hormones, drugs and xenobiotics. Mutations in POR cause a complex set of disorders that often resemble defects in steroid metabolizing enzymes 17α-hydroxylase, 21-hydroxylase and aromatase. Since our initial reports of POR mutations in 2004, more than 200 different mutations and polymorphisms in POR gene have been identified. Several missense variations in POR have been tested for their effect on activities of multiple steroid and drug metabolizing P450 proteins. Mutations in POR may have variable effects on different P450 partner proteins depending on the location of the mutation. The POR mutations that disrupt the binding of co-factors have negative impact on all partner proteins, while mutations causing subtle structural changes may lead to altered interaction with specific partner proteins and the overall effect may be different for each partner. This review summarizes the recent discoveries related to mutations and polymorphisms in POR and discusses these mutations in the context of historical developments in the discovery and characterization of POR as an electron transfer protein. The review is focused on the structural, enzymatic and clinical implications of the mutations linked to newly identified disorders in humans, now categorized as POR deficiency.

Immunogenicity and safety of seasonal and 2009 pandemic A/H1N1 influenza vaccines for patients with autoimmune diseases: a prospective, monocentre trial on 199 patients

The 2009 pandemic A/H1N1 influenza outbreak represented a theoretical risk for patients with autoimmune diseases (AID), especially those immunosuppressed. This study was undertaken to evaluate immunogenicity and tolerance of seasonal (SFV) and A/H1N1 flu vaccines (HFV) in AID patients.

Canine neurological diseases in a referral hospital population between 1989 and 2000 in Switzerland

OBJECTIVES: To merge clinical information from partly overlapping medical record databases of the Small Animal Teaching Hospital of the Vetsuisse Faculty, University of Berne. To describe the frequencies and localisations of neurological diseases in dogs, as well as their age, gender, breed and geographical distributions. METHODS: In this retrospective study, a new database, with specific variables and a diagnosis key list 'VITAMIN D', was created and defined. A total of 4497 dogs (average of 375 per year) with a well-documented neurological disease were included in the study. A key list for the diagnoses was developed and applied to either the presumptive or the clinical and neurohistopathological diagnosis, with a serial number, a code for localisation and a code for differential diagnoses. RESULTS: Approximately 1159 dogs (26 per cent) had a neurohistopathological diagnosis confirmed, 1431 (32 per cent) had a clinical diagnosis confirmed and 1491 (33 per cent) had a presumptive diagnosis. The most frequent breeds were mixed-breed dogs (577 of 4497, 13 per cent), followed by German shepherd dogs (466 of 4497, 10 per cent). The most common localisations were the forebrain (908 of 4497, 20 per cent) and the spinal cord at the thoracolumbar area (840 of 4497, 19 per cent). Most dogs were diagnosed with degenerative diseases (38 per cent), followed by inflammatory/infectious diseases (14 per cent). The highest number of submissions originated from geographic regions around the referral hospital and from regions with higher human population densities. CLINICAL SIGNIFICANCE: By defining closed-list fields and allocating all data to the corresponding fields, a standardised database that can be used for further studies was generated. The analysis of this study gives examples of the possible uses of a standardised database.

Neurodegenerative diseases in domestic animals: a comparative review

Neurodegenerative diseases are characterised by selective damage to specific neurons in the nervous system. Interest in such diseases in humans has resulted in considerable progress in the molecular understanding of these disorders in recent decades. Numerous neurodegenerative diseases have also been described in domestic animals but relatively little molecular work has been reported. In the present review, we have classified neurodegenerative disease according to neuroanatomical criteria. We have established two large groups, based on whether the neuronal cell body or its axon was primarily affected. Conditions such as motor neuron diseases, cerebellar degenerations and neuroaxonal dystrophies are discussed in terms of their clinical and neuropathological features. In the most studied disorders, we also present what is known about underlying pathomechanisms, and compare them with their human counterparts. The purpose of this review is to re-kindle interest in this group of diseases and to encourage veterinary researchers to investigate molecular mechanisms by taking advantage of current diagnostic tools.

Equine botulism and acute pasture myodystrophy: new soil-borne emerging diseases in Switzerland?

In Switzerland, the incidence of equine botulism and acute pasture myodystrophy have remarkably increased in the last five years. Equine fodder-borne botulism in Europe is most likely caused by Clostridium botulinum types C and D that produce the toxins BoNT/C and BoNT/D. Horses showing signs suggestive of botulism (muscle weakness and tremors, reduced tongue tone, slow chewing, salivation and difficulties swallowing, drooping eyelids, mydriasis), especially patients that have fed on suspect fodder (mostly haylage), must be treated with anti-serum as soon as possible.They also need intensive care, which is often difficult to provide and always expensive in the face of a guarded to poor prognosis. Therefore, prevention (high standards of forage quality and vaccination) is all the more important. Pasture myodystrophy is an acute disease with signs of rhabdomyolysis and lethality rate over 90%. It affects grazing horses under frosty, windy and rainy conditions. Preliminary results indicate that Clostridium sordellii and Clostridium bifermentans producing lethal toxin may play a role in pasture myodystrophy. Our efforts concentrate on developing a new subunit vaccine for equine botulism and understanding the ethiology and pathogenesis of pasture myodystrophy with the goal of improving prevention against these highly fatal diseases that present a significant risk to our horse population.

Anatomical study of the human middle ear for the design of implantable hearing aids

OBJECTIVE: To generate anatomical data on the human middle ear and adjacent structures to serve as a base for the development and optimization of new implantable hearing aid transducers. Implantable middle ear hearing aid transducers, i.e. the equivalent to the loudspeaker in conventional hearing aids, should ideally fit into the majority of adult middle ears and should utilize the limited space optimally to achieve sufficiently high maximal output levels. For several designs, more anatomical data are needed. METHODS: Twenty temporal bones of 10 formalin-fixed adult human heads were scanned by a computed tomography system (CT) using a slide thickness of 0.63 mm. Twelve landmarks were defined and 24 different distances were calculated for each temporal bone. RESULTS: A statistical description of 24 distances in the adult human middle ear which may limit or influence the design of middle ear transducers is presented. Significant inter-individual differences but no significant differences for gender, side, age or degree of pneumatization of the mastoid were found. Distances, which were not analyzed for the first time in this study, were found to be in good agreement with the results of earlier studies. CONCLUSION: A data set describing the adult human middle ear anatomy quantitatively from the point of view of designers of new implantable hearing aid transducers has been generated. In principle, the method employed in this study using standard CT scans could also be used preoperatively to rule out exclusion criteria.