A mouse model for improving cell survival of bisected cattle embryos

Selostus: Hiiren alkio mallina solukestävyyden parantamiseksi naudan alkioiden halkaisussa

Limited genetic diversity and high differentiation among the remnant adder (Vipera berus) populations in the Swiss and French Jura Mountains

Although the adder (Vipera berus) has a large distribution area, this species is particularly threatened in Western Europe due to high habitat fragmentation and human persecution. We developed 13 new microsatellite markers in order to evaluate population structure and genetic diversity in the Swiss and French Jura Mountains, where the species is limited to only a few scattered populations. We found that V. berus exhibits a considerable genetic differentiation among populations (global F-ST = 0.269), even if these are not geographically isolated. Moreover, the genetic diversity within populations in the Jura Mountains and in the less perturbed Swiss Alps is significantly lower than in other French populations, possibly due to post-glacial recolonisation processes. Finally, in order to minimize losses of genetic diversities within isolated populations, suggestions for the conservation of this species in fragmented habitats are proposed.

Lessons From the Swiss Medical Board Recommendation Against Mammography Screening Programs

When the US Preventive Services Task Force (USPSTF) in 2009 recommended against universal breast cancer screening with mammography in women aged 40 to 49 years, some scientists, radiologists, politicians, and patients strongly objected. The controversy has been called the "mammography wars." The latest chapter in these wars comes from the Swiss Medical Board, which is mandated by the Conference of Health Ministers of the Swiss Cantons, the Swiss Medical Association, and the Swiss Academy of Medical Sciences to conduct health technology assessments. In a February 2014 report, the Swiss Medical Board stated that new systematic mammography screening programs should not be introduced, irrespective of the age of the women, and that existing programs should be discontinued. The board's main argument was that the absolute reduction in breast cancer mortality was low and that the adverse consequences of the screening were substantial. The absolute risk reduction in breast cancer mortality has been estimated by the board at 0.16% for women screened during 6.2 years and followed-up over 13 years, based on the results of a recent Cochrane Review. The adverse consequences include falsepositive test results, overdiagnosis and overtreatment of patients, and high costs, including the expense of follow-up testing and procedures.

Subalpine-nival gradient of species richness for vascular plants, lichens and bryophytes in the Swiss Inner Alps

In the European GLORIA project, 12 summits (treeline to nival belt) were inventoried in three regions of Switzerland: two in the Swiss National Park Graubünden and one in Valais. Vascular plants were recorded in all three regions and bryophytes and lichens were recorded only in Valais. On each summit, vegetation and temperature data were sampled using sampling protocols for the GLORIA project (Global Observation Research Initiative in Alpine environment) on large summit sections and in clusters of four 1x1-m quadrats. We observed a general decrease of species richness for all three systematic groups with increasing elevation in the summit sections, but only for vascular plants in the quadrats. In Valais, there was higher species richness for vascular plants than for bryophytes and lichens on the lower summits, but as the decrease in species richness was less pronounced for cryptogams, the latter were more numerous than vascular plants on the highest summit. Vascular species showed a clear shift of the dominant life form with elevation, with chamaephytes replacing hemicryptophytes. Bryophytes and lichens showed a weak trend among the life forms at the summit section scale, but a stronger shift of the dominant forms was seen in the quadrats, with cushion replacing turf bryophytes and crustaceous replacing fruticose lichens. Altogether, these results sustain the temperature-physiographic hypothesis to explain the species richness decrease along the altitudinal gradient: the harsh climatic conditions of the alpine-nival belts act as a filter for species, but the diminishing diversity of microhabitats is also an important factor. Because cryptogams depend more on humidity than temperature and more on smaller microhabitats than vascular plants, the decrease of species richness is more gradual with elevation for bryophytes and lichens.

Appropriateness of use of infliximab in the Swiss IBD Cohort Study

Introduction: Anti-TNFs have significantly improved the management of Crohn's disease (CD), but not all patients will benefit from this therapy. We used data from the Swiss IBD Cohort Study (SIBDCS) and preset appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients. aims & methods: EPACT II (European Panel on the Appropriateness of Crohn's disease Therapy) appropriateness criteria (www.epact.ch) have been developed by a formal panel process combining evidence from the published literature and expert opinion (end 2007), yielding 3 categories of indications: appropriate, uncertain, and inappropriate. Enrolment and follow-up of all SIBDCS patients were achieved with questionnaires relating to EPACT II criteria. Patients could correspond to several clinical categories; pregnant patients or those with stenosing disease could not be assessed using EPACT II criteria. A step-by-step analysis based on frequency allowed identification of the most appropriate indication for IFX in a given patient. results: 822 CD patients were included between November 2006 and March 2009. 146 patients (18%) were on IFX at inclusion (130 maintenance of remission, 16 new treatments). At inclusion, and in comparison with non-IFX treated patients, patients on infliximab were more frequently female (56% vs 51%), younger at diagnosis (27.4 years old vs 30.4) and had a slightly shorter disease duration (10.3 years vs 11.7). Disease extension was greater in these patients, who were mainly treated in university centres (83% vs 72%). IFX therapy was considered appropriate in 47%, uncertain in 36% and inappropriate in 18 % of patients (6% of situations could not be assessed). conclusion: In this cohort, most indications (47%) for IFX therapy were appropriate. Uncertain or inappropriate indications were mostly due to complex patient characteristics (e.g. complex fistulas, history of multiple drug-failures), which reflect the broad use of IFX in clinical practice. Cohort studies are well suited to evaluating the implementation of new scientific evidence in clinical practice.

Imported Cattle and other Livestock, June 2010

The Imported and other Livestock report monthly by the Department of Agricultural.

Imported Cattle and other Livestock, July 2010

The Imported and other Livestock report monthly by the Department of Agricultural.

Imported Cattle and other Livestock, August 2010

The Imported and other Livestock report monthly by the Department of Agricultural.

Imported Cattle and Other Livestock Report, June 2010

The imported Cattle and Other Livestock report monthly by the Department of Agricultural.

Risk of cardiovascular events and blood pressure control in hypertensive HIV-infected patients: Swiss HIV Cohort Study (SHCS).

BACKGROUND: Prevalence of hypertension in HIV infection is high, and information on blood pressure control in HIV-infected individuals is insufficient. We modeled blood pressure over time and the risk of cardiovascular events in hypertensive HIV-infected individuals. METHODS: All patients from the Swiss HIV Cohort Study with confirmed hypertension (systolic or diastolic blood pressure above 139 or 89 mm Hg on 2 consecutive visits and presence of at least 1 additional cardiovascular risk factor) between April 1, 2000 and March 31, 2011 were included. Patients with previous cardiovascular events, already on antihypertensive drugs, and pregnant women were excluded. Change in blood pressure over time was modeled using linear mixed models with repeated measurement. RESULTS: Hypertension was diagnosed in 2595 of 10,361 eligible patients. Of those, 869 initiated antihypertensive treatment. For patients treated for hypertension, we found a mean (95% confidence interval) decrease in systolic and diastolic blood pressure of -0.82 (-1.06 to -0.58) mm Hg and -0.89 (-1.05 to -0.73) mm Hg/yr, respectively. Factors associated with a decline in systolic blood pressure were baseline blood pressure, presence of chronic kidney disease, cardiovascular events, and the typical risk factors for cardiovascular disease. In patients with hypertension, increase in systolic blood pressure [(hazard ratio 1.18 (1.06 to 1.32) per 10 mm Hg increase], total cholesterol, smoking, age, and cumulative exposure to protease inhibitor-based and triple nucleoside regimens were associated with cardiovascular events. CONCLUSIONS: Insufficient control of hypertension was associated with increased risk of cardiovascular events indicating the need for improved management of hypertension in HIV-infected individuals.

Efforts to standardise Ki-67 counting in breast cancer. A pilot study of the Swiss Working Group of Gyneco- and Breast Pathologists

Goals: Adjuvant chemotherapy decisions in breast cancer are increasing based on the pathologist's assessment of the proliferation fraction in the tumor. Yet, how good and how reproducible are we pathologists at providing reliable Ki-67 readings on breast carcinomas. Exactly how to count and in which areas to count within a tumor remains inadequately standardized. The Swiss Working Group of Gyneco- and Breast Pathologists has tried to appreciate this dilemma and to propose ways to obtain more reproducible results.Methods: In a first phase, 5 pathologists evaluated Ki67 counts in 10 breast cancers by exact counting (500 cells) and by eyeballing. Pathologists were free to select the region in which Ki67 was evaluated. In a second phase 16 pathologists evaluated Ki-67 counts in 3 breast cancers also by exact counting and eyeballing, but in predefined fields of interest. In both phases, Ki67 was assessed in centrally immunostained slides (ZH) and on slides immunostained in the 11 participating laboratories. In a third phase, these same 16 pathologists were once again asked to read the 3 cases from phase 2, plus three new cases, and this time exact guidelines were provided as to what exactly is considered a Ki-67 positive nucleus.Results: Discordance of Ki67 assessment was due to each of the following 4 factors: (i) pathologists' divergent definitions of what counts as a positive nucleus (ii) the mode of assessment (counting vs. eyeballing), (iii) immunostaining technique/protocol/antibody, and (iv) the selection of the area in which to count.Conclusion: Providing guidelines as to where to count (representative field in the tumor periphery and omitting hot spots) and what nuclei to count (even faintly immunostained nuclei count as positive) reduces the discordance rates of Ki67 readings between pathologists. Laboratory technique is only of minor importance (even over a large antibody dilution range), and counting nuclei does not improve accuracy, but rather aggravates deviations from the group mean values.Disclosure of Interest: None Declared

Analysis of patient physical restraints usage in a Swiss emergency service

Introduction: Emergency services (ES) are often faced with agitated,confused or aggressive patients. Such situations may require physicalrestraint. The prevalence of these measures is poorly documented,concerning 1 to 10% of patients admitted in the ES. The indications forrestraint, the context and the related complications are poorly studied.The emergency service and the security service of our hospital havedocumented physical restraint for several years, using specific protocolsintegrated into the medical records. The study evaluated the magnitudeof the problem, the patient characteristics, and degree of adherence tothe restraint protocol.Methods: Retrospective study of physical restraint used on adultpatients in the ES in 2009. The study included analysis of medical anddemographic characteristics, indications justifying restraint and qualityof restraint documentation. Patients were identified from computerizedES and security service records. The data were supplemented byexamination of patients' medical records.Results: In 2009, according to the security service, 390 patients (1%)were physically restrained in the ES. The ES computerized systemidentified only 196 patients. Most patients were male (62%). The medianage was 40 years (15-98 years; P90 = 80 years). 63 % of the situationsoccurred between 18h00 and 6h00, and most frequently on Saturday(19%). Substance or alcohol abuse was present in 48.7% of cases andacute psychiatric crisis was mentioned in 16.7%. In most cases,restraint was motivated by extreme agitation or auto / hetero-aggressiveviolence. Most patients (68 %) were restrained with upper limb andabdominal restraints. More than three anatomic restraints werenecessary in 52 % of the patients. Intervention of security guards wasrequired in 77% of the cases. 61 restraint protocols (31 %) were missingand 57% of the records were incomplete. In many cases, the protocolsdid not include the signature of the physician (22%) or of the nurse(43.8%). Medical records analysis did not allow reliable estimation ofthe number of restraint-induced complications.Conclusions: Physical restraint is most often motivated by majoragitation and/or secondary to substance abuse. Caregivers regularlycall security guards for help. Restraint documentation is often missing orincomplete, requiring major improvement in education and prescription.

Imported Cattle and other Livestock, September 2010

The Imported and other Livestock report monthly by the Department of Agricultural.

Imported Cattle and other Livestock, October 2010

The Imported and other Livestock report monthly by the Department of Agricultural.