Ocular involvement in idiopathic hypereosinophilic syndrome: a rare finding [Augenbeteiligung beim idiopathischen Hypereosinophilen Syndrom: ein seltener Befund]

Hypereosinophilic syndrome (HES) is a myeloproliferative disorder characterised by persistent eosinophilia associated with multiple organ damage. The three criteria required for the diagnosis of the disease are: a sustained absolute eosinophilic count in the serum greater than 1500/μl present for longer than 6 months, no aetiology for secondary eosinophilia present and identification of signs and symptoms of end-organ involvement [1][2]. Despite significant progress in our understanding of the pathogenesis of some forms of hypereosinophilic syndrome, the current state of knowledge is still insufficient to formulate a new comprehensive etiologic definition of HES [3]. Very few reports can be retrieved describing ocular involvement in HES. Retinal arteriolar occlusions were observed in the pre-equatorial region and documented by angiography in one report [4], while the principal defects noted in a second report were occlusions of major retinal vessels, choroidal infarct, and patchy or delayed choroidal filling [5]. We present a case of extensive bilateral choroidal infiltrates in a patient suffering from idiopathic hypereosinophilia, potentially attributable to her disease.

Obstetric analgesia and anesthesia in Switzerland in 2007

Introduction: The last twenty years has witnessed important changes in the field of obstetric analgesia and anesthesia. In 2007, we conducted a survey to obtain information regarding the clinical practice of obstetric anesthesia in our country. The main objective was to ascertain whether recent developments in obstetric anesthesia had been adequately implemented into current clinical practice. Methodology: A confidential questionnaire was sent to 391 identified wiss obstetric anesthetists. The questionnaire included 58 questions on 5 main topics: activity and organization of the obstetric unit, practice of labor analgesia, practice of anesthesia for caesarean section, prevention of aspiration syndrome, and pain treatment after cesarean section. Results: The response rate was 80% (311/391). 66% of the surveyed anesthetists worked in intermediate size obstetric units (500-1500 deliveries per year). An anesthetist was on site 24/24 hours in only 53% of the obstetric units. Epidural labor analgesia with low dose local anesthetics combined with opioids was used by 87% but only 30% used patient controlled epidural analgesia (PCEA). Spinal anesthesia was the first choice for elective and urgent cesarean section for 95% of the responders. Adequate prevention of aspiration syndrome was prescribed by 78%. After cesarean section, a multimodal analgesic regimen was prescribed by 74%. Conclusion: When comparing these results with those of the two previous Swiss surveys [1, 2], it clearly appears that Swiss obstetric anesthetists have progressively adapted their practice to current clinical recommendations. But this survey also revealed some insufficiencies: 1. Of the public health system: a. Insufficient number of obstetric anesthetists on site 24 hours/24. b. Lack of budget in some hospitals to purchase PCEA pumps. 2. Of individual medical practice: a. Frequent excessive dosage of hyperbaric bupivacaine during spinal anesthesia for cesarean section. b. Frequent use of cristalloid preload before spinal anesthesia for cesarean section. c. Frequent systematic use of opioids when inducing general anesthesia for cesarean section. d. Fentanyl as the first choice opioid during induction of general anesthesia for severe preeclampsia. In the future, wider and more systematic information campaigns by the mean of the Swiss Association of Obstetric Anesthesia (SAOA) should be able to correct these points.

La Filosofia Política de Maquiavel a Locke (segles XVI i XVII)

Versió Word d'una pàgina web expositiva sobre la filosofia política entre els anys 1500 i 1700.

Simulium (Chirostilbia) bifenestratum (Diptera, Simuliidae), a new black-fly species from the Atlantic forest, State of São Paulo, Brazil

The larva, pupa, male, and female of Simulium bifenestratum n. sp. are described and illustrated. The pupae of the new species have 10 gill filaments, thick at their base and arranged in a three-dimensional way, surrounding the head and thorax. Its pupal cocoon is peculiar, not found in any of the known Brazilian black-fly species; it is very thick and hard with two openings in the anterior region. S. bifenestratum n. sp. was collected in one stream in the Bocaina mountain chain, Atlantic forest, in São José do Barreiro county, state of São Paulo, in a high (1500 m) natural grassland. Larvae and pupae were collected on the edges of small waterfalls and in places with-high speed laminar water flow, attached to the bedrock.

A Report from a Local Initiative Concerning Alcohol / Drug Use Among Teenagers 1998-1999

This study was carried out by participants in a North Tipperary Community Services drug/alcohol awareness course. Its objectives were to: assess the level of drug and alcohol awareness among second-level students under the age of 18 years; to find out the extent of under-age drinking;to find out the extent of the use of illegal substances as well as stimulants such as glue and solvents in this age group; and to use this information to develop educational programmes for parents and students. Date was obtained through a survey of 1500 secondary school students in the North Tippeary area. The survey found that, although ilict drug use was very low, abuse of alcohol was quite common.This resource was contributed by The National Documentation Centre on Drug Use.

Gemcitabine, oxaliplatin and 5-FU in advanced bile duct and gallbladder carcinoma: two parallel, multicentre phase-II trials.

BACKGROUND: Gemcitabine, oxaliplatin and 5-fluorouracil (5-FU) are active in biliary tract cancer and have a potentially synergistic mode of action and non-overlapping toxicity. The objective of these trials was to determine response, survival and toxicity separately in patients with bile duct cancer (BDC) and gallbladder cancer (GBC) treated with gemcitabine/oxaliplatin/5-FU chemotherapy. METHODS: Eligible patients with histologically proven, advanced or metastatic BDC (n=37) or GBC (n=35) were treated with gemcitabine (900 mg m(-2) over 30 min), oxaliplatin (65 mg m(-2)) and 5-FU (1500 mg m(-2) over 24 h) on days 1 and 8 of a 21-day cycle. Tumour response was the primary outcome measure. RESULTS: Response rates were 19% (95% CI: 6-32%) and 23% (95% CI: 9-37%) for BDC and GBC, respectively. Median survivals were 10.0 months (95% CI: 8.6-12.4) and 9.9 months (95% CI: 7.5-12.2) for BDC and GBC, respectively, and 1- and 2-year survival rates were 40 and 23% in BDC and 34 and 6% in GBC (intention-to-treat analysis). Major grade III and IV adverse events were neutropenia, thrombocytopenia, elevated bilirubin and anorexia. CONCLUSION: Triple-drug chemotherapy achieves comparable results for response and survival to previously reported regimens, but with more toxicity.

Seroepidemiology of Herpes Simplex virus type 1 and 2 in Western and Southern Switzerland in adults aged 25-74 in 1992-93: a population-based study.

BACKGROUND: Genital herpes is one of the most prevalent sexually-transmitted diseases, and accounts for a substantial morbidity. Genital herpes puts newborns at risk for very severe disease and also increases the risk of horizontal HIV transmission. It thus stands as an important public health problem. The recent availability of type-specific gG-based assays detecting IgG against HSV-1 and HSV-2 allows to establish the prevalence of each subtype. Worldwide, few data have been published regarding the seroprevalence in general populations of HSV-2, the major causative agent for genital herpes, while no data exist regarding the Swiss population. METHODS: To evaluate the prevalence of IgG antibodies against HSV-1 and HSV-2 in Switzerland, we used a population-based serum repository from a health examination survey conducted in the Western and Southern area of Switzerland in 1992-93. A total of 3,120 sera were analysed by type-specific gG-based ELISA and seroprevalence was correlated with available volunteers characteristics by logistic regression. RESULTS: Overall, seroprevalence rates were 80.0 +/- 0.9% (SE, 95% CI: 78.1-81.8) for HSV-1 and 19.3 +/- 0.9% (SE, 95% CI: 17.6-21.1) for HSV-2 in adults 35-64 year old. HSV-1 and HSV-2 seroprevalence increased with age, with a peak HSV-2 seroprevalence in elderly gentlemen, possibly a seroarcheological evidence of sexually transmitted disease epidemics during World War II. Risk factors for HSV-2 infection included female sex, marital status other than married, and size of town of residence larger than 1500 inhabitants. Unexpectedly and conversely to HSV-1, HSV-2 seroprevalence increased with educational level. HSV-2 infection was less prevalent among HSV-1 infected individuals when compared to HSV-1 uninfected individuals. This effect was most apparent among women at high risk for HSV-2 infection. CONCLUSIONS: Our data demonstrate that by the early nineties, HSV-2 had spread quite largely in the Swiss population. However, the epidemiology of HSV-2 in Switzerland presents paradoxical characteristics, e.g. positive correlation with education level, that have not been observed elsewhere.

Effective exposure to solar UV in building workers: influence of local and individual factors.

Excessive exposure to solar UV light is the main cause of skin cancers in humans. UV exposure depends on environmental as well as individual factors related to activity. Although outdoor occupational activities contribute significantly to the individual dose received, data on effective exposure are scarce and limited to a few occupations. A study was undertaken in order to assess effective short-term exposure among building workers and characterize the influence of individual and local factors on exposure. The effective exposure of construction workers in a mountainous area in the southern part of Switzerland was investigated through short-term dosimetry (97 dosimeters). Three altitudes, of about 500, 1500 and 2500 m were considered. Individual measurements over 20 working periods were performed using Spore film dosimeters on five body locations. The postural activity of workers was concomitantly recorded and static UV measurements were also performed. Effective exposure among building workers was high and exceeded occupational recommendations, for all individuals for at least one body location. The mean daily UV dose in plain was 11.9 SED (0.0-31.3 SED), in middle mountain 21.4 SED (6.6-46.8 SED) and in high mountain 28.6 SED (0.0-91.1 SED). Measured doses between workers and anatomical locations exhibited a high variability, stressing the role of local exposure conditions and individual factors. Short-term effective exposure ranged between 0 and 200% of ambient irradiation, indicating the occurrence of intense, subacute exposures. A predictive irradiation model was developed to investigate the role of individual factors. Posture and orientation were found to account for at least 38% of the total variance of relative individual exposure, and were also found to account more than altitude on the total variance of effective daily exposures. Targeted sensitization actions through professional information channels and specific prevention messages are recommended. Altitude outdoor workers should also benefit from preventive medical examination.

Spiritual Kinship, Political Mobilization and Social Cooperation: a Swiss Alpine valley in the Eighteenth and Nineteenth Centuries

In this chapter I will present some observations and results about Ritual Kinship and political mobilization of popular groups in an Alpine valley: the Val de Bagnes, in the Swiss canton of Valais, - a mountain valley, well known today thanks to the tourist station of Verbier - where we can rely on excellent sources about local families. This region presents a particular political situation, because the 11 major villages of the valley form only one commune, which includes the whole valley.¦There are two major reasons to choose the Val de Bagnes for our inquiry on kinship and social networks in a rural society:¦A. The existence of sharp political and social conflicts during the 18th and the 19th centuries;¦B. The existence of almost systematic genealogical data between 1700 and 1900. (Casanova, Gard, Perrenoud 2005-08)¦The 18th century was characterized by the struggle of an important part of the community of Bagnes against the feudal lord, the abbot of St-Maurice. The culminating point was a local upheaval in 1745 in Le Châble, during which the abbot was forced to sign several documents in accordance with the wishes of the rebels (Guzzi-Heeb 2007). In the 19th century feudal lordship was abolished, but now the struggle confronted a liberal-radical faction and the conservative majority in the commune.¦The starting point of my presentation focuses on this question: which role did spiritual kinship play in the political mobilization of popular groups and in the organization of competing factions? This question allows us to shed light on some utilizations and meanings of spiritual kinship in the local society. Was spiritual kinship a significant instrument for economic cooperation? Or was it a channel for privileged social contacts and transactions?

Participle Preposing and Other Related Phenomena in Old Spanish and Old Catalan

El participi i altres fenòmens relacionats en el Castellà i el Català antic

Análisis discursivo de ser y estar: aspectos de la periodización de sus usos y valores

En esta comunicación se presentan los resultados de un trabajo en curso cuyo objetivo es profundizar en la explicación de la naturaleza del cambio lingüístico que comporta la progresiva sustitución de ser por estar en castellano medieval y en la periodización de este cambio. La comunicación se organiza en cuatro apartados. El primero expone los aspectos generales del comportamiento de ser y estar en oraciones atributivas, pasivas resultativas y construcciones locativas. El segundo se centra en la descripción de la distribución de estos verbos en el Cantar de Myo Çid, obra en la que estar se atestigua únicamente en construcciones locativas. En el tercer apartado se examinan los datos del Calila e Dimna, los cuales ponen de manifiesto el avance de estar en detrimento de ser en oraciones atributivas cuyo predicado expresa estado, en algunas pasivas resultativas y en construcciones locativas. El último apartado presenta una propuesta de análisis en la línea de Roberts y Roussou (1999, 2002 y 2003) que es perfectamente compatible con las propuestas pragmáticas en la línea de la Teoría de la Relevancia

Pronoms àtons i tònics en funció d’objecte a les estructures de doblament de clític del català antic

En aquest treball descriurem algunes de les estructures que integren pronoms tònics en funció d’objecte directe o d’objecte indirecte i examinarem les dades relatives a les configuracions de doblament de clític i de pronom tònic aïllat en català antic. L’apartat 2 presenta la identificació i descripció de les dades que estudiarem, les quals han estat extretes del Corpus del Català Antic constituït sota el projecte Vers una Sintaxi Històrica del Català. A l’apartat 3 s’examina la freqüència de les estructures esmentades i les dues seccions següents se centren en l’estudi de la forma ell en contrast amb a ell. A 6 s’ofereix una explicació general de la posició que ocupen els pronoms tònics dins la frase i a 7 es fa una comparació de les dades del català antic amb les del portuguès antic. Finalment, a 8 se citen els resultats d’aquest estudi preliminar

L'expressió de la conseqüència en català antic: les consecutives d’intensitat - manera

Tradicionalment els gramàtics hem agrupat sota el rètol d’oracions consecutives estructures molt diverses que tenen en comú el fet que la segona de les dues proposicions relacionades expressa la conseqüència del que es diu a la primera. Dins d’aquestes estructures s’han distingit dos grans grups. D’una banda, les anomenades consecutives paratàctiques o il·latives, on la relació lògica establerta entre les dues proposicions té caràcter asindètic o bé es codifica mitjançant un marcador discursiu i, de l’altra, les consecutives subordinades, on la proposició que expressa la conseqüència s’introdueix a través de nexos subordinants. En aquest article volem tractar l’evolució d’un tipus d’oracions consecutives subordinades, les anomenades consecutives d’intensitat-manera que il·lustrem amb els exemples de català medieval

Los nexos causales y finales en el Curial e Güelfa: descripción de una sincronía histórica

En este estudio se examinan las estructuras que expresan causa yfinalidad en el Curial e Güelfa. El estudio cuantitativo de los nexossimples y compuestos evidencia que el autor sigue un modelo retóricoacotado por la tradición de la scripta medieval catalana. A diferenciade los primeros textos, la lengua del Curial es una prosa trabada,alejada de la oralidad, en la que los nexos no suelen ser ambiguos y,por tanto, no se precisan inferencias pragmáticas para interpretar lasrelaciones lógicas existentes entre las proposiciones

Foco oracional y polaridad: en torno a una asimetría entre el español y el catalán

En aquest estudi s’examina la perifèria esquerra del català antic en comparació amb la del castellà antic, i es descriuen les diferències més rellevants