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PubMed2001

Preservation of products with MCI/MI in Switzerland.

Preservation of products with the combination of 5-chloro-2-methyl-4-isothiazolinone (methylchloroisothiazolinone, MCI) and 2-methyl-4-isothiazolinone (methylisothiazolinone, MI), commercialized as Kathon CG or WT, is widely used. Allergic contact dermatitis reactions to the preservative have been described in many publications of epidemiological studies. In addition, a number of allergic, airborne reactions to MCI/MI were observed in recent years. The aim of the presented study was: (i) to compare epidemiological data of MCI/MI with data of other preservatives; (ii) to estimate the possible exposure to MCI/MI from commercial products and the distribution of MCI/MI in chemical products based on a product evaluation of the chemical product register of the Swiss Federal Office of Public Health; (iii) to estimate the exposure to MCI/MI, volatile organic chemicals (VOC) and glycols from freshly painted walls; (iv) to compare the contact allergenic potential of MCI/MI with other preservatives. It was found that the number of registered chemical products, unambiguously identifiable as containing MCI increased from 3644 products in July 1999 to 4843 products in April 2001 in Switzerland. It is estimated that today, the total number of chemical products preserved with MCI/MI on the Swiss market is about 6000. A further increase is to be expected. The contact allergenic potential of MCI/MI seems to be higher than for other preservatives. Measurements of MCI/MI concentrations in air samples of freshly painted rooms have shown that the concentration of MCI/MI in the air a few days after painting may be high enough to elicit airborne reactions in already-sensitized patients. In a single case, reactions to MCI/MI were observed over months after wall painting. In this case, both wall paint and plaster contained MCI (40 and 46 ppm). Volatile organic chemicals (VOC) may also be relevant for the elicitation of airborne reactions. In 1/3 of the measurements, the VOC concentrations measured within 14 days after painting were in a range within which sensory irritation and discomfort may be induced. Declaration of MCI/MI-containing products, replacement of MCI/MI by alternative preservatives or the separate use of preservatives in industrial products and in cosmetics might reduce the risk of airborne reactions.

Air Pollution, Indoor↗
PubMed2002

Knowledge and prevention of dental trauma in team handball in Switzerland and Germany.

The aim of this work was to conduct a comparative study between Switzerland and Germany about the frequency of dental injuries in handball, athletes' habits of wearing mouthguard, as well as the general level of information about first emergency measures after a dental trauma and the resulting consequences for athletes and their coaches alike. For this, using interviews, seven handball teams each in two countries (Switzerland/Germany) belonging to the amateur and semiprofessional leagues were surveyed. A total of 112 individuals, 28 females and 84 males, were interviewed. Thirty-two of the 112 interviewees have once observed a dental injury; 12 have experienced a dental injury themselves. Only 10 individuals wore a mouthguard. The results show that the area of handball still requires more information and education.

Adult↗
PubMed1991

Morphologic analysis of digestive cancers from the registry of Vaud, Switzerland.

Detailed data and statistics per each morphological site of various digestive neoplasms were obtained for the period 1976-87 from the Vaud Cancer Registry datafile, a population-based cancer registration scheme covering about 530,000 inhabitants from the French-speaking part of Switzerland. Tabulations presented include absolute number of cases (1,041 oral and pharyngeal, 545 oesophageal, 1,131 gastric, 83 small intestine, 1,980 colon, 1,267 rectal, 357 liver, 328 gallbladder and 725 pancreatic cancers), percent distributions, age-standardised rates, sex ratios and 5-year survival. The report has essentially a descriptive value, and should be viewed as a contribution towards quantification, in a well surveilled population of the West-central part of Europe, of the proportional distribution of digestive neoplasms by morphological type, and corresponding incidence and survival rates. Among the points deserving specific attention, there are the elevated frequency of upper digestive tract cancers, the very high male-to-female ratios for squamous cell carcinomas, adenocarcinomas of the oesophagus and hepatocellular carcinomas of the liver, the female excesses in infiltrating carcinoids of the colon, transitional and squamous cell carcinomas of the rectum and adenocarcinomas of the gallbladder, and the crossover in male-to-female ratio in squamous cell carcinoma along the digestive tract (i.e. from 6.0 at the level of the mouth/pharynx to 0.5 in the rectum). As concerns survival, rates were higher for lymphomas and sarcomas than for carcinomas in oral cavity and stomach, similar for carcinoids and carcinomas in the small bowel (about 35% at 5 years), as well as for colon (34%) and rectal (37%) cancers. Some of the findings, such as the higher survival of carcinomas arising from polyps in the colon and rectum, or the higher proportion of cholangiocellular and combined cholangio- and hepatocellular carcinomas in females than in males find plausible prognostic or aetiologic correlates, but others, such as the large proportions of squamous and transitional cell cancers of the rectum in females are more difficult to explain. These and several other indications emerging from careful examination of the data herein presented underline the interest of morphological analyses of digestive tract cancers.

Adult↗
PubMed2006

Converging prevalences of obesity across educational groups in Switzerland.

OBJECTIVE: To assess whether the rapid increase in obesity prevalence among persons with higher education levels observed in one U.S. study is also observed in a European adult population. RESEARCH METHODS AND PROCEDURES: This study involved continuous surveillance of the adult population of Geneva, Switzerland (1993 to 2004), with annual random, independent, cross-sectional, representative samples (6635 men and 6558 women, ages 35 to 74 years) and analysis of 12-year trends in obesity prevalence across educational level subgroups. RESULTS: Obesity prevalence in men had an upward trend in the medium education subgroup (p < 0.02), a borderline upward trend in the high education subgroup (p < 0.08), but no trend in the low education subgroup. There was a borderline trend interaction between the male low and medium education subgroups (p < 0.09). Obesity prevalence in women had a borderline increase in the low education subgroup (p < 0.08), an almost borderline increase in the high education subgroup (p = 0.11), but no significant trend in the medium education subgroup. There was no evidence of trend interaction between the female education groups. DISCUSSION: In Geneva, as in the United States, the inverse association between education level and obesity rates has weakened over time among men, but, inconsistent with the U.S. findings, has persisted for women. Explanations may include more physically demanding occupations for men with low education levels and different attitudes toward body image between the sexes.

Adult↗
PubMed2006

Impact of high-resolution matching in allogeneic unrelated donor stem cell transplantation in Switzerland.

It is currently unknown what degree of human leukocyte antigen (HLA)-mismatching is acceptable in unrelated donor hematopoietic stem cell transplantation (UD-HSCT). Mismatches at some loci may be more permissive than others. We have analyzed the effect of high-resolution HLA-matching on outcome of all 214 consecutive recipients of UD-HSCT carried out in Switzerland. All typing was by the Swiss reference laboratory. Donor-recipient pairs were HLA-10/10 matched (n=130) or mismatched for either HLA-A/-B/-DRB1/multiple loci (n=33; (HLA-A/-B=10); (-DRB1=8); (multiple=15)); HLA-C (n=29) or HLA-DQ/-DRB3 (n=22; (DQ=16); (-DRB1=6)). The median follow-up was 32 months. Survival probabilities (+/-95% confidence interval) at 3 years were 57 (+/-10)% for recipients of HLA 10/10-matched transplants, 53 (+/-22)% for recipients of HLA-DQ/-DRB3-mismatched transplants, 44 (+/-20)% for recipients of HLA-C-mismatched transplants and 0% for recipients of transplants mismatched at HLA-A/-B/-DRB1/multiple loci (P<0.0001). In multivariate analyses, HLA compatibility was the variable most significantly associated with survival and treatment-related mortality. We found important differences in survival in recipients of UD-HSCT with best results for transplants from 10/10 matched donors. Single mismatches at HLA-DQ/-DRB3 were well tolerated, mismatches at HLA-C had intermediate results and mismatches at HLA-A/-B/-DRB1/multiple loci resulted in poor survival.

Adolescent↗
PubMed2000

Food habits and sport activity during adolescence: differences between athletic and non-athletic teenagers in Switzerland.

OBJECTIVE: To describe food habits and dietary intakes of athletic and non-athletic adolescents in Switzerland. SETTING: College, high schools and professional centers in the Swiss canton of Vaud. METHOD: A total of 3,540 subjects aged 9-19 y answered a self-reported anonymous questionnaire to assess lifestyles, physical plus sports activity and food habits. Within this sample, a subgroup of 246 subjects aged 11-15 also participated in an in-depth ancillary study including a 3 day dietary record completed by an interview with a dietician. RESULTS: More boys than girls reported engaging in regular sports activities (P<0.001). Adolescent food habits are quite traditional: up to 15 y, most of the respondents have a breakfast and eat at least two hot meals a day, the percentages decreasing thereafter. Snacking is widespread among adolescents (60-80% in the morning, 80-90% in the afternoon). Food habits among athletic adolescents are healthier and also are perceived as such in a higher proportion. Among athletic adolescents, consumption frequency is higher for dairy products and ready to eat (RTE) cereals, for fruit, fruit juices and salad (P<0.05 at least). Thus the athletic adolescent's food brings more micronutrients than the diet of their non-athletic counterparts. Within the subgroup (ancillary study), mean energy intake corresponds to requirements for age/gender group. CONCLUSIONS: Athletic adolescents display healthier food habits than non-athletic adolescents: this result supports the idea that healthy behavior tends to cluster and suggests that prevention programs among this age group should target simultaneously both sports activity and food habits.

Adolescent↗
PubMed2005

Orlistat in responding obese type 2 diabetic patients: meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland.

OBJECTIVE: The aim of this study is to review the clinical and economic rationale for the reimbursement of orlistat in responding obese patients with type 2 diabetes. METHODS: Data from seven randomized controlled clinical trials of orlistat in overweight and obese patients with type 2 diabetes were pooled. A subgroup analysis involving patients who achieved a response (defined as a weight loss of >/=5% after 12 weeks of treatment) was conducted. The outcomes of the pooled analysis were then used to construct a Markov health economic model covering an 11-y period. The incidences of diabetes-related micro- and macrovascular complications were derived from the United Kingdom Prospective Diabetes Study. The effects of changes in body mass index, and the impact of micro- and macrovascular complications on utilities were derived from published sources. Publicly available cost data were used and are presented here in 2001 Euros. Discounting of 3% was applied. A probabilistic sensitivity analysis was conducted to examine the robustness of results. RESULTS: A total of 1249 patients treated with orlistat and 1230 given placebo were eligible for the intent-to-treat analysis. At the end of the study period, 23% of orlistat patients achieved a weight reduction of >/=5%. These patients showed a mean decrease in HbA1C of 1.16%, a weight reduction of 8.6 kg, a reduction in total cholesterol of 5.3% and a reduction in systolic blood pressure of 5.2 mmHg. The base-case economic analysis revealed costs per quality-adjusted life year gained of euro14 000 in Sweden and euro13 600 in Switzerland. CONCLUSION: The data presented here support the utilization and reimbursement of orlistat in overweight and obese diabetic patients who respond to the treatment.

Anti-Obesity Agents↗
PubMed1996

Alcohol consumption in Switzerland 1987-93: adjusting for differential effect of assessment techniques on the analysis of trends.

Estimation of time trends in alcohol consumption for recent years in Switzerland is complicated by the fact that the assessment method was changed from personal interview to self-administered questionnaire. With a large-scale study which compared the two methods, it is possible in estimating time trends to allow for adjustment of the effects produced by this change of assessment method. Results indicate that alcohol consumption decreased by about 17% between 1987 and 1993. This decrease was observed uniformly for both genders and all age-groups, which supports the basic assumptions of Skog's revised theory of Ledermann (1985). Personal interviews resulted in considerably higher reported alcohol consumption (+22%) than written questionnaires.

Adolescent↗
PubMed1998

Comparison of the opinion of students and teachers concerning medical education programmes in Switzerland.

Three medical schools in Switzerland (Geneva, Lausanne and Bern) have recently started to implement a problem-based learning community-oriented reform. It seemed worthwhile to attempt to identify the opinion of those who would be concerned (teachers and students) before any changes were made. Data were collected through interviews and questionnaires on the seven following themes: (i) community-oriented education; (ii) professional profile; (iii) learner-centred education; (iv) teachers' educational competence; (v) coveritis; (vi) problem-based learning; and (vii) programme evaluation. The opinions of teachers and students were also compared with the position taken by specialists in medical education. The aim of this article was to present the key finding of this complex research. Interested readers are invited to refer to the full report.

Attitude↗
PubMed2000

Support and faculty mentoring programmes for medical students in Germany, Switzerland and Austria.

OBJECTIVES: To study what is being done at German-speaking universities regarding the counselling and tutoring of students, we carried out a survey among the deans of medical faculties in Germany, Austria and Switzerland. Our main concern was if any such projects were already available to the medical student or whether efforts to this purpose were under way. DESIGN: We focused in particular on faculty mentoring programmes, a continuous tutoring by designated members of the faculty on a person-to-person basis. SETTING: German, Austrian and Swiss medical faculties. SUBJECTS: Medical faculty deans. RESULTS: The return rate was 80%. While general student counselling is, if required, available at nearly all of the faculties, faculty mentoring programmes are offered by only 36.1% of the medical schools, and individualized career counselling by 30.6%. CONCLUSIONS: Compared to other countries, such as the United Kingdom or the United States, counselling and tutoring programmes, e.g. career planning or faculty mentoring, are not generally available to the German medical student. Regional differences are evident, which can be attributed to differences in the universities' legal and financial situation. The medical faculties at German-speaking universities should make it their priority to offer these services to the student on a permanent basis.

Austria↗
PubMed2003

Molecular characterization of endolithic cyanobacteria inhabiting exposed dolomite in central Switzerland.

The phototrophic microbial community inhabiting exposed dolomite in the alpine Piora Valley (Switzerland) forms a distinct endolithic bilayer that features adjacent red dolomite (exterior) and green dolomite (interior) layers that are c. 0.5-1 mm below the rock surface. Characterization of the community, with an emphasis on cyanobacteria, was conducted with culture-dependent and -independent approaches. Direct microscopy of green dolomite revealed four distinct morphotypes consistent with Chlorophyta genera Chlorella and Stichococcus and the Cyanobacterial genera Nostoc and Calothrix, whereas only Stichococcus and Nostoc were observed in the red dolomite. Enrichment in BG-11 media resulted in the growth of Chlorella and Stichococcus. Denaturing gradient gel electrophoresis (DGGE) analysis of DNA extracted from the enrichment revealed two dominant phylotypes with sequence similarity to Chlorella osrokiniana chloroplast and the cyanobacteria genus Leptolyngbya. 16S rRNA gene-based DGGE analysis of DNA extracted directly from both layers indicated that although both layers harboured phylotypes most similar to the Cyanobacterial genera Nostoc, Chroococcidiopsis, and Microcoleus, and the Chlorophyte Stichococcus bacillaris, the two layers also harboured unique genera such as Scytonema, and Symploca (red, external layer of dolomite) and Chlorella (green, internal layer of dolomite). The unique community structure of each layer suggests a selection process directed by the pressures of the endolithic environment. We conclude that the overall composition of the phototrophic community closely resembles that of endolithic communities located in extreme habitats, suggesting that a cosmopolitan community inhabits this defined niche.

Calcium Carbonate↗
PubMed2002

Molecular epidemiology of predominant clones and sporadic strains of methicillin resistant Staphylococcus aureus in Switzerland and comparison with European epidemic clones.

OBJECTIVE: To assess the molecular epidemiology and risk factors of predominant clones and sporadic strains of methicillin-resistant Staphylococcus aureus (MRSA) in Swiss hospitals and to compare them with European strains of epidemic clones. MATERIAL AND METHODS: One-year national survey of MRSA cases. Analysis of epidemiological and molecular typing data (PFGE) of MRSA strains. RESULTS: In 1997, 385 cases of MRSA were recorded in the five Swiss university hospitals and in 47 community hospitals. Half of the cases were found in Geneva hospitals where MRSA was already known to be endemic. Molecular typing of 288 isolates (one per case) showed that 186 (65%) belong to four predominant clones, three of which were mostly present in Geneva hospitals. In contrast, the fourth clone (85 cases) was found in 23 hospitals (in one to 16 cases per hospital). The remaining 35% of the strains were clustered into 62 pulsed field gel electrophoresis types. They accounted for one to five patients per hospital and were defined as sporadic. Multivariate analysis revealed no independent risk factors for harboring a predominant versus a sporadic strain, except that transfer from a foreign hospital increases the risk of harboring a sporadic strain (OR, 42; 95% CI, 5-360). CONCLUSION: While cases with predominant clones were due to the local spread of these clones, most sporadic cases appear to be due to the continuous introduction of new strains into the country. With the exception of a transfer from a hospital outside Switzerland, no difference in the clinical or epidemiological characteristics was observed between patients harboring a predominant clone and those with a sporadic strain.

Anti-Bacterial Agents↗
PubMed2001

Resistance patterns of non-O157 Shiga toxin-producing Escherichia coli (STEC) strains isolated from animals, food and asymptomatic human carriers in Switzerland.

AIMS: The objective of the present study was to determine the resistance patterns of non-O157 Shiga toxin-producing Escherichia coli (STEC) strains isolated from different sources in Switzerland during the period 1997-99 as an epidemiological marker. METHODS AND RESULTS: The disk diffusion method was used to test 82 non-O157 STEC strains for susceptibility to 13 antibiotics. Ten strains were resistant to one and 20 strains to two and more antibiotics. The most frequent resistance types were streptomycin (14 strains), cephalothin (14 strains), sulfamethoxazole (14 strains) and tetracycline (14 strains). Three O100:H- STEC strains isolated from healthy slaughter pigs were resistant to eight antibiotics: streptomycin, sulfamethoxazole, trimethoprim, tetracycline, ampicillin, chloramphenicol, neomycin and gentamicin. CONCLUSION: Periodic surveillance of the antibiotic susceptibilities would be an important measure in detecting emergence and spread of resistance. SIGNIFICANCE AND IMPACT OF THE STUDY: Antibiotic susceptibility testing can be a useful tool for typing strains and should be used in combination with other phenotypic and genotypic methods.

Animals↗
PubMed2003

[Concepts in studying cost effectiveness of pediatric asthma treatment in Germany, Switzerland and Austria].

Increasing expenditures of health care systems in industrialised western countries are caused by chronic diseases. Hence, issues on the cost-effectiveness of private as well as public financial resources for asthma therapy in children are gaining importance. In order to study cost-effectiveness issues of defining outcome-measures as well as the reliability and validity of methods to assess these outcomes have to be addressed. Data on direct and indirect costs of asthma have to be gathered. In a first step, comparative costs of asthma therapy of children in Germany, Switzerland and Austria have to be analysed. Subsequently, a randomised, prospective study will be able to demonstrate, whether treatment according to national evidence-based guidelines will be more cost-effective than treatment not taking guidelines into account. Data on the cost-effectiveness of therapy guidelines will help in decision-making of national health care authorities.

Anti-Asthmatic Agents↗
PubMed1998

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland.

Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. In spring 1986, the seroprevalence was 28.1%. At the beginning of the study, 84.3% of orienteers reported a history of tick bite, and 3.8% reported a past history of Lyme borreliosis. During the first (spring 1986-autumn 1986), second (autumn 1986-spring 1987) and third (spring 1987-autumn 1987) period, rates of seroconversion were 0.6%, 2.7% and 2.1% respectively. During the first and second period, clinical incidence were 1.0% and 0.25% respectively. No active Lyme borreliosis was detected during the third period. Among orienteers who seroconverted during the study (n = 16), only two developed clinical symptoms. Hence, Borrelia burgdorferi infection is often asymptomatic.

Adult↗
PubMed2005

Echinococcus multlocularis infections of rural, residential and urban foxes (Vulpes vulpes) in the canton of Geneva, Switzerland.

We examined 267 red foxes (Vulpes vulpes) from the canton of Geneva, Switzerland, for intestinal infections with Echinococcus multilocularis. This region is situated in the core area of the endemic range of this zoonotic cestode in Central Europe. Several factors were taken into account and urbanisation level appeared to be the most explicative to describe observed differences. The prevalence decreased significantly from rural and residential areas (prevalence of 52%, CI 43-62%, and 49%, CI 38-59 %, respectively) to the urban area (prevalence of 31%, CI 19-42%). A few juvenile foxes harboured very high burdens up to more than 120,000 worms and were significantly more heavily infected than adults. The intensity of infection decreased from rural and residential areas to the city, suggesting a lower contamination of the urban environment.

Age Factors↗
PubMed2002

Acute pain management after surgery or in the emergency room in Switzerland: a comparative survey of Swiss anaesthesiologists and surgeons.

The treatment of acute pain remains unsatisfactory despite advances in pain research and the publication of numerous guidelines. The aim of this study was to survey postoperative and emergency room acute pain treatment in Switzerland, particularly regarding compliance with practice guidelines on therapeutic responsibility, treatment algorithms, pain documentation, quality control and education.A representative sample of anaesthesiologists and surgeons (general and orthopaedic) was selected from all Swiss hospitals with regular surgical activity and sent a 256 point questionnaire on acute pain management. Five hundred and seventy five doctors were contacted in 98 hospitals, 44% of doctors (covering 89% of hospitals) returned fully completed questionnaires. Half the respondents work in a hospital with an acute pain service. For postoperative pain management, only 10% of prescription is by algorithm, less than a third of respondents regularly determine pain scores, only 15% perform any statistical analysis of pain management, less than one third regularly meet to discuss management problems, and half claim not to have received-or be receiving-formal (i.e. structured/accredited) pain education. The situation is even less satisfactory for emergency room analgesia. Respondents accept the contribution of postoperative and emergency room analgesia to reduced costs and improved medical outcomes. Asked to highlight their major concerns in acute pain management, lack of education and inadequate organisation are listed in first and second positions. This survey suggests that compliance with published practice guidelines for acute pain management can be improved, and highlights the need for continuing organisational and educational development in acute analgesia, particularly for the emergency room.

Acute Disease↗