Effect of production system and geographic location on milk quality parameters

A main reason for the rapid increase in organic food consumption is the perception that organic foods have a superior nutritional composition and/or convey health benefits. However, there is currently limited scientific knowledge about the effect of production systems on food composition. The study reported here compared fatty acid profiles and levels of fat soluble antioxidants in milk from organic and conventional production systems in 5 geographic regions in Europe (Wales, England, Denmark, Sweden and Italy). Levels of nutritionally desirable mono- and poly-unsaturated fatty acids (vaccenic acid, CLA, α-linolenic acid) and/or a range of fat soluble antioxidants were found to be significantly higher in organic milk

A systematic review on biomonitoring of individuals living near or working at solid waste incinerator plants

Background: Solid waste incinerators (SWI) emit several pollutants among which polychlorodibenzodioxins and furans (PCDD/Fs), polychlorobiphenyls, metals, monocyclic and polycyclic aromatic hydrocarbons (PAHs). Aim of the study: To present a systematic review of peer-reviewed literature on human biological monitoring of exposure and effect following potential exposure to SWI pollutants to bring together evidences and to highlight strengths and deficiencies of the studies conducted so far. Methods: Relevant studies on biomonitoring of individuals living near or working at SWIs were selected through three steps: (1) a literature search in the Medline, CAplus, and Embase database; (2) the retrieved abstracts were screened by four independent reviewers; (3) the full text of the relevant papers was read, papers were pooled in studies, and then analyzed to highlight strengths and weaknesses. Studies with the strongest epidemiological design and/or the largest sample size were identified as reference studies. Results: One hundred and thirty-two papers, pooled in 82 studies, were included in the review: 67 on general population, 52 on SWI workers, and 14 on both groups. The most frequently investigated biomarkers were PCDD/Fs in plasma (87). Several studies presented limitations, such as a small samples size, scarce information on confounders, and a poor statistical analysis. Some earlier studies showed an increase of PCDD/Fs, lead, and PAHs in individuals (mainly workers) exposed to emissions from old SWIs; studies from the year 2000 showed no increase of biomarkers or biomarkers within the range of the general population; decreasing trends were observed in prospective studies. Conclusions: Most studies presented methodological pitfalls; reference studies showed no or a limited evidence of the impact of SWI on exposure and effect biomarkers

Consultation interdisciplinaire des variations du développement sexuel au CHUV

Contexte : La prise en charge des personnes présentant une variation du développement sexuel (VDS) est très complexe et nécessite une équipe de professionnels formés et sensibilisés à cette thématique, étant donnés l’impact et les enjeux éthiques que les décisions médicales peuvent avoir sur la vie de ces personnes. Le CHUV a mis en place depuis quelques années, une équipe interdisciplinaire qui agit selon les principes contenus dans les recommandations du Comité National d’Ethique éditées en 2012, proposant des pratiques moins agressives et plus attentives aux besoins du patient par rapport à celles du passé. Ce projet a débuté en 2010, grâce à la création du premier cours à option interdisciplinaire sur les VDS, offert aux étudiants de médecine et organisé par un chirurgien pédiatre et une philosophe des sciences. L’objectif du cours était de sensibiliser les futurs médecins à la thématique, mais aussi de réunir une première fois les différents acteurs impliqués dans la prise en charge, discuter des différentes approches et coordonner ainsi leurs actions. L’équipe, à présent formée par des spécialistes en endocrinologie pédiatrique, chirurgie pédiatrique, pédopsychiatrie, génétique, médecine foetale, néonatologie, radiologie, ainsi que par un éthicien et un juriste reste pourtant encore incomplète pour le moment et nécessite d’un ultérieur développement dans le futur. L’objectif de ce travail est donc de contextualiser la prise en charge actuelle dans son parcours historique jusqu’à aujourd’hui et d’évaluer la consultation multidisciplinaire actuelle, par rapport aux guidelines et aux équipes d’autres centres universitaires suisses, afin d’offrir un guide pour perfectionner l’équipe existante. Méthode • Revue de littérature systématique sur livres, articles, sites internet et cours à option pour les étudiants en 3ème année de médecine. • Recherche qualitative basée sur des entretiens semi-dirigés avec 3 échantillons raisonnés : 1. Personnel impliqué actuellement dans l’équipe multidisciplinaire au CHUV et possibles futurs acteurs concernés. 2. Un à deux professionnels de santé par centre hospitalier universitaire suisse, faisant partie de l’équipe de prise en charge des VDS et pouvant décrire les pratiques adoptées dans leur hôpital, ainsi que les acteurs impliqués. 3. 5-10 patients du CHUV présentant une VDS ou leurs parents acceptant de s’exprimer à propos des besoins ressentis par rapport à l’équipe de prise en charge. Résultats : Un état des lieux de l’équipe actuelle, de la prise en charge périnatale, pendant l’enfance et lors de la transition a été réalisé par le moyen d’entretiens, permettant d’en apprécier les points forts et les points faibles, aussi en rapport à d’autres centres universitaires suisses et d’en tirer des propositions futures. Conclusion : La prise en charge actuelle au CHUV adhère aux dernières guidelines européennes, mais des projets futurs pour la formation du personnel périnatal, de transition, pour une meilleure organisation des consultations et du team seraient à envisager, parallèlement à une meilleure coordination entre centres universitaires

Deterministic spin models with a glassy phase transition

We consider the infinite-range deterministic spin models with Hamiltonian $H=\sum_{i,j=1}^N J_{i,j}\sigma_i\sigma_j$, where $J$ is the quantization of a chaotic map of the torus. The mean field (TAP) equations are derived by summing the high temperature expansion. They predict a glassy phase transition at the critical temperature $T\sim 0.8$.Comment: 8 pages, no figures, RevTex forma

Grey-Blue Regression in Melanoma In Situ—Evaluation on 111 Cases

As fibrosis and melanosis are often seen in malignant melanoma, the presence of dermoscopic signs of regression may represent a clue for the diagnosis of malignancy. Our aim was to assess the frequency and extent of 11 dermoscopic features of regression evaluating dermoscopic images of 111 melanomas in situ (MIS). Regression structures (grey-blue areas, white areas, peppering, and/or blue-whitish veil) were present in 80.1% of the lesions. Approximately 80% of the lesions showed regression of dermoscopic structures and light brown areas. Most lesions showed the presence of grey-blue areas (74.7%), whereas peppering was observable in 30.6% of MIS. Areas of fibrosis were mainly observable as structureless areas with a pinkish hue (50.4%). Based on our data, the reticular pattern of blue regression and light brown areas can be considered a significant discriminator and a reliable predictor of MIS

Autologous micro-fragmented adipose tissue for the treatment of diabetic foot minor amputations: A randomized controlled single-center clinical trial (MiFrAADiF)

Background: The diabetic foot ulcer (DFU) is one of the most prevalent complications of diabetes mellitus and often develops severe effects that can lead to amputation. A non-healing "minor" amputation often precedes a major amputation resulting in a negative impact on the function and quality of life of the patients. Stem cell-based therapies have emerged as a promising option to improve healing, and the adipose tissue is an abundant and easy to access source. The injection of autologous micro-fragmented adipose tissue at the amputation stump of a diabetic population undergoing a lower limb minor amputation was evaluated and compared with the standard care. Methods: In this randomized controlled trial with two arms (parallel assignment) and no masking, 114 patients undergoing a lower limb minor amputation were randomized to standard of care or to micro-fragmented adipose tissue injection prepared using a minimal manipulation technique (Lipogems®) in a closed system. Clinical outcomes were determined monthly up to 6 months. Primary endpoint of the study was the evaluation of the healing rate and time after the minor amputation. Secondary endpoints included the assessment of safety, feasibility, technical success, relapse rate, skin tropism, and intensity of pain. Results: At 6 months, 80% of the micro-fragmented adipose tissue-treated feet healed and 20% failed as compared with the control group where 46% healed and 54% failed (p = 0.0064). No treatment-related adverse events nor relapses were documented, and technical success was achieved in all cases. The skin tropism was improved in the treatment group, and the pain scale did not differ between the two groups. Conclusion: The results of this randomized controlled trial suggest that the local injection of autologous micro-fragmented adipose tissue is a safe and valid therapeutic option able to improve healing rate following minor amputations of irreversible DFU. The technique overcomes several stem cell therapy-related criticisms and its potential in wound care should be better evaluated and the therapeutic indications could be expanded. Trial registration: ClinicalTrials.gov number: NCT03276312. Date of registration: September 8, 2017 (retrospectively registered)

Ground states for a class of deterministic spin models with glassy behaviour

We consider the deterministic model with glassy behaviour, recently introduced by Marinari, Parisi and Ritort, with \ha\ $H=\sum_{i,j=1}^N J_{i,j}\sigma_i\sigma_j$, where $J$ is the discrete sine Fourier transform. The ground state found by these authors for $N$ odd and $2N+1$ prime is shown to become asymptotically dege\-ne\-ra\-te when $2N+1$ is a product of odd primes, and to disappear for $N$ even. This last result is based on the explicit construction of a set of eigenvectors for $J$, obtained through its formal identity with the imaginary part of the propagator of the quantized unit symplectic matrix over the $2$-torus.Comment: 15 pages, plain LaTe

Efficacy and Safety of Systemic Treatments for Psoriasis in Elderly Patients

0.12, 0.32, 1.4 and 0.5 per patient-year in the methotrexate, acitretin, cyclosporine and PUVA groups and 0.11, 0.35, 0.19, 0.3 and 0.26 in the etanercept, adalimumab, infliximab, efalizumab and ustekinumab groups. Traditional drugs were less effective than biologics in our e