Effect of vitamin D3 supplementation on Staphylococcus aureus nasal carriage: a randomized, double-blind, placebo-controlled trial in healthy adults

AbstractObservational studies have reported an inverse association between serum 25-hydroxyvitamin D (25OHD) concentrations and Staphylococcus aureus nasal carriage; however, clinical trials of vitamin D supplementation are lacking. To assess the effect of vitamin D3 supplementation on persistent S. aureus nasal carriage we conducted a randomized, double-blind, placebo-controlled trial among 322 healthy adults. Participants were given an oral dose of either 200 000 IU vitamin D3 for each of 2 months, followed by 100 000 IU monthly or placebo in an identical dosing regimen, for a total of 18 months. Nasal swabs for S. aureus culture and serum for 25OHD measurement were obtained at baseline, 6, 12 and 18 months of study. The mean baseline concentration of 25OHD was 72 nM (SD 22 nM). Vitamin D3 supplementation increased 25OHD levels which were maintained at >120 nM throughout the study. Nasal colonization by S. aureus was found in 31% of participants at baseline. Persistent carriage, defined as those that had positive S. aureus nasal cultures for all post-baseline swabs, occurred in 20% of the participants but vitamin D3 supplementation was not associated with a reduction in persistent carriage (OR = 1.39, 95% CI 0.63–3.06). Risk factor analysis showed that only gender was significantly associated with carriage, where women were less likely to be carriers than men (relative risk 0.83, 95% CI 0.54–0.99). Serum 25OHD concentrations were not associated with the risk of carriage. In conclusion, monthly administration of 100 000 IU of vitamin D3 did not reduce persistent S. aureus nasal carriage

State of Emergency Medicine in Switzerland: a national profile of emergency departments in 2006

BACKGROUND: Emergency departments (EDs) are an essential component of any developed health care system. There is, however, no national description of EDs in Switzerland. Our objective was to establish the number and location of EDs, patient visits and flow, medical staff and organization, and capabilities in 2006, as a benchmark before emergency medicine became a subspecialty in Switzerland. METHODS: In 2007, we started to create an inventory of all hospital-based EDs with a preliminary list from the Swiss Society of Emergency and Rescue Medicine that was improved with input from ED physicians nationwide. EDs were eligible if they offered acute care 24 h per day, 7 days per week. Our goal was to have 2006 data from at least 80% of all EDs. The survey was initiated in 2007 and the 80% threshold reached in 2012. RESULTS: In 2006, Switzerland had a total of 138 hospital-based EDs. The number of ED visits was 1.475 million visits or 20 visits per 100 inhabitants. The median number of visits was 8,806 per year; 25% of EDs admitted 5,000 patients or less, 31% 5,001-10,000 patients, 26% 10,001-20,000 patients, and 17% >20,000 patients per year. Crowding was reported by 84% of EDs with >20,000 visits/year. Residents with limited experience provided care for 77% of visits. Imaging was not immediately available for all patients: standard X-ray within 15 min (70%), non-contrast head CT scan within 15 min (38%), and focused sonography for trauma (70%); 67% of EDs had an intensive care unit within the hospital, and 87% had an operating room always available. CONCLUSIONS: Swiss EDs were significant providers of health care in 2006. Crowding, physicians with limited experience, and the heterogeneity of emergency care capabilities were likely threats to the ubiquitous and consistent delivery of quality emergency care, particularly for time-sensitive conditions. Our survey establishes a benchmark to better understand future improvements in Swiss emergency care

Extracellular enzyme activities in tropical soils are driven by seasonal litter input

Background It is relatively unknown if and how seasonal fluctuations of tropical microbial activity affect soil nutrient availability. In tropical forests, nutrient economics are often considered to be centered around phosphorus, which might be a limiting factor to sustain crucial ecosystem processes, such as primary production and decomposition of organic material, thus in turn affecting microbial processes and associated nutrient dynamics of the forest ecosystem. Aims We investigate seasonal fluctuations in extracellular hydrolytic soil enzyme activities and soil nutrients and its relationship with precipitation and litterfall input, in a lowland tropical forest in the Central Amazon region. Methods We analyzed data obtained from monitoring microbial enzyme activity and nutrient dynamics in litter and soil and use stoichiometric enzyme theory and proportional vectors for assessing relative nutrient limitation throughout a year. Results Our results show that precipitation seasonality was driving leaf litterfall, which was subsequently synchronized with extracellular enzyme activities in soil, such that both litterfall and enzyme activities peaked during the dry season. Conclusions Our study indicates that soil extractable nutrient concentrations were positively related to microbial enzyme activities, which thus highlights the importance of soil microbial processes for nutrient cycling in this phosphorus limited ecosystem. Our results suggest that projected shifts in climate seasonality that result in longer and more pronounced dry seasons, might desynchronize seasonal patterns of aboveground nutrient input and belowground microbial activity, and thus leading to a decoupling of nutrient cycling in tropical forest ecosystems

Produção da cenoura e efeito na fertilidade do solo e nutrição decorrente da solarização do solo para controle da tiririca.

Dentre os desafios do cultivo orgânico de hortaliças destaca-se o controle de plantas daninhas, devido à proibição do uso de herbicidas. Entre as invasoras, a tiririca (Cyperus rotundus L.) é de difícil controle pela sua alta competitividade. A solarização é uma alternativa para desinfestação do solo, a qual consiste em cobri-lo com plástico transparente, com bons resultados no controle da tiririca. A fim de avaliar a influência do preparo e do revolvimento do solo sobre a eficiência da solarização no controle da tiririca, bem como seu posterior efeito sobre o cultivo da cenoura, foi realizado um experimento na Fazendinha Agroecológica, em Seropédica (RJ). O experimento foi disposto em blocos ao acaso com três repetições, em arranjo fatorial 2 x 3 mais uma testemunha adicional, sendo: 1) solo solarizado, preparado (com grade aradora) e revolvido 30 dias após a solarização (manualmente com auxílio de uma enxada); 2) solo solarizado, preparado e revolvido aos 60 dias; 3) solo solarizado, preparado e não revolvido; 4) solo solarizado, não preparado e revolvido aos 30 dias; 5) solo solarizado, não preparado e revolvido aos 60 dias; 6) solo solarizado, não preparado e não revolvido; solo não solarizado, não preparado e não revolvido (testemunha). A solarização iniciou-se em 29/1/2002, e durou cem dias. A solarização reduziu em 86% a infestação de tiririca no cultivo da cenoura. Até 10 cm de profundidade, a temperatura do solo foi superior nas parcelas solarizadas, porém a 5 cm, a solarização foi mais eficiente quando associada ao preparo do solo, não havendo efeito do revolvimento. A solarização aumentou os valores da biomassa microbiana e dos teores de Ca, Mg e P do solo. O desenvolvimento da cenoura foi influenciado pela solarização que resultou em maior produtividade