Measuring female genital mutilation/cutting in Switzerland: from indirect prevalence estimates to Swiss University Hospital data

The aim of this PhD was to evaluate the available FGM/C data in Switzerland to help improve future FGM/C monitoring and routine data collection. It is based on five interrelated studies, employing indirect, direct and routine hospital data collection methods: Firstly, an update of the national indirect estimates for women and girls living with FGM/C in Switzerland was conducted, with the use of annual estimates for 2010-2018. Secondly, based on systematic reviews and available literature on complications of FGM/C, we compiled a comprehensive list of diseases, disorders and health-related consequences of FGM/C in alignment with the International Classification of Diseases (ICD) ninth and tenth revisions. Thirdly, we gathered anonymized data from Swiss University hospitals about women and girls with a primary or secondary ICD diagnosis of FGM/C and their co-morbidities. And finally, we conducted a national exploratory cross-sectional study, assisted by the Swiss HIV Cohort (SHCS). We administered two questions on history of FGM/C and previous discussion about it with a healthcare professional during routine visits between June and December 2019 to help validate our estimates for the number of women living with FGM/C in Switzerland

The role of the Gerontologist in the fight against Ageism

O envelhecimento progressivo das sociedades é um fenómeno que tende a acentuar-se devido aos avanços científicos e à melhoria das condições de vida que permitem às pessoas viver mais. Mas se as conquistas em termos de anos de vida são, em si mesmas, positivas, a elas surge associado um conjunto de preconceitos relativos à idade. Assim, o idadismo tornou-se uma realidade presente, tanto nos discursos, como nas práticas. Os gerontólogos, como profissionais com conhecimentos teóricos e práticos sobre o envelhecimento, têm o dever ético e moral de lutar contra o idadismo. Disso se pretende dar conta neste artigo.The progressive aging of societies is an unavoidable phenomenon that tends to be accentuated due to the scientific advances and the improvement of living conditions that allow people to live longer. But if the achievements in terms of years of life are, themselves, positive, they are accompanied by a set of prejudices associated with age. Thus, ageism has become a present reality, both in speeches and in practices. Gerontologists, as professionals with theoretical and practical knowledge on aging have an ethical and moral duty to fight ageism. This is intended to be accounted for in this article

Use of a new form of protected sodium butyrate to control Salmonella infection in fattening pigs

A field trial on a commercial pig farm was carried out to assess the efficacy of the addition in the diet of fattening pigs of a new form of sodium butyrate protected with a sodium salt of coconut fatty acid distillate (3 kg/ton of feed) to control Salmonella spp. infection. Around 50 pigs were assigned to treatment group and 50 kept as controls. During the fattening period pigs were monthly sampled (serum and feces), and after slaughter fecal and mesenteric lymph nodes samples were collected. No differences in the proportion of shedders were observed between the sodium butyrate and the control groups, but a significant reduction in the number of infected pigs (61% vs. 4%; p<0.01) and in the median ELISA Optical Density percentage values (55.9% vs. 19.4%; p<0.01) at slaughter was observed in pigs under treatment compared to the controls. In addition, an overall significant association between seropositivity and Salmonella shedding and infection was detected. Results from this study add more evidences on the positive effect of butyrate on the control of pig salmonellosis

Miocardiopatia dilatada associada a infeção VIH : causas e impacto na sociedade atual : revisão

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016A patologia do miocárdio é vista como uma alteração importante quando se fala de doentes infetados pelo vírus da imunodeficiência humana. Destas, a miocardiopatia dilatada (MCD) constituiu a complicação mais prevalente da era pré-TARVc e uma das principais causas de insuficiência cardíaca congestiva. A introdução da terapêutica combinada alterou o panorama de incidência de MCD em países desenvolvidos. Contudo, é fundamental perceber que, os doentes infetados têm maior longevidade e formas assintomáticas da doença, que não podem ser descuradas. A fisiopatologia da MCD, quando causada pelo VIH, parece ser multifatorial. Pode assim resultar de um processo de ação direta do próprio vírus, ou de ação indireta através de co-infeção, autoimunidade cardíaca, ação de citocinas inflamatórias, imunodepressão, défices nutricionais ou cardiotoxicidade por fármacos. O mecanismo de lesão basal parece ser comum a todas as causas e corresponde a um processo de miocardite, que pode ser de etiologia infeciosa ou não. Esta revisão pretende elucidar sobre o impacto que a MCD tem na atualidade, tanto em países em vias de desenvolvimento como desenvolvidos, bem como esclarecer sobre o processo fisiopatológico subjacente e inquirir sobre a necessidade de medidas de rastreio ou prevenção da doença.Heart Muscle disease is now considered important when talking about patients infected with the human immunodeficiency virus. Of these, dilated cardiomyopathy (DCM) is considered the most prevalent pre-HAART complication and the major cause of congestive heart failure. Despite the introduction of this type of therapy have changed the current incidence and panorama of DCM in developed countries, the fact is that this patients also have greater longevity and asymptomatic forms of presentation, which cannot be neglected. The pathophysiology seems to be multifactorial and may be a result either of a direct action of the virus itself or of an indirect action by processes of co-infection, cardiac autoimmunity, inflammatory cytokines, immunosuppression, nutritional deficits or cardiotoxic drugs. Despite the main cause, it seems to be based on a process of myocarditis, whether infectious or not. This review aims to elucidate on the impact of DCM in both developing and developed countries, to clarify about the underlying pathophysiology and inquire about the need for screening or preventive measures

Meticillin-resistant Staphylococcus aureus Contact Screening Strategy in a Low Prevalence Setting; a Nested Case-Control Study.

Background The optimal screening strategy in hospitals to identify secondary cases after contact with a meticillin-resistant Staphylococcus aureus (MRSA) index patient in a low prevalence setting is not well defined. We aimed at identifying factors associated with documented MRSA transmissions. Method Single center, retrospective, nested case-control study. We evaluated the screening strategy in our 950 bed tertiary care hospital from 2008 - 2014. Room and ward contacts of MRSA index patients present at time of MRSA identification were screened. We compared characteristics of Staphylococcus aureus Protein A (spa)-type matched contact patients (cases) to negative or spa-type mismatched contact patients (controls). Results Among 270,000 inpatients from 2008 - 2014, 215 MRSA screenings yielded 3013 contact patients, and 6 (0.2%) spa-type matched pairs. We included 225 controls for the nested case-control study. The contact type for the cases was more frequently "same room" and less frequently "same ward" compared with the controls (P = 0.001). Also, exposure time was longer for cases (median of 6 days [IQR 3-9]) than for controls (1 day [0-3], P=0.016). Conclusion The extensive MRSA screening strategy revealed only few index/contact matches based on spa-typing. Prolonged exposure time and a shared room were significantly associated with MRSA transmission. A targeted screening strategy may be more useful in a low prevalence setting than screening entire wards