Spread and establishment of Aedes albopictus in southern Switzerland between 2003 and 2014 : an analysis of oviposition data and weather conditions

The Asian tiger mosquito, Aedes albopictus, is a highly invasive mosquito species of public health importance. In the wake of its arrival in neighbouring Italy the authorities of the canton of Ticino in southern Switzerland initiated a surveillance programme in 2000 that is still on-going. Here we explored the unique data set, compiled from 2003 to 2014, to analyse the local dynamic of introduction and establishment of Ae. albopictus, its relative density in relation to precipitation and temperature, and its potential distribution at the passage from southern to northern Europe.; The presence of Ae. albopictus was recorded by ovitraps placed across Ticino. In addition to presence-absence, the relationship between relative egg densities and year, month, temperature and precipitation was analysed by a generalised linear mixed model.; Since its first detection in 2003 at Ticino's border with Italy Ae. albopictus has continuously spread north across the lower valleys, mainly along the trans-European motorway, E35. Detailed local analysis showed that industrial areas were colonised by the mosquito before residential areas and that, afterwards, the mosquito was more present in residential than in industrial areas. Ae. albopictus appeared sporadically and then became more present in the same places the following years, suggesting gradual establishment of locally reproducing populations that manage to overwinter. This trend continues as witnessed by both a growing area being infested and increasing egg counts in the ovitraps. There was a clear South-North gradient with more traps being repeatedly positive in the South and fewer eggs laid during periods of intensive precipitation. In the North, the mosquito appeared repeatedly through the years, but never managed to establish, probably because of unfavourable weather conditions and low road traffic.; Given the present results we assume that additional areas may still become infested. While the current study provides good estimates of relative egg densities and shows the local and regional dynamics of Ae. albopictus invasion, additional parameters ought to be measured to make an objective risk assessment for epidemic disease transmission. The likelihood of Ae. albopictus to further spread and increase in densities calls for continued surveillance

Prostate cancer screening in Switzerland: a literature review and consensus statement from the Swiss Society of Urology

Over a decade ago, the United States Preventive Services Taskforce (USPSTF) recommended against prostate-specific antigen (PSA)-based screening for prostate cancer in all men, which considerably influenced prostate cancer screening policies worldwide after that. Consequently, the world has seen increasing numbers of advanced stages and prostate cancer deaths, which later led the USPSTF to withdraw its initial statement. Meanwhile, the European Union has elaborated a directive to address the problem of implementing prostate cancer screening in “Europe’s Beating Cancer Plan”. In Switzerland, concerned urologists formed an open Swiss Prostate Cancer Screening Group to improve the early detection of prostate cancer. On the 20th of September 2023, during the annual general assembly of the Swiss Society of Urology (SGU/SSU) in Lausanne, members positively voted for a stepwise approach to evaluate the feasibility of implementing organised prostate cancer screening programs in Switzerland. The following article will summarise the events and scientific advances in the last decade during which evidence and promising additional modalities to complement PSA-based prostate cancer screening have emerged. It also aims to provide an overview of contemporary strategies and their potential harms and benefits

Insecticide susceptibility of Aedes albopictus and Ae. aegypti from Brazil and the Swiss-Italian border region

Aedes aegypti and Ae. albopictus are two highly invasive mosquito species, both vectors of several viruses, including dengue, chikungunya and Zika. While Ae. aegypti is the primary vector in the tropics and sub-tropics, Ae. albopictus is increasingly under the public health watch as it has been implicated in arbovirus-transmission in more temperate regions, including continental Europe. Vector control using insecticides is the pillar of most control programmes; hence development of insecticide resistance is of great concern. As part of a Brazilian-Swiss Joint Research Programme we set out to assess whether there are any signs of existing or incipient insecticide resistance primarily against the larvicide Bacillus thuringiensis svar. israelensis (Bti), but also against currently applied and potentially alternative insecticides in our areas, Recife (Brazil) and the Swiss-Italian border region.; Following World Health Organization guidelines, dose-response curves for a range of insecticides were established for both colonized and field caught Ae. aegypti and Ae. albopictus. The larvicides included Bti, two of its toxins, Cry11Aa and Cry4Ba, Lysinibacillus sphaericus, Vectomax CG®, a formulated combination of Bti and L. sphaericus, and diflubenzuron. In addition to the larvicides, the Swiss-Italian Ae. albopictus populations were also tested against five adulticides (bendiocarb, dichlorodiphenyltrichloroethane, malathion, permethrin and λ-cyhalothrin).; Showing a similar dose-response, all mosquito populations were fully susceptible to the larvicides tested and, in particular, to Bti which is currently used both in Brazil and Switzerland. In addition, there were no signs of incipient resistance against Bti as larvae were equally susceptible to the individual toxins, Cry11Aa and Cry4Ba. The field-caught Swiss-Italian populations were susceptible to the adulticides tested but DDT mortality rates showed signs of reduced susceptibility.; The insecticides currently used for mosquito control in Switzerland and Brazil are still effective against the target populations. The present study provides an important reference as relatively few insecticide susceptibility surveys have been carried out with Ae. albopictus

Serum AMH concentration as a marker evaluating gonadal function in boys operated on for unilateral cryptorchidism between 1st and 4th year of life

The aim of this study was to measure the serum AMH (anti-Mullerian hormone) concentrations in a group of boys with or without cryptorchidism, evaluation of karyotypes, testicular position, morphology, and major length of the undescended testes. Fifty boys who were 1–4 years old (median = 2.4 years) with unilateral cryptorchidism were evaluated. All of them underwent orchidopexy in 2010. Prior to the procedure, all of the subjects had undergone karyotyping to exclude chromosomal abnormalities. Fifty healthy boys within the same age range (median = 2.1 years) admitted for planned inguinal hernia repair in 2010, served as controls. Blood samples were collected, while obtaining blood for standard laboratory tests routinely performed before the surgeries. Medians of AMH in boys with cryptorchidism were lower than in boys with inguinal hernia and differed significantly between two groups. Undescended testes were generally found in superficial inguinal pouch (n = 46), in two cases were noted to be in the external ring of the inguinal canal, and in another two instances, in the abdominal cavity. The major lengths of the undescended testes were smaller in comparison to the testes positioned normally (mean of 1 cm vs. a mean of 1.5 cm, respectively). In nine of the cases, the testes had turgor deficit, a drop shape, with epididymides that were small, dysplastic, and separated from the testis. The authors found that AMH was lower in boys with unilateral cryptorchidism (also found to have smaller testis) when compared with the control group

First report of the invasive mosquito species Aedes koreicus in the Swiss-Italian border region

In 2012 and 2013, an entomological survey of Aedes albopictus, the Asian tiger mosquito, was carried out in the border region of southern Switzerland and northern Italy, using ovitraps. In July 2013, besides A. albopictus already known to the region several unusual eggs were recovered.; A total of 548 seemingly different eggs were found within three communities: Chiasso (Switzerland), and Como and Brunate (Italy). Proteomic diagnostics based on matrix-assisted laser desorption/ionization mass-spectrometry (MALDI-TOF MS) and morphological identification of one reared adult revealed the presence of at least 18 A. (Finlaya) koreicus (Edwards, 1917) specimens. A. koreicus is a species native to Southeast Asia and is competent to transmit Japanese encephalitis and potentially other arboviruses, as well as the dog heartworm Dirofilaria immitis. While new to Switzerland, this invasive species has previously been reported from Belgium, north-eastern Italy and European Russia.; This is the first report of the introduction of this exotic mosquito species into Switzerland and Lombardy, Italy, suggesting the range of A. koreicus is expanding in Central Europe. As A. koreicus is competent to vector pathogens its establishment imposes a risk to public and veterinary health. From a technical point of view, the presence of A. koreicus alongside A. albopictus requires careful analysis and reliable diagnostics. As a diagnostic tool the use of the recently developed MALDI-TOF MS approach has proofed to be a very useful approach, particularly since hatching rates of A. koreicus seem to be low, making identification by classic morphology difficult, if not impossible

Surveillance and control of Aedes albopictus in the Swiss-Italian border region: differences in egg densities between intervention and non-intervention areas

BACKGROUND: Aedes albopictus, the Asian tiger mosquito, originates from the tropical and subtropical regions of Southeast Asia. Over the recent decades it has been passively spread across the globe, primarily through the used tyre trade and passive transportation along major traffic routes. A. albopictus is a proven vector for many arboviruses, most notably chikungunya and dengue, with recent outbreaks also in continental Europe. In southern Switzerland, in the Canton of Ticino A. albopictus was spotted for the first time in 2003. Since then the local authorities have implemented a control programme based on larval source reduction. Despite these efforts, mosquito densities have increased over the last decade, casting doubts on the effectiveness of such larval control programmes. METHODOLOGY/PRINCIPAL FINDINGS: The Italian communities just across the Swiss-Italian border lack a control programme. This motivated us to compare the intervention and the non-intervention areas side by side in an attempt to find evidence for, or against, the effectiveness of larval A. albopictus control. Using ovitraps and a randomised sampling scheme, we examined the seasonal and spatial abundance of A. albopictus in sylvatic and urban environments across the Swiss-Italian border in 2012 and 2013. In the urban environments of the non-intervention area, egg densities were 2.26 times higher as compared to the intervention area. In the sylvatic environments, as compared to the urban environments, egg densities were 36% in the intervention area and 18% in the non-intervention area. CONCLUSIONS/SIGNIFICANCE: Though alternative explanations are also valid, the results support the hypothesis that the Ticino intervention programme does have an impact. At the same time the data also suggest that current larval interventions fall short in gaining full control over the mosquito, calling for the evaluation of additional, or alternative, approaches. Ideally, these should also consider inclusion of the neighbouring Italian communities in the surveillance and control efforts

Strategies of a thirteen year surveillance programme on Aedes albopictus (Stegomyia albopicta) in southern Switzerland

Background In Ticino, a canton located south of the Alps in Switzerland, a surveillance programme on Aedes albopictus (Stegomyia albopicta) started in 2000 seeing that the region was considered at high risk of introduction based on the rapid spread of this mosquito in neighbouring Italy. Methods The surveillance programme, which is still ongoing, was adapted continuously to handle preventive measures of arrival, dispersal and establishment of this invasive species. The monitoring was based on ovitraps supported by reports from the population. The integrated control measures included removal of breeding sites, larvicide applications with Bacillus thuringiensis israelensis or diflubenzuron and, in some circumstances, adulticide applications with permethrin. These measures involved citizens, municipalities and Civil Protection Units. Results Ae. albopictus was first observed in 2003 in Ticino. We describe the strategies adopted and their adaptations to the evolving problem since year 2000. The approach used allowed keeping the mosquito densities at tolerable levels and below the threshold of autochthonous Ae. albopictus borne disease transmission. During the surveillance period, new typologies of breeding sites for Ae. albopictus have been discovered. Conclusions It was worth tackling the arrival of Ae. albopictus and adopting immediate control measures, followed by regular control measures after its establishment. Early intervention and prevention of the possible spread of the tiger mosquito over the territory avoided facing a crisis situation. This also reduced the difficulty of managing the situation and probably also reduced the overall cost if this had not been put in place.ISSN:1756-330

Comparison of prostatic artery embolisation (PAE) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial

OBJECTIVE To compare prostatic artery embolisation (PAE) with transurethral resection of the prostate (TURP) in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia in terms of patient reported and functional outcomes. DESIGN Randomised, open label, non-inferiority trial. SETTING Urology and radiology departments of a Swiss tertiary care centre. PARTICIPANTS 103 patients aged ≥40 years with refractory lower urinary tract symptoms secondary to benign prostatic hyperplasia were randomised between 11 February 2014 and 24 May 2017; 48 and 51 patients reached the primary endpoint 12 weeks after PAE and TURP, respectively. INTERVENTIONS PAE performed with 250-400 μm microspheres under local anaesthesia versus monopolar TURP performed under spinal or general anaesthesia. MAIN OUTCOMES AND MEASURES Primary outcome was change in international prostate symptoms score (IPSS) from baseline to 12 weeks after surgery; a difference of less than 3 points between treatments was defined as non-inferiority for PAE and tested with a one sided test. Secondary outcomes included further questionnaires, functional measures, magnetic resonance imaging findings, and adverse events; changes from baseline to 12 weeks were compared between treatments with two sided tests for superiority. RESULTS Mean reduction in IPSS from baseline to 12 weeks was -9.23 points after PAE and -10.77 points after TURP. Although the difference was less than 3 points (1.54 points in favour of TURP (95% confidence interval -1.45 to 4.52)), non-inferiority of PAE could not be shown (P=0.17). None of the patient reported secondary outcomes differed significantly between treatments when tested for superiority; IPSS also did not differ significantly (P=0.31). At 12 weeks, PAE was less effective than TURP regarding changes in maximum rate of urinary flow (5.19 15.34 mL/s; difference 10.15 (95% confidence interval -14.67 to -5.63); P<0.001), postvoid residual urine (-86.36 -199.98 mL; 113.62 (39.25 to 187.98); P=0.003), prostate volume (-12.17 -30.27 mL; 18.11 (10.11 to 26.10); P<0.001), and desobstructive effectiveness according to pressure flow studies (56% 93% shift towards less obstructive category; P=0.003). Fewer adverse events occurred after PAE than after TURP (36 70 events; P=0.003). CONCLUSIONS The improvement in lower urinary tract symptoms secondary to benign prostatic hyperplasia seen 12 weeks after PAE is close to that after TURP. PAE is associated with fewer complications than TURP but has disadvantages regarding functional outcomes, which should be considered when selecting patients. Further comparative study findings, including longer follow-up, should be evaluated before PAE can be considered as a routine treatment. TRIAL REGISTRATION Clinicaltrials.gov NCT02054013

Prostatic artery embolization versus conventional TUR-P in the treatment of benign prostatic hyperplasia: protocol for a prospective randomized non-inferiority trial

BACKGROUND Benign prostatic hyperplasia (BPH) is a prevalent entity in elderly men and transurethral resection of the prostate (TURP) still represents the gold standard of surgical treatment despite its considerable perioperative morbidity. Recently, prostatic artery embolization (PAE) was described as a novel effective and less invasive treatment alternative. Despite promising first results, PAE still has to be considered experimental due to a lack of good quality studies. Prospective randomized controlled trials comparing PAE with TUR-P are highly warranted. METHODS/DESIGN This is a single-centre, prospective, randomized, non-inferiority trial comparing treatment effects and adverse events of PAE and TURP in a tertiary referral centre. One hundred patients who are electable for both treatment options are randomized to either PAE or TURP. Changes of the International Prostate Symptom Score (IPSS) after 3 months are defined as primary endpoint. Changes in bladder diaries, laboratory analyses, urodynamic investigations and standardised questionnaires are assessed as secondary outcome measures. In addition contrast-enhanced magnetic resonance imaging of the pelvis before and after the interventions will provide crucial information regarding morphological changes and vascularisation of the prostate. Adverse events will be assessed on every follow-up visit in both treatment arms according to the National Cancer Institute Common Terminology Criteria for Adverse events and the Clavien classification. DISCUSSION The aim of this study is to assess whether PAE represents a valid treatment alternative to TURP in patients suffering from BPH in terms of efficacy and safety. TRIAL REGISTRATION ClinicalTrials.gov NCT02054013