Shiga toxin-producing Escherichia coli O157 associated with human infections in Switzerland, 2000-2009

Shiga toxin-producing Escherichia coli (STEC), an important foodborne pathogen, can cause mild to severe bloody diarrhoea (BD), sometimes followed by life-threatening complications such as haemolytic uraemic syndrome (HUS). A total of 44 O157 strains isolated from different patients from 2000 through 2009 in Switzerland were further characterized and linked to medical history data. Non-bloody diarrhoea was experienced by 15·9%, BD by 61·4% of the patients, and 29·5% developed HUS. All strains belonged to MLST type 11, were positive for stx2 variants (stx2 and/or stx2c), eae and ehxA, and only two strains showed antibiotic resistance. Of the 44 strains, nine phage types (PTs) were detected the most frequent being PT32 (43·2%) and PT8 (18·2%). By PFGE, 39 different patterns were found. This high genetic diversity within the strains leads to the conclusion that STEC O157 infections in Switzerland most often occur as sporadic case

Communication and optimal hierarchical networks

We study a general and simple model for communication processes. In the model, agents in a network (in particular, an organization) interchange information packets following simple rules that take into account the limited capability of the agents to deal with packets and the cost associated to the existence of open communication channels. Due to the limitation in the capability, the network collapses under certain conditions. We focus on when the collapse occurs for hierarchical networks and also on the influence of the flatness or steepness of the structure. We find that the need for hierarchy is related to the existence of costly connections.Comment: 7 pages, 2 figures. NATO ARW on Econophysic

Intermediate care in caring for dementia, the point of view of general practitioners: A key informant survey across Europe.

Background: Intermediate care is often defined as healthcare occurring somewhere between traditional primary (community) and secondary (hospital) care settings. High quality intermediate care is important in dementia, may prevent caregiver burnout and also lead to optimal care for people with dementia. However, very little is known about the point of intermediate care for persons with dementia in Europe. Research questions: What intermediate care services exist and how are they utilized in the care of people with dementia in Europe? Objective: This study aims at describing the point of view of General Practitioners on intermediate care services for people with dementia across Europe. Methods: Key informant survey was sent to GPs via a self-developed questionnaire with space for open ended comments. 16 European countries participated to this cross-sectional mixed method study. Given the volunteer nature of the study, no minimum sample size requirements were applied to participation. Convenience sampling technique was used to address variations due to regional variations and regulations within the same country. Descriptive analyses of all intermediate care facilities groups by countries were performed. Qualitative analyses approach was used for the optional-free text to exemplify and/or complete the reasons contained in the closed response categories. Results: The questionnaire was sent to 16 European countries. 583 questionnaires were analyzed. The responding physicians were 48 (± 11) years old on average and they had been in practice for an average of 18 (+ /11) years. The types of intermediate care considered were integrated at-home services, respite and relief services, day care centers and nursing homes. Their availability was considered very inhomogeneous by the majority of respondents. The main benefits of intermediate care cited were better medical care for the patient (78%), better quality of life for the caregiver (67%), prevention of the caregiver burden (73%) and a break for the caregiver (59%). The reported difficulties were: accessing these facilities due to limited financial support (76%) and cumbersome administrative procedures (67%). Many other facets of our findings were captured in the qualitative themes that emerged. Conclusion: Intermediate care in Europe is diverse and heterogeneous. Major concerns of GPs are about the cost issues and the cumbersome administrative procedures to access them

Systemic and local effects of disportional longitudinal growth of bones in foals and lambs and the impact on bone mineral density and content

In the present study the effects of „periosteal stripping“ on bone and cartilage metabolism of foals with angular limb deformities and healthy experimental lambs were examined. Five foals with angular limb deformities were treated surgically by means of „hemicircumferential transection of the periosteum and periosteal stripping“ (HCTP/HP). Before surgery as well as twice after surgery, 1,25(OH)2Vitamin D, bone and cartilage markers in the serum were determined and compared to 5 healthy foals of the same age. In addition 10 healthy lambs were treated by HCTP/HP, in which the same parameters and bone density were determined. At 22 days after surgery the lambs were sacrificed and treated and control bones were sampled and processed for immunohistochemistry. Neither in foals nor in lambs, significant differences could be observed between treated and untreated animals with regard to the parameters measured in serum. Nevertheless, both treated groups revealed a tendency for higher bone remodelling compared to control animals. This could be the result of an increased bone remodelling rate following surgery. No statistically significant difference in bone mineral density between treated and untreated animals could be detected. In contrast local changes of signal transduction related to parathyroid hormone related protein and indian hedgehog (PTHrP/Ihh) were observed using immunhistochemistry. It was concluded that HCTP/HP at the level of epiphysis and metaphysis does not lead to systemic effects, even though local events detected by immunohistochemistry point to an increased bone formation at the treated site