The chromosomal polymorphism of Drosophila subobscura: a microevolutionary weapon to monitor global change

The Palaearctic species Drosophila subobscura recently invaded the west coast of Chile and North America. This invasion helped to corroborate the adaptive value of the rich chromosomal polymorphism of the species, as the same clinal patterns than those observed in the original Palaearctic area were reproduced in the colonized areas in a relatively short period of time. The rapid response of this polymorphism to environmental conditions makes it a good candidate to measure the effect of the global rising of temperatures on the genetic composition of populations. Indeed, the long-term variation of this polymorphism shows a general increase in the frequency of those inversions typical of low latitudes, with a corresponding decrease of those typical of populations closer to the poles. Although the mechanisms underlying these changes are not well understood, the system remains a valid tool to monitor the genetic impact of global warming on natural populations. Heredity ( 2009) 103, 364-367; doi: 10.1038/hdy.2009.86; published online 29 July 200

Obésité – le lien avec la survenue d’événements indésirables intra-opératoires.

Introduction Sécurité en anesthésie et ADS La sécurité en anesthésie est une préoccupation de santé publique importante, avec l’aug-mentation du nombre de comorbidités lors des opérations, l’âge avancé des patients et les interventions chirurgicales de plus en plus techniques, la sécurité et la stabilité des patients sont primordiales et sont du ressort des anesthésistes [1]. C’est dans ce contexte qu’un registre des actes d’anesthésie (ADS) a été mis en place en Suisse en 1999, près d’un quart des hôpitaux suisses y ont participé jusqu’en 2014. Quelques 2 mil-lions de données ont été enregistrées et sont régulièrement analysées dans le but d’améliorer la qualité et la sécurité des actes d’anesthésie [1,2]. Ce registre se compose de trois modules de données, les hôpitaux choisissent de remplir ou non : le Minimal Data Set (MDS), le module Qualité et le module Techniques and Management. [2] Avec l’évolution des soins chirurgicaux, il est nécessaire de réévaluer les techniques d’anes-thésie et d’étudier la survenue de complications

Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports.

Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations. Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs. This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008. ES were classified into three categories of practice, according to the type of risk at the time of the fall. Among the 616 cases meeting inclusion criteria, 219 (36%) were clearly high-risk ES accidents; 69 (11%) and 328 (53%) were related to potential ES, but with respectively low or indeterminate risk at the time of the fall. In the high-risk ES group, the median age was 32 years and 80% were male. Mortality at 48h was 11%, almost ten times higher than in the other two groups. The proportion of potentially life-threatening injuries (the National Advisory Committee for Aeronautics (NACA) score≥4) was 39% in the high-risk ES group and 13% in the other two groups. Thirty per cent of the cases in the high-risk ES group presented an Injury Severity Score (ISS) >15, compared with 7% in the other groups. Thoracolumbar vertebral fractures were the most common injuries with 32% of all cases having at least one, involving the T12-L2 junction in 56% of cases. The other most frequent injuries were traumatic brain injuries (16%), rib fractures (9%), pneumothorax (8%) and femoral (7%), cervical (7%), ankle (5%) and pelvic (5%) fractures. Median time on site for rescue teams was higher in the confirmed high-risk ES group, with 50% of prehospital missions including at least one environmental difficulty. High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12-L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions

Comment augmenter l’accès aux outils d’aide à la décision en Suisse romande ? [Can we increase the availability of decision aids in French-speaking Switzerland?]

Models of shared decision making recommend the use of patient decision aids. Hundreds of such aids exist worldwide but scaling up of their use in French-speaking Switzerland requires their translation to French and their adaptation to the clinical context. We review seven sources of tools that we assume relevant for French-speaking Switzerland. A short survey on a selection of three decision aids of general practitioners in the canton of Vaud confirmed their general interest in using such tools. They preferred a limited amount and a simple presentation of information in the decision aids to facilitate integration in clinical practice. Given the complexity of the required translations and adaptations, the medical community should develop a collaborative approach to lift this important task