Plus forts ensemble - Swiss School of Public Health

De vénérables écoles de santé publique ont fêté leur 100 e anniversaire au cours des 20 dernières années. En Suisse, la pandémie a pris au dépourvu une institution adolescente - un modèle innovant qui fête son 16 e anniversaire cette année. L'âge adulte a-t-il été atteint

Safety of co-administration versus separate administration of the same vaccines in children: a systematic literature review

The growing number of available vaccines that can be potentially co-administered makes the assessment of the safety of vaccine co-administration increasingly relevant but complex. We aimed to synthesize the available scientific evidence on the safety of vaccine co-administrations in children by performing a systematic literature review of studies assessing the safety of vaccine co-administrations in children between 1999 and 2019, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifty studies compared co-administered vaccines versus the same vaccines administered separately. The most frequently studied vaccines included quadrivalent meningococcal conjugate (MenACWY) vaccine, diphtheria and tetanus toxoids and acellular pertussis (DTaP) or tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccines, diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B, inactivated poliovirus and Haemophilus influenzae type b conjugate (DTaP-HepB-IPV/Hib) vaccine, measles, mumps, and rubella (MMR) vaccine, and pneumococcal conjugate 7-valent (PCV7) or 13-valent (PCV13) vaccines. Of this, 16% (n = 8) of the studies reported significantly more adverse events following immunization (AEFI) while in 10% (n = 5) significantly fewer adverse events were found in the co-administration groups. Statistically significant differences between co-administration and separate administration were found for 16 adverse events, for 11 different vaccine co-administrations. In general, studies briefly described safety and one-third of studies lacked any statistical assessment of AEFI. Overall, the evidence on the safety of vaccine co-administrations compared to separate vaccine administrations is inconclusive and there is a paucity of large post-licensure studies addressing this issue

Fieber, Husten und Dyspnoe bei einer nierentransplantierten 38-jährigen Patientin

Zusammenfassung: Eine 38-jährige nierentransplantierte Patientin stellte sich mit Fieber, Husten und Dyspnoe vor. Sie stand unter Immunsuppression mit Mycophenolat und Prednison. Aufgrund der Klinik wurde bei Nachweis pulmonaler Infiltrate die Diagnose einer ambulant erworbenen Pneumonie gestellt und eine antibiotische Therapie begonnen. Bei klinischer Verschlechterung musste die Patientin auf die Intensivstation verlegt werden. Trotz antibiotischer Therapie verbesserte sich der Zustand kaum. Im Verlauf wurde eine bronchoalveoläre Lavage durchgeführt, in der das Parainfluenza-1-Virus nachgewiesen werden konnte. Infektionen mit respiratorischen Viren können bei immunsupprimierten Patienten schwer verlaufen und gehen mit einer hohen Mortalität einher. Humane Parainfluenza-Viren sind die dritthäufigsten Erreger viraler Pneumonien. Molekulargenetische Nachweismethoden ermöglichen eine schnelle und sensitive Diagnostik an respiratorischen Materialien. Da die therapeutischen Möglichkeiten limitiert sind, kommt prophylaktischen Maßnahmen eine besondere Bedeutung z

Indoor monitoring of heavy metals and NO2 using active monitoring by moss and palmes diffusion tubes

Background; : Indoor pollution is a real threat to human health all over the world. Indoor pollution derives from indoor sources (e.g. smoking, gas stoves, coated furniture) as well as from outdoor sources (e.g. industries, vehicles). Long-term monitoring measurements in indoor environments are missing to a large extent due to a lack of simple to operate measuring devices. Mosses proved well as biomonitors in hundreds of studies. Nevertheless, indoor use has been extremely scarce. Therefore, this study aimed to determine indoor and outdoor pollution by active biomonitoring using moss as well as NO2 samplers to analyse outdoor and indoor levels of pollution. We exposed moss (Pleurozium schreberi) for 8 weeks indoors and outdoors in 20 households in the city of Girona, Spain. Al, Cr, Cu, Zn, Sn, Cd, Pb, Mo, and Sb were analysed by moss-samplers. Additionally, NO2 was measured with Palmes diffusion tubes.; Results; : Compared to the pre-exposure analysis, concentrations of almost all elements both on indoor and outdoor mosses increased. Except for Cd, all metals and NO2 had, on average, higher concentrations in outdoor mosses than at corresponding indoor sites. However, some 20% of the samples showed inverse patterns, thus, indicating both indoor and outdoor sources. Indoor/outdoor correlations of elements were not significant, but highest for markers of traffic-related pollution, such as Sn, Sb, and NO2. The wide range of indoor-outdoor ratios of NO2 exemplified the relevance of indoor sources such as smoking or gas cooking. Though mostly excluded in this study, a few sites had these sources present.; Conclusions; : The study at hand showed that moss exposed at indoor sites could be a promising tool for long-time biomonitoring. However, it had also identified some drawbacks that should be considered in future indoor studies. Increments of pollutants were sometimes really low compared to the initial concentration and therefore not detectable. This fact hampers the investigation of elements with low basic element levels as, e.g. Pt. Therefore, moss with real low basic levels is needed for active monitoring, especially for future studies in indoor monitoring. Cloned material could be a proper material for indoor monitoring yet never was tested for this purpose

Assessment of Deaths Attributable to Air Pollution: Should We Use Risk Estimates based on Time Series or on Cohort Studies?

Epidemiologic studies are crucial to the estimation of numbers of deaths attributable to air pollution. In this paper, the authors present a framework for distinguishing estimates of attributable cases based on time-series studies from those based on cohort studies, the latter being 5-10 times larger. The authors distinguish four categories of death associated with air pollution: A) air pollution increases both the risk of underlying diseases leading to frailty and the short term risk of death among the frail; B) air pollution increases the risk of chronic diseases leading to frailty but is unrelated to timing of death; C) air pollution is unrelated to risk of chronic diseases but short term exposure increases mortality among persons who are frail; and D) neither underlying chronic disease nor the event of death is related to air pollution exposure. Time-series approaches capture deaths from categories A and C, whereas cohort studies assess cases from categories A, B, and C. In addition, years of life lost can only be derived from cohort studies, where time to death is the outcome, while in time-series studies, death is a once-only event (no dimension in time). The authors conclude that time-series analyses underestimate cases of death attributable to air pollution and that assessment of the impact of air pollution on mortality should be based on cohort studie