Surveillance systems for sexually transmitted diseases in Switzerland

BACKGROUND: In Switzerland (population 7.4 million), 3 different systems contribute to surveillance for sexually transmitted infections. GOAL: The goal of this study was to compare time trends from surveillance systems for chlamydia, gonorrhea, and syphilis. STUDY DESIGN: We studied surveillance data (1997-2003) from laboratory reports in women and men, men attending dermatology clinics, and women attending gynecologists. RESULTS: Laboratory reports of episodes of Chlamydia trachomatis and Neisseria gonorrhoeae increased by 31% (from 2573 to 3449 cases) and 104% (from 259 to 528 cases), respectively. Over the same period, chlamydia reports from men attending dermatology clinics and women attending gynecologists did not change and dermatology clinic-based reports of gonorrhea in men increased only slightly. Syphilis reports from dermatology clinics increased by 127% (from 22 to 50 cases). CONCLUSIONS: Increases in laboratory reports of chlamydia and gonorrhea were not consistently detected in sentinel populations. Numbers of cases reported to all 3 systems were low. The performance of surveillance systems for sexually transmitted infections should be evaluated regularly.     

Synthesis of symmetric bis-α-ketoamides from renewable starting materials and comparative study of their nucleating efficiency in PLLA

An efficient and smart synthesis of bis-α-ketoamides has been disclosed. The desired products have been obtained through a Passerini multicomponent reaction using biobased aldehydes, acetic acid and bis-isocyanides (prepared from the corresponding biobased diamides), followed by a deprotection/oxidation step. The effect of the synthesized compounds on the crystallization behavior of poly(l-lactide) (PLLA) has been investigated by differential scanning calorimetry (DSC) in non-isothermal conditions. Among all the synthesized compounds, only a few are able to meaningfully enhance the nucleation of PLLA, as confirmed by a shift of the polymer crystallization peak temperature towards higher values. With the research of active polymer nucleating agents being mostly empirical, the combinatorial synthetic approach proposed herein, coupled with the possibility of a small scale mixing procedure, can potentially represent a useful strategy for the discovery of new efficient biobased polymer additives.

A new class of organic nucleating agents for PLLA has been obtained through a Passerini multicomponent reaction using biobased building blocks.     

Chronic outpatient management of asthmatics attending the emergency department: a survey from a country with low income.

PURPOSE: Little is known about compliance with international guidelines of asthma management in developing countries where some medications are prohibitively expensive. METHODS: A survey was conducted in asthmatic patients attending the emergency department for acute asthma. Asthma severity was evaluated and conformity of chronic treatment with international guidelines was assessed. Additional features of asthmatic education were also evaluated. RESULTS: A total of 127 consecutive patients (mean age 34 +/- 14 years) answered the questionnaire. Mild asthma was present in 19.7% patients, 56.7% had moderate asthma and 23.6% had severe asthma. Of the 124 known asthmatic patients, 33% had no treatment for chronic asthma. In the remaining, treatment adhered to international guidelines in 44% patients. The major cause of treatment inadequacy was the lack of inhaled corticosteroids (64%) or suboptimal dosage of corticosteroids (13%). Conformity to guidelines according to favorable or unfavorable economic conditions was 59% and 33%, respectively (P = 0.036). Treating physicians provided an 'action plan' for managing acute symptoms to 19% patients. Forty percent of asthmatic patients performed correctly the five components of metered dose inhaler use. CONCLUSION: Our study reveals an important proportion of non-treated asthmatic patients. In most asthmatic patients, treatment did not conform with guidelines because of an underutilization of corticosteroids, mainly because of economic obstacles.     

Prognostic value of the normalization of the exercise test under medical treatment in coronary insufficiency

The prognostic value of exercise testing was studied in 118 patients with angiographically proven chronic coronary disease, positive ET and/or a history of myocardial infarction (MI) who were followed up for 698 years (mean 5.9 years). Medical treatment was instituted step by step and controlled by repeated ET's. ET remained positive (ST depression 1 mm) in 58 cases (group I), was alternately positive and negative in 22 cases (group II) and became normal in 38 cases (group III). The mean duration of follow-up in these three groups was 5.0, 7.6 and 6.4 years respectively. Eight patients were lost sight of. Ergometric data and outcome were similar in groups II and III, but there were differences between group I (58 patients) and groups II + III (60 patients) as regards: (a) ergometric data: total workload (22,077 +/- 9,860 vs 34,856 +/- 15,552 joules), workload causing a 1 mm ST depression (13,892 +/- 9,253 vs 31,555 +/- 15,811 joules) and maximal ST depression (2.5 +/- 0.9 vs 0.9 +/- 0.8 mm); (b) outcome: cardiac deaths (12 vs 3), myocardial revascularization (19 vs 6); but there was no significant difference as regards MI (4 vs 5), heart failure (11 vs 5) and extracardiac deaths (3 vs 4). It is concluded that the persistence of a positive ET under optimal medical treatment is a major argument in favour of myocardial revascularization.     

Malignant lymphoma on a gastric stump

We report a case of lymphoplasmocytic and immunoblastic gastric remnant lymphoma occurring in a 51 year-old male. This patient had undergone subtotal gastrectomy for a gastric peptic ulcer at age 37. Histologic findings in the initial gastric specimen showed a dense lymphoid infiltrate surrounding the ulcer within the gastric mucosa. This proliferation was grouped into distinct follicles, and was compatible with pseudo-lymphoma. The progression of pseudo-lymphoma to malignant lymphoma is suggested.