Spital Uster

Despite a growing interest in animal welfare in production systems, research on fish welfare remains limited, particularly in commercial fisheries. Fish caught in fixed-net fisheries experience multiple stressors from the time of capture to mortality on deck considered detrimental to their welfare. We examined the impact of bottom-set gill nets and on-board handling on catch welfare using behavioural and physiological indicators. Vitality assessments were performed on four commercially important fish species on-board fishing vessels through a devised vitality scale that included behaviours, morphological condition and reflexes as indicators of welfare. Physiological stress parameters (Cortisol, Glucose, Lactate and Osmolality) were evaluated in blood collected on deck and analysed in relation to the vitality scores. The vitality at arrival on deck as well as the rate of decrease in vitality differed significantly amongst the tested species. Furthermore, Generalised Linear Models predicted that several biological, operational, and environmental variables significantly affect the extent of time the fish shows activity, and hence, on the welfare. Elevated average cortisol levels were found at all the vitality stages highlighting the stress experienced by fish due to the fishing process. The findings of this study enable us to recommend welfare-friendly methods in set-net fisheries to promote better fishing standards.

Endometriosis is a persistent inflammatory condition characterised by chronic pain, increasing the chances of infertility and adverse pregnancy outcomes. However, the existing evidence on this matter lacks consistency. The disease is associated with impaired folliculogenesis exerting a negative effect on egg quality and leading to defects during the luteal phase, decreased rates of fertilisation and abnormal embryonic development, all of which contribute to reproductive difficulties. As the number of endometriosis patients who become pregnant increases, there is a greater demand for comprehensive assessments to identify the possible negative impact of the condition on pregnancy outcomes, including the postnatal period. Patients with endometriosis might experience obstetric complications, including placenta accreta spectrum, fetal growth restriction and a higher likelihood of having to undergo a caesarean section, giving birth prematurely, and experiencing postpartum haemorrhage. The field of obstetrics often neglects to fully recognise and examine these complex issues, leading to the lack of thorough investigation. The impact of the disease extends beyond the conception stage, potentially influencing results in obstetrics and neonatology. Hence, it is imperative to carry out a targeted investigation to determine the most efficient strategies for managing and monitoring pregnant women who were diagnosed with endometriosis. An updated summary of the most recent research in this area is given in this review. An updated summary of the most recent research in this area is given in this review.

This review examines the animal welfare implications associated with the purse seine fishing method as applied to the following small pelagic species: Atlantic herring (Clupea harengus), Peruvian anchoveta (Engraulis ringens), Atlantic chub mackerel (Scomber colias), and Atlantic mackerel (Scomber scombrus). The analysis is based on synthesized data from the purse seine Method Profile, recently introduced in the catch branch of the fair-fish database—an open-access platform dedicated to compiling, evaluating, and systematically categorizing technical and/or scientific literature on aquatic animal behaviour and welfare. The Method Profile is a novel tool that outlines the commercial relevance of the respective fishing method, its target species, and general operational setup. It provides a structured overview of welfare hazards encountered across the main phases of the fishing process, including prospection, setting, capture, hauling, emersion, gear release, sorting, storage, and stunning and slaughter. In addition, this profile also addresses bycatch and discarding issues as well as environmental hazards associated with the fishing method. Identified welfare concerns in purse seining for the four small pelagic species include high stress levels resulting from intense crowding—primarily leading to hypoxia, mechanical injuries, and mortality—as well as issues related to scooping or pumping fish on board, (live) storage, and the lack of effective stunning and slaughter protocols. Furthermore, the bycatch rate of (undersized) target and diverse non-target species, as well as ghost fishing from abandoned, lost, or discarded gear, pose significant risks requiring effective mitigation. In this review, we critically evaluate factors influencing the welfare outcomes of the four pelagic species caught by purse seine and discuss potential mitigation strategies, such as operational improvements, gear modifications, and management measures.

<bold>Background:</bold> Pulmonary embolism (PE) is a major health burden. Its acute management has been extensively studied permitting in the past decades progress on mortality. Recent studies showed that number of patients complains of long-term symptoms after a PE. Up to half of patients report dyspnea months after acute PE. The term post-PE syndrome was proposed as definition for all the manifestations after PE that cannot be associated to other causes. These symptomatic patients seem to have a higher morbidity and therefore to consume more healthcare resources. <bold>Objectives:</bold> The aim of this study is to analyses which are the preexisting conditions associated with a dyspnea after PE. <bold>Methods:</bold> This study is a post-hoc analysis on a large cohort of PE patients (n=508) followed with a dyspnea-based algorithm (INPUT study). We analyzed which baseline characteristics of these patients were significantly associated with a NYHA functional class ≥ II after an acute PE. <bold>Results:</bold> 19% of the patients in the cohort presented new dyspnea during the two years following an acute PE. Multivariate and univariate analysis showed that higher BMI (OR 1.08), female sex (OR 2.48) and CETPH were significantly associated with dyspnea. Age, smoking status, anticoagulation type, active cancer, cause of PE were not significantly associated with dyspnea. <bold>Conclusions:</bold> Dyspnea is a frequent complain after a PE. Pre-existing characteristics such BMI and female sex may play a role in its development. The comorbidities probably also play a relevant role in the development of a dyspnea after a PE. Further studies are needed to assess and help patient with persisting respiratory symptoms after PE.

Iron deficiency (ID) often leads to iron deficiency anemia (IDA). Oral iron supplements are frequently associated with gastrointestinal intolerance and poor adherence. Ferric derisomaltose (FDI), a single high-dose intravenous (IV) infusion, is another option. The real-world Real-CHOICE study investigated the attitudes of patients with IDA and ID without anemia (IDNA) towards IV iron therapy. Secondary objectives were the effectiveness and safety of FDI. Real-CHOICE (NCT04318405) enrolled adults with IDA or IDNA in Switzerland. Custom questionnaires evaluated attitudes and treatment satisfaction at baseline and follow-up (≥ 12weeks). Hemoglobin, ferritin, and transferrin saturation levels, and treatment-emergent adverse events (TEAEs) were assessed. Of 319 patients (114 with IDA, 205 with IDNA) who received FDI, most were female (n = 305, 93.9%) and aged < 65years (n = 298, 91.7%). Over three-quarters of patients were not hesitant to receive IV iron treatment at baseline (n = 228, 76.3%) and follow-up (n = 194, 78.2%). The proportion of patients whose attitude towards receiving IV iron therapy remained stable or improved at follow-up versus baseline was 86.1% (n = 204/237). Of 195 patients with available data, mean (standard deviation) changes from baseline to follow-up in hemoglobin, ferritin, and transferrin saturation levels were 1.15 (1.50) g/dL, 144.87 (131.77) µg/L, and 8.71% (13.29%), respectively. TEAEs and adverse drug reactions occurred in 76 (23.8%) and 22 patients (6.9%), respectively. Real-CHOICE revealed favorable attitudes of patients and physicians towards IV iron therapies, particularly FDI, in a real-world setting. Improved hematologic parameters and favorable safety highlight FDI's potential as a clinically effective treatment for ID and IDA.

ObjectivesA possible co-occurence of hypomineralizations in deciduous teeth (HD) and Molar Incisor Hypomineralization (MIH) is matter of ongoing discussion. This case control study aimed to assess whether there was a correlation between HD and MIH in a suburban Swiss population.MethodsPatients were seen once at the age of 4–6 and a second time at 8–9 years, each, for comprehensive dental examination, including the diagnosis of HD and MIH. Appointments took place as part of routinely annual examinations in a school dental clinic of the municipality of Uster. In a retrospective approach, children with hypomineralizations in the deciduous dentition at the first appointment were defined as “cases”. An identical number of age- and gender-matched “controls” without hypomineralizations were randomly chosen from the patient files. The odds ratio for MIH - as reported during the second appointment - for cases with HD compared to controls without was calculated using chi-square, quota ratio and Fisher’s exact test with a level of significance of 0.05%.ResultsIn the cohort of 426 children (112 females and 101 males in each group) the overall prevalence of MIH was 11.7%, with mainly mild signs of MIH. Case patients showed 1.24 ± 0.70 teeth with HD. For the test group, the odds ratio for MIH was 1.44 as compared to the controls, failing to show statistical significance.ConclusionThere might be a slightly enhanced probability for MIH if the deciduous dentition display hypomineralizations.Clinical significanceGiven hypomineralizations in the deciduous dentition, the probability for Molar Incisor Hypomineralizations might be slightly enhanced.

BackgroundPhyllodes tumors are highly uncommon fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast tumors. Differential diagnosis between phyllodes tumors and fibroadenomas by using imaging techniques such as ultrasound or mammography, as well as histological methods, can be challenging due to overlapping features. Phyllodes tumors are categorized into benign, borderline, and malignant types, each posing a different risk of recurrence and metastasis. Despite many advances in the imaging and biopsy techniques, diagnosing phyllodes tumors remains challenging. The purpose of this study is to review the existing literature on this topic and describe two cases of misdiagnosed phyllodes tumors.Materials and methodsA literature review was conducted by using the Medline (PubMed) database over 10 years. Information concerning the patients was sourced from the Uster Hospital database. After analyzing the cases of women with breast lumps from 2020 to 2023 in the Uster Hospital database, two cases of misdiagnosed phyllodes tumors were identified. These two cases were analyzed retrospectively.ResultsA retrospective study of two cases confirms that phyllodes tumors are a rare phenomenon. A 51-year-old premenopausal woman presented with an 8 × 4 × 5 cm mass, initially diagnosed as a fibroadenoma. The final histopathology after surgical excision revealed a borderline phyllodes tumor with features overlapping those of a fibroadenoma. The second case involved a 59-year-old postmenopausal woman with a rapidly growing mass, which reached 11.9 × 11.3 cm and was initially diagnosed as a fibroadenoma but later confirmed as a borderline malignant phyllodes tumor with focal malignant components. Both cases highlight the limitations of imaging and core biopsy in accurately diagnosing phyllodes tumors and emphasize the need for comprehensive histopathological evaluation. The described clinical cases corresponded to the characteristics of phyllodes tumors indicated in the literature: they appeared in women older than 35 years, were hard to distinguish from fibroadenomas, and required surgical treatment.ConclusionsPhyllodes tumors are challenging to distinguish from fibroadenomas based on imaging and the initial biopsy results alone. Accurate diagnosis requires thorough histopathological examination following surgical excision. A multidisciplinary approach is essential for optimal management. Our cases show the complexity of phyllodes tumor diagnosis and the importance of considering phyllodes tumors in the differential diagnosis of breast masses, especially when clinical and imaging findings suggest a more aggressive pathology.

Transbronchial lung biopsy is routinely employed to identify acute cellular rejection (ACR) in lung transplant recipients (LTRs). This trial evaluates the clinical value of forceps and cryobiopsies and assesses the potential of cryobiopsies as a standalone histological diagnostic tool. In this open-label, randomised trial, LTRs undergoing surveillance bronchoscopy (analgosedation + intubation) 2, 4, 6, and 12 months after transplantation were included. Participants were randomly assigned (1:1) to receive either two cryobiopsies with a 2.4 mm probe alone (freezing time 3-4 seconds) or a combined five transbronchial forceps- and two cryobiopsies (combined group). The primary outcome was the diagnostic yield (suitability to detect ACR). Between July, 2021, and January, 2024, 79 LTRs were randomly assigned to the cryobiopsy-only group (n=37) or the combined group (n=41) with 82 and 80 procedures, respectively. The diagnostic yield in the cryobiopsy-only group was similar to the combined group for ACR (98.6% vs 97.3%, p=0.568). In intraindividual analyses of the combined group, cryobiopsies demonstrated a higher diagnostic yield than forceps biopsies (97.3% vs 18.7%, p=0.003), and the incidence of ACR was higher for cryobiopsies (RR 4.7 [95%CI 2.9-7.3], p<0.001). The incidence of adverse events did not differ between groups (60.9% vs 57.5%, p=0.655). The pneumothorax rate was 1.2%; no deaths or severe bleedings were observed. Transbronchial cryobiopsies are more effective than forceps biopsies in detecting ACR among LTRs. Cryobiopsies, which are safe to perform, can be used as the primary and standalone diagnostic tool for histological assessment of ACR.

Group A Streptococcus (GAS, aka Streptococcus pyogenes) poses a significant public health concern, causing a diverse spectrum of infections with high mortality rates. Following the COVID-19 pandemic, a resurgence of invasive GAS (iGAS) infections has been documented, necessitating efficient outbreak detection methods. Whole genome sequencing (WGS) serves as the gold standard for GAS molecular typing, albeit constrained by time and costs. This study aimed to characterize the post-pandemic increased prevalence of iGAS on the molecular epidemiological level in order to assess whether new, more virulent variants have emerged. A total of 66 iGAS strains isolated from nine Swiss hospitals during the COVID-19 post-pandemic increased GAS prevalence were evaluated and compared to 15 strains collected before and 12 during the COVID-19 pandemic. FT-IR measurements and WGS were conducted for network analysis. Demographic, clinical, and epidemiological data were collected. Skin and soft tissue infection was the most common diagnosis, followed by primary bacteremia and pneumonia. Viral co-infections were found in 25% of cases and were significantly associated with more severe disease requiring intensive care unit admission. WGS analysis did not reveal emerging GAS genetic distinct variants after the COVID-19 pandemic, indicating the absence of a pandemic-induced shift. FT-IR spectroscopy exhibited limitations in differentiating genetically distant GAS strains, yielding poor overlap with WGS-derived clusters. The emm1/ST28 genotype was predominant in our cohort and was associated with five of the seven deaths recorded, in accordance with the molecular epidemiological data before the pandemic. Additionally, no notable shift in antibiotic susceptibility patterns was observed. Our data suggest that mainly non-pathogen related factors contributed to the recent increased prevalence of iGAS.