Dewatering behavior of sewage screenings

Screenings from municipal sewage treatment plants have increased in importance in recent years, particularly in Germany, where laws prohibit depositing of screenings in landfill. This paper presents basic investigations of sewage screenings, especially the structure and dewatering behavior. Two standard experiments are conducted. First, the relationship between pressure and water content is determined. Secondly the flow resistance as a function of pressure is evaluated. The results help to derive simulation models in order to understand how the material behaves inside a wash press.

Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss Respiratory Society

The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements are based on the available literature, on other national guidelines and, in particular, on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report. Our aim is to advise pulmonary physicians, general practitioners and other health care workers on the early detection and diagnosis, prevention, best symptomatic control, and avoidance of COPD as well as its complications and deterioration.

Establishment of an early warning system against Bluetongue virus in Switzerland

Bluetongue (BT) is a vector-borne animal disease of economical importance due to the international trade restrictions likely to be put into place in a country once the infection is discovered. The presence of BT and its vectors in countries adjacent to Switzerland stresses the need of implementing a surveillance system and to raise disease awareness among potential stakeholders. A national survey in Switzerland 2003 indicated freedom of Bluetongue virus (BTV), although a single individual of the main BT vector Culicoides imicola was caught in the canton of Ticino. The survey also demonstrated that potential BT vectors, C. obsoletus and C. pulicaris are locally abundant in Switzerland. Therefore, a new surveillance method based on sentinel herds in high risk areas was implemented in 2004 for the early detection of both an incursion of BT vectors into Switzerland, and potential virus circulation among cattle.

[Non-small-cell lung cancer - from symptoms to operation]

Lung cancer is the leading cause of cancer death in the western world. Unfortunately, lung cancer is usually recognised late in its natural history. The most important risk factor is tobacco smoking. An abnormal chest radiograph is often the first line of imaging. Bronchoscopy is very important to get conclusive histological and cytological material. The PET/CT has a major role in the correct staging of non-small-cell lung cancer. Pulmonary resection candidates should undergo a structured pre-operative evaluation.

Carbapenem-resistant Gram-negative bacilli in Canada 2009-10: results from the Canadian Nosocomial Infection Surveillance Program (CNISP)

OBJECTIVES

To investigate the occurrence and molecular mechanisms associated with carbapenemases in carbapenem-resistant Gram-negative isolates from Canadian cases.

METHODS

Twenty hospital sites across Canada submitted isolates for a 1 year period starting 1 September 2009. All Enterobacteriaceae with MICs ≥ 2 mg/L and Acinetobacter baumannii and Pseudomonas aeruginosa with MICs ≥ 16 mg/L of carbapenems were submitted to the National Microbiology Laboratory (NML) where carbapenem MICs were confirmed by Etest and isolates were characterized by PCR for carbapenemase genes, antimicrobial susceptibilities, PFGE and plasmid isolation.

RESULTS

A total of 444 isolates (298 P. aeruginosa, 134 Enterobacteriaceae and 12 A. baumannii) were submitted to the NML of which 274 (61.7%; 206 P. aeruginosa, 59 Enterobacteriaceae and 9 A. baumannii) met the inclusion criteria as determined by Etest. Carbapenemase genes were identified in 30 isolates: bla(GES-5) (n = 3; P. aeruginosa), bla(KPC-3) (n = 7; Enterobacteriaceae), bla(NDM-1) (n = 2; Enterobacteriaceae), bla(VIM-2) and bla(VIM-4) (n = 8; P. aeruginosa) bla(SME-2) (n = 1; Enterobacteriaceae) and bla(OXA-23) (n = m9; A. baumannii). PFGE identified a cluster in each of Enterobacteriaceae, P. aeruginosa and A. baumannii corresponding to isolates harbouring carbapenemase genes. Three KPC plasmid patterns (IncN and FllA) were identified where indistinguishable plasmid patterns were identified in unrelated clinical isolates.

CONCLUSIONS

Carbapenemases were rare at the time of this study. Dissemination of carbapenemases was due to both dominant clones and common plasmid backbones.

A novel N440K sodium channel mutation causes myotonia with exercise-induced weakness--exclusion of CLCN1 exon deletion/duplication by MLPA

We report a 4-generation Turkish family with 10 affected members presenting with myotonia and potassium- and exercise-induced paralytic attacks. The clinical presentation was neither typical for the chloride channel myotonias Thomsen and Becker nor for the separate sodium channel myotonia entities potassium-aggravated myotonia, paramyotonia congenita, and hyperkalemic periodic paralysis. It is best described by a combination of potassium-aggravated myotonia and hyperkalemic periodic paralysis. We excluded exonic chloride channel mutations including CLCN1 exon deletion/duplication by MLPA. Instead we identified a novel p.N440K sodium channel mutation that is located at the inner end of segment S6 of repeat I. We discuss the genotype phenotype relation.

[A rare interstitital lung disease in two smokers]

Pulmonary Langerhans-cell histiocytosis should be suspected in patients with nodular or cystic changes in the upper pulmonary lobes. Patients with Langerhans-cell histiocytosis usually have a history of smoking; lack of nicotine exposure or an age over 60 years makes the diagnosis unlikely. The diagnostic work-up should include a high-resolution CT of the chest as well as a bronchoalveolar lavage, bronchoscopic and/or surgical lung biopsy. Smoking cessation is the essential part of the treatment.