Pertussis outbreak mainly in unvaccinated young children in ultra-orthodox Jewish groups, Jerusalem, Israel 2023.

Despite being a vaccine-preventable disease for decades, pertussis control is still a public health challenge. A pertussis outbreak emerged in Jerusalem (n = 257 cases, January to June 2023). Most cases were young children (median age 1.5 years), and 100 were infants under 1 year. The hospitalisation rate of infants was 24%, which was considerably higher than that of cases aged 1 year and above (3.8%). There was one fatality in an unvaccinated, 10-week-old infant whose mother had not received pertussis vaccination during pregnancy. Most children were unvaccinated and resided in Jewish ultra-orthodox neighbourhoods in Jerusalem district. An intervention programme and vaccination campaign are ongoing.

[A rare cause of hypertension with hypokalemia: A case of reninoma]. / Une cause rare d'hypertension artérielle avec hypokaliémie : un cas de réninome.

Reninoma or juxtaglomerular cell tumor is a rare usually benign renal renin secreting tumor. We report the case of an 18-year old woman, without any medical history, investigated in our hospital's emergency department for a bilateral papilledema. Ambulatory ophthalmological investigations were performed because of a newly occurring blurry vision, associated with diffuse headaches. Cerebral mRI and lumbar puncture recommended by the ophthalmologist and neurologist excluded intra-cranial hypertension. The patient presented with severe hypertension. Laboratory values showed hypokalemia, compensated metabolic alkalosis and microalbuminuria. During the hospital stay, she developed AKIN 1 acute renal injury. Ultrasound revealed a tissular cystic lesion of the superior pole of the right kidney. Abdominal mRI confirmed the lesion and raised suspicion for a renal cell carcinoma without calicial or vascular invasion. Plasma renin value was >500 mUI/L with normal values for plasma aldosterone. Renal biopsy diagnosed a juxtaglomerular cell tumor. After an aggressive initial treatment, hypertension remained well controlled with spironolactone only, finally allowing for withdrawal of all antihypertensive medications. Robot-assisted laparoscopic partial nephrectomy was performed. Studies of the operative specimen confirmed the diagnosis of benign reninoma. Clinical follow-up showed complete resolution of clinical and biological parameters.

Swiss gynecologists' opinions and perceptions concerning the use of intrauterine devices by nulliparous and multiparous women: an online survey study.

OBJECTIVE: The aim of this study was to 1) evaluate the Swiss physicians' attitudes and beliefs on intrauterine device (IUD) use in multiparous and nulliparous women and 2) determine whether the woman's parity was a factor influencing the gynecologists' IUD practice. MATERIAL AND METHODS: The Global Survey questionnaire investigating IUD use was modified and adapted to the Swiss guidelines. A link to the online questionnaire was sent to gynecologists practicing in the French- and German-speaking parts of Switzerland. We defined IUD use as frequent whenever it was prescribed by gynecologists for 25% or more out of all women consulting for contraception. RESULTS: A total of 299/1,696 gynecologists completed the online questionnaire (17.6%). Frequent IUD prescription was found in 72.9% of multiparous and in 11.8% of nulliparous women. The most frequently reported barriers to IUD use in nulliparous women were as follows: concern over a painful insertion, difficulty of insertion, higher risk of perforation, pelvic inflammatory disease, changes in bleeding pattern, high cost, and risk of extrauterine pregnancy. The presence of such perceived obstacles was associated with less frequent IUD insertion in nulliparous women. CONCLUSION: The results of this study provide a valuable insight into the attitudes and opinions of Switzerland's gynecologists on the use of IUDs in nulliparous and multiparous women, showing that the women's parity is a factor influencing the physicians' attitudes and opinions. Further health education might help minimize the physicians' attitude discrepancies in IUD prescription to nulliparous and multiparous women.