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Lausanne, Switzerland

Patients presenting with alcohol-related problems frequently suffer from comorbid mental health problems. From a broader perspective, patients having a comorbid situation between an addiction and a psychiatric trouble are at risk of being underdiagnosed for one of the two diseases. This litterature review tries to outline the issues linked to rigorous psychiatric diagnoses in the alcoologic situation, to describe the epidemiology of alcohol dual diagnosis, and to sum up scientific knowledge about the most adapted medication options and treatment settings.

Baid-Agrawal S.,Charite - Medical University of Berlin | Pascual M.,University of Lausanne | Moradpour D.,CHUV | Somasundaram R.,Charite - Medical University of Berlin | Muche M.,Charite - Medical University of Berlin
American Journal of Transplantation | Year: 2014

Chronic hepatitis C virus (HCV) infection remains an important health problem, which is associated with deleterious consequences in kidney transplant recipients. Besides hepatic complications, several extrahepatic complications contribute to reduced patient and allograft survival in HCV-infected kidney recipients. However, HCV infection should not be considered as a contraindication for kidney transplantation because patient survival is better with transplantation than on dialysis. Treatment of HCV infection is currently interferon-alpha (IFN-a) based, which has been associated with higher renal allograft rejection rates. Therefore, antiviral treatment before transplantation is preferable. As in the nontransplant setting, IFN-free treatment regimens, because of their greater efficacy and reduced toxicity, currently represent promising and attractive therapeutic options after kidney transplantation as well. However, clinical trials will be required to closely evaluate these regimens in kidney recipients. There is also a need for prospective controlled studies to determine the optimal immunosuppressive regimens after transplantation in HCVinfected recipients. Combined kidney and liver transplantation is required in patients with advanced liver cirrhosis. However, in patients with cleared HCV infection and early cirrhosis without portal hypertension, kidney transplantation alone may be considered. There is some agreement about the use of HCVpositive donors in HCV-infected recipients, although data regarding posttransplant survival rates are controversial. © 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Hafner A.M.,ETH Zurich | Corthesy B.,CHUV | Textor M.,ETH Zurich | Merkle H.P.,ETH Zurich
Biomaterials | Year: 2011

The artificial dsRNA polyriboinosinic acid-polyribocytidylic acid, poly(I:C), is a potent adjuvant candidate for vaccination, as it strongly drives cell-mediated immunity. However, because of its effects on non-immune bystander cells, poly(I:C) administration may bear danger for the development of autoimmune diseases. Thus poly(I:C) should be applied in the lowest dose possible. We investigated microspheres carrying surface-assembled poly(I:C) as a two-in-one adjuvant formulation to stimulate maturation of monocyte-derived dendritic cells (MoDCs). Negatively charged polystyrene microspheres were equipped with a poly(ethylene glycol) corona through electrostatically driven surface assembly of a library of polycationic poly(l-lysine)-graft-poly(ethylene glycol) copolymers, PLL-g-PEG. Stable surface assembly of poly(I:C) was achieved by incubation of polymer-coated microspheres in an aqueous poly(I:C) solution. Surface-assembled poly(I:C) exhibited a strongly enhanced efficacy to stimulate maturation of MoDCs by up to two orders of magnitude, as compared to free poly(I:C). Multiple phagocytosis events were the key factor to enhance the efficacy. The cytokine secretion pattern of MoDCs after exposure to surface-assembled poly(I:C) differed from that of free poly(I:C), while their ability to stimulate T cell proliferation was similar. Overall, phagocytic signaling plays an important role in defining the resulting immune response to such two-in-one adjuvant formulations. © 2011 Elsevier Ltd.

Bovet P.,CHUV
Information Psychiatrique | Year: 2013

The concept of schizoidia, which emerged in Bleuler's team about one hundred years ago, is dying. We sketch its history, and show how some of the discussions that it raised during the first half of the 20th century have anticipated many of the current debates concerning schizophrenia. If the term "schizoidia" itself may well disappear, the way E. Minkowski envisaged the concept should at least be preserved. By focusing on the distortions of the individual's presence to the world, Minkowski has enriched our understanding of psychopathology, which is nowadays too entrenched into an objectivist perspective.

Lyngdoh T.,University of Lausanne | Marques-Vidal P.,University of Lausanne | Paccaud F.,University of Lausanne | Preisig M.,CHUV | And 3 more authors.
PLoS ONE | Year: 2011

Background: The relation of serum uric acid (SUA) with systemic inflammation has been little explored in humans and results have been inconsistent. We analyzed the association between SUA and circulating levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor- α (TNF-α) and C-reactive protein (CRP). Methods and Findings: This cross-sectional population-based study conducted in Lausanne, Switzerland, included 6085 participants aged 35 to 75 years. SUA was measured using uricase-PAP method. Plasma TNF-α, IL-1β and IL-6 were measured by a multiplexed particle-based flow cytometric assay and hs-CRP by an immunometric assay. The median levels of SUA, IL-6, TNF-α, CRP and IL-1β were 355 μmol/L, 1.46 pg/mL, 3.04 pg/mL, 1.2 mg/L and 0.34 pg/mL in men and 262 μmol/L, 1.21 pg/mL, 2.74 pg/mL, 1.3 mg/L and 0.45 pg/mL in women, respectively. SUA correlated positively with IL-6, TNF-α and CRP and negatively with IL-1β (Spearman r: 0.04, 0.07, 0.20 and 0.05 in men, and 0.09, 0.13, 0.30 and 0.07 in women, respectively, P<0.05). In multivariable analyses, SUA was associated positively with CRP (β coefficient ± SE = 0.35±0.02, P<0.001), TNF-α (0.08±0.02, P<0.001) and IL-6 (0.10±0.03, P<0.001), and negatively with IL-1β (-0.07±0.03, P = 0.027). Upon further adjustment for body mass index, these associations were substantially attenuated. Conclusions: SUA was associated positively with IL-6, CRP and TNF-α and negatively with IL-1β, particularly in women. These results suggest that uric acid contributes to systemic inflammation in humans and are in line with experimental data showing that uric acid triggers sterile inflammation. © 2011 Lyngdoh et al.

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