CHUV Lausanne

Switzerland

CHUV Lausanne

Switzerland
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Hammer M.D.,University of Pittsburgh | Schwamm L.,Massachusetts General Hospital | Starkman S.,University of California at Los Angeles | Schellinger P.D.,Friedrich - Alexander - University, Erlangen - Nuremberg | And 10 more authors.
International Journal of Stroke | Year: 2012

Background: Acute treatment of ischemic stroke patients presenting more than eight-hours after symptom onset remains limited and largely unproven. Partial aortic occlusion using the NeuroFlo catheter can augment cerebral perfusion in animals. We investigated the safety and feasibility of employing this novel catheter to treat ischemic stroke patients eight-hours to 24h following symptom onset. Methods: A multicenter, single-arm trial enrolled ischemic stroke patients at nine international academic medical centers. Eligibility included age 18-85 years old, National Institutes of Health stroke scale (NIHSS) score between four and 20, within eight-hours to 24h after symptom onset, and perfusion-diffusion mismatch confirmed by magnetic resonance imaging. The primary outcome was all adverse events occurring from baseline to 30 days posttreatment. Secondary outcomes included stroke severity on neurological indices through 90 days. This study is registered with ClinicalTrials.gov, number NCT00436592. Results: A total of 26 patients were enrolled. Of these, 25 received treatment (one excluded due to aortic morphology); five (20%) died. Favorable neurological outcome at 90 days (modified Rankin score 0-2 vs. 3-6) was associated with lower baseline NIHSS (P<0·001) and with longer duration from symptom discovery to treatment. There were no symptomatic intracranial hemorrhages or parenchymal hematomas. Asymptomatic intracranial hemorrhage was visible on computed tomography in 32% and only on microbleed in another 20%. Conclusions: Partial aortic occlusion using the NeuroFlo catheter, a novel collateral therapeutic strategy, appears safe and feasible in stroke patients eight-hours to 24h after symptom onset. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.


Bourgier C.,Montpellier University | Bourgier C.,Institute Of Recherche En Cancerologie Of Montpellier | Bourgier C.,Institute Regional Du Cancer Of Montpellier Icm Val Daurelle | Lacombe J.,Montpellier University | And 12 more authors.
Critical Reviews in Oncology/Hematology | Year: 2015

Radiation therapy undeniably enhances local control and thus improves overall survival in cancer patients. However, some long-term cancer survivors (less than 10%) develop severe late radio-induced toxicities altering their quality of life. Therefore, there is a need to identify patients who are sensitive to those toxicities and who could benefit from adapted care. In this review, we address all available techniques aiming to detect patients' hyper-radiosensitivity and present the scientific rationales these techniques are based on. © 2014 Elsevier Ireland Ltd.


Zago M.,Minimally Invasive Surgery Unit | Martinez Casas I.,Hospital Medico Quirurgico | Pereira J.,Tondela Viseu Hospital Center | Mariani D.,Legnano Hospital | And 10 more authors.
European Journal of Trauma and Emergency Surgery | Year: 2016

Purpose: The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit. Methods: Modular UltraSound ESTES Course (MUSEC) is a modular blended-learning course. It incorporates pre-test/post-test examinations, pre-course online materials, didactic and interactive lectures, interactive case scenarios discussion with pathological US clips, hands-on practice on healthy volunteer models, and on original phantoms for simulating both pathological US findings and practicing US-guided interventional maneuvers. Four independent modules were provided. Surgical decision-making didactics were also included in the course curriculum. Learning gain (Δ of the rating of pre-test and post-test) was calculated for each module. An anonymous post-course satisfaction survey was also administered (16 questions with a Likert’s 5-point scale of evaluation). Results: Twenty-three MUSEC Courses were run in a 30 months period, training 416 doctors from 29 countries. A total of 52 modules were delivered. The mean pre-test and post-test grades were 8.3/12 and 10.7/12, respectively, yielding a significant mean learning gain of 28.9 % (p = 0.001). Post-course satisfaction survey got an overall ranking of 4.5/5. Conclusions: MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing. © 2016, Springer-Verlag Berlin Heidelberg.


PubMed | Legnano Hospital, Minimally Invasive Surgery Unit, Tondela Viseu Hospital Center, Goethe University Frankfurt and 7 more.
Type: Journal Article | Journal: European journal of trauma and emergency surgery : official publication of the European Trauma Society | Year: 2016

The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit.Modular UltraSound ESTES Course (MUSEC) is a modular blended-learning course. It incorporates pre-test/post-test examinations, pre-course online materials, didactic and interactive lectures, interactive case scenarios discussion with pathological US clips, hands-on practice on healthy volunteer models, and on original phantoms for simulating both pathological US findings and practicing US-guided interventional maneuvers. Four independent modules were provided. Surgical decision-making didactics were also included in the course curriculum. Learning gain ( of the rating of pre-test and post-test) was calculated for each module. An anonymous post-course satisfaction survey was also administered (16 questions with a Likerts 5-point scale of evaluation).Twenty-three MUSEC Courses were run in a 30months period, training 416 doctors from 29 countries. A total of 52 modules were delivered. The mean pre-test and post-test grades were 8.3/12 and 10.7/12, respectively, yielding a significant mean learning gain of 28.9% (p=0.001). Post-course satisfaction survey got an overall ranking of 4.5/5.MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing.


Berthold D.,CHUV Lausanne | Lhermitte B.,CHUV Lausanne | Uffer M.,CHUV Lausanne | Doerfler A.,CHUV Lausanne | Doerfler A.,Caen University Hospital Center
Andrologia | Year: 2012

Leydig cell tumours (LCTs) of the testis are rare. Their origin is still unknown. This case report describes a potential relationship between LCT and prolonged exposure to Finasteride. © 2011 Blackwell Verlag GmbH.


Taverna C.,Medizinische Klinik | Bargetzi M.,Kantonsspital Aarau | Betticher D.,Kantonsspital Fribourg | Gmur J.,Hirslanden Zurich | And 8 more authors.
Swiss Medical Weekly | Year: 2010

The treatment of multiple myeloma has undergone significant changes in the recent past. The arrival of novel agents, especially thalidomide, bortezomib and lenalidomide, has expanded treatment options and patient outcomes are improving significantly. This article summarises the discussions of an expert meeting which was held to debate current treatment practices for multiple myeloma in Switzerland concerning the role of the novel agents and to provide recommendations for their use in different treatment stages based on currently available clinical data. Novel agent combinations for the treatment of newly diagnosed, as well as relapsed multiple myeloma are examined. In addition, the role of novel agents in patients with cytogenetic abnormalities and renal impairment, as well as the management of the most frequent side effects of the novel agents are discussed. The aim of this article is to assist in treatment decisions in daily clinical practice to achieve the best possible outcome for patients with multiple myeloma.


Bonarelli C.,Nancy University Hospital Center | Teixeira P.A.G.,Nancy University Hospital Center | Hossu G.,Nancy University Hospital Center | Hossu G.,French Institute of Health and Medical Research | And 5 more authors.
American Journal of Roentgenology | Year: 2015

OBJECTIVE. The objective of our study was to assess the impact of two methods of apparent diffusion coefficient (ADC) selection on the diagnostic performance of DWI in the characterization of nonfatty soft-tissue masses. SUBJECTS AND METHODS. Sixty-five histologically confirmed soft-tissue tumors imaged from November 2009 through October 2012 were evaluated. The minimal ADC (ADCmin) and average ADC (ADCavg) values for each tumor were obtained using two ROI-positioning methods: manual and semiautomatic. Two readers correlated the findings to lesion histology and morphology on conventional MRI sequences. RESULTS. The ADCmin values obtained using the manual method presented a better sensitivity with a similar specificity when compared with the ADCmin values obtained using the semiautomatic method (manual vs semiautomatic: 75-83% and 59-63% vs 58-67% and 63% and 63%, respectively). The interobserver agreement for the ADCmin values was similar between the ADC selection methods (intraclass correlation coefficient = 0.81 and 0.87 for manual and semiautomatic methods, respectively). In the subgroup of solid lesions, the ADCavg values obtained using the manual method offered a better sensitivity for benign-malignant differentiation (60-81% vs 60% and 60% for ADCavg and ADCmin, respectively). CONCLUSION. The ADCmin values obtained with manual ROI positioning offered the best diagnostic performance for tumor characterization. The semiautomatic method yielded similar specificity values. For solid masses, the ADCavg values were better correlated with tumor histology than the ADCmin values.


PubMed | CHUV Lausanne, Montpellier University Hospital Center and Montpellier University
Type: Journal Article | Journal: Critical reviews in oncology/hematology | Year: 2015

Radiation therapy undeniably enhances local control and thus improves overall survival in cancer patients. However, some long-term cancer survivors (less than 10%) develop severe late radio-induced toxicities altering their quality of life. Therefore, there is a need to identify patients who are sensitive to those toxicities and who could benefit from adapted care. In this review, we address all available techniques aiming to detect patients hyper-radiosensitivity and present the scientific rationales these techniques are based on.


PubMed | CHUV Lausanne
Type: | Journal: Andrologia | Year: 2012

Leydig cell tumours (LCTs) of the testis are rare. Their origin is still unknown. This case report describes a potential relationship between LCT and prolonged exposure to Finasteride.


PubMed | CHUV and CHUV Lausanne
Type: | Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine | Year: 2017

The aim of this study was to compare survival of patients treated for unresectable hepatocellular carcinoma (uHCC) with Yttrium-90 (We performed a retrospective analysis of prospectively collected data on 77 consecutively treated (mean age 66.4 12.2 y) for uHCC (36 uni-nodular, 5 multi-nodular, 36 diffuse) with Characteristics of two groups were comparable in regard to demographic data, comorbidities, Child-Pugh score, BCLC, serum AFP level and Comparison between resin and glass microspheres revealed no significant survival difference in patients treated for uHCC with

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