Bellinzona, Switzerland
Bellinzona, Switzerland

Time filter

Source Type

Del Giorno R.,Hopital Regional de Bellinzona | Ceschi A.,Ente Ospedaliero Cantonale | Gabutti L.,Hopital Regional de Bellinzona
Revue Medicale Suisse | Year: 2017

Clinical studies show that prescription of benzodiazepines increases with age, and well outside of recognized indications. It often is inappropriate and abusive. Its consequences can be very serious and considerably increase patients' morbidity and mortality. Strategies exist to stop these medications through a multidisciplinary approach. Widespread campaigns are necessary to correct what has become a significant public health problem.


PubMed | Ente Ospedaliero Cantonale, University of Lausanne, University of Zürich, Institute for Immunogenetics and 3 more.
Type: | Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America | Year: 2016

In the absence of therapy CXCR4-tropic HIV-1 increases over time, associated with accelerated disease progression. In contrast, the majority of patients under long-term cART presents with CCR5-tropic HIV-1 variants. It is unclear, whether cART itself mediates the reduction of CXCR4-tropic HIV-1. This study aimed at assessing the tropism of viral integrates in patients blood during fully suppressive cART.Relative frequencies of CXCR4-tropic proviral HIV-1 variants were determined by NGS (FPR3.5%, R5=X4<2%) for 35 treated patients in the Swiss HIV Cohort Study and followed longitudinally over time. Full viral suppression and a continuous CD4 T cell recovery under cART were documented for all patients. Viral phylogenetic changes and sequence evolution were analyzed.The majority of patients (80%) experienced under therapy no frequency-increase of CXCR4-tropic proviruses. Although some proviral sequence evolution was demonstrable in over 50% of these patients under therapy this growing viral diversity was in no case paralleled by the emergence or expansion of CXCR4-tropic provirus variants. In the remaining 20% of patients the documented expansion of CXCR4-tropic provirus was based on the outgrowth of single viral variants from minority populations already present before therapy initiation.Our study demonstrates that CXCR4-tropic HIV sharply declines in most patients under successful therapy, which indicates a preferential tropism-dependent provirus elimination in the immune-competent host. The recently implemented WHO-strategies of immediate therapy initiation are fully in line with this gradual loss of CXCR4-tropism during therapy. Moreover, the early use of co-receptor antagonists against the remaining CCR5-tropic viruses may be indicated.


Grant
Agency: European Commission | Branch: FP7 | Program: MC-IRG | Phase: PEOPLE-2007-4-3.IRG | Award Amount: 100.00K | Year: 2009

The irreversible cell growth arrest, termed cellular senescence, is emerging as an intrinsic tumour suppressive mechanism, which restricts progression of early cancerous lesions in humans. We have recently reported, a new type of cellular senescence, which occurs after the acute inactivation of the tumour suppressor Pten and significantly opposes tumorigenesis in vivo. Pten induced cellular senescence (PICS) occurs at early time points after Pten inactivation even in absence of cellular proliferation and DNA Damage. I will discuss the mechanism that trigger PICS in cancer, hailing the potential therapeutic implication of p53 stabilizing drugs and Pten inhibitors. Importantly, I will discuss how the oncogenic stress induced by complete loss of Pten can still triggers senescence in cells with low proliferative potential, such as cancer stem cells. I propose to apply this model to the treatment of pediatric brain tumors.


Stienen M.N.,University of Geneva | Netuka D.,Charles University | Demetriades A.K.,Western General Hospital | Ringel F.,TU Munich | And 4 more authors.
Acta Neurochirurgica | Year: 2016

Introduction: The introduction of the European Working Time directive 2003/88/EC has led to a reduction of the working hours with distinct impact on the clinical and surgical activity of neurosurgical residents in training. Methods: A survey was performed among European neurosurgical residents between 06/2014 and 03/2015. Multiple logistic regression was used to assess the relationship between responder-specific variables (e.g., age, gender, country, postgraduate year (PGY)) and outcome (e.g., working time). Results: A total of 652 responses were collected, of which n = 532 responses were taken into consideration. In total, 17.5, 22.1, 29.5, 19.5, 5.9, and 5.5 % of European residents indicated to work <40, 40–50, 51–60, 61–70, 71–80, or >80 h/week, respectively. Residents from France and Turkey (OR 4.72, 95 % CI 1.29–17.17, p = 0.019) and Germany (OR 2.06, 95 % CI 1.15–3.67, p = 0.014) were more likely to work >60 h/week than residents from other European countries. In total, 29 % of European residents were satisfied with their current working time, 11.3 % indicated to prefer reduced working time. More than half (55 %) would prefer to work more hours/week if this would improve their clinical education. Residents that rated their operative exposure as insufficient were 2.3 times as likely as others to be willing to work more hours (OR 2.32, 95 % CI 1.47–3.70, p < 0.001). Less than every fifth European resident spends >50 % of his/her working time in the operating room. By contrast, 77.4 % indicate to devote >25 % of their daily working time to administrative work. For every advanced PGY, the likelihood to spend >50 % of the working time in the OR increases by 19 % (OR 1.19, 95 % CI 1.02–1.40, p = 0.024) and the likelihood to spend >50 % of the working time with administrative work decreases by 18 % (OR 0.84, 95 % CI 0.76-0.94, p = 0.002). Conclusions: The results of this survey on >500 European neurosurgical residents clearly prove that less than 40 % conform with the 48-h week as claimed by the WTD2003/88/EC. Still, more than half of them would chose to work even more hours/week if their clinical education were to improve; probably due to subjective impression of insufficient training. © 2015, Springer-Verlag Wien.


Stienen M.N.,University of Geneva | Netuka D.,Charles University | Demetriades A.K.,Western General Hospital | Ringel F.,TU Munich | And 4 more authors.
Acta Neurochirurgica | Year: 2016

Introduction: Neurosurgical training aims at educating future generations of specialist neurosurgeons and at providing the highest-quality medical services to patients. Attaining and maintaining these highest standards constitutes a major responsibility of academic or other training medical centers. Methods: An electronic survey was sent to European neurosurgical residents between 06/2014 and 03/2015. Multiple logistic regression analysis was used to assess the effect size of the relationship between responder-specific variables (e.g., age, gender, postgraduate year (PGY), country) and the outcomes (e.g., satisfaction). Results: A total of 652 responses were collected, of which n = 532 were taken into consideration. Eighty-five percent were 26–35 years old, 76 % male, 62 % PGY 4 or higher, and 73.5 % working at a university clinic. Satisfaction rates with theoretical education such as clinical lectures (overall: 50.2 %), anatomical lectures (31.2 %), amongst others, differed largely between the EANS member countries. Likewise, satisfaction rates with practical aspects of training such as hands-on surgical experience (overall: 73.9 %), microsurgical training (52.5 %), simulator training (13.4 %), amongst others, were highly country-dependant. In general, 89.1 % of European residents carried out the first surgical procedure under supervision within the first year of training. Supervised lumbar-/cervical spine surgeries were performed by 78.2 and 17.9 % of European residents within 12 and 24 months of training, respectively, and 54.6 % of European residents operate a cranial case within the first 36 months of training. Logistic regression analysis identified countries where residents were much more or much less likely to operate as primary surgeons compared to the European average. The caseload of craniotomies per trainee (overall: 30.6 % ≥10 craniotomies/month) and spinal procedures (overall: 29.7 % ≥10 spinal surgeries/month) varied throughout the countries and was significantly associated with more advanced residency (craniotomy: OR 1.35, 95 % CI 1.18–1.53, p < 0.001; spinal surgery: OR 1.37, 95 % CI 1.20–1.57, p < 0.001). Conclusions: Theoretical and practical aspects of neurosurgical training are highly variable throughout European countries, despite some efforts within the last two decades to harmonize this. Some countries are rated significantly above (and others significantly below) the current European average for several analyzed parameters. It is hoped that the results of this survey should provide the incentive as well as the opportunity for a critical analysis of the local conditions for all training centers, but especially those in countries scoring significantly below the European average. © 2015, Springer-Verlag Wien.


Perren A.,Ente Ospedaliero Cantonale | Previsdomini M.,Ente Ospedaliero Cantonale | Llamas M.,University of Geneva | Cerutti B.,University of Geneva | And 3 more authors.
Intensive Care Medicine | Year: 2010

Purpose: The spontaneous breathing trial (SBT) - relying on objective criteria assessed by the clinician - is the major diagnostic tool to determine if patients can be successfully extubated. However, little is known regarding the patient's subjective perception of autonomous breathing. Methods: We performed a prospective observational study in 211 mechanically ventilated adult patients successfully completing a SBT. Patients were randomly assigned to be interviewed during this trial regarding their prediction of extubation success. We compared post-extubation outcomes in three patient groups: patients confident (confidents; n = 115) or not (non-confidents; n = 38) of their extubation success and patients not subjected to interview (control group; n = 58). Results: Extubation success was more frequent in confidents than in non-confidents (90 vs. 45%; p < 0.001/positive likelihood ratio = 2.00) or in the control group (90 vs. 78%; p = 0.04). On the contrary, extubation failure was more common in non-confidents than in confidents (55 vs. 10%; p < 0.001/negative likelihood ratio = 0.19). Logistic regression analysis showed that extubation success was associated with patient's prediction [OR (95% CI): 9.2 (3.74-22.42) for confidents vs.non-confidents] as well as to age [0.72 (0.66-0.78) for age 75 vs. 65 and 1.31 (1.28-1.51) for age 55 vs. 65]. Conclusions: Our data suggest that at the end of a sustained SBT, extubation success might be correlated to the patients' subjective perception of autonomous breathing. The results of this study should be confirmed by a large multicenter trial. © 2010 Copyright jointly held by Springer and ESICM.


News Article | December 7, 2016
Site: www.businesswire.com

Theraclion (Paris:ALTHE) (Alternext, FR0010120402 – ALTHE), a company specialized in leading-edge medical equipment for echotherapy, today announced that the Ente Ospedaliero Cantonale (EOC), the first center to offer echotherapy in Switzerland for the treatment of benign thyroid nodules, has exercised its option to buy an Echopulse® system. Following a one-year rental period, the EOC purchased the system. “Echopulse® is a very promising non-invasive approach to treating benign thyroid nodules,” said Prof. Lucas Giovanella, Director of the EOC Competence Centre for Thyroid Diagnosis and Treatment and Head of the Nuclear Medicine Department and the PET-CT Center. “We are highly interested by Theraclion’s technology as it completes our panel of treatment options for benign thyroid diseases. Theraclion’s specialists provided dedicated support to our clinician team in the initial phase and we are very happy now to continue to work with Theraclion.” The EOC is a group of all public hospitals operating in Ticino, a region located in the Italian-speaking region of Switzerland. The group is comprised of six general hospitals and two specialized clinics. A unique feature of this group’s structure is the presence of centers of excellence that serve patients from the region regardless of the hospital at which they initially present. The EOC is responsible for the majority of all health care delivered in Ticino. “Continuing our collaboration with this Center of Excellence for the management of thyroid pathologies represents strong validation and trust of our technology by renowned specialists such as Prof. Giovanella,” said David Caumartin, CEO of Theraclion. "EOC’s purchase of an Echopulse® system demonstrates the growing support of echotherapy among alternative therapeutic and surgical options for effective and safe treatment of patients.” About Theraclion Theraclion is a French company specializing in high-tech medical equipment using therapeutic ultrasound. Drawing on leading-edge technologies, Theraclion has designed and manufactured an innovative solution for echotherapy, the Echopulse®, allowing non-invasive tumor treatment through ultrasound-guided high-intensity focused ultrasound. Theraclion is ISO 13485 certified and has received the CE mark for non-invasive ablation of breast fibroadenomas and thyroid nodules. Based in Malakoff, near Paris, France Theraclion has brought together a team of 35 people, 50% of whom are dedicated to R&D and clinical trials. For more information, please visit Theraclion’s website: www.theraclion.com.


Grant
Agency: European Commission | Branch: H2020 | Program: MSCA-RISE | Phase: MSCA-RISE-2015 | Award Amount: 931.50K | Year: 2016

The combination of longer life expectancy, evolving socio-economical norms and conditions, and new technologies are dramatically changing life after retirement, and not always for the better. In more and more countries, pensioners find themselves with many years in front of them, some of them likely characterized by reduced physical and cognitive abilities. For older adults, this span of time out of the workforce was traditionally devoted to the role (and source of great joy) of caring for grandchildren. However, this role is fading out because of increased mobility of children, which often live far away for work, love, or other reasons, leading to an increase of loneliness and social isolation. This project aims at rethinking long life and understanding the socio-economical context that can make this period of life more exiting and attractive. The specific angle we take is that of enabling older adults of all ages - and specifically including adults who cannot leave their home or that have reduced cognitive abilities - to learn, grow, interact, and contribute to society through ICT. In other words, we aim at enabling adults to be contributors to societal wellbeing. We generically refer to this group of abilities as life participation abilities, and we focus on these aspects because studies tell us that the ability of interacting and feeling useful and helpful to others is essential to a persons wellbeing, sometimes more so than health. The multi- and inter-disciplinary nature of the project provides the perfect environment for collaboration and knowledge transfer. As such, it requires the expertise and perspective that only the consortium as a whole can provide. The synergies that we build in the project will help not only in the materialization of the solutions starting from the original problems, challenges and requirements, but they will also foster the growth of research and innovation skills of the researchers and institutions involved in the project.


Imperiali M.,Ente Ospedaliero Cantonale | Jelmini P.,Ente Ospedaliero Cantonale | Ferraro B.,Ente Ospedaliero Cantonale | Keller F.,Ente Ospedaliero Cantonale | And 3 more authors.
European Journal of Clinical Investigation | Year: 2010

Background Thyroid-stimulating hormone (TSH) measurement plays a major role in the diagnosis of thyroid disorders. Despite the good quality of immunochemical tests measuring TSH levels, the presence of interfering substances can sometimes alter the TSH results. Design We reported the case of a 79-year-old man affected by primary autoimmune hypothyroidism hospitalized for pneumonia. A TSH value > 100 mIU L-1 (reference: 0.44 mIU L -1) was found at admission. No signs and symptoms of hypothyroidism were found upon clinical examination and serum concentration of the free thyroxine (FT4) was normal. Results Serum treatment in heterophile antibody blocking tubes did not change the TSH result in our assay, while normal levels were found in a different immunoassay method. An abnormal pattern was found in protein electrophoresis at admission, with IgG / j and IgM / k monoclonal bands proved in immunofixation. Interestingly, the disappearance of monoclonal bands was paralleled with a normalization of the TSH value. Conclusions We suggest in this study that the TSH determination might be influenced by the presence of transient paraproteins. © 2010 Stichting European Society for Clinical Investigation Journal Foundation.


Grant
Agency: European Commission | Branch: FP7 | Program: ERC-SG | Phase: ERC-SG-LS7 | Award Amount: 1.50M | Year: 2011

This proposal aims to harness a novel type of senescence that we have identified in response to acute Pten inactivation, and which we believe offers a radical therapeutic approach to target the quiescent cancer stem cell in vivo. In characterizing Pten loss Induced Cellular Senescence, which we have named PICS for short, we have discovered that PICS is distinct from other forms of cellular senescence including oncogene-induced senescence (OIS) and replicative senescence. These distinct differences are characterized by a lack of DNA damage and hyper-replication, breaking the current dogma for senescence induction. The ability to induce senescence, an irreversible growth arrest, in cells by targeting Pten signaling, without a requirement for hyper-replication and DNA damage opens up the possibility to target quiescent cells, including stem cells, that have a low proliferative index. This approach has tremendous therapeutic potential and represents one of the most exciting developments for the advancement of prostate cancer therapy in recent years. Through the manipulation of senescence induction pathways we will identify PICS enhancing drugs and redefine the paradigm for cancer therapy. By developing novel mouse models that target prostate stem cells we will evaluate these PICS pro-senescence drugs in a pre-clinical setting. Finally, these results will be cross referenced with data from human prostate stem cells and we will lay the ground work to translate this to the clinical setting, further developing the clinical potential of these findings to eradicate prostate cancer.

Loading Ente Ospedaliero Cantonale collaborators
Loading Ente Ospedaliero Cantonale collaborators