Fribourg, Switzerland
Fribourg, Switzerland

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Tsao A.S.,University of Texas M. D. Anderson Cancer Center | Scagliotti G.V.,University of Turin | Bunn P.A.,Aurora University | Carbone D.P.,Ohio State University | And 34 more authors.
Journal of Thoracic Oncology | Year: 2016

Lung cancer continues to be a major global health problem; the disease is diagnosed in more than 1.6 million new patients each year. However, significant progress is underway in both the prevention and treatment of lung cancer. Lung cancer therapy has now emerged as a "role model" for precision cancer medicine, with several important therapeutic breakthroughs occurring during 2015. These advances have occurred primarily in the immunotherapy field and in treatments directed against tumors harboring specific oncogenic drivers. Our knowledge about molecular mechanisms for oncogene-driven tumors and about resistance to targeted therapies has increased quickly over the past year. As a result, several regulatory approvals of new agents that significantly improve survival and quality of life for patients with lung cancer who have advanced disease have occurred. The International Association for the Study of Lung Cancer has gathered experts in different areas of lung cancer research and management to summarize the most significant scientific advancements related to prevention and therapy of lung cancer during the past year. © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.


PubMed | HFR Fribourg, Riviera Chablais Hospital and Laboratory of Pathology and Cytology Unilabs
Type: | Journal: Case reports in surgery | Year: 2016

Chronic aortoiliac occlusive disease most often affects the common iliac arteries and distal aorta but can progress all the way to the renal arteries, occluding the inferior mesenteric artery. A compensatory collateral network typically develops to preserve lower body perfusion. Inadvertent compression or ligation of such collaterals during surgery can have catastrophic consequences. In this article, we present the case of a 63-year-old patient with aortoiliac occlusive disease, requiring surgery for an adenocarcinoma of the rectosigmoid junction. A CT angiography was performed in order to map out the collateral pathways that had developed and Doppler ultrasound was used to mark their positions. The surgical procedure was adapted to his specific anatomy. A successful anterior resection was performed, and the patient made an uneventful recovery. In cases of aortoiliac obliteration, the existence of collaterals must be kept in mind and investigated with a multidisciplinary approach before any surgery is considered.


Boehncke W.-H.,University of Geneva | Anliker M.D.,Cantonal Hospital | Conrad C.,University of Lausanne | Dudler J.,HFR Fribourg | And 11 more authors.
Dermatology | Year: 2015

Background: Psoriatic arthritis (PsA) substantially impacts the management of psoriatic disease. Objective: This study aimed to generate an interdisciplinary national consensus on recommendations of how PsA should be managed. Methods: Based on a systematic literature search, an interdisciplinary expert group identified important domains and went through 3 rounds of a Delphi exercise, followed by a nominal group discussion to generate specific recommendations. Results: A strong consensus was reached on numerous central messages regarding the impact of PsA, screening procedures, organization of the interaction between dermatologists and rheumatologists, and treatment goals. Conclusion: These recommendations can serve as a template for similar initiatives in other countries. At the same time, they highlight the need to take into account the impact of the respective national health care system. © 2015 S. Karger AG, Basel.


Orecchio A.,HFR Fribourg | Periard D.,HFR Fribourg | Kashef A.,Gynecology and Obstetrics | Magnin J.-L.,Central Laboratory | And 2 more authors.
Gynecological Endocrinology | Year: 2014

To evaluate the incidence of gestational diabetes mellitus (GDM), gestational glucose intolerance (GGI), and birth major complications, a population of 1042 pregnant women was screened after the end of the second trimester with a two-step screening method. Patients with a positive 50-g screening test (plasma glucose 7.8mmol/l at 1h) underwent a 3-h standard 100-g oral glucose tolerance test. Clinical records of patients and newborns were analysed and compared to normotolerant patients group. GDM was found in 4.8% and GGI in 2.6% of all screened women of this study population. The patient group with GDM significantly differed from control, with a higher proportion of Asiatic women (32.0% versus 2.9%, p=0.001) and high prevalence of previous GDM (26.0% versus 0.0%, p<0.001). Major neonatal complications occurred more frequently in the dysmetabolic groups compared to normotolerant group. Macrosomia was not noted in our population. Asiatic origin and previous GDM were strongly associated with an increased incidence of GDM in multivariate analysis. This study represents the first epidemiological evaluation of GDM/GGI in Switzerland, with a two-step screening method. Incidence of GDM and GGI as well as birth complications resulted significant in our country. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.


Vo Q.D.,HFR Fribourg | Monnard E.,HFR Fribourg | Hoogewoud H.M.,HFR Fribourg
BMJ Case Reports | Year: 2013

We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells. Copyright 2013 BMJ Publishing Group. All rights reserved.


Demierre N.,HFR Fribourg | Zoete V.,University of Lausanne | Michielin O.,University of Lausanne | Stauffer E.,Institute of Pathology | And 3 more authors.
Lung Cancer | Year: 2013

We report on the medical history of a Caucasian smoker woman diagnosed with a stage IV NSCLC adenocarcinoma, characterized by a rare epidermal growth factor receptor (EGFR) point mutation in exon 21 codon 843 (p.V843I/c.2527G. >A/COSMIC ID 85894). This genetic alteration revealed to be germline, after its presence was demonstrated in chondroblasts from the bone biopsy. While it is the first description of germline V843I mutation without concomitant additional known EGFR activating mutation, we modeled the EGFR ATP catalytic domain in complex with ATP, gefitinib and erlotinib using computer-aided approaches to estimate possible changes in affinity upon the V843I mutation. © 2012 Elsevier Ireland Ltd.


Vo Q.D.,HFR Fribourg
BMJ case reports | Year: 2013

We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells.


Chronic blood malignancies in the elderly remain incurable diseases. However, recent advances in therapies allow not only to extend treatment at advanced ages and in presence of significant comorbidities, but also to induce prolonged remissions. However, this is achieved at the cost of increased risk of infectious diseases, due to disease - and treatment - related immunosuppression. This article will review the infectious diseases associated with chronic lymphatic leukemia, myelodysplastic syndrome and multiple myeloma. Furthermore we will discuss the recommendation of antiinfectious prophylaxis and vaccination for each of the conditions listed above.


PubMed | HFR Fribourg
Type: Journal Article | Journal: Revue medicale suisse | Year: 2010

Microscopic hematuria is common in medical practice; its prevalence in the adult population varies between 2.5 and 13%. Currently available data are insufficient to determine an algorithm based on evidence of the most effective diagnostic strategy of hematuria. Avoid invasive tests for the patient and expensive for the community, determine whether the hematuria of glomerular origin or not, facilitate the clinician referral to a nephrologist or urologist for the etiological diagnosis, should be the basic principles of any approach to develop such an algorithm. We try to answer on this question in this article.


To measure the real T1 relaxation time of the lumbar intervertebral discs in a young and healthy population, using different inversion recovery times, and assess diurnal variation.Intervertebral discs from D12 to S1 of 50 healthy volunteers from 18 to 25 years old were evaluated twice the same day, in the morning and in the late afternoon. Dedicated MRI sequences with different inversion recovery times (from 100 to 2500ms) were used to calculate the real T1 relaxation time. Three regions of interest (ROIs) were defined in each disc, the middle representing the nucleus pulposus (NP) and the outer parts the annulus fibrosus (AF) anterior and posterior. Diurnal variation and differences between each disc level were analyzed.T1 mean values in the NP were 114212ms in the morning and 108513ms in the afternoon, showing a highly significant decrease of 57ms (p<0.001). A highly significant difference between the levels of the spine was found. The mean T1 of the anterior part of the AF was 5779ms in the morning and 5548ms in the afternoon. For the posterior part, the mean values were 6338ms in the morning and 5817ms in the evening. It shows a highly significant decrease of 23ms for the anterior part and 51ms for the posterior part (all p<0.001).T1 mapping is a promising method of intervertebral disc evaluation. Significant diurnal variation and difference between levels of the lumbar spine were demonstrated. A potential use for longitudinal study in post-operative follow up or sport medicine needs to be evaluated.

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