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Zürich (Kreis 7) / Hirslanden, Switzerland

Francis J.,Baby Memorial Hospital | Reek S.,Hirslanden Medical Center
Indian Heart Journal | Year: 2014

It is well established that implantable cardioverter defibrillator (ICD) is a life saving device ensuring protection against life threatening ventricular arrhythmias. But there are certain situations like a recent myocardial infarction where the standard guidelines do not recommend the implantation of an ICD while the patient can still be at a risk of demise due to a life threatening ventricular arrhythmia. There could also be a temporary indication for protection while explanting an infected ICD system. The wearable cardioverter defibrillator (WCD) is a device which comes to the rescue in such situations. In this brief review, we discuss the historical aspects of the development of a WCD, technical aspects as well as the clinical trial data and real world scenario of its use. Copyright © 2013, Cardiological Society of India. All rights reserved.

Simmler R.,Hirslanden Medical Center
Radiologe | Year: 2013

When applying the standard DIN V 6868-57 rule "acceptance testing for image display devices" it always comes to misunderstandings in the practical implementation. In a brief summary the most important requirements are presented. With the pending replacement of DIN V 6868-57 by DIN 6868-157 "acceptance and constancy tests of image display systems in their environment" there will be fundamental changes. Future requirements are presented as examples. Besides the introduction of a classroom concept and new test images, the focus of the standard is aligned with the image display system. This change places new demands on the management concept of picture archiving and communication system (PACS) workstations. For testing the unit, consisting of a computer system, video card, operating system and image display equipment only one organizational unit should be responsible. © 2013 Springer-Verlag Berlin Heidelberg.

Guijarro-Martinez R.,Craniofacial Center | Gellrich N.-C.,Hannover Medical School | Witte J.,BrainLAB | Von Briel C.,Hirslanden Medical Center | And 6 more authors.
International Journal of Oral and Maxillofacial Surgery | Year: 2014

A navigation-assisted multidisciplinary network to improve the interface between radiology, surgery, radiotherapy, and pathology in the field of head and neck cancer is described. All implicated fields are integrated by a common server platform and have remote data access in a ready-to-use format. The margins of resection and exact locations of biopsies are mapped intraoperatively. The pathologist uses the numerical coordinates of these samples to precisely trace each specimen in the anatomical field. Subsequently, map-guided radiotherapy is planned. In addition to the benefits of image-guided resection, this model enables radiotherapy planning according to the specific coordinates of the resection defect plus any residually affected sites identified by the pathologist. Irradiation of adjacent healthy structures is thereby minimized. In summary, the navigation-assisted network described grants timely multidisciplinary feedback between all fields involved, attains meticulous pathological definition, and permits optimized coordinate-directed radiotherapy. © 2013 International Association of Oral and Maxillofacial Surgeons.

Schneider U.,University of Zurich | Schneider U.,Hirslanden Medical Center | Halg R.A.,Hirslanden Medical Center | Hartmann M.,Hirslanden Medical Center | And 5 more authors.
Zeitschrift fur Medizinische Physik | Year: 2014

Purpose: Late toxicities such as second cancer induction become more important as treatment outcome improves. Often the dose distribution calculated with a commercial treatment planning system (TPS) is used to estimate radiation carcinogenesis for the radiotherapy patient. However, for locations beyond the treatment field borders, the accuracy is not well known. The aim of this study was to perform detailed out-of-field-measurements for a typical radiotherapy treatment plan administered with a Cyberknife and a Tomotherapy machine and to compare the measurements to the predictions of the TPS. Materials and methods: Individually calibrated thermoluminescent dosimeters were used to measure absorbed dose in an anthropomorphic phantom at 184 locations. The measured dose distributions from 6 MV intensity-modulated treatment beams for CyberKnife and TomoTherapy machines were compared to the dose calculations from the TPS. Results: The TPS are underestimating the dose far away from the target volume. Quantitatively the Cyberknife underestimates the dose at 40. cm from the PTV border by a factor of 60, the Tomotherapy TPS by a factor of two. If a 50% dose uncertainty is accepted, the Cyberknife TPS can predict doses down to approximately 10 mGy/treatment Gy, the Tomotherapy-TPS down to 0.75 mGy/treatment Gy. The Cyberknife TPS can then be used up to 10. cm from the PTV border the Tomotherapy up to 35. cm. Conclusions: We determined that the Cyberknife and Tomotherapy TPS underestimate substantially the doses far away from the treated volume. It is recommended not to use out-of-field doses from the Cyberknife TPS for applications like modeling of second cancer induction. The Tomotherapy TPS can be used up to 35cm from the PTV border (for a 390 cm3 large PTV). © 2013.

Popescu R.A.,Hirslanden Medical Center | Schafer R.,European Society for Medical Oncology | Califano R.,The Christie NHS Foundation Trust | Califano R.,University of Manchester | And 18 more authors.
Annals of Oncology | Year: 2014

The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.© The Author 2013.Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

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