Cantonal Hospital St Gallen

Sankt Gallen, Switzerland

Cantonal Hospital St Gallen

Sankt Gallen, Switzerland
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News Article | February 15, 2017

Helsinn Provides Grant for ESMO's Preceptorship Course on Supportive and Palliative Care Lugano, Switzerland, February 15, 2017 - Helsinn, a Swiss pharmaceutical group focused on building quality cancer care, announces that the Group has provided a grant to the European Society for Medical Oncology ("ESMO") for a preceptorship event dedicated to supportive and palliative care for physicians. The preceptorship course will take place in Zurich on February 20-21, 2017 and will touch on a broad range of aspects related to cancer supportive and palliative care. The key learning objectives of the preceptorship are to: The Chair of the event will be Dr Florian Strasser MD, Associate Professor in the Clinic Oncology/Hematology at the Cantonal Hospital St. Gallen, Head of Oncological Palliative Medicine at Cantonal Hospital St Gallen, Switzerland, where he is responsible for the clinical and research activities in Palliative Oncology and in Geriatric Oncology. He is also substantially involved in Geriatric Oncology, Supportive Care and Cancer Rehabilitation for both in- and out-patients in the Comprehensive Cancer Center. The co-Chair is Dr Karin Jordan who, since 2010, has been Associate Professor of Medical Oncology and Supportive Care in the Department of Oncology/Haematology at the University Hospital, Halle, and who has just recently changed position and is now working at the University of Heidelberg. The event is expected to be attended by members of ESMO from around the world. The aim of these educational courses, which focus on teaching standard of care in specific areas, is to provide "state of the art" lectures in an interactive setting including formal presentations and interaction between experts and attendees presenting clinical cases. The full meeting program is available here. Sergio Cantoreggi, Helsinn Group Chief Scientific Officer, said: "At Helsinn we are delighted to be able to provide a grant to ESMO to work with physicians and further advance supportive and palliative care through this Preceptorship Course. This event will help foster relationships between senior, experienced physicians, and those at the start of their careers, meaning that patients will receive the best possible supportive care to help them live with cancer on a day to day basis." Dr Florian Strasser MD, Chair of the Preceptorship Course on Supportive and Palliative Care, commented: "I am delighted this event dedicated to both supportive and palliative care has been organized, and I thank those at Helsinn for their generous and fully unrestricted support in helping us establish this. Supportive and palliative care is an area of oncology that does not receive enough merit increasing attention in modern, personalized oncology and this event will help to address this problem." Helsinn is a privately owned pharmaceutical group with an extensive portfolio of marketed cancer care products and a broad development pipeline. Since 1976, Helsinn has been improving the everyday lives of patients, guided by core family values of respect, integrity and quality. The Group works across pharmaceuticals, biotechnology, medical devices and nutritional supplements and has expertise in research, development, manufacture and the commercialization of therapeutic and supportive care products for cancer, pain and inflammation and gastroenterology. In 2016, Helsinn created the Helsinn Investment Fund to support early-stage investment opportunities in areas of unmet patient need. The company is headquartered in Lugano, Switzerland, with operating subsidiaries in Ireland and the US, a representative office in China as well as a product presence in about 90 countries globally. For more information, please visit ESMO is the leading professional organisation for medical oncology. With 15,000 members representing oncology professionals from over 130 countries worldwide, ESMO is the society of reference for oncology education and information. We are committed to supporting our members to develop and advance in a fast-evolving professional environment.

Tasman A.-J.,Cantonal Hospital St Gallen
Facial Plastic Surgery | Year: 2017

The quest for the ideal method for augmenting the nasal dorsum continues to be a matter of debate, with both most surgeons and patients preferring autologous tissue. This article reviews the current use of diced cartilage for nasal augmentation, emphasizing the diced cartilage in fibrin glue (DCG) graft. It offers the first collation of unfavorable outcomes and complications of the DCG graft seen in a series of 108 patients treated at the author's institution. The DCG graft continues to be a versatile graft that is stable over time and combines unique features. It has proved to be particularly well suited for segmental augmentations of the dorsum. Resorption of the graft has been rare and infrequent unfavorable outcomes have all been amenable to successful minor surgical revisions. © 2017 by Thieme Medical Publishers, Inc.

Adamina M.,Cantonal Hospital St Gallen | Joerger M.,Cantonal Hospital St Gallen
Expert Opinion on Drug Metabolism and Toxicology | Year: 2011

Introduction: The first human exposure to a new medicine always carries a major risk. Assessment of the safety profile and determination of a therapeutic dose are formidable tasks, particularly in oncology where toxicity is seen as a surrogate for efficacy. Increasing evidence supports the adoption of innovative dose-toxicity models, as these are safer and more efficient in meeting the challenges of modern investigational oncology than traditional models used in Phase I clinical trials. Areas covered: A literature review on dose-toxicity models in oncology was carried out. The objective of this study was to provide a non-mathematical, reader-friendly overview of current and innovative dose-toxicity models in oncology with an emphasis on recent clinical advances, including the benefits of a Bayesian framework. Expert opinion: Innovative dose-toxicity models attempt to minimize clinical risk and maximize research performance. Of these, the Bayesian Continual Reassessment Method and the Escalation With Overdose Control are two successful contemporary designs that outperformed traditional models in clinical trials; they account for patient heterogeneity, combination therapy, and they appropriately assess molecularly targeted agents. Support by regulatory authorities is providing an additional incentive to the widespread use of innovative and efficient dose-toxicity designs: this will improve investigational oncology, and ultimately benefit patients and science alike. © 2011 Informa UK, Ltd.

Craig V.J.,University of Zürich | Cogliatti S.B.,Cantonal Hospital St Gallen | Rehrauer H.,University of Zürich | Wundisch T.,University of Marburg | Muller A.,University of Zürich
Cancer Research | Year: 2011

Gastric B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) develops in the chronically inflamed mucosa of patients infected with the bacterial pathogen Helicobacter pylori. Here we use patient material, primary gastric lymphoma cell cultures, and a preclinical model of the disease to examine the role of microRNA (miRNA)-mediated posttranscriptional regulation - focusing in particular on miR-203 and its target ABL1 - in gastric MALT lymphomagenesis. Microarray-based miRNA expression profiling revealed a strong downregulation of the putative tumor suppressor miRNA miR-203 in human MALT lymphoma samples, which resulted from extensive promoter hypermethylation of the miR-203 locus and coincided with the dysregulation of the miR-203 target ABL1 in lymphoma biopsies compared with matched adjacent normal material from the same patients. Treatment of lymphoma B cells with demethylating agents led to increased miR-203 expression and the concomitant downregulation of ABL1, confirming the epigenetic regulation of this miRNA. Ectopic reexpression of miR-203 by transfection of a human lymphoma cell line or lentiviral transduction of explanted primary MALT lymphoma cells was sufficient to prevent tumor cell proliferation in vitro. Similarly, the treatment of primary MALT lymphoma cells with the ABL inhibitors imatinib and dasatinib prevented tumor cell growth. Finally, we show that the treatment of tumor-bearing mice with imatinib induces MALT lymphoma regression in a preclinical model of the disease, implicating ABL1 in MALT lymphoma progression. In summary, our results show that the transformation from gastritis to MALT lymphoma is epigenetically regulated by miR-203 promoter methylation and identify ABL1 as a novel target for the treatment of this malignancy. ©2011 AACR.

Di Marco V.,University of Palermo | De Vita F.,The Second University of Naples | Koskinas J.,Hippokration General Hospital | Semela D.,Cantonal Hospital St Gallen | And 2 more authors.
Annals of Oncology | Year: 2013

Sorafenib is considered the standard systemic therapy for hepatocellular carcinoma (HCC), in patients with wellpreserved liver function (Child-Pugh A class) and advanced-stage HCC (BCLC-C) or in patients with HCC progressing after locoregional therapies, with a high grade of recommendation. The approval of sorafenib for this indication was grounded on the efficacy and the safety results reported by two international randomized, controlled trials, the SHARP and the Asia-Pacific studies. In addition, the efficacy and the safety of sorafenib in clinical practice are addressed by several field-practice experiences, including the multinational GIDEON study and the SOFIA study. Finally, further research on sorafenib is ongoing to optimize the use of this molecule. This review aims to provide an overview of the most relevant clinical data on the efficacy and the safety of sorafenib in patients with HCC. © The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Tasman A.-J.,Cantonal Hospital St Gallen
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2013

Purpose of Review: The quest for the ideal method for augmenting the nasal dorsum continues to be a matter of debate, with alloplastic materials and autologous tissues each having distinct advantages. This review focuses on the use of autologous tissues, diced cartilage in particular. Recent Findings: In the western world, the preferred tissue has been autologous cartilage with diced cartilage in a sleeve of fascia having become the dominant technique in the last decade. This review highlights the characteristics of different augmentation techniques, giving particular attention to a recent modification of a diced cartilage graft, described as the Tasman technique. The technique bonds the cartilage with fibrin glue, greatly improving the ease of graft preparation and its versatility. A morphometric study has shown this graft to be stable over a 15-month follow-up period. Summary: Using autologous tissue for nasal dorsal augmentation meets the preference of most patients and surgeons. The diced cartilage glue graft is a welcome addition to the rhinoplasty armamentarium. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Tasman A.-J.,Cantonal Hospital St Gallen
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2010

Purpose of review: Literature on the psychological aspects of rhinoplasty is sparse compared with publications on methods and instrumentation. Understanding the psychological aspects of rhinoplasty and, more importantly, recognizing the patient who may have an unfavorable postoperative course regardless of the objective outcome is of fundamental importance to the surgeon. Recent findings: Several profiles of patients with a high risk of postoperative dissatisfaction have been described and the important role of body dysmorphic disorder and its treatment has been stressed. Still, these criteria can be insufficient when facing the individual patient, as reliable screening instruments for clinical practice have not been developed and the question when not to operate is subject to controversy. The role of computer imaging as a safeguard in preoperative counseling has been highlighted. Summary: The surgeon must rely on instinct and experience to avoid overlooking any signs of psychological imbalance in the patient that may herald adversity. Archetypes described in the literature should be recognized and computer imaging should be used during the preoperative consultation. © 2010 Wolters Kluwer Health | Lippincott Williams and Wilkins.

Witteck A.,Cantonal Hospital St Gallen
Swiss medical weekly | Year: 2011

In Switzerland, intravenous drug use (IDU) accounts for 80% of newly acquired hepatitis C virus (HCV) infections. Early HCV treatment has the potential to interrupt the transmission chain and reduce morbidity/mortality due to decompensated liver cirrhosis and hepatocellular carcinoma. Nevertheless, patients in drug substitution programs are often insufficiently screened and treated. With the aim to improve HCV management in IDUs, we conducted a cross sectional chart review in three opioid substitution programs in St. Gallen (125 methadone and 71 heroin recipients). Results were compared with another heroin substitution program in Bern (202 patients) and SCCS/SHCS data. Among the methadone/heroin recipients in St. Gallen, diagnostic workup of HCV was better than expected: HCV/HIV-status was unknown in only 1% (2/196), HCV RNA was not performed in 9% (13/146) of anti-HCV-positives and the genotype missing in 15% (12/78) of HCV RNA-positives. In those without spontaneous clearance (two thirds), HCV treatment uptake was 23% (21/91) (HIV-: 29% (20/68), HIV+: 4% (1/23)), which was lower than in methadone/heroin recipients and particularly non-IDUs within the SCCS/SHCS, but higher than in the, mainly psychiatrically focussed, heroin substitution program in Bern (8%). Sustained virological response (SVR) rates were comparable in all settings (overall: 50%, genotype 1: 35-40%, genotype 3: two thirds). In St. Gallen, the median delay from the estimated date of infection (IDU start) to first diagnosis was 10 years and to treatment was another 7.5 years. Future efforts need to focus on earlier HCV diagnosis and improvement of treatment uptake among patients in drug substitution programs, particularly if patients are HIV-co-infected. New potent drugs might facilitate the decision to initiate treatment.

Ivanovic N.,Institute Of Applied Nursing Science St Gallen | Buche D.,Cantonal Hospital St Gallen | Fringer A.,Institute Of Applied Nursing Science St Gallen
BMC Palliative Care | Year: 2014

Background: The terminally ill person's autonomy and control are important in preserving the quality of life in situations of unbearable suffering. Voluntary stopping of eating and drinking (VSED) at the end of life has been discussed over the past 20 years as one possibility of hastening death. This article presents a 'systematic search and review' of published literature concerned with VSED as an option of hastening death at the end of life by adults with decision-making capacity. Methods. Electronic databases PubMed, EBSCOhost CINAHL and Ovid PsycINFO were systematically searched. Additionally, Google Scholar was searched and reference lists of included articles were checked. Data of the included studies were extracted, evaluated and summarized in narrative form. Results: Overall, out of 29 eligible articles 16 were included in this review. VSED can be defined as an action by a competent, capacitated person, who voluntarily and deliberately chooses to stop eating and drinking with the primary intention of hastening death because of the persistence of unacceptable suffering. An estimated number of deaths by VSED was only provided by one study from the Netherlands, which revealed a prevalence of 2.1% of deaths/year (on average 2800 deaths/year). Main reasons for patients hastening death by VSED are: readiness to die, life perceived as being pointless, poor quality of life, a desire to die at home, and the wish to control the circumstances of death. The physiological processes occurring during VSED and the supportive care interventions could not be identified through our search. Conclusions: The included articles provide marginal insight into VSED for hastening death. Research is needed in the field of theory-building and should be based on qualitative studies from different perspectives (patient, family members, and healthcare workers) about physiological processes during VSED, and about the prevalence and magnitude of VSED. Based on these findings supportive care interventions for patients and family members and recommendations for healthcare staff should be developed and tested. © 2014 Ivanović et al.; licensee BioMed Central Ltd.

Yildiz M.,Cantonal Hospital St Gallen
International Journal of Clinical Practice | Year: 2012

Aims: To identify the relevance and impact of walking speed (WS) over a short distance on activities of daily living (ADLs) in patients with multiple sclerosis (MS). Methods: An internet-administered survey of MS patients in four countries was distributed to 605 individuals in 2010. Participants had MS for > 5 years and must have reported difficulty walking as a result of MS. The impact of MS on walking and the effects of WS on ADLs were assessed based upon responses (scored on a scale of 1-10) to five questions and categorised post hoc as: high (8-10), moderate (4-7) or low (1-3) impact/importance. Results: Of the participants who completed the survey (n = 112), 60% were female patients, 63% were aged ≥ 45 years, and 55% had relapsing-remitting MS. Approximately, half of participants reported a high impact of MS on their general walking ability (46%) and their ability to increase WS over a short distance (55%). Up to 53% of participants reported avoiding ADLs because of concerns about WS; within this cohort, older male patients and patients with secondary-progressive MS were highly represented. Discussion: These results, which highlight the importance of WS to patients with MS and emphasise the impact of WS on health-related quality of life and ADLs, underscore the importance of clinical measures of WS, such as the timed 25-foot walk, in assessing walking in MS patients. Conclusion: Walking speed over a short distance has a significant impact on ADLs for patients with MS. © 2012 Blackwell Publishing Ltd.

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