Right ventricular function in Marfan patients remains stable despite multiple cardiac interventions.

Objectives: Mitral valve regurgitation and left ventricular dysfunction are cardiovascular symptoms of Marfan syndrome. There is a paucity of information on tricuspid valve regurgitation and right ventricular function. In patients with Marfan syndrome, we looked at long-term changes in right ventricular function, tricuspid valve regurgitation and freedom from tricuspid valve repair.

Cognition after a 4-week high phenylalanine intake in adults with phenylketonuria - a randomized controlled trial.

Background: Phenylketonuria (PKU) is an autosomal recessive metabolic disorder characterized by increased phenylalanine (Phe) concentrations in the blood and brain. Despite wide agreement on treatment during childhood, recommendations for adults are still controversial.

Objective: To assess the impact of a 4-week increase in Phe intake (simulating normal dietary Phe consumption) on cognition, mood, and depression in early-treated adults with PKU in a double-blind, randomized controlled trial (RCT).

Regional variation and temporal trends in transcatheter and surgical aortic valve replacement in Switzerland: A population-based small area analysis.

Background: Aortic valve stenosis (AS) is the most common valvular heart disease and if severe, is treated with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). We assessed temporal trends and regional variation of these interventions in Switzerland and examined potential determinants of geographic variation.

Methods: We conducted a population-based analysis using patient discharge data from all Swiss public and private acute care hospitals from 2013 to 2018.

Large regional variation in cardiac closure procedures to prevent ischemic stroke in Switzerland a population-based small area analysis.

Background: Percutaneous closure of a patent foramen ovale (PFO) or the left atrial appendage (LAA) are controversial procedures to prevent stroke but often used in clinical practice. We assessed the regional variation of these interventions and explored potential determinants of such a variation.

Methods: We conducted a population-based analysis using patient discharge data from all Swiss hospitals from 2013-2018.

Adherence to thrombophilia testing guidelines and its influence on anticoagulation therapy: A single-center cross-sectional study.

Introduction: The collected evidence on thrombophilia guidelines is scarce and data about their impact on clinical decisions are unknown. We aimed to investigate the adherence to thrombophilia testing guidelines, its therapeutic impact in patients with guideline-adherent and non-adherent testing and identify the patients' clinical characteristics mostly associated with treatment decisions.

Materials And Methods: We conducted a single-center cross-sectional study of patients referred for thrombophilia testing at the outpatient clinic of a tertiary hospital between 01/2010-10/2020.

Development of an electronic Poor Outcome Screening (ePOS) Score to identify critically ill patients with potential palliative care needs.

Purpose: To develop and validate an electronic poor outcome screening (ePOS) score to identify critically ill patients with potentially unmet palliative care (PC) needs at 48 hours after ICU admission.

Materials And Methods: Retrospective single-centre cohort study of 1'772 critically ill adult patients admitted to a tertiary academic ICU in Switzerland between 2017 and 2018. We used data available from electronic health records (EHR) in the first 48 hours and least absolute shrinkage and selection operator (LASSO) logistic regression to develop a prediction model and generate a score to predict the risk of all cause 6-month mortality.

Variation in regional implantation patterns of cardiac implantable electronic device in Switzerland.

Introduction: There is a substantial geographical variation in the rates of pacemaker (PM), implantable cardioverter defibrillator (ICD), and cardiac resynchronization therapy (CRT) device implantation across European countries. We assessed the extent of regional variation and potential determinants of such variation.

Methods: We conducted a population-based analysis using discharge data for PM/ICD/CRT implantations from all Swiss acute care hospitals during 2013-2016.

High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.

Background: Among various treatment options for benign prostatic hyperplasia (BPH), surgical therapy is the most invasive. As Switzerland has the highest transurethral prostatectomy rate among OECD countries, we assessed the regional variation in prostate surgery for BPH and explored potential determinants of variation.

Methods: We conducted a population-based analysis using discharge data for men aged ≥40 years with transurethral or simple prostatectomy from all Swiss hospitals during 2013-2018.

Peripheral Artery Disease Leading to Major Amputation: Trends in Revascularization and Mortality Over 18 Years.

Background: Patients with peripheral artery disease (PAD) are at risk for amputation. The aim of this study was to assess the type of revascularization prior to and the 30-day mortality rate after major amputation due to PAD.

Methods: Retrospective analysis of consecutive patients undergoing major amputation for PAD between 01/2000 and 12/2017 at a tertiary referral center.

Regional variation in hip and knee arthroplasty rates in Switzerland: A population-based small area analysis.

Background: Compared to other OECD countries, Switzerland has the highest rates of hip (HA) and knee arthroplasty (KA).

Objective: We assessed the regional variation in HA/KA rates and potential determinants of variation in Switzerland.

Methods: We conducted a population-based analysis using discharge data from all Swiss hospitals during 2013-2016.

Regional variation of hysterectomy for benign uterine diseases in Switzerland.

Background: Hysterectomy is the last treatment option for benign uterine diseases, and vaginal hysterectomy is preferred over more invasive techniques. We assessed the regional variation in hysterectomy rates for benign uterine diseases across Switzerland and explored potential determinants of variation.

Methods: We conducted a population-based analysis using patient discharge data from all Swiss hospitals between 2013 and 2016.

Breast shield design impacts milk removal dynamics during pumping: A randomized controlled non-inferiority trial.

Introduction: While many studies have investigated the importance of optimizing pumping patterns for milk removal, the influence of breast shield design on milk removal has not been the focus of extensive investigation. This study aimed to determine the effectiveness of breast shields with either a 105° or a 90° flange opening angle on breast drainage and milk volume expressed during pumping.

Material And Methods: This study was a cross-over, randomized controlled non-inferiority trial (Registration; NCT03091985).

Automated delineation of hospital service areas as a new tool for health care planning.

Objective: To develop an automated, reproducible method for delineating hospital service areas (HSAs).

Data Sources/setting: Discharge data from all Swiss acute care hospitals for the years 2013 to 2016.

Study Design: We derived HSAs and hospital referral regions for Switzerland using a newly developed flow-based, automated, objective, and reproducible method using all discharge data.

The Swiss Narcolepsy Scale (SNS) and its short form (sSNS) for the discrimination of narcolepsy in patients with hypersomnolence: a cohort study based on the Bern Sleep-Wake Database.

Previous studies reported high sensitivity and specificity of the Swiss Narcolepsy Scale (SNS) for the diagnosis of narcolepsy type 1. We used data from the Bern Sleep-Wake Database to investigate the discriminating capacity of both the SNS and the Epworth Sleepiness Scale (ESS) to identify narcolepsy type 1 and type 2 in patients with central disorders of hypersomnolence (CDH) or sleepy patients with obstructive sleep apnea (OSA). In addition, we aimed to develop a simplified version of the SNS.

Prevalence of sleep-disordered breathing after stroke and TIA: A meta-analysis.

Objective: To perform a systematic review and meta-analysis on the prevalence of sleep-disordered breathing (SDB) after stroke.

Methods: We searched PubMed, Embase (Ovid), the Cochrane Library, and CINAHL (from their commencements to April 7, 2017) for clinical studies reporting prevalence and/or severity of SDB after stroke or TIA. Only sleep apnea tests performed with full polysomnography and diagnostic devices of the American Academy of Sleep Medicine categories I-IV were included.

Unwarranted regional variation in vertebroplasty and kyphoplasty in Switzerland: A population-based small area variation analysis.

Background: Percutaneous vertebroplasty (VP) and balloon kyphoplasty (BKP) for treating painful osteoporotic vertebral fractures are controversial.

Objective: We assessed the regional variation in the use of VP/BKP in Switzerland.

Methods: We conducted a population-based small area variation analysis using patient discharge data for VP/BKP from all Swiss hospitals and Swiss census data for calendar years 2012/13.

Baseline characteristics and patterns of care in testicular cancer patients: first data from the Swiss Austrian German Testicular Cancer Cohort Study (SAG TCCS).

Background: The majority of germ cell tumour (GCT) patients can be cured by orchiectomy followed by active surveillance or subsequent systemic and/or local treatments. There are various guidelines for a structured follow-up including radiographic and clinical examinations.

Objective: The Swiss Austrian German Testicular Cancer Cohort Study (SAG TCCS) prospectively evaluates follow-up, indicator of relapse and late toxicities.

Long-term oxygen therapy in COPD patients: population-based cohort study on mortality.

Purpose: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and is associated with a growing and substantial socioeconomic burden. Long-term oxygen therapy (LTOT), recommended by current treatment guidelines for COPD patients with severe chronic hypoxemia, has shown to reduce mortality in this population. The aim of our study was to assess the standardized mortality ratios of incident and prevalent LTOT users and to identify predictors of mortality.

CPAP as treatment of sleep apnea after stroke: A meta-analysis of randomized trials.

Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB).

Methods: In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care or sham CPAP in adult patients with stroke or TIA with SDB. Mean CPAP use, odds ratios (ORs), and standardized mean differences (SMDs) were calculated.

Patency of the arterial pedal-plantar arch in patients with chronic kidney disease or diabetes mellitus.

Background: Patency of the pedal-plantar arch limits risk of amputation in peripheral artery disease (PAD). We examined patients without chronic kidney disease (CKD)/diabetes mellits (DM) [PAD-control], those with DM without CKD, and those with CKD without DM.

Method: Uni- and multivariate logistic regression was used to assess association of CKD with loss of patency of the pedal-plantar arch and presence of tibial or peroneal vessel occlusion.

Predicting Mortality After Transcatheter Aortic Valve Replacement: External Validation of the Transcatheter Valve Therapy Registry Model.

Background: The Transcatheter Valve Therapy (TVT) registry model was recently developed to predict the risk of in-hospital mortality in patients undergoing transcatheter aortic valve replacement. We sought to externally validate the model in an independent data set of consecutively enrolled patients in the Swiss Transcatheter Aortic Valve Implantation registry.

Methods And Results: The original prediction model was retrospectively applied to 3491 consecutive patients undergoing transcatheter aortic valve replacement in Switzerland between February 2011 and February 2016.

Data management of clinical trials during an outbreak of Ebola virus disease.

Introduction: Clinical trial data management (DM) conducted during outbreaks like that of Ebola virus disease (EVD) in West Africa, 2014-2016, has to adapt to specific, unique circumstances. CTU Bern was asked to set up a safe data capture/management system that could be launched within a few weeks and cover two different vaccine trials. This article describes some of the challenges we faced and our solutions during the two different trials.

Transcatheter aortic valve thrombosis: incidence, clinical presentation and long-term outcomes.

Aims: To assess the incidence, management and long-term outcomes of transcatheter heart valve thrombosis (THVT).

Methods And Results: Between August 2007 and February 2016, 1396 patients were included in the Bern TAVI Registry and prospectively followed-up through echocardiographic and clinical evaluation. THVT was suspected in case of: (i) a mean transvalvular pressure gradient greater than 20 mmHg at transthoracic echocardiography, or (ii) an increase of more than 50% of the mean transvalvular pressure gradient compared with previous measurements or (iii) new symptoms or signs of heart failure with the presence of thrombus documented by transoesophageal echocardiography or multi-slice computed tomography.