1,429 results match your criteria: "Cantonal Hospital St.Gallen[Affiliation]"

Improving antimicrobial treatment in terms of antimicrobial stewardship and health costs by an OPAT service.

Infection

August 2024

Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Article Synopsis
  • The study focuses on the effectiveness of outpatient parenteral antimicrobial therapy (OPAT) and its role in antimicrobial stewardship (AMS) at the University Hospital of Zurich from November 2018 to September 2022.
  • It analyzed 303 OPAT assignments, with 260 leading to effective treatment; significant cost savings of approximately 9.8 million CHF were achieved by reducing in-hospital stays, while maintaining patient safety and a 77% clinical cure rate.
  • The findings suggest that integrating OPAT within AMS enhances patient care and hospital efficiency, with minimal adverse events and readmissions linked to the treatment.
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Background And Purpose: The value of intravenous thrombolysis (IVT) in eligible tandem lesion patients undergoing endovascular treatment (EVT) is unknown. We investigated treatment effect heterogeneity of EVT + IVT versus EVT-only in tandem lesion patients. Additional analyses were performed for patients undergoing emergent internal carotid artery (ICA) stenting.

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Article Synopsis
  • During the COVID-19 pandemic, the Dr. Risch medical group utilized a specific RT-PCR testing kit for diagnosing infections in Switzerland and Liechtenstein, which targeted three genes essential for identifying the virus.
  • The emergence of the Alpha variant (B.1.1.7) led to a notable diagnostic issue, where the S-gene target was absent due to genetic deletions, marking it as an early indicator of new variants; this phenomenon was also seen in Omicron but not with the Delta variant.
  • Over two years, the group studied the significance of S-gene target failure (SGTF) as a signal for identifying variants, confirming that differences in cycle threshold values could help distinguish true SGTF cases from discrepancies
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The objectives of the present study were to evaluate the discriminating power of spirometric and plethysmographic lung function parameters to differenciate the diagnosis of asthma, ACO, COPD, and to define functional characteristics for more precise classification of obstructive lung diseases. From the databases of 4 centers, a total of 756 lung function tests (194 healthy subjects, 175 with asthma, 71 with ACO, 78 with COPD and 238 with CF) were collected, and gradients among combinations of target parameters from spirometry (forced expiratory volume one second: FEV1; FEV1/forced vital capacity: FEV1/FVC; forced expiratory flow between 25-75% FVC: FEF25-75), and plethysmography (effective, resistive airway resistance: sReff; aerodynamic work of breathing at rest: sWOB), separately for in- and expiration (sReffIN, sReffEX, sWOBin, sWOBex) as well as static lung volumes (total lung capacity: TLC; functional residual capacity: FRCpleth; residual volume: RV), the control of breathing (mouth occlusion pressure: P0.1; mean inspiratory flow: VT/TI; the inspiratory to total time ratio: TI/Ttot) and the inspiratory impedance (Zinpleth = P0.

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Article Synopsis
  • Researchers studied proteins in the blood called tumor markers to see how they relate to lung cancer treatment in patients who are getting chemotherapy.
  • They looked at different markers in 261 patients and found that some markers like CYFRA 21-1 and CA125 could help tell if treatment was working and predict how long patients might live.
  • The study showed that these blood markers are important tools for doctors to understand how well a patient is responding to treatment for non-small cell lung cancer.
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Objective: Uncertainty remains regarding antithrombotic treatment in cervical artery dissection. This analysis aimed to explore whether certain patient profiles influence the effects of different types of antithrombotic treatment.

Methods: This was a post hoc exploratory analysis based on the per-protocol dataset from TREAT-CAD (NCT02046460), a randomized controlled trial comparing aspirin to anticoagulation in patients with cervical artery dissection.

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Background: Living donor (LD) kidney transplantation in the setting of ABO blood group incompatibility (ABOi) has been previously reported to be associated with increased risk for antibody-mediated rejection (ABMR). It is however unclear if the presence of pre-transplant donor specific antibodies (DSA) works as an additive risk factor in the setting of ABOi and if DSA positive ABOi transplants have a significantly worse long-term outcome as compared with ABO compatible (ABOc) DSA positive transplants.

Methods: We investigated the effect of pre-transplant DSA in the ABOi and ABOc setting on the risk of antibody-mediated rejection (ABMR) and graft loss in a cohort of 952 LD kidney transplants.

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Article Synopsis
  • The study examined the long-term efficacy and safety of nusinersen in adults with 5q-associated spinal muscular atrophy (SMA) over a period of 38 months, utilizing a large cohort from Germany, Switzerland, and Austria.
  • Overall, significant improvements were noted in various motor performance measures (HFMSE, RULM, and 6MWT) at multiple time points compared to baseline, indicating ongoing benefits from the treatment.
  • No new safety concerns were found, reinforcing the idea that nusinersen remains a viable therapy for adults with SMA over extended periods.
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Complement Activation Is Associated With Disease Severity in Multiple Sclerosis.

Neurol Neuroimmunol Neuroinflamm

March 2024

From the Department of Neurology (J.O., A.M.M., A.O., S. Meier, E.W., T.D., M.D.S., M.L., B.F.-B., C. Granziera, L.K., D.L., J.K.); Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) (J.O., S.A.S., A.M.M., A.O., S. Meier, E.W., T.D., P.B., M.D.S., M.L., B.F.-B., C. Granziera, L.K., D.L., J.K.), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Switzerland; Department of Neurology with Institute of Translational Neurology (K.S., H.W., J.D.L.), University Hospital 4 Münster, Germany; Clinical Trial Unit (S.A.S., P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland; Octavebio Bioscience (F.Q.), Menlo Park, CA; Division of Medical Immunology (I.H.), Laboratory Medicine, University Hospital Basel, Switzerland; Medica Laboratory (A.R.), Zürich; Department of Neurology (L.A.), Cantonal Hospital, Aarau; Department of Neurology (S. Mueller), Cantonal Hospital St. Gallen; Department of Neurology (A.S.), Inselspital, Bern University Hospital and University of Bern; Department of Clinical Neurosciences (P.H.L., C.B.), Division of Neurology; Diagnostic Department (P.H.L.), Division of Laboratory Medicine; Department of Pathology and Immunology (P.H.L.), Faculty of Medicine, University of Geneva; Division of Neurology (C.P., R.A.D.P.), Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne; Neurocentre of Southern Switzerland (C. Gobbi), Multiple Sclerosis Centre, Ospedale Civico; Faculty of Biomedical Sciences (C. Gobbi), Università della Svizzera Italiana (USI), Lugano, Switzerland; Translational Imaging in Neurology (ThINk) Basel (C. Granziera), Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel; and Division of Internal Medicine (M.T.), University Hospital Basel and Clinical Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland.

Article Synopsis
  • The study investigates the role of complement components (CCs) and activation products (CAPs) in multiple sclerosis (MS), particularly focusing on how their levels are affected by the presence of intrathecal IgM synthesis, which is linked to higher disease severity.
  • By analyzing samples from 112 clinically isolated syndrome (CIS) patients and 127 MS patients, it was found that specific complement levels in the cerebrospinal fluid (CSF) were significantly higher in those with MS compared to control groups.
  • Key findings indicate that increased levels of complement components like C3a and C4a in the CSF correlate with worse disability and disease progression in MS patients, emphasizing the relationship between complement activation and neurodegeneration in
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Article Synopsis
  • The study looked at how patients with bleeding in the brain (called intracerebral hemorrhage) did after taking certain blood-thinning medicines or none at all.
  • It combined data from two countries (Switzerland and Norway) and checked the effects over 3 months on how well patients recovered and if they survived.
  • Results showed that patients who took blood thinners had a harder time recovering and were more likely to die compared to those who didn’t take any blood thinners.
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Screening for heart failure in patients with diabetes mellitus in tertiary care - A SwissDiab study.

Diabetes Res Clin Pract

March 2024

Division of General Internal Medicine and Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. Electronic address:

Aims: To evaluate the prevalence of heart failure (HF) in patients with diabetes in tertiary care, and the implementation of sodium-glucose co-transporter 2 inhibitor (SGLT2i).

Methods: Between 28.09.

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Introduction: The safety and efficacy of first-line durvalumab in PS2 patients with advanced NSCLC is unknown. Here, we present the primary analysis of first-line durvalumab in PS2 patients, unsuitable for combination chemotherapy.

Methods: In this single-arm, multicenter, phase II trial patients with PD-L1 positive (tumor proportional score ≥25%), advanced NSCLC with PS2, received four-weekly durvalumab 1500 mg.

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Metronomic cyclophosphamide for bone marrow carcinomatosis in metastatic castration-resistant prostate cancer.

J Cancer Res Clin Oncol

February 2024

Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland.

Purpose: In some patients with prostate cancer, bone marrow carcinomatosis develops later in the course of the disease, which has a poor prognosis. These are often heavily pretreated patients in the castration-resistant situation for whom there are no other therapeutic options, because either all available systemic therapies have already been used or the use of one is not possible due to the cytopenias associated with bone marrow carcinomatosis. In our literature search, there are no data on this treatment in the setting available, especially no clinical trial or even randomized data.

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Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories.

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Single nucleotide polymorphisms (SNPs) in the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) gene, an inhibitor of T-cell priming, are associated with auto and alloimmunity. Studies implied a role for these SNPs as surrogate markers for immunotherapy-outcome in patients with melanoma. However, no predictive SNPs are defined to date.

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Objective: We developed a robust characterization of immune recovery trajectories in people living with HIV on antiretroviral treatment (ART) and relate our findings to epidemiological risk factors and bacterial pneumonia.

Methods: Using data from the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Cohort Study (n = 5907), we analyzed the long-term trajectories of CD4 cell and CD8 cell counts and their ratio in people living with HIV on ART for at least 8 years by fitting nonlinear mixed-effects models. The determinants of long-term immune recovery were investigated using generalized additive models.

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Background: Medication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients' post-hospitalization medication non-adherence in Switzerland.

Objectives: Our primary aim was to assess the prevalence of post-discharge medication non-adherence in patients with HF.

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Reversible Mechanical Contraception and Endometriosis Treatment Using Stimuli-Responsive Hydrogels.

Adv Mater

June 2024

Nanoparticle Systems Engineering Laboratory, Institute of Energy and Process Engineering (IEPE), Department of Mechanical and Process Engineering (D-MAVT), ETH Zurich, Sonneggstrasse 3, Zurich, 8092, Switzerland.

Female sterilization via fallopian tube ligation is a common procedure; However, after the operation, over 10% of women seek re-fertilization, which is frequently unsuccessful. In addition, there is evidence that fallopian tubes contribute to the spread of endometriotic tissue as they serve as channels for proinflammatory media entering the abdominal cavity via retrograde menstruation. Here, stimuli-degradable hydrogel implants are presented for the functional, biocompatible, and reversible occlusion of fallopian tubes.

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Metabolic acidosis in chronic kidney disease: mere consequence or also culprit?

Pflugers Arch

April 2024

Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Metabolic acidosis is a frequent complication in non-transplant chronic kidney disease (CKD) and after kidney transplantation. It occurs when net endogenous acid production exceeds net acid excretion. While nephron loss with reduced ammoniagenesis is the main cause of acid retention in non-transplant CKD patients, additional pathophysiological mechanisms are likely inflicted in kidney transplant recipients.

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Background: Programmed cell death receptors and ligands in cancer tissue samples are established companion diagnostics for immune checkpoint inhibitor (ICI) therapies.

Objective: To investigate the relevance of soluble PD-1, PD-L1 and PD-L2 for estimating therapy response and prognosis in non-small cell lung cancer patients (NSCLC) undergoing platin-based combination chemotherapies.

Methods: In a biomarker substudy of a prospective, multicentric clinical trial (CEPAC-TDM) on advanced NSCLC patients, soluble PD-1, PD-L1 and PD-L2 were assessed in serial serum samples by highly sensitive enzyme-linked immunosorbent assays and correlated with radiological response after two cycles of chemotherapy and with overall survival (OS).

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Article Synopsis
  • Lower respiratory tract infections (LRTIs) are common and lead to unnecessary antibiotic use; this study examines a new method to accurately diagnose bacterial pneumonia using clinical scores, lung ultrasound, and a biomarker called procalcitonin (PCT).* -
  • The PLUS-IS-LESS study, conducted in 10 emergency departments in Switzerland, will test the effectiveness of the PLUS algorithm, which combines various diagnostic tools, against standard care to see if it reduces antibiotic prescriptions while keeping patients safe.* -
  • By optimizing antibiotic prescribing through reliable diagnostics and ensuring safety, the PLUS algorithm aims to enhance treatment outcomes and gather data on factors like quality of life, hospital stays, and cost-effectiveness in LRTI cases.*
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Endometriosis, a systemic ailment, profoundly affects various aspects of life, often eluding detection for over a decade. This leads to enduring issues such as chronic pain, infertility, emotional strain, and potential organ dysfunction. The prolonged absence of diagnosis can contribute to unexplained obstetric challenges and fertility issues, necessitating costly and emotionally taxing treatments.

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Methotrexate in rheumatoid arthritis-another brick in the wall.

Lancet Rheumatol

April 2023

Division of Rheumatology and Immunology, Cantonal Hospital St Gallen, St Gallen, Switzerland. Electronic address:

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Value of Immediate Flat Panel Perfusion Imaging after Endovascular Therapy (AFTERMATH): A Proof of Concept Study.

AJNR Am J Neuroradiol

February 2024

From the Departments of Diagnostic and Interventional Neuroradiology (A.M., C.C.K., E.I.P., S.M.P.-P., B.L.S., J.G., T.D., P.M., J.K.), University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland

Background And Purpose: Potential utility of flat panel CT perfusion imaging (FPCT-PI) performed immediately after mechanical thrombectomy (MT) is unknown. We aimed to assess whether FPCT-PI obtained directly post-MT could provide additional potentially relevant information on tissue reperfusion status.

Materials And Methods: This was a single-center analysis of all patients with consecutive acute stroke admitted between June 2019 and March 2021 who underwent MT and postinterventional FPCT-PI ( = 26).

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