[Clinical nurse specialists: leadership, entrepreneurship and research for healthcare].

Clinical nurse specialists (CNS) are nurses with a Master in Science Nursing degree. CNS key competences include leadership, entrepreneurship and research. Using the Symptom Navi programme as an example, we show the importance of CNSs in developing an innovative project and their leadership role in implementing the programme into practice.

[Practice of clinical nurse specialists ina hospital setting].

Clinical nurse specialists provide specialized care to individuals with complex health issues, while also supporting healthcare professionals and institutions in delivering evidence-based care. In hospital settings, they work at various levels within the organization: in a ward-based role. in transversal focused on specific issues such as pain management, and in the longitudinal follow-up of patients, ensuring continuity between hospitalization, outpatient care, and home care.

[The role of nurse practitioner at the University hospital of Lausanne].

It is recognized that integrating the role of nurse practitioners (NPs) into new care models can positively impact patient outcomes and the healthcare system. The Canton of Vaud is currently in the initial phase of developing this role. The University Hospital of Lausanne currently employs 15 NPs across various clinical departments, and several initiatives to further develop NP roles are in progress.

[Legal framework for nurse practitioners in the Canton of Vaud].

Nurse practitioners (NPs) have existed internationally for several decades, with scientific literature demonstrating improved access to care, patient safety, and well-being. To address the sociodemographic challenges of public health and the shortage of healthcare professionals, the Canton of Vaud was the first in Switzerland to develop a legal framework that defines the responsibilities and requirements of the NP role in order to integrate them into the healthcare system. The integration of NPs into the hospital setting has shown promising results.

The Role of Esophageal Physiologic Tests in Eosinophilic Esophagitis.

Background: In patients with eosinophilic esophagitis (EoE), the correlation between symptoms of esophageal dysfunction and endoscopic and histologic disease activity is generally poor and probably related to multiple causes such as esophageal remodeling processes that might go undetected using endoscopy and histology as well as esophageal hypervigilance and symptom-specific anxiety. Hence, there is a need for a holistic management of patients that goes beyond the control of eosinophilia and symptoms.

Summary And Key Messages: Physiological esophageal testing using high-resolution manometry, functional lumen imaging probe, pH-impedance, wireless pH monitoring, and mucosal impedance may unveil the effects of chronic transmural fibro-inflammatory changes of the esophageal wall as well as esophageal hypervigilance, thereby assisting to phenotype patients, predict therapeutic response to therapy, and identify motility disorders that may need a specific targeted therapy to ameliorate patients' outcomes.

Development of patient-derived lymphomoids with preserved tumor architecture for lymphoma therapy screening.

The efficacy of anti-cancer therapies depends on the genomic composition of the tumor, its microenvironment, spatial organization, and intra-tumor heterogeneity. B-cell lymphomas are a heterogeneous group of tumors emerging from B-cells at different stages of differentiation and exhibiting tumor-specific interactions with the tumor microenvironment. Thus, the effect of drug treatments can be influenced by the tumor composition and functional interactions among immune cells.

Neurological Pupil Index and Intracranial Hypertension in Patients With Acute Brain Injury: A Secondary Analysis of the ORANGE Study.

Importance: Invasive intracranial pressure (ICP) is the standard of care in patients with acute brain injury (ABI) with impaired consciousness. The Neurological Pupil Index (NPi) obtained by automated pupillometry is promising for noninvasively estimating ICP.

Objectives: To evaluate the association between repeated NPi and invasive ICP values.

Safety and immunogenicity of CD40.HIVRI.Env, a dendritic cell-based HIV vaccine, in healthy HIV-uninfected adults: a first-in-human randomized, placebo-controlled, dose-escalation study (ANRS VRI06).

Background: Current HIV prophylactic vaccines evaluate HIV Env as purified proteins. CD40.HIVRI.

[Implementation of nurse practioner role in an emergency department].

The major challenges facing our healthcare system foster the emergence of new inter-professional roles such as the Specialized Nurse Practitioner. These professionals, recognized by a legal framework, hold advanced practice medical and nursing skills obtained after a 120-credit Master's-level university training. In 2018, the Emergency Department (ED) of the Centre Hospitalier Universitaire Vaudois was one of the first departments in Switzerland to implement such a role.

[Racism in healthcare (part 1) : a health equity issue].

Racism remains a major obstacle in access to quality healthcare. Understanding the concept and definition of racism in healthcare remains unclear for many. This first article in a series on racism in health care, aims to clarify the different forms of racism in health care, their influence on access to health care, and propose measures to limit their influence in the care of racialized groups.

Lung function in adult patients with osteogenesis imperfecta: a cohort study.

Background: Osteogenesis imperfecta (OI) is a rare hereditary bone disease resulting from a defect in collagen synthesis or processing, leading to bone fragility, frequent fractures and skeletal deformities. OI is associated with increased respiratory morbidity and mortality, but the mechanisms of lung involvement are poorly understood, and there are no data on the natural history of lung function. We studied lung function over time in a cohort of adult OI patients at one center.

Maximizing Aesthetic Outcomes in Delayed Breast Reconstruction: the Be.A.U.T-I.F.U.L. DIEP Step-by-Step Inset Technique.

Introduction: In microvascular breast reconstruction, the focus has shifted to achieving aesthetically pleasing results. Delayed breast reconstruction poses challenges such as ensuring natural ptosis and avoiding a "patch" effect. The Be.

Vaccines for cancer prevention: exploring opportunities and navigating challenges.

Improved understanding of cancer immunology has gradually brought increasing attention towards cancer-preventive vaccines as an important tool in the fight against cancer. The aim of this approach is to reduce cancer occurrence by inducing a specific immune response targeting tumours at an early stage before they can fully develop. The great advantage of preventive cancer vaccines lies in the potential to harness a less-compromised immune system in vaccine recipients before their immune responses become affected by the advanced status of the disease itself or by aggressive treatments such as chemotherapy.

Partially inverted and degloved penile skin mimicking the appearance of female genitalia in cases of deaths caused by trains.

Death by collision with an incoming train is common in countries where a railroad network exists. In such cases, when there is severe pelvic trauma, the penis may be partially degloved and turned inside out. The inverted penile skin may then resemble a vulva and the scrotum may mimic labia majora, causing the injured male genitalia to strongly resemble female genitalia.

Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis.

Background: Thiamine and ascorbic acid have been proposed to mitigate the devastating consequences of sepsis and septic shock. To date, randomized controlled trials have failed to demonstrate a benefit of these therapies and heterogeneity of treatment effect is suspected. In this study, we aimed at assessing the heterogeneity of treatment effect of thiamine (B1) and the combination of B1 plus ascorbic acid (AA + B1) in critically ill patients with sepsis.

Susceptibility-induced internal gradients reveal axon morphology and cause anisotropic effects in the diffusion-weighted MRI signal.

Diffusion-weighted MRI is our most promising method for estimating microscopic tissue morphology in vivo. The signal acquisition is based on scanner-generated external magnetic gradients. However, it will also be affected by susceptibility-induced internal magnetic gradients caused by interactions between the tissue and the static magnetic field of the scanner.

Association of early general anesthesia with outcome in adults with status epilepticus: A propensity-matched observational study.

General anesthesia (GA) earlier than recommended (as first- or second-line treatment) was recently described to improve status epilepticus (SE) outcome. We aimed to assess the impact of early GA on outcome in matched groups. Data from a multicenter, prospective cohort of 1179 SE episodes in 1049 adults were retrospectively analyzed.

[Peripheral arterial disease: 2024 update].

Peripheral arterial disease (PAD) is a major public health issue, with a growing prevalence due to the aging population and the rise in risk factors such as diabetes, hypertension, and dyslipidemia. Managing PAD involves a multidisciplinary approach, with the primary care physician playing a crucial role in early screening. This article compiles the latest data from 2024 and current practices for the management of this disease.