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Fabian Grass, Basile Pache, Christiane Petignat, Estelle Moulin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
OBJECTIVE: The present study aimed to evaluate whether teaching had an influence on surgical site infections (SSI) after colonic surgery. DESIGN: Colonic surgeries between January 2014 and December 2016 were retrospectively reviewed. Demographics, surgical details, and SSI rates were compared between teaching procedures vs. experts. Risk factors for SSI were identified by multinominal logistic regression. SETTING: SSI were prospectively assessed by an independent National Surveillance Program (www...
February 27, 2018: Journal of Surgical Education
Carina Eklund, Ola Forslund, Keng-Ling Wallin, Joakim Dillner
BACKGROUND: Accurate and internationally comparable human papillomavirus (HPV) DNA detection and typing services are essential for HPV vaccine research and surveillance. OBJECTIVES: This study assessed the proficiency of different HPV typing services offered routinely in laboratories worldwide. STUDY DESIGN: The HPV Laboratory Network (LabNet) has designed international proficiency panels that can be regularly issued. The HPV genotyping proficiency panels of 2013 and 2014 contained 43 and 41 coded samples, respectively, composed of purified plasmids of sixteen HPV types (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68a and 68b) and 3 extraction controls...
February 9, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Bérengère Aubry-Rozier, Delphine Stoll, Elena Gonzalez Rodriguez, Didier Hans, Veronique Prudent, Ariane Seuret, Alain Farron, Olivier Lamy
In 2008, the Centre Hospitalier Universitaire Vaudois (CHUV, Lausanne, Switzerland) initiated a Fracture Liaison Service (FLS). All patients hospitalised for a low trauma fracture are identified by the FLS. Inpatients then choose to be managed by either the FLS team or their general practitioner (GP). In this study we compared the management between the FLS team and the GP in terms of diagnosis of osteoporosis, treatment, refracture rates and mortality after FLS recording. Results are compared with the management of osteoporosis before the creation of the FLS, as reported in the survey study Osteocare...
January 29, 2018: Swiss Medical Weekly
Valérie Mosimann, Olivier Lamy, Julien Castioni
Due to the chronic lack of beds in hospitals, patients are often hospitalized in other departments (outlier patients), with a responsible physician working in another department. This causes increased thromboembolics risks, nosocomial infections, falls and delirium in the elderly, morbidity and mortality. Outlier patients, compared to standard patients, stay longer in the emergency department and their discharge documents are available later. Outlying is used daily in the CHUV hospital and new strategies are elaborated to manage patient flow, especially during the flu epidemic...
January 17, 2018: Revue Médicale Suisse
Vanessa Kraege, Evrim Jaccard, Alain Kenfak, Elisabeth Stamm, Fanny Blondet, Grégoire Humair, Plamena Tasheva, Oriane Aebischer, Sabine Giroud, Jonathan Tschopp, Claudio Sartori
2017 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From bedside screening for beta-lactam allergies, to statins as primary prevention in the elderly, SGLT2 inhibitors in heart failure, azithromycin in severe asthmatics and tofacitinib in ulcero-haemorrhagic recto-colitis, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings: here is their selection of eleven articles, chosen, summarized and commented for you...
January 17, 2018: Revue Médicale Suisse
Caroline Krieger, David Baud, Judith Bouchardy, Stephanie Christen-Zaech, Anthony De Buys, Sebastien Deglise, Oumama El Ezzi, Marco Fresa, Michael Hofer, Daniel Hohl, Matthias Kirsch, Romain Lazor, Patrick Michel, Pierre Monney, Francis Munier, Salah Dine Qanadli, Wassim Raffoul, Berangere Aubry Rozier, François Saucy, Alain Schoepfer, Guillaume Saliou, Nicole Sekarski, Andrea Superti-Furga, Gregoire Wuerzner, Jean-Blaise Wasserfallen, Lucia Mazzolai
Rare Vascular Diseases (RVD) encompass different types of vessel involvement. Some cause a dilation, others a weakening or tortuosity of the arterial wall, others an obstruction or excessive calcification of arterial walls. Clinical pathway of patients with RVD to diagnosis is often long and complex. Thus, in order to allow early diagnosis and coordinated multidisciplinary management and follow-up, a specialized RVD centre has been set-up at the CHUV, following the framework of the national concept of rare diseases...
December 6, 2017: Revue Médicale Suisse
Frédérica Schyrr, Anita Wolfer, Jérôme Pasquier, Anne-Laure Nicoulaz, Olivier Lamy, Olaia Naveiras
This retrospective study attempts to establish if a correlation exists between osteoporosis and hematopoiesis before and after adjuvant chemotherapy in the context of non-metastatic breast cancer. Osteoporosis is interpreted both as a direct marker of osteoblastic decline and as an indirect marker of increased bone marrow adiposity within the hematopoietic microenvironment. Patients from the "Centre du Sein" at CHUV (Centre Hospitalier Universitaire Vaudois) undergoing adjuvant chemotherapy were included in this study...
February 2018: Annals of Hematology
Selin Tusgul, Pierre-Nicolas Carron, Bertrand Yersin, Thierry Calandra, Fabrice Dami
BACKGROUND: Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage...
November 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ahmad Haydar, Yvan Vial, David Baud, David Desseauve
We conducted a retrospective study was conducted in the Centre Hospitalier Universitaire Vaudois (CHUV) including all births between the 1st January 1997 and 31st December 2011 to analyze the cesarean section (CS) rate using the different groups of the Robson classification in a Swiss maternity hospital. The overall CS rate was 29 %, mainly related to group 5 (multiparous with previous CS) and group 2 (nulliparous women induced or who had CS before labor). The study also shows that induction of labor on maternal request in nulliparous at term (group 2a) increased significantly the risk of CS compared to induction of labor for medical reason (p<0...
October 25, 2017: Revue Médicale Suisse
Jean Philippe Brouland, Andreas F Hottinger
The revised WHO classification 2016 of central nervous system tumours incorporates molecular biomarkers in addition to histological features in an « integrated diagnosis ». Thus, it refines classification with more homogenous diagnosis groups in order to improve prognosis and to guide treatment, notably for gliomas. This article firstly summarized the new concept of this revised classification, some basis of the molecular genetics of gliomas and practical application of the « integrated diagnosis ». It analyses the impact of this classification on the diagnosis and outcome of gliomas performed at the University Institute of Pathology - CHUV, Lausanne from October 2015 to November 2016...
October 18, 2017: Revue Médicale Suisse
Murielle Bochud, Christine Currat, Laurence Chapatte, Cindy Roth, Vincent Mooser
AIMS: We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. METHODS: Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing...
October 24, 2017: Swiss Medical Weekly
Pierre Lequin, Marie-Anne Brisard, Ifigeneia Skyllakou, Fabrice Herrera, Philippe Golay, Jacques Herrgott, Philippe Conus
An important number of psychiatric patients have difficulties to live outside of hospital and to stabilize their living situation. This results in long hospitalizations which are in conflict with the current strategies of brief hospital admissions for acute treatment. In order to tackle this issue, the service of general psychiatry of the Department of psychiatry of the CHUV, in Lausanne, Switzerland, has opened in June 2016 a rehabilitation inpatient unit of 18 beds focusing specifically on the development of the minimal abilities required to adapt to living in a flat or in a sheltered accommodation...
September 20, 2017: Revue Médicale Suisse
Marc Uhlmann, Estelle Lécureux, Anne-Claude Griesser, Hong Dung Duong, Olivier Lamy
INTRODUCTION: The 30-day post-discharge readmission rate is a quality indicator that may reflect suboptimal care. The computerised algorithm SQLape® can retrospectively identify a potentially avoidable readmission (PARA) with high sensitivity and specificity. We retrospectively analysed the hospital stays of patients readmitted to the Department of Internal Medicine of the CHUV (Centre Hospitalier Universitaire Vaudois) in order to quantify the proportion of PARAs and derive a risk prediction model...
July 27, 2017: Swiss Medical Weekly
Adèle Rakosi, Francois Kuonen, Olivier Gaide
As of today, the skin will never look the same. Indeed, several technologies allowing the observation of the skin at a microscopic level are now coming of age. This magnifies our visual acuity and thus our capacity to recognize various pathological processes. We herein present three different methods of non-invasive skin imaging we have worked with at the CHUV, which revolutionize the practice of dermatology. In vivo confocal microscopy, ex-vivo confocal microscopy and optical coherence tomography are complementary techniques that are now becoming essential for the modern management of skin cancers, among other uses...
March 29, 2017: Revue Médicale Suisse
Sandra Fornage, Francesco Bianchi-Demicheli
Sexuality is a natural function, part of global health and has to be evaluated in every patient. When difficulties or dyfunctions happen in this domain, a specific mangement should be proposed. Sexual medicine is a « young » transversal discipline developping these last years in the french-speaking area of Switzerland. We present in this article a short history of sexual medicine in Lausanne and the recent activity in the Sexual Medicine Consultation of the Maternity in the CHUV.
March 15, 2017: Revue Médicale Suisse
Fabienne Teike Lüthi, Gian Domenico Borasio, Mathieu Bernard
From a health care perspective, and in order to improve the quality of care, early identification of palliative patients is a necessary step for the development of palliative care. Unfortunately, this early identification is still sub-optimal, resulting in a delayed introduction of palliative care in the patients' health care pathway. Although several tools exist to support health care professionals in this endeavour, their level of validity is incomplete, and they do not distinguish between patients in need of general versus specialised palliative care...
February 1, 2017: Revue Médicale Suisse
Stéphane Cherix, Frédéric Vauclair, Boris Morattel, Matthias Vautrin, Maurice Matter, Michael Montemurro, Antonia Digklia, Igor Letovanec, Patrick Omoumi, François Saucy, Michel Gonzalez, André-Dante Durham, Francesca Bosisio, Anja C Zyska Cherix, Hannes A Rudiger
Sarcomas are rare diseases, the treatment of which requires an appropriate technical plateform and a broad spectrum of multidisciplinary specialists. Many are initially treated by unplanned excision, and then referred to specialized centres. Secondary treatments may lead to higher complication rates and local recurrence, with lower functional outcome, life quality and possibly overall survival. In order to improve the accessibility for referral to a specialist centre, the coordination of clinical and research activities, and the quality of the management of sarcomas in general, Lausanne University Hospital (CHUV) has opened a Sarcoma centre on October 1st 2016...
December 14, 2016: Revue Médicale Suisse
Samuel Rotman, Thomas Zaugg, Pierre-Alexandre Bart
The number of medical autopsies has declined in recent decades due to the development of imaging techniques and some risks linked to autopsies. However, the contribution of autopsy is diagnostically significant, even better than new technologies currently available. It is thus a good indicator of quality, but also a training tool, and has a significant impact in the grieving process. At the CHUV, under the leadership of Pathology Department, institutional projects have been implemented in order to increase the number of autopsies, including a pre- and post-graduate training and systematic request for autopsy, with significant gain for clinicians and pathologists, but also for families who get systematic and customized return results...
November 23, 2016: Revue Médicale Suisse
Jean-Michel Kaision, Jacques Gasser
Suicide in the mental hospital is first a human tragedy that affects the patients' families and relatives but also touches all medical staff involved. As for suicide prevention, it is a key issue of public health, and the canton of Vaud has made it a top priority of his mental health policy. We will present some epidemiologic data general of suicide and some specific elements to our institution, the Psychiatry Department of the Centre Hospitalier Universitaire Vaudois (DP-CHUV). Then we will show how our institution addresses the issue of suicide prevention through the analysis of so-called « adverse clinical events » and the systematic training of its caregivers...
September 21, 2016: Revue Médicale Suisse
Emmanuel Tamchès, Lazare Benaroyo, Marc Antoine Bornet, Jean-Pierre Hornung, Gian Domenico Borasio
The optional course « Living facing death » is the result of an innovative educational approach jointly developed by CHUV's Palliative Care Service, Lausanne's School of Medicine, Medical Ethics Unit and the students' association « Doctors & Death ». It is intended for 3rd and 4th grade medical students and was inspired by previous experiences conducted at Harvard Medical School. Its primary objective is to help students to « take some distances ». A mixed quantitative/qualitative satisfaction questionnaire was administered to all participating students at the completion of the course...
May 24, 2017: Revue Médicale Suisse
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