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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
D E Gomez, E Doré, D Francoz, A Desrochers, H Pierre, G Fecteau
BACKGROUND: The signalment, clinicopathologic, bacteriological, histopathological, ultrasonographic characteristics, and the treatment and outcomes of adult cattle with cholangiohepatitis are poorly defined. ANIMALS: Thirteen Holstein cows with cholangiohepatitis. METHODS: Retrospective study of medical records of cattle admitted to the CHUV and the AVC between 1992 and 2012 and 2000 and 2012, respectively, for cattle older than 3 months of age with a histopathological diagnosis of cholangiohepatitis...
May 2017: Journal of Veterinary Internal Medicine
Yotam Levin, Efrat Kochba, Sachin Mani
No abstract text is available yet for this article.
March 8, 2017: Vaccine
Gaëtan-Romain Joliat, Ismail Labgaa, Nicolas Demartines, Nermin Halkic
AIM: To identify a preoperative blood marker predictive of alveolar echinococcosis (AE) recurrence after hepatectomy. METHODS: All consecutive patients who underwent operation for liver AE at the Lausanne University Hospital (CHUV) between January 1992 and December 2015 were included in this retrospective study. Preoperative laboratory values of leukocytes, mean corpuscular volume (MCV), red blood cell distribution width (RDW), thrombocytes, C-reactive protein (CRP) and albumin were collected and analyzed...
February 7, 2017: World Journal of Gastroenterology: WJG
Francis L Munier, Pascal Mosimann, Francesco Puccinelli, Marie-Claire Gaillard, Christina Stathopoulos, Susan Houghton, Ciara Bergin, Maja Beck-Popovic
PURPOSE: The introduction of intra-arterial chemotherapy (IAC) as salvage treatment has improved the prognosis for eye conservation in group D retinoblastoma. The aim of this study was to compare the outcomes of consecutive patients with advanced unilateral disease treated with either first-line intravenous chemotherapy (IVC) or first-line IAC. DESIGN: This is a retrospective mono-centric comparative review of consecutive patients. PATIENTS: Sporadic unilateral retinoblastoma group D cases treated conservatively at Jules-Gonin Eye Hospital and CHUV between 1997 and 2014...
August 2017: British Journal of Ophthalmology
Onya Opota, Seydina M Diene, Claire Bertelli, Guy Prod'hom, Philippe Eckert, Gilbert Greub
Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV revealed the presence of a high number of resistance genes, including the presence of the blaGOB-13 and blaB-9 carbapenemase-encoding genes...
January 2017: International Journal of Antimicrobial Agents
Vincent Alvarez, Jong Woo Lee, M Brandon Westover, Frank W Drislane, Jan Novy, Mohamed Faouzi, Nicola A Marchi, Barbara A Dworetzky, Andrea O Rossetti
OBJECTIVE: Our aim was to analyze and compare the use of therapeutic coma (TC) for refractory status epilepticus (SE) across different centers and its effect on outcome. METHODS: Clinical data for all consecutive adults (>16 years) with SE of all etiologies (except postanoxic) admitted to 4 tertiary care centers belonging to Harvard Affiliated Hospitals (HAH) and the Centre Hospitalier Universitaire Vaudois (CHUV) were prospectively collected and analyzed for TC details, mortality, and duration of hospitalization...
October 18, 2016: Neurology
Karin Diserens, Jean-Paul Robert, Cristina Pellet, Loric Berney, Marc Levivier, Andreas F Hottinger
New treatment modalities in oncology, radiation oncology and surgery have led to a significant improvement in life expectancy for cancer patients. Some will however develop severe neurologic deficits that will impact their quality of life. To limit this impact, it is essential to offer optimal neurorehabilitation. In this context, a pilot project of early and intensive neurorehabilitation for brain tumor patients has been set up. A collaboration between the teams of neurooncology, acute neurorehabilitation and neurosurgery from the CHUV and the Clinique La Lignière allows an intensive and direct neurorehabilitation following neurosurgery...
April 27, 2016: Revue Médicale Suisse
Andrea O Rossetti, Eugen Trinka, Christine Stähli, Jan Novy
OBJECTIVES: In 2015, the International League Against Epilepsy (ILAE) issued a new status epilepticus (SE) classification, including a detailed semiologic axis. This study assesses frequencies of SE forms in a cohort of adult patients, and explores differences and practical implications as compared to a seizure-type-bound classification. METHODS: The prospective adult SE registry of the Lausanne University Hospital (CHUV) was considered over 5 years (2011-2015); each SE episode was retrospectively reclassified for its semiology according to the new ILAE scheme...
July 2016: Epilepsia
Fang Wang, Jun Lin, Jitao Chang, Yingying Cao, Shaomin Qin, Jianmin Wu, Li Yu
A Chuzan virus (CHUV), defined as GX871 here, was isolated from blood from a sentinel cattle firstly in China, and its full-length genome was sequenced in this study. The GX871 genome included 10 segments and 18914 bp, one base fewer than the CHUV prototype strain K-47 due to a one-base deletion in the 5' non-coding region of segment 8. A frameshift mutation was detected in a short coding region (1010-1026 nt) corresponding to the VP1 protein; this frameshift resulted in a five-amino acid mutation from 336CVLSY340 to 336YGAKL340...
February 2016: Virus Genes
Heng Yang, Lei Xiao, Jinxing Meng, Heli Xiong, Lin Gao, Defang Liao, Huachun Li
Chuzan virus (CHUV) belongs to the Palyam serogroup, causes bovine congenital disease, and is prevalent in Asia. To date, only one full Palyam virus (PALV) genome sequence, that of Japanese CHUV strain K47, has been reported. Sequence analysis indicates that PALV strains isolated from different geographical regions show significant diversity, which is mainly shaped by geographically independent evolution and genetic reassortment. Our understanding of the genetic characteristics of PALV is hampered by a very limited genomic sequence database...
April 2016: Archives of Virology
J Servet, P-A Bart, J-B Wasserfallen, J Castioni
How to recognize, announce and analyze incidents in internal medicine units is a daily challenge that is taught to all hospital staff. It allows suggesting useful improvements for patients, as well as for the medical department and the institution. Here is presented the assessment made in the CHUV internal medicine department one year after the beginning of the institutional procedure which promotes an open process regarding communication and risk management. The department of internal medicine underlines the importance of feedback to the reporters, ensures the staff of regular follow-up concerning the measures being taken and offers to external reporters such as general practioners the possibility of using this reporting system too...
November 4, 2015: Revue Médicale Suisse
François Spertini, Régine Audran, Reza Chakour, Olfa Karoui, Viviane Steiner-Monard, Anne-Christine Thierry, Carole E Mayor, Nils Rettby, Katia Jaton, Laure Vallotton, Catherine Lazor-Blanchet, Juana Doce, Eugenia Puentes, Dessislava Marinova, Nacho Aguilo, Carlos Martin
BACKGROUND: Tuberculosis remains one of the world's deadliest transmissible diseases despite widespread use of the BCG vaccine. MTBVAC is a new live tuberculosis vaccine based on genetically attenuated Mycobacterium tuberculosis that expresses most antigens present in human isolates of M tuberculosis. We aimed to compare the safety of MTBVAC with BCG in healthy adult volunteers. METHODS: We did this single-centre, randomised, double-blind, controlled phase 1 study at the Centre Hospitalier Universitaire Vaudois (CHUV; Lausanne, Switzerland)...
December 2015: Lancet Respiratory Medicine
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