Scientific Report 2013

Ente Ospedaliero Cantonale Index

Preface 5 4. Swiss Clinical Trial Organization 87 4.1 EOC Clinical Trial Unit (CTU-EOC) 88 1. Oncology Institute of Southern Switzerland (IOSI) 9 1.1 Medical Oncology Service 12 5. Scientific Research Advisory Board (ABREOC) 91 1.2 Radiation Oncology Service 13 1.3 Medical Physics Unit of the Radiation Oncology Service 15 6. The new Federal Act on research involving humans (HRA) and General 95 1.4 Nuclear Medicine Service and PET/CT Centre 16 Authorization for research studies granted to the EOC by the Berne 1.5 Palliative Care Service 18 Panel of Experts on Professional Confidentiality in Medical Research 1.6 Haematology Service 20 1.7 Research Division 22 7. Publications in 2013 99 1.8 IOSI Nursing Service 30 Publications in peer-reviewed journals in 2013 101

Publications in non-peer-reviewed journals in 2013 124 2. Neurocenter of Southern Switzerland (NSI) 33 Publications of medical congress abstracts in 2013 124 2.1 Multiple Sclerosis Centre 34 Publications in books in 2013 140 2.2 Sleep and Epilepsy group 37 2.3 Movement Disorders 41 8. Appendices 143 2.4 Stroke Center 43 Appendix 1 - Research projects funded by ABREOC in 2008 144 2.5 Neuropsychology 44 Appendix 2 - Research projects funded by ABREOC in 2009 146 2.6 Neurosurgery 45 Appendix 3 - Research projects funded by ABREOC in 2010 148 2.7 Neuroradiology 46 Appendix 4 - Research projects funded by ABREOC in 2011 150 2.8 Neuroanaesthesia 47 Appendix 5 - Research projects funded by ABREOC in 2012 - 2013 152 2.9 Experimental laboratory 49 Appendix 6 - EOC Projects 2013 subject to General Authorisation (AG) 152

3. EOC Multisite Departments and Services 55 3.1 EOC Department of Surgery 56 3.2 EOC Department of Internal Medicine 61 3.3 EOC Department of Intensive Care Medicine 69 3.4 Paediatric Department of Southern Switzerland 72 3.5 EOC Department of Laboratory Medicine 78 3.6 Anaesthesiology Services 78 3.7 Geriatric Service 79 3.8 Gynaecology and Obstetrics Services 80 3.9 Radiology Services 81

Together for a better care

Preface Preface

Let me start by referring to an unequivocal figure: the two features which are essential to ensure In particular, the Act contains provisions relating Medical Research on 7th May 2012, will remain + 26% in only one year. I am talking about the safe and quality treatments. This positive develop- to the use of biological material and personal data valid until the expiration date of May 2017. increasing number of EOC's peer-reviewed scien- ment in the gradual growth of scientific research of patients for research purposes. tific publications in just 12 months (2012: 194 produced within the EOC is - along with the One of these provisions specifically authorizes Finally, I wish to express my gratitude to all those vs. 2013: 244 peer-reviewed publications), many increasing consolidation of the Clinical Trial Unit their use, as stated in Article 321bis of the who - once more and with great dedication, com- of which are the result of multicenter studies and basic and translational research - the best Criminal Code, in case it is not possible to obtain mitment and passion - contributed to a further mainly based in Ticino Canton, with both national basis and one of the fundamental pillars within the consent of the patients or it is not feasible to growth of knowledge produced by scientific re- and international important collaborations. As a the newly-established Human Medicine Master of provide them with the necessary information on search in the clinical field in order to put it quickly result, the number of journals with good impact the future Department of Biomedical Sciences, the right of opposition. at the disposal of our patients who resort to our factor, where these studies were published, also Università della Svizzera Italiana. services. increased. In addition, if we include the publica- The Act invests the cantonal ethics committees tion of 12 books or chapters in books, 12 original The Federal Act on research involving humans with powers to grant permission for research. Until quite recently, we have taken particular care articles published in non-peer-reviewed scientific (HRA), approved by the Federal Parlament on Therefore, the Federal Commission of Experts on to add "time to life", while nowadays - as we are journals and 175 communications at national and 30th September 2011, and its associated Professional Confidentiality in Medical Research able to offer effective, quality and safe treatments international conferences, we can immediately ordinances, and namely: the Ordinance on human of Bern, terminated the task with the entry into - it becomes increasingly important to ensure that appreciate the dynamism with which everyone is research (HRO), the Ordinance on clinical trials force of the Human Research Act. Regarding the these treatments can really add "life to time". We working in the scientific research field within our in human research (ClinO) and the Ordinance on authorizations issued by 31st December 2013, sincerely hope that research development will be institutes and therefore, the EOC's services. Such organizational aspects of the Human Research the transitional provision of the Act states that all effectively oriented towards meeting the require- a growing development of scientific research is Act (OrgO-HRA), entered into force on 1st Janu- (special and general) authorizations to disclose ments and practical needs of our patients. the best basis to ensure our patients to receive ary 2014. These new regulatory provisions sub- professional secrecy for clinical research studies increasingly updated and timely treatments, stantially represent the development, as legally will remain valid until they expire. Therefore, the thanks to the prompt transfer of the most recent required, of instruments which are necessary general authorization to disclose professional Fabrizio Barazzoni MD MPH knowledge from this sector to patients. Further- to carry out scientific research in our Country in secrecy for research studies carried out at the FMH Prevention and Public Health Head of the Medical Area of the EOC Head Office more, if we add our inter-and multidisciplinary order to meet challenges that increasingly arise EOC's institutes and granted by the Bern Commis- Chairman of the Scientific Research Advisory Board

approach to patient care, then we are faced with in this area. sion of Experts on Professional Confidentiality in Bellinzona, July 2014

6 Scientific Report 2013 Preface 7 1 Oncology Institute of Southern Switzerland (IOSI) 1. Oncology Institute of Southern Switzerland (IOSI)

Introduction in Biomedicine (IRB) are part of the Institute of On- of malignant lymphomas, the current database Giovanni) – or through studies carried out within The IOSI includes all the specializations dealing with cology Research (IOR) and are run by the "Fondazi- includes more than 2,300 patients treated since the IOSI, as in the case of the International Breast oncology within the EOC in a single organizational one ticinese per la ricerca e la cura dei linfomi" (Ti- 1980, for whom all the diseased tissue has been Cancer Study Group. The IOSI has always been one structure. The IOSI has been devised on the basis cino Foundation for the research and treatment of re-examined by the same team of pathologists. of the most active centres in Switzerland for the of the North American model of "comprehensive lymphomas), although functionally, they are part of Moreover, we are merging our lymphoma da- assessment of new oncological drugs. cancer centres", but has its own particular struc- the IOSI’s research division. tabase with the one of the University of Novara, This requires laboratory research (pharmacog- ture, as it has a horizontal structure throughout which has been built up based on our template. enomics, pharmacokinetics and pharmacodynam- the EOC. Research These databases are essential for the develop- ics) and structures for clinical coordination which Research is a strategic sector for the IOSI, which ment of new research ideas and also for a quality can, where necessary, carry out Phase I and II tri- The IOSI is, therefore, intended to be an all-inclusive allocates more than 15% of its annual budget to control of the results achieved. als independently. The Trial Unit Sponsor of the structure, containing all the specializations that this sector. IOSI has been integrated into the CTU-EOC. deal with the diagnosis, treatment and research in From the very beginning the IOSI has focused on Another specific feature of the research carried At a national level most of the clinical studies are the field of tumour diseases. three main areas of research: out by the IOSI is constantly to try to link clinical carried out within the structures of the Swiss • malignant lymphomas, studies to laboratory research, which is carried Group for Clinical Cancer Research (Schweizer- The IOSI has six Services: medical oncology, radi- • new drugs, out in the structures of the IOR. In the field of clini- ische Arbeitsgruppe für klinische Krebsforschung, ooncology, haematology, nuclear medicine, pallia- • breast cancer. cal research, the ties with international research SAKK). tive care and research. Each service has its own In the last years another important area of re- groups are of particular importance, either directly research program coordinated by the IOSI’s Sci- search, developed by the division of nuclear medi- managed by the IOSI – as in the case of lympho- The IOSI has spent around 7 million Swiss francs entific Board, which meets once every two months cine, is represented by thyroid cancer. mas with the International Extranodal Lymphoma on research during 2013. Two thirds of this sum and decides on common research guidelines. The For every research topic, the IOSI has a database Study Group (IELSG) whose "operational office" is has been spent on laboratory research while one research laboratories of the Institute for Research containing the records of all patients. In the case in the IOSI at Regional Hospital of Bellinzona (San third was devoted to clinical research.

10 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 11 De Dosso, Zanellato E, Nucifora M, Boldorini R, ractionated and accelerated irradiation of the Sonzogni A, Biffi R, Fazio N, Bucci E, Beretta O, sole surgical cavity, in patients suffering from Crippa S, Saletti P, Frattini M. ERCC1 predicts breast cancer with low risk of local recurrence outcome in patients with gastric cancer treated and undergoing conservative surgery, is not with adjuvant cisplatin-based chemotherapy. Can- inferior to postoperative irradiation with con- cer Chemother Pharmacol. 2013;72(1);159-165. ventional fractionation of the entire breast as regards local control, measured in terms of Colombo N, Preti E, Landoni F, Carinelli S, Colombo incidence of ipsilateral recurrences as a first A, Marini C, Sessa C. on behalf of the ESMO Guide- event. lines Working Group. Endometrial cancer: ESMO Total number of randomized pts: 1865, IOSI/ Clinical Practice Guidelines for diagnosis, treat- RT pts: 62. ment and follow-up. Ann Oncol. 2013;24(Suppl 6): vi33-vi38. • IBCSG 38-10 / BIG 3-07 / TROG 07.01: a ran- domized phase III study of radiation doses and 1.2 Radiation Oncology Service fractionation schedules for ductal carcinoma in Antonella Richetti MD situ (DCIS) of the breast. Head Doctor Lead investigator: IOSI: A. Richetti. Sub investigators: MC. Valli, P. Pittoni. Main areas of research 1. Breast cancer: Women with completely excised non-low risk 1.1 Medical Oncology Service (Dr. Wannesson). • IRMA: breast cancer with low risk of local re- ductal carcinoma in situ (DCIS) treated by Prof. Michele Ghielmini MD Two new projects are starting on the treatment of currence: partial and accelerated irradiation breast conserving surgery suitable for adjuvant Medical Director of the IOSI and Head Doctor bone metastases in collaboration with the neuro- with three-dimensional conformal radiotherapy whole breast radiation therapy (RT) are eligible surgery department in Lugano (Dr. Di Lascio). (3DCRT) vs. standard radiotherapy after con- for the study. Women will be randomised to re- Main areas of research Another study has been started in the field of geri- serving surgery (phase III study). ceive one of the following two treatments: Arm The main clinical research activity of the medical atric oncology: patients above the age of 70 are Lead investigator IOSI: MC. Valli. 1: Whole breast RT alone using standard frac- oncology department is the participation to multi- classified as fit, frail or vulnerable, and the treat- Sub-investigators: A. Richetti, P. Pittoni. tionation (50 Gy / 25 fractions, 5 per week) center national trials of the Swiss Group for Clini- ment is determined according to specific guide- Arm 2: Whole breast RT using standard frac- cal Research (SAKK). Here we include 50 to 60 lines. Their outcome will be compared to patients Conservative surgery (including large breast tionation (50 Gy / 25 fractions, 5 per week) patients every year, mainly in the fields of breast treated without this assessment (Dr. Ratti and resection and lumpectomy + biopsy of the sen- plus tumour bed boost (16 Gy / 8 fractions, cancer, gastrointestinal cancer and lymphoma. Marini). tinel lymph node and/or axillary dissection) 5 per week). Primary objective: To individualize We also strictly collaborate with the research of followed by post-op RT: trial arm 38.5 Gy total treatment selection for women with DCIS fol- the lymphoma unit, of the breast unit and of the Main funding in 10 fractions (3.85 Gy per fraction), twice a lowing breast conserving surgery to achieve drug development unit of the IOSI with which we The above mentioned activities are financed by day with an interval of at least 6 hours between long term disease control with minimal toxicity. share a number of projects. SAKK, by the ABREOC foundation, by our own sci- the two fractions, for five consecutive working Total number of randomized pts 1389, IOSI/ A fruitful collaboration is with the Canton’s Insti- entific foundation, by the scientific foundations of days. Control arm 45 Gy/18 fractions, or 50 RT pts 4. tute of Pathology, particularly the molecular biol- the departments with which we perform the trials. Gy/25 fractions, or 50.4 Gy/28 fractions, or ogy lab of Dr. Frattini, with which we conduct stud- isoeffective fraction schemes, once a day for 5 2. Neuro-Oncology cancer: ies on molecular markers which are predictive for Peer reviewed publications in 2013 (selection) days a week. A 10 - 16 Gy boost is allowed in • CDX110-04, ACT IV: an international, rand- response to therapy in colorectal and gastric can- Brugger W, Ghielmini M. Bendamustine in indolent centres where it is part of the standard treat- omized, double-blind, controlled study of Rindo- cer (Dr. Saletti and De Dosso) and on the receptor non-Hodgkin's lymphoma: a practice guide for patient ment. Primary Objectives: the main purpose of pepimut/GM-CSF with adjuvant Temozolomide tyrosine kinase expression in lung cancer biopsies management. Oncologist. 2013; 18(8):954-964. the study is to evaluate whether partial hypof- in patients with newly diagnosed, surgically re-

12 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 13 sected, EGFRvIII-positive glioblastoma (the ACT pT3a-b R0-1 cN0M0 / pT2 R1 cN0M0, Glea- ckenberger M, Zwahlen DR, Azinwi NC, Plasswilm curacy and importance of the dose estima- IV study). son score 5-10 prostatic carcinoma. A phase L, Takacs I, Reuter C, Sumila M, Manser P, Ost tion out of the main radiation field, where Lead investigator IOSI: GF. Pesce. III study. P, Böhmer D, Pilop C, Aebersold DM, Ghadjar P. there is a clinical impact in relation to the Sub investigator: NC. Azinwi. Lead investigator IOSI: GF. Pesce. Use of EORTC target definition guidelines for dose- possible induction of secondary tumours. Sub investigator: NC. Azinwi. intensified salvage radiation therapy for recurrent Also, the evaluation of the clinical impact This is an international, multicenter, double- prostate cancer: results of the quality assurance and accuracy in non-standard conditions like blind clinical trial of rindopepimut in which Total number of randomized pts 86, IOSI/RT program of the randomized trial SAKK 09/10. Int those generated by the small fields used in approximately 700 patients with newly diag- 2 pts. Primature study closure due to poor re- J Radiat Oncol Biol Phys. 2013;87(3):534-541. stereotactical treatments was pointed out, nosed, resected, EGFRvIII positive glioblastoma cruitment, follow-up still ongoing. especially in low density tissues like lungs. will, after completion of standard chemoradia- 1.3 Medical Physics Unit of the Radiation tion, be randomized to receive either rindopepi- • SAKK 09/10: Dose intensified salvage ra- Oncology Service • Evaluation and research in the flattening filter mut/GM-CSF or control (KLH), in combination diotherapy in biochemically relapsed prostate Fogliata Antonella MSc SSRMP/SGSMP Medi- free (FFF) beam field. with standard adjuvant temozolomide. The pri- cancer without macroscopic disease. A rand- cal Physicist In this project our research evaluated the pos- mary purpose of the study is to confirm that omized phase III trial. Unit Head sible benefit in using such photon beams on the addition of rindopepimut/GM-CSF to adju- Lead investigator IOSI: GF. Pesce. different anatomical sites, different pathologies vant temozolomide improves overall survival in Sub investigator NC. Azinwi. Main areas of research and different treatment delivery techniques. A patients with newly diagnosed EGFRvIII positive During 2013, the Medical Physics Unit of the Ra- comparison with Monte Carlo simulation using glioblastoma who have undergone gross-total Megavoltage equipments with nominal pho- diotherapy Service, thanks to the scientific advi- predefined phase space files was also carried resection. ton energies ≥ 6 MV are required. Rotational sory and coordination of Dr. Luca Cozzi, continued out. Total number of randomized pts 390, IOSI/RT techniques such as Tomotherapy®, Rapi- to follow its research projects also in collaboration study opened for accrual in January 2014. darc®, intensity-modulated arc technique and with international groups like the Istituto Clinico • Evaluation of dose distributions in patients volumetric-modulated arc therapy will also be Humanitas of Milan in Italy, the Kaiser-Franz-Josef treated with the RapidArc technology (volumet- • EORTC 22033-26033: primary chemotherapy eligible. The patient will be treated in an iso- Spital of Vienna in Austria, the CRLC Val d'Aurelle ric modulated arc therapy VMAT) in different with Temozolomide vs. radiotherapy in patients centric setting and all fields will be applied for of Montpellier and the Institut Sainte Catherine of anatomical sites, compared with other tech- with low grade gliomas after stratification for 5 days per week for the total RT duration. RT Avignon in France, the Yashoda Super Speciality niques. genetic 1p loss: a phase III study. in the standard arm A will be administered to Hospital of Hyderabad in India, the Cheng-Ching Lead investigator IOSI: GF. Pesce. a total dose of 64 Gy in 32 fractions of 2 Gy General Hospital of Taichung in Taiwan, the Adding- • Usage of amorphous silicon detectors in quality Sub investigator: NC. Azinwi. over 6.4 weeks. RT in the experimental arm B ton Hospital of Durban in South Africa, the Charité assurance procedures for different treatment will be administered to a total dose of 70 Gy University Hospital of Berlin in Germany. techniques and different beams. Patients will be treated with Radiotherapy 50.4 in 35 fractions of 2 Gy over 7 weeks. Primary The research projects at the Medical Physics Unit The ongoing study on the dose released to the Gy in 28 fractions x 1.8 Gy or Temozolomide objective: assessment of tumour control, toxic- are mainly focused in the fields of dose calculation patient during the radiation treatment with the 75 mg/m2 daily x 21 days, q 28 days until pro- ity and quality of life (QoL) after dose intensified algorithms and the dose optimization algorithms, acquisition of such images is continuing. gression or for max. 12 cycles. The purpose of salvage radiotherapy (RT). as well as on the new optimization algorithms the study is to demonstrate a difference in pro- Total number of randomized pts: 310, IOSI/RT based on the knowledge based concept. Another Main funding gression-free survival for primary treatment. pts: 12. theme is the flattening filter free (FFF) beams. No financing. Total number of randomized pts 700, IOSI/RT 4 pts. Study closed for accrual, follow-up still Main funding In particular in 2013 the activities were mainly on Peer-reviewed publications in 2013 (selection) ongoing. SAKK (SAKK 01/10, SAKK 09/10, IBCSG 38- the following subjects: Fogliata A, Scorsetti M, Navarria P, Catalano M, 10), ABREOC (IOSI-RTO-001), Celldex Therapeu- Clivio A, Cozzi L, Lobefalo F, Nicolini G, Palumbo V, 3. Urogenital cancer: tics, Inc (CDX110-04), EORTC (EORTC 22033), • Evaluation and validation of the dose calculation Pellegrini C, Reggiori G, Roggio A, Vanetti E, Alongi • EORTC 22043-30041: immediate or early sal- other study EORTC and study IRMA no funding. algorithm Acuros. F, Pentimalli S, Mancosu P. Dosimetric compari- vage post-operative external radiotherapy com- This project started in 2010 and is devoted son between VMAT with different dose calculation bined with concomitant and adjuvant hormonal Peer reviewed publications in 2013 (selection) to evaluate the dose calculation accuracy on algorithms and protons for soft-tissue sarcoma treatment versus immediate or early salvage Sassowsky M, Gut P, Hölscher T, Hildebrandt G, patient level. This year the aim was focused radiotherapy. Acta Oncol. 2013;52(3):545-552. post-operative external radiotherapy alone in Müller AC, Najafi Y, Kohler G, Kranzbühler H, Gu- on the evaluation of the clinical impact, ac-

14 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 15 Nicolini G, Clivio A, Vanetti E, Krauss H, Fenogliet- as thyroid treatments using low-activity radioiodine highly sensitive Tg assay carried out at EOLAB. fuse large B-cell lymphomas and its mediastinal to P, Cozzi L, Fogliata A. Evaluation of an aSi-EPID and treatments for inflammatory joint diseases. variant. with flattening filter free beams: applicability to the High-activities radioiodine therapies are carried • Role of 18FDG PET/CT in patients with ad- GLAaS algorithm for portal dosimetry and first ex- out in a designated area (three rooms) located at vanced thyroid cancer. 3. Meta-analysis and systematic reviews: perience for pretreatment QA of RapidArc. Med the IOSI building in Bellinzona. The Nuclear Medi- Lead investigator: L. Giovanella. • Meta-analysis, systematic reviews and cost- Phys. 2013; 40(11): 111719. cine Service also includes the EOC Competence effectiveness studies on the diagnostic perfor- Centre for Thyroid Diseases. A thyroid day-clinic Metastatic differentiated thyroid cancers that mance or prognostic significance of PET/CT Fogliata A, Clivio A, Vanetti E, Nicolini G, Belosi (with dedicated scintigraphy, ultrasound and inter- are non-responsive to radioiodine show a rapid using different tracers in oncology. MF, Cozzi L. Dosimetric evaluation of photon dose ventional ultrasound facilities) is available in Bell- progression, while iodine-responsive cancers Lead investigator: G. Treglia. calculation under jaw and MLC shielding. Med inzona and Lugano sites, respectively. A number show a better prognosis. The only way to as- Phys. 2013; 40(10): 101706. of types of collaboration are underway concerning sess the iodine avidity of metastatic tissue is The purpose of our research is to create ev- both teaching and research, mainly in the fields to administer high activities of radioiodine. Cur- idence-based manuscripts about the diagnos- Nicolini G, Abraham S, Fogliata A, Jordaan A, Cliv- of thyroid diseases, PET/CT evaluation of lympho- rent studies are examining, using an interna- tic performance or prognostic significance of io A, Vanetti E, Cozzi L. Critical appraisal of volu- mas, nuclear cardiology and meta-analysis and tional multicenter prospective approach, the PET/CT using different tracers in oncology. metric-modulated arc therapy compared with elec- cost-effectiveness studies in nuclear medicine and role of 18FDG PET/CT in selecting patients for To this end, as a first step, a systematic re- trons for the radiotherapy of cutaneous Kaposi's thyroidology (in collaboration with the Universities high-activity radioiodine therapy. view of literature about the application of PET/ sarcoma of lower extremities with bone sparing. of Zurich, Aachen, Marburg, Leiden, Birmingham CT in a specific tumour is performed. Subse- Br J Radiol. 2013; 86(1023):20120543. and Pavia, the National Cancer Centre in Milan and • Individual dosimetry in radiometabolic therapy. quently, quality analysis of the eligible articles the Mayo Clinic). Lead investigator: L. Giovanella. and pooled analysis through specific software Clivio A, Kluge A, Cozzi L, Köhler C, Neumann O, (MetaDisc and/or StatsDirect) are performed. Vanetti E, Wlodarczyk W, Marnitz S. Intensity Main areas of research Comparative studies are currently underway Furthermore, analysis of possible bias (hetero- Modulated Proton Beam Radiation for Brachy- 1. Thyroid disorders: on efficacy and cost effectiveness of radiomet- geneity, publication bias, etc.) and possible sub- therapy in Patients With Cervical Carcinoma. Int J • Role of 99mTc-sestaMIBI in the differential di- abolic therapy performed with or without pre- group analyses are also carried out. The main Radiat Oncol Biol Phys. 2013;87(5):897-903. agnosis of follicular thyroid nodules. liminary dosimetric protocols. outcome measurements are sensitivity, speci- Lead investigator: L. Giovanella. ficity and accuracy for diagnostic accuracy me- 1.4 Nuclear Medicine Service and PET/CT 2. PET/CT and Lymphomas: ta-analyses and hazard ratios for prognostic Centre 20% of thyroid nodules removed using fine-nee- • Role of 18FDG PET/CT in lymphomas meta-analyses. Luca Giovanella MD PD dle aspiration fall into the TIR 3 category (fol- Lead investigator: L. Ceriani. Head Doctor licular proliferation) and need to be removed in Main funding order to have a definite histological diagnosis The role of PET/CT in assessing patients with ABREOC, Mallinkrodt Diagnostics, ROCHE Diag- Nuclear medicine uses substances emitting a (benign in 80% of cases). Our study examines, lymphomas has increased greatly over the last nostics, GE Diagnostics, SAKK, IELSG, Genzyme- low level of radiation (radiopharmaceuticals) and using an international multicenter prospective few years. IELSG studies 26 and 37 are aimed Sanofi, Ibsen AB. technologically very advanced equipment (gamma- approach, the role of 99mTc-sestaMIBI in dif- at focusing on the clinical advantages of PET cameras, PET machines) to carry out diagnostic ferentiating between benign and malignant fol- in primary mediastinal large B-cell lymphomas, Peer reviewed publications in 2013 (selection) tests (scintigraphy, tomoscintigraphy, SPET/CT licular nodules. investigating whether a complete metabolic Verburg FA, Luster M, Cupini C, Chiovato L, Duntas and PET/CT) in every branch of medicine. Moreo- response after chemotherapy can prevent the L, Elisei R, Feldt-Rasmussen U, Rimmele H, Seregni ver, special radiopharmaceuticals are used in the • Clinical role of highly sensitive thyroglobulin need for subsequent consolidation radiothera- E, Smit JW, Theimer C, Giovanella L. Implications treatment of benign thyroid disease (hyperthyroid- measurement. py. Other evidence highlights the potential role of thyroglobulin antibody positivity in patients with ism and goitre, thyroid carcinomas, bone metas- Lead investigator: L. Giovanella. of metabolic imaging in defining the prognosis differentiated thyroid cancer: a clinical position tases, neuroendocrine tumours, lymphomas and for the disease at its outset by helping to deter- statement. Thyroid. 2013;23(10):1211-1225. inflammatory joint diseases). The Service is locat- On the basis of a meta-analysis study performed mine the most efficient form of treatment (e.g. ed in the Regional Hospital of Bellinzona and Valli in our centre, the role of highly sensitive Tg as- "risk adapted therapy"). Under this assumption, Giovanella L, Trimboli P, Verburg FA, Treglia G, (San Giovanni) and the Regional Hospital of Lugano says in the follow-up of differentiated thyroid the prognostic role of certain metabolic param- Piccardo A, Foppiani L, Ceriani L. Thyroglobulin (Civico). Nuclear medicine diagnostic tests, includ- cancer was proved. An international multicent- eters, which can be calculated by means of a levels and thyroglobulin doubling time indepen- ing PET/CT, are carried out in both sites, as well er prospective study is now underway with the basic PET, is being studied in patients with dif- dently predict a positive 18F-FDG PET/CT scan in

16 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 17 patients with biochemical recurrence of differenti- The IOSI’s palliative care service is considered a • An interview Study on Swiss palliative care phy- Lead investigator: S. Pautex (HUG). ated thyroid carcinoma. Eur J Nucl Med Mol Imag- highly advanced pioneering model, both nationally sicians’ opinions concerning hastened death ing. 2013;40(6):874-880. and internationally, labelled "Designated Centre- practices. This is an open, multicenter observational Centre of Integrated Oncology and Palliative Care Lead investigator: C. Gamondi. quantitative study, whose primary purpose Treglia G, Kakhki VR, Giovanella L, Sadeghi R. (ESMO 2004-2016. The palliative care unit has This project tries to describe Swiss palliative is to understand what kind of (socio-cultural, Diagnostic performance of fluorine-18-fluoro- been awarded the label "Quality in Palliative Care" care experts’ perspectives on assisted suicide, physical, psychological and spiritual), patient’s deoxyglucose positron emission tomography in (Qualité Palliative 2012-2015). considering that this is a highly controversial is- characteristics, expectations and attitudes to- patients with Merkel’s cell carcinoma: a system- sue, discussed in literature and by the public wards being informed and included in decisions atic review and meta-analysis. Am J Clin Dermatol The research unit includes Claudia Gamondi, MsC opinion. The primary purpose of this study is and which therapeutic representatives, affect 2013;14(6):437-447. (responsible physician), Silvia Walther, MsC (part- to investigate and highlight controversies con- the decision of whether or not to complete the time research nurse) and Yves Franzosi (part-time cerning assisted suicide in itself and its possible expected directives. The secondary purposes Awards 2013 data manager) and boasts of national and inter- legalization. It is a qualitative study, using open of the study are to understand the degree of Giorgio Treglia MD received the Best poster national collaborations. Its main partners are: the interviews to 15-20 palliative care physicians authority that patients expect from their rep- award at the Annual Congress of the Swiss Society IOSI oncology Department, SUPSI, Haute École recruited from the three different linguistic re- resentatives and health professionals and to of Radiology (SSR) and Nuclear Medicine (SGNM), Santé Lausanne, Service de Soins Palliatifs (CHUV gions. It will be a one-year project. identify the needs along with the expectations Lucerne, 30th May - 1st June 2013. Lausanne) and the International Observatory for of the representatives about their involvement End of Life Care (Lancaster, UK). • FIT (Fine Vita Ticino – “End of life Ticino”) study. in end-of-life decisions. A further purpose is to Luca Ceriani MD received the Best abstract award Epidemiology of death in Ticino’s public hospi- study the experience of health professionals re- at the “Terza Giornata della Ricerca Clinica della Main areas of research tals. garding end-of life decisions and issues relating Svizzera Italiana”, Lugano, 22nd March 2013. The main research projects are: Lead investigator: C. Gamondi. to "Advanced Health Care Directives (AHCDs)" • Cross-sectional non interventional multicenter with patients and their relatives/representa- 1.5 Palliative Care Service clinical study for the evaluation of the preva- This is a one-year observational prospective tives. Hans Neuenschwander MD lence of nausea in hospitalized patients admit- study with the following purposes: describing Head Doctor ted to a palliative care unit. how adult patients die in public hospitals in Ti- • Monitoring of life, the use of sedatives in the Lead investigator: C. Gamondi. cino and, in particular, how they are assisted as last days of life in patients hospitalized in two Palliative care involves looking after a patient and they approach death; identifying any differenc- Swiss Acute Palliative Care Hospital Units: a his family using a more global approach aimed at This is a two-year observational study which es in the treatment of patients whose death is retrospective, comparative study. trying to maintain or re-establish the best possible involves submitting questionnaires to patients expected compared to those whose death is Lead investigator: C. Gamondi. quality of life through an interdisciplinary approach, admitted to a palliative care unit suffering from not expected; assessing the perception of doc- involving doctors, nurses, psychologists and social nausea when initially assessed. The purpose of tors and nurses as regards the quality of the Monitoring of life, the use of sedatives in the last workers, all with highly specialized skills. the study is to evaluate the prevalence of nau- care provided before death. days of life in patients hospitalized in two Swiss Palliative Care Service (SCP - Servizio di Cure Pal- sea and to examine the multifaceted aspect of Acute Palliative Care Hospital Units: a retro- liative), which is present in all EOC hospitals, has this symptom, assessing the different spheres • Meaning of life, personal values and spirituality spective, comparative study. Palliative Sedation the mission of promoting this philosophy and dis- it affects. at the end of life. is a clinical procedure aimed at relieving/alle- seminating the specific know-how of palliative care Lead investigator: G. Borasio (CHUV). viating intolerable suffering (physical, psycho- to hospital teams through specialist consultation • Participer à un suicide assisté: étude explora- logical, existential) from symptoms which are at the patient’s bedside and by developing the nec- toire sur l’expérience des proches et leurs This is an 18-month, mixed prospective study refractory to standard treatment, despite ag- essary training programs. représentations de la fin de vie, de la mort et aimed at studying the connection between peo- gressive efforts. This can be achieved via the The Palliative Care Unit (UCP - Unità di Cure Pal- du deuil. ple questioning themselves as to the meaning monitored use of sedative medication (mainly liative) is equipped with seven beds and a special- Lead investigator: C. Gamondi. of life and spirituality at the end of their lives in benzodiazepines) in dosages and combinations ist team as a part of the IOSI’s inpatient units at This is a three-year open multicenter qualitative an end-of-life context. required to reduce consciousness in a terminal Regional Hospital of Bellinzona and Valli (San Gio- study (phase II) aimed at describing the charac- patient as much as necessary, with no intent of vanni). The unit admits patients in need of palliative teristics of the mourning of relatives of patients • Advanced directives in patients with advanced causing or hastening death. This project aims care, in a specialized ward. who die through assisted suicide. oncological disease: patients' right or health at retreiving the use of sedative drugs, within professionals’ duty. a palliative care sedation procedure or not, in

18 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 19 two palliative care units (Bellinzona and Laus- symptom distress among patients with chronic standard arm. The first experimental arm was cal toxicity, transient ischemic attacks have anne). The secondary purpose is to compare kidney disease receiving dialysis. Swiss Med Wkly. lenalidomide and the accrual in Switzerland has also been described. The effects on cell mem- indications, drugs and procedures, between 2013;143:w13750. been very good. Given the new trial design, long branes and free radical scavenging implicate these two settings. discussions with the health authorities were an influence of haemostatic mechanisms. Little 1.6 Haematology Service necessary to open the second arm of the trial is known on direct changes of haemostatic and • Palliative Sedation: perceptions and experi- Georg Stüssi MD PD (Tosedostat). Unfortunately, in the meantime coagulation mechanisms immediately after ences of the palliative care team in Southern Head Doctor all studies with this drug have been put on a DMSO administration. Transfusion of cryopre- Switzerland. temporary hold for suspected toxicity of the served stem cell preparations causes activa- Lead investigator: C. Gamondi. Haematology is a medical specialty with interac- drug. The investigations of the FDA are cur- tion of haemostatic mechanisms, by direct or tions with various medical departments in the hos- rently ongoing. A potentially third trial arm with indirect stimulation of cellular components. The practice of sedation is debated from an pital. In 2013, it set up a closer collaboration with a CRM1 inhibitor is being evaluated. This effect might be attributed to DMSO which ethical and clinical point of view. There are the internal medicine departments. In the near is present in cell suspension or in other cellular many studies exploring the procedures on pa- future, this collaboration will also be extended to • The effect of cryopreservation on the function products. tients, the outcomes on family members and other departments, thereby establishing its role as of thrombocytes in vivo. the experiences of the professionals involved. Cantonal haematology service. The haematologic Lead investigators: B. Gerber, L. Alberio, G. Peer reviewed publications in 2013 This study is intended to explore the attitudes diagnostic is performed in the centralized haema- Stüssi. Millard AL, Valli PV, Stussi G, Mueller NJ, Yung GP, and the experiences of the palliative care spe- tology laboratory (LEM) in Bellinzona. The main fo- Seebach JD. Brief Exercise Increases Peripheral cialist in Ticino. The participants (physicians cus of the haematology service is also the develop- This study looks at the effect of platelet func- Blood NK Cell Counts without Immediate Function- and nurses specialized in palliative care) will ment of a non-malignant haematology branch and tion after cryopreservation and thawing. So far, al Changes, but Impairs their Responses to ex vivo be recruited from the first and second line, the formation of the physicians in Ticino. it has been thought that the cryopreservation Stimulation. Front Immunol. 2013;4:125. practicing both in hospital and in the home In 2013, Georg Stüssi was appointed President process inhibits the functional activity of plate- care setting. This study uses a mixed method: of the leukemia project group of the SAKK. There- lets. We have shown, in a clinical study, that von Hohenstaufen KA, Conconi A, De Campos CP, a questionnaire duly created will be sent to all fore, an important part of the clinical scientific ac- cryopreserved platelets prevent bleeding. Dur- Franceschetti S, Bertoni F, Margiotta Casaluci G, professionals and 7 face-to-face interviews, will tivity is the development and participation of SAKK ing 2013, a number of functional experiments Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano be carried out to explore the challenges of pal- studies with a focus in the diagnostics and therapy were performed to show in vitro their activa- G, Zucca E. Prognostic impact of monocyte count liative sedation deeply. of acute and chronic leukemias. The IOSI offers tion. The study is currently finished and will be at presentation in mantle cell lymphoma. Br J Hae- treatment within clinical trials for all patients with published in 2014. matol. 2013;162(4):465-73. Main funding leukemia, mostly in international phase III trials. In ABREOC, Swiss National Science Foundation 2014, several new leukemia trials will be opened. • DMSO toxicity on haemostatic mechanisms Lobetti-Bodoni, C, Bertoni, F, Stussi G, Cavalli, F. (SNSF), SAMW and Fondazione Realini. The haematology service is also launching a trans- after transfusion of cryopreserved stem cell & Zucca E. The changing paradigm of chronic lym- lational research activity in collaboration with Dr. preparations. phocytic leukemia management. Eur J Intern Med. Peer reviewed publications in 2013 Francesco Bertoni’s laboratory, mainly in the field Lead investigator: D. Tsakiris in collaboration 2013;24(5):401-10. Gamondi C, Pott M, and Payne S. Families' expe- of chronic lymphatic leukemia. with G. Stüssi. riences with patients who died after assisted sui- Mian M, Rinaldi A, Mensah AA, Rossi D, Ladetto cide: a retrospective interview study in southern Main areas of research Dimethyl sulfoxide (DMSO) is extensively used M, Forconi F, Marasca R, Uhr M, Stussi G, Kwee I, Switzerland. Ann Oncol 2013;24(6):1639-44. • Clinical research into acute myeloid leukemia in as a cryoprotectant in hemopoietic stem cell Cavalli F, Gaidano G, Zucca E, Bertoni F. Large elderly patients. preservation. In vitro properties and toxic ef- genomic aberrations detected by SNP array Gamondi C, Larkin P, Payne S. Core competencies Lead investigators: G. Ossenkoppele, B. Löwen- fects of DMSO include rapid penetration across are independent prognosticators of a shorter in palliative care: an EAPC White Paper on pallia- berg, G. Stüssi. biologic membranes, free radical scavenging, time to first treatment in chronic lymphocytic tive care education. European Journal of Palliative histamine release by mast cells. Although toxic- leukemia patients with normal FISH. Ann Oncol. Care, 2013; 20(2). In 2011 the HOVON 103 trial was started by ity of DMSO on stem cells has been found to be 2013;24(5):1378-84. introducing a novel trial design to SAKK stud- low, adverse reactions in patients after trans- Gamondi C, Galli N, Schönholzer C, Marone C, ies. It is a randomized phase II study in elderly fusion have been described, such as nausea, Zwahlen H, Gabutti L, Bianchi G, Ferrier C, Cereghe- AML patients with multiple parallel experimen- vomiting, chills, fever. Isolated serious adverse tti C, Giannini O. Frequency and severity of pain and tal arms, which are all compared to a common events, such as multi-organ failure, neurologi-

20 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 21 1.7 Research Division of the IOSI-IOR research division coordinates scien- c. Breast Cancer Unit, coordinated by Olivia Pa- of rituximab to chlorambucil produces superior Prof. Franco Cavalli MD tific research for the whole IOSI. gani MD. event-free survival in the treatment of patients with Scientific Director For this reason, he chairs the IOSI Scientific Board, This Unit is particularly active in the research extranodal marginal-zone B-Cell lymphoma: 5-year which meets every three months. From an oper- being carried out by the International Breast analysis of the IELSG-19 Randomized Study. J Clin The IOSI Research Division functionally includes ational point of view, the IOSI clinical research is Cancer Study Group (IBCSG) and manages a Oncol. 2013;31(5):565-572. two closely linked units: the clinical research cen- mainly divided into five units: database on Ticino patients with breast can- tre, which is located at the IOSI in the Regional Hos- cer. It is currently expanding and looking for von Hohenstaufen KA, Conconi A, De Campos CP, pital of Bellinzona (San Giovanni) and the Institute a. New Drug Development Unit, under the direc- permanent headquarters. Franceschetti S, Bertoni F, Margiotta Casaluci G, of Oncology Research (IOR), which is located in the tion of Prof. Cristiana Sessa MD. Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano IRB (Institute for Biomedical Research) and contig- This group offers patients the possibility of re- d. Gastrointestinal Cancer Group, coordinated by G, Zucca E. Prognostic impact of monocyte count uous buildings. The close intellectual and physical ceiving therapy with experimental drugs that Piercarlo Saletti MD. at presentation in mantle cell lymphoma. Br J Hae- proximity of the IOR and the IOSI clinical research are still being tested. At present, the Unit is The group promotes clinical and translational matol. 2013;162(4):465-473. sectors is fundamental to guarantee the quality of coordinating twelve phase I studies (eight in research into tumours of the gastrointestinal the work and the continuous flow of information solid tumours and four in lymphomas) and two tract in close collaboration with the Canton’s 1.7.1 New Drug Development Unit between the laboratory area and the dedicated re- phase II studies. Sometimes, as in the case Institute of Pathology di Locarno (ICP). Prof. Cristiana Sessa MD search area for patients. It is rare to find functional of one of the phase I studies in lymphomas, Deputy Head Doctor at the IOSI units like this in Switzerland, that is why the IOR the new experimental drug was previously as- e. Prostate Cancer Unit, coordinated by Enrico – as the only oncological institute in Switzerland sessed in the preclinical models available at Roggero, MD. Main areas of research – has been receiving federal grants since 2013 the IOR and then subsequently passed on to This is the newest unit, which is rapidly grow- In 2013, the structure of the CTU/New Drugs Unit in pursuance of Article 16 of Federal Law on the the evaluation phase with patients in the IOSI. ing, also in close cooperation with the prostate of IOSI was consolidated. It was possible to activate promotion of research and innovation. Currently, all these studies with new anti-can- cancer program of the IOR. a 3rd investigator promoted study assessing the cer molecules are carried out under very strict combination of two chemotherapeutic agents with The IOR and main areas of research conditions and with rigorous assessment, and Peer reviewed publications in 2013 (selection) one molecule targeted agent. This combination This is the basic, translational research unit at the have all been previously approved by both the Conconi A, Franceschetti S, Lobetti-Bodoni C, Sta- will be tested for the first time in humans and, at IOSI. Originally opened at the IRB in Bellinzona in Canton’s Ethics Committee and Swissmedic this A, Casaluci GM, Ramponi A, Mazzucchelli L, first, only in patients with advanced solid tumours. April 2003, this research department currently - the Swiss Agency for Therapeutic Products. Bertoni F, Ghielmini M, Gaidano G, Cavalli F, Zuc- In 2013, there was also an increase in the activi- employs around forty researchers. At first, it was ca E. Risk factors of central nervous system re- ties of the Clinical Trial Unit of the EOC (CTU/EOC) called the IOSI Experimental Cancer Laboratory b. The Lymphoma Unit, coordinated by Emanuele lapse in Mantle cell lymphoma. Leuk Lymphoma. which took over 21 projects. The main services re- and was administratively run by the EOC. To be- Zucca MD PD. 2013;54(9):1908-1914. quested were those related to monitoring, statisti- come eligible for federal funds on 1st September This Unit manages the lymphoma database, cal plan and statistical analysis, electronic prepa- 2011 it was turned into the IOR, which is currently dating back to 1980, where information is Cavalli F. An appeal to world cancer leaders: stop ration of CFR and preparation of the documents managed by the Fondazione Ticinese per la Ricer- stored about over 2,300 patients and is up- cancer now. Lancet. 2013;381(9865):425-426. for the submission of new studies to Swissmedic. ca e la Cura dei Linfomi (Ticino Foundation for Re- dated continuously. The Unit also manages the In 2013, based on the extensive work performed in search and Treatment of Lymphomas), although scientific, logistic and IT divisions of the Inter- Conconi A, Franceschetti S, Lobetti-Bodoni C, Sta- 2012, 2 new phase I studies were started by the from a functional point of view, the IOR is still part national Extranodal Lymphoma Study Group this A, Casaluci GM, Ramponi A, Mazzucchelli L, New Drugs Group of the SAKK with a fast increase of the research division of the IOSI. The IOR is an (IELSG), a cooperative group spanning: 1. On- Bertoni F, Ghielmini M, Gaidano G, Cavalli F, Zuc- in patient accrual. In 2013, in the New Drugs Unit important training centre in the field of biomedical cology Institute of Southern Switzerland (IOSI); ca E. Risk factors of central nervous system re- 12 studies with new molecules in patients with ad- and cancer research for PhD students, postdoc- 2. five continents with currently over 200 in- lapse in mantle cell lymphoma. Leuk Lymphoma. vanced tumours were already opened or started toral fellows and students in collaboration with var- stitutions (further information on IELSG can 2013;54(9):1908-1914. (8 in solid tumours), with a total of 25 patients ious Swiss and Italian universities. The laboratory be found at www.ielsg.org). IELSG is also one treated; 2 phase II studies were also undertaken range of competences, currently available in the of the few institutions in Switzerland that can Zucca E, Conconi A, Laszlo D, López-Guillermo A, for a total of 4 patients treated. laboratory, include cellular and molecular biology, obtain funding for clinical studies from the Na- Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vi- The phase I unit of IOSI is deeply involved in assess- molecular pharmacology, functional genomics, tional Research Fund (FNR), which usually only tolo U, Morschhauser F, Pileri SA, Copie-Bergman ing inhibitors of the PI3K/AKT/mTOR signalling pharmacogenomics and bioinformatics. From a finances laboratory research. C, Campo E, Jack A, Floriani I, Johnson P, Martelli pathway. We are testing not only new molecules structural point of view, Professor Cavalli, Director M, Cavalli F, Martinelli G, Thieblemont C. Addition but also combination studies with other molecule

22 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 23 targeted agents, such as FGFR inhibitors. 1.7.2 Lymphoma Unit – IELSG by brain irradiation vs. high-dose chemotherapy 2019). Emanuele Zucca MD PD supported by autologous stem cell transplanta- Main funding Deputy Head Doctor at the IOSI tion for immunocompetent patients with newly • IELSG 39 - International prospective Phase 2 SAKK, ABREOC, Pharmaceutical Companies for diagnosed primary CNS lymphoma. trial addressing the effectiveness of first-line specific clinical studies. Main areas of research Lead investigators: A. Ferreri, G. Illerhaus, E. Zucca. Chlamydophila psittaci-eradicating therapy 1. Phase I studies: with protracted administration of doxycycline Peer reviewed publications in 2013 (selection) • OSI-LND-001: A Phase I study of Inotuzumab On 31.12.2013: 205 patients enrolled in 52 followed by eradication monitoring and antibi- Gallerani E, Zucchetti M, Brunelli D, Marangon Ozogamicin (CMC-544) in combination with Institutes and 5 Countries (sample size: 200 otic re-treatment at infection re-occurrence in E, Noberasco C, Hess D, Delmonte A, Martinelli Temsirolimus (CCI-779) in patients with re- evaluable patients - End of trial expected for Q2 patients with newly diagnosed Ocular Adnexal G, Böhm S, Driessen C, De Braud F, Marsoni S, lapsed or refractory CD22-positive B-cell Non 2014). Marginal Zone Lymphoma (OAMZL). Cereda R, Sala F, D’Incalci M, Sessa C. A first in Hodgkin’s Lymphomas. Lead investigators: A. Ferreri, E. Zucca. human phase I study of the proteasome inhibitor Lead investigator: A. Stathis. • IELSG 34 - A Multicenter Phase II study to eval- CEP-18770 in patients with advanced solid tu- uate the clinical activity and the safety profile On 31.12.2013: 11 patients enrolled in 1 In- mours and multiple myeloma. Eur J Cancer, 2013, Phase I study for patients with lymphoma. Be- of everolimus (RAD001) in marginal zone B-cell stitute in 1 Country (Sample size: 34 patients - 49(2):290-296. sides the IOSI, the study is open in other two lymphomas (MZL). 3-year enrollment + 5 years follow-up). Swiss Centres (St Gallen and Bern). Lead investigators: E. Zucca, A. Conconi. Sessa C, Del Conte G, Christinat A, Cresta S, Per- On 31.12.2013: Six patients enrolled in 3 Insti- 3. IELSG Retrospective Studies: otti A, Gallerani E, Lardelli P, Kahatt C, Alfaro V, tutes in Switzerland (End of trial expected for On 31.12.2013: 30 patients enrolled in 10 In- • IELSG 17 - Multi-institutional retrospective Iglesias JL, Fernández-Teruel C, Gianni L. Phase I Q4 2015). stitutes in 3 Countries (completed enrollment ). analysis of intravascular lymphomatosis. clinical and pharmacokinetic study of trabectedin Lead investigators: A. Ferreri, M. Ponzoni. and cisplatin given every three weeks in patients • A Phase I, Multicenter, Open-label study of • IELSG 37 - A randomized, open-label, multicent- with advanced solid tumors. Invest New Drugs. IMGN529 administered intravenously in adult er, two-arm phase III comparative study assess- On 31.12.2013: 68 patients enrolled in 16 In- 2013;31(5):1236-43. patients with relapsed or refractory NHL. ing the role of involved mediastinal radiotherapy stitutes and in 7 Countries. Lead investigator: A. Stathis. after Rituximab containing chemotherapy regi- Sessa C, Shapiro GI, Bhalla KN, Britten C, Jacks mens to patients with newly diagnosed Primary • IELSG 31 - A retrospective international study KS, Mita M, Papadimitrakopoulou V, Pluard T, • A phase I, dose-finding study of the bromodo- Mediastinal Large B-Cell Lymphoma (PMLBCL). of primary extranodal follicular lymphoma Samuel TA, Akimov M, Quadt C, Fernandez-Ibarra main (Brd) inhibitor OTX015 in haematological Lead investigators: M. Martelli, AJ. Davies, M. Lead investigators: E. Zucca, B. Pro, M. Fed- C, Lu H, Bailey S, Chica S, Banerji U. First-in-Human malignancies. Gospodarowicz, E. Zucca. erico, AG. Lopez. Phase I Dose-Escalation Study of the HSP90 Inhibi- Lead investigator: A. Stathis. tor AUY922 in Patients with Advanced Solid Tu- On 31.12.2013: 73 patients enrolled in 25 In- On 31.12.2013: 274 patients enrolled in 10 mours. Clin Cancer Res. 2013;19(13):3671-80. 2. IELSG - Prospective Studies: stitutes and in 5 Countries - (sample size: 752 Institutes and in 7 Countries. • IELSG 30 - A phase II study of R-CHOP with in- patients - End of trial expected for Q4 2015). Sessa C, Lorusso P, Tolcher A, Farace F, Lassau tensive CNS prophylaxis and scrotal irradiation • IELSG 35 - A retrospective international study N, Delmonte A, Braghetti A, Bahleda R, Cohen P, in patients with primary testicular diffuse large • IELSG 38 - A phase II study of Chlorambucil of primary extranodal lymphoma of female gen- Hospitel M, Veyrat-Follet C, Soria JC. Phase I Safe- B-cell lymphoma - Study. in combination with subcutaneous Rituximab ital tract. ty, Pharmacokinetic and Pharmacodynamic Evalu- Lead investigators: U. Vitolo, E. Zucca. followed by maintenance therapy with subcu- Lead investigators: G. Martinell, G. Ryan. ation of the Vascular Disrupting Agent Ombrabulin taneous Rituximab in patients with extranodal (AVE8062) in Patients with Advanced Solid Tu- On 31.12.2013: 28 patients enrolled in 13 marginal zone B-cell lymphoma of mucosa as- On 31.12.2013: 37 patients, in 4 Institutes mours. Clin Cancer Res. 2013;19(17):4832-42. Institutes and in 2 Countries (sample size: 35 - sociated lymphoid tissue (MALT Lymphoma). and in 4 Countries. End of trial expected for Q2 2014). Lead investigators: A. Stathis, S. Luminari, L. Ledermann JA, Raja FA, Fotopoulou C, Gonzalez- Baldini, C. Thieblemkont, R. Gressin, E. Zucca. Main funding Martin A, Colombo N, Sessa C. ESMO Guidelines • IELSG 32 - Randomized phase II trial on prima- “IELSG 32 - Randomized phase II trial on primary Working Group. Newly Diagnosed and Relapsed Ep- ry chemotherapy with high-dose methotrexate On 31.12.2013: 0 patients enrolled (the study, chemotherapy with high-dose methotrexate and ithelial Ovarian Carcinoma: ESMO Clinical Practice and high-dose cytarabine with or without thi- at present, is only open at IOSI - sample size: high-dose cytarabine with or without thiotepa, and Guidelines. Ann Oncol. 2013;24 (Suppl 6):vi24-32. otepa, and with or without rituximab, followed 112 patients - end of trial expected for Q4 with or without rituximab, followed by brain irra-

24 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 25 diation vs. high-dose chemotherapy supported by 2013;24(5):1344-51. intraductal neoplasia (coordinated by the Inter- N, Janni W, Kreipe H, Fitzal F, Resch A, Costa A, autologous stem cells transplantation for immuno- national Breast Cancer Study Group - IBCSG) Bago-Horvath Z, Peintinger F. German, Austrian competent patients with newly diagnosed primary Von Hohenstaufen KA, Conconi A, de Campos CP, and women with early breast cancer (an Italian and Swiss consensus conference on the diagnosis CNS lymphoma”: Franceschetti S, Bertoni F, Margiotta Casaluci G, multicenter study on partial breast irradiation, and local treatment of the axilla in breast cancer. Swiss National Science Foundation (SNSF from Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano also involving Dutch and Israeli centres). Eur J Cancer. 2013;49(10):2277-2283. 2011 to 2013 - 3 years). G, Zucca E. Prognostic impact of monocyte count “IELSG 37 - A randomized, open-label, multicenter, at presentation in mantle cell lymphoma. Br J Hae- • Medical oncology Lin NU, Thomssen C, Cardoso F, Cameron D, Cufer two-arm phase III comparative study assessing matol. 2013;162(4):465-73. One clinical study in women with early breast T, Fallowfield L, Francis PA, Kyriakides S, Pagani the role of involved mediastinal radiotherapy after cancer, coordinated by the Swiss Group for O, Senkus E, Costa A, Winer EP, ESO-MBC Task Rituximab containing chemotherapy regimens to 1.7.3 Breast Cancer Unit Clinical cancer research (SAKK), addressing Force. International guidelines for management of patients with newly diagnosed Primary Mediastinal Olivia Pagani MD the Impact of a multi-gene expression profile metastatic breast cancer (MBC) from the Europe- Large B-Cell Lymphoma (PMLBCL)”: Head Service at the IOSI (Oncotype DX®) on Recommendations for Ad- an School of Oncology (ESO)-MBC Task Force: Sur- Oncosuisse (KFS-2859-08-2011 from 2012 to juvant Treatment in Patients with ER-positive veillance, staging, and evaluation of patients with 2014 - 3 years); The Breast Unit of Southern Switzerland (CSSI) is Breast Cancer. early-stage and metastatic breast cancer. Breast. Swiss National Science Foundation (SNSF from a dedicated centre for breast care, whose tasks Three studies coordinated by IBCSG (Interna- 2013;22(3):203-210. 2013 to 2016 - 3 years); include an early detection of breast cancer and a tional Breast Cancer Study Group), SAKK and Oncosuisse - Performance Agreement (from multidisciplinary management. The Centre offers Novartis addressing some of the pending ques- Christinat A, Di Lascio S, Pagani O. Hormonal ther- Q1.2013 to Q2. 2014 - 1.5 years). patients the great advantage of being treated un- tions in advanced breast cancer (the better apies in young breast cancer patients: when, what der one roof by a team of specialists, dedicated to schedule of chemotherapy, double-targeted and for how long? J Thorac Dis. 2013;5(Suppl Peer reviewed publications in 2013 (selection) breast care. This is made possible thanks to the therapy and endocrine resistance) and an ob- 1):S36-46. Conconi A, Franceschetti S, Lobetti-Bodoni C, Sta- close collaboration between all the members of servational study on the medical and psycho- this A, Casaluci GM, Ramponi A, Mazzucchelli L, the team and the availability of modern diagnostic social aspects in young patients coordinated by Christinat A, Pagani O. Practical Aspects of Ge- Bertoni F, Ghielmini M, Gaidano G, Cavalli F, Zuc- and therapeutic equipment. the IBCSG. netic Counseling in Breast Cancer: lights and shad- ca E. Risk factors of central nervous system re- The Breast Unit of Southern Switzerland was the ows. Breast. 2013;22(4):375-82. lapse in mantle cell lymphoma. Leuk Lymphoma. first Swiss centre to be certified by the European • Feasibility study on adipose-derived regenera- 2013;54(9):1908-1914. Society of Breast Cancer Specialists (EUSOMA) tive cell-enriched fat grafting in breast onco- Cardoso F, Bese N, Distelhorst SR, Bevilacqua JL, as a Breast Cancer Care Unit. The Centre is also plastic surgery. Safety and efficacy of the tech- Ginsburg O, Grunberg SM, Gralla RJ, Steyn A, Paga- Zucca E, Conconi A, Laszlo D, López-Guillermo A, about to obtain certification from the Swiss Society nique. ni O, Partridge AH, Knaul FM, Aapro MS, Andersen Bouabdallah R, Coiffier B, Sebban C, Jardin F, Vi- of Breast Cancer Specialists and the Swiss Cancer BL, Thompson B, Gralow JR, Anderson BO. Sup- tolo U, Morschhauser F, Pileri SA, Copie-Bergman League. Main funding portive care during treatment for breast cancer: C, Campo E, Jack A, Floriani I, Johnson P, Martelli These are not only important recognitions but SAKK, IBCSG, Novartis and other competitive and Resource allocations in low- and middle-income M, Cavalli F, Martinelli G, Thieblemont C. Addition rather a guarantee for patients. Indeed they can non-competitive external funding. countries. A Breast Health Global Initiative 2013 of rituximab to chlorambucil produces superior be confident that the Centre follows well-defined consensus statement. Breast. 2013;22(5):593- event-free survival in the treatment of patients with methodologies using recognized specialists. Peer reviewed publications in 2013 (selection) 605. extranodal marginal-zone B-Cell lymphoma: 5-year Goldhirsch A, Winer EP, Coates AS, Gelber RD, analysis of the IELSG-19 Randomized Study. J Clin Main areas of research Piccart-Gebhart M, Thürlimann B, Senn HJ, Cos- Regan MM, Pagani O, Fleming GF, Walley BA, Oncol. 2013;31(5):565-572. Core members of CSSI are deeply involved in the ta A. Personalizing the treatment of women with Price KN, Rabaglio M, Maibach R, Ruepp B, Coates development and dissemination of international early breast cancer: highlights of the St. Gallen AS, Goldhirsch A, Colleoni M, Gelber RD, Francis Wirth A, Gospodarowicz M, Aleman BM, Bressel guidelines for the management of early and ad- International Expert Consensus on the Primary PA; International Breast Cancer Study; GroupSOFT M, Ng A, Chao M, Hoppe RT, Thieblemont C, Tsang vanced breast cancer and breast cancer in young Therapy of Early Breast Cancer 2013. Ann Oncol. and TEXT Investigators. Adjuvant treatment of pre- R, Moser L, Specht L, Szpytma T, Lennard A, Sey- women. 2013;24(9):2206-2223. menopausal women with endocrine-responsive mour JF, Zucca E. Long-term outcome for gastric Involvement in clinical studies of: early breast cancer: Design of the TEXT and SOFT marginal zone lymphoma treated with radiothera- AGO; DGS; SGS; ÖGS; Panelists; Executive Board trials. Breast. 2013;22(6):1094-1100. py: a retrospective, multi-centre, International Ex- • Radiotherapy Members, Hoffmann J, Souchon R, Lebeau A, Öhls- tranodal Lymphoma Study Group study. Ann Oncol. Studies are currently underway in women with chlegel C, Gruber G, Rageth C, Weber W, Harbeck Pagani O, Gelber S, Colleoni M, Price KN, Simon-

26 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 27 cini E. Impact of SERM adherence on treatment Peer reviewed publications in 2013 PCa patients that are diagnosed and treated studied the expression of UHRF1, a multi-do- effect: International Breast Cancer Study Group Bianchi V, Spitale A, Ortelli L, Mazzucchelli L, Bor- at our institution. Moreover, the database is a main nuclear protein with epigenetic regulatory Trials 13-93 and 14-93. Breast Cancer Res Treat. doni A; QC3 CRC Working Group. Quality indica- tool to find out new prognostic factors, to as- activity, in a cohort of primary prostate cancer 2013;142(2):455-9. tors of clinical cancer care (QC3) in colorectal can- sess their impact on disease outcome and to (PCa) patients treated by radical prostatecto- cer. BMJ Open 2013;3(7). pii: e002818. support clinical and translational research. my and we showed the association of UHRF1 1.7.4 Gastrointestinal Cancer Group expression with aggressive disease and its Piercarlo Saletti MD De Dosso S, Zanellato E, Nucifora M, Boldorini • Pilot study comparing genomic and metabo- role as an independent prognostic factor for Deputy Head Doctor of Medical Oncology Service R, Sonzogni A, Biffi R, Fazio N, Bucci E, Beretta O, lomic profiling of patients’ prostate cancer at biochemical recurrence and overall survival Crippa S, Saletti P, Frattini M. ERCC1 predicts out- diagnosis and during disease progression to (OS). Secondly, we investigated the nuclear ex- Main areas of research come in patients with gastric cancer treated with find specific intra-individual genetic and meta- pression of human papillomavirus (HPV) whose Also in 2013, the research activity in GI malignan- adjuvant cisplatin-based chemotherapy. Cancer bolic alterations. role in PCa is very controversial. In our cohort cies was mainly conducted in cooperation with the Chemother Pharmacol 2013;72(1):159-65. Lead investigator: E. Roggero. of primary PCa patients, we observed a high Molecular Laboratory of the Pathology Institute, Collaborators: MR. Pascale, B. Marongiu, A. Ali- prevalence of nuclear HPV E7 oncoprotein and Locarno. Martin V, Landi L, Molinari F, Fountzilas G, Geva R, monti, F. Stoffel. a worse OS of HPV-positive cancer patients Riva A, Saletti P, De Dosso S, Spitale A, Tejpar S, (median 4.5 years) compared to HPV-negative Correlative clinico-pathological studies have been Kalogeras KT, Mazzucchelli L, Frattini M, Cappuzzo This is a retrospective pilot study whose pur- (median 8.2 years). Moreover, HPV status was performed and completed in: F. HER2 gene copy number status may influence pose is to assess the technical feasibility of an independent prognostic factor. Now, the clinical efficacy to anti-EGFR monoclonal antibodies an integrated approach, based on genomics prognostic value of UHRF1 and the oncogenic • Metastatic colorectal cancer (HER2 in predict- in metastatic colorectal cancer patients. Br J Can- and metabolomics, for the characterization of role of HPV in PCa need to be validated in a ing response to anti-EGFR monoclonal antibod- cer. 2013;108(3):668-75. prostate cancer at diagnosis and at disease prospective study. ies). recurrence and/or metastasis. Besides test- 1.7.5 Prostate Cancer Unit ing technical feasibility, the main objectives of • The Uroboard: multidisciplinary management • Gastric cancer (ERCC1 and outcome in pa- Enrico Roggero MD the study, are to investigate the intra-tumour of urogenital tumours. tients treated with adjuvant cisplatin-based Adjunct Physician of Medical Oncology Service heterogeneity and to identify specific molecu- Lead investigator: E. Roggero. chemotherapy) lar signature associated with different steps Collaborators: F. Stoffel, GF. Pesce and the Uro- Main areas of research of cancer development. Using our prostate genital multidisciplinary board. • Squamous cell anal cancer (characterization • The Prostate Cancer Database. cancer database, we have currently selected of potential molecular targets for therapeutic Lead investigator: E. Roggero. 4 cases of patients for whom prostatectomies In 2010, the tumour board (Uroboard) for the purposes). Collaborator: B. Marongiu. are performed at the time of diagnosis, and bi- multidisciplinary discussion of cases of uro- opsy specimens are available at disease pro- genital malignancies referring to hospitals of • Colon cancer (role of predictive markers in Collection of clinical and histopathological infor- gression. 2 of these cases have prostatecto- EOC was founded. From October 2010 to July stage III disease, according to adjuvant treat- mation of patients with prostate cancer (PCa) mies available as well as positive lymph nodes 2013, the Uroboard discussed 300 cases of ment). diagnosed and treated at the IOSI and Urology at the time of diagnosis. Now, these samples urogenital tumours, of which 43% were cases service of Regional Hospital of Bellinzona and will be submitted to the planned biological in- of prostate cancer. The analysis of cases, at Additionally, a substantial part of the activity was Valli (San Giovanni). Currently 1027 patients vestigations. their first presentation at Uroboard, showed devoted to the contribution in clinical trials of the with a diagnosis until 2011 have been record- an increase in patients that were being dis- SAKK group, focusing on locally advanced resect- ed retrospectively in the database. In this se- • Study on molecular factors related to tumour ag- cussed at the time of the first diagnosis (from able oesophageal cancer, advanced hepatocellular ries, the median survival is 10 years and the gressiveness and to carcinogenesis to find out 15% to 40%). From 2014, we will start a clini- cancer and mCRC. median age is 68 years old. The overall mortal- new prognostic markers for prostate cancer. cal trial to assess whether the multidisciplinary ity is 31% and the specific mortality from PCa Lead investigator: E. Roggero. discussion of individual prostate cancer cases Main funding is 17%. Preliminary multivariate analysis con- Collaborator: MR. Pascale. at the time of diagnosis, can promote different Projects 1 and 2: ABREOC; firmed the value of known prognostic factors, and more appropriate therapeutic strategies Project 3: San Salvatore Foundation; such as age, Gleason score, TNM stage and This study aims at exploring potential prognos- in specific categories of risk (financial support Project 4: Private Foundation. PSA. The utility of the PCa database is mainly tic factors involved into the pRb/E2F-1 path- requested to “Lega Ticinese contro il cancro” - the collection of clinical-pathological data of way. Firstly, in collaboration with the IOR, we "Ticino League Against Cancer").

28 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 29 • Clinical Urogenital Trials. tific literature. At the end of 2013, 225 PICC in June 2013 and has been going on for about “Multicenter observational study to assess and de- Lead investigator: E. Roggero. have been placed (176 removed) with a very one year. Data are being collected from pa- scribe risk factors for job burnout among nurses”: Clinical trials concerning new strategies for low rate of complications: venous thrombosis tients (questionnaires and semi-structured in- not funded, ongoing project (data analysis). treatment of patients with urogenital malignan- (0.72/1000 cath/day) or suspected infec- terviews) and nurses (focus groups) in the out- cies opened for recruitment in 2013: tions (0.46/1000 cath/day). The study is on- patient departments. At the end of 2013, 47 Peer reviewed publications in 2013 SAKK 08/11. going. questionnaires and 7 interviews were collected Valcarenghi D, Pedrazzani C, Bianchi M. To know Orteronel maintenance therapy in patients with and a focus group was set up. to change: the nurses of the Oncology Institute of metastatic castration resistant prostate can- • Look Good - Feel Better workshops: an opportu- Southern Switzerland (IOSI) and their relationship cer and non-progressive disease after first-line nity for oncology patients at the IOSI? • Multicenter observational study to assess and with the Evidence based Practise (EBP) and Nurs- docetaxel therapy: a multicenter, randomized Lead investigator: M. Bianchi, describe risk factors for job burnout among ing Research. Professioni Infermieristiche (Para- double-blind placebo-controlled phase III trial. Collaborators: S. Tosi, C. Pedrazzoli, C. Pedraz- nurses. medical professions). 2013; 66(3):159-67. zani, M. Zanon, D. Valcarenghi. Lead investigator: R. Caruso (IEO-Milan, Italy). New clinical trials are going to be opened in Local investigator/coordinator: D. Valcarenghi. Awards 2013 2014. The study started in January 2012. Its purpose Collaborators: L. Moser, C. Pedrazzani, M. Bi- Bianchi M, Zanon M, Foletti F, Valcarenghi D. is to assess the effects of Look Good - Feel Bet- anchi. Förderpreis 2013 der Onkologiepflege Schweiz - Main funding ter workshops attendance on patients. In the 3° Prize with the project: "Implementation of the ABREOC. workshops, patients learn, from expert beauti- The purpose of the study, in its local version, is Relationship-based nursing in an outpatient de- cians, how to enhance their body image further to estimate the prevalence of burnout among partment of the Oncology Institute of Southern Peer reviewed publications in 2013 to cancer and cancer treatments. Patients are IOSI nurses. The clinical area of belonging and Switzerland": Verleihung Förderpreis 2013. Onkol- Pascale M, Pracella D, Barbazza R, Marongiu B, asked to fill in the Body Image Scale (BIS), an some personal characteristics (sex, age, years ogiepflege Soins en oncologie. 2013; 2:15. Roggero E, Bonin S, Stanta G. Is human papilloma- international validated tool, about 8 weeks be- of experience, education, marital status) will be virus associated with prostate cancer survival? fore and after attending the workshop. At the assessed as possible risk factors. The study Dis Markers. 2013; 35(6): 607-613. end of 2013, 12 workshops have been set up has an observational design. IOSI nurses have with 73 participants and up to now, 43 women been asked, on a voluntary basis and after sign- 1.8 IOSI Nursing Service have agreed to participate in the study, which ing an informed consent, to fill out a form (with Monica Bianchi is ongoing. some personal data) and a validated scale for Nurse Director at IOSI the estimation of burnout (Burnout Potential (Regional Hospital of Bellinzona and Valli, San Gio- • Patient education for oral antitumour treat- Inventory - Italian version - CRF). The data col- vanni) ments. lection phase has already been completed and Lead investigator: D. Valcarenghi. data analysis is in progress. The percentage of Main areas of research Collaborators: C. Pedrazzani, A. Chiriatti, M. respondents is 55.9%. • The use of the Peripherally Inserted Central Zanon, M. Bianchi. Catheters (PICC) in the Oncology Institute of Main funding obtained in 2013 Southern Switzerland: evaluation of the effects. The purpose of the study is to explore how edu- “The use of the Peripherally Inserted Central Cath- Lead investigator: M. Bianchi. cation for oral antitumour treatments is carried eters (PICC) in the Oncology Institute of Southern Collaborators: S. Tosi, C. Pedrazzoli, S. Lussu, out in outpatient IOSI departments. Particularly, Switzerland: evaluation of the effects”: not funded, L. Moser, P. Servida, M. Zanon, D. Valcarenghi. the study is aimed at assessing if the nursing ongoing project. educational approach (contents, methods and The study started in May 2011. Its purpose is significance assigned) is seen as efficacious “LOOK GOOD - Feel Better workshops: an opportu- to assess the effects of PICC use in patients, by patients and if some educational needs are nity for oncology patients at the IOSI?”: not funded, mainly in oncology. Data are collected system- unsatisfied. Subordinately, it will be evaluated if ongoing project. atically in a database and are periodically used some other (organizational or cultural) factors for the process evaluation and adjustment. may affect the educational process. The study “Patient education for oral antitumour treat- Every complication is in-depth analyzed to de- has a mixed, quantitative and qualitative, design. ments”: ABREOC in 2012. Started in June 2013, tect causes and data are compared with scien- I Approved by ABREOC in 2012, it was started going on for about one year.

30 Scientific Report 2013 1. Oncology Institute of Southern Switzerland (IOSI) 31 2 Neurocenter of Southern Switzerland (NSI) 2. Neurocenter of Southern Switzerland (NSI)

Fabrizio Barazzoni MD ale (CTU-EOC) is located at the NSI. The Clinical lower urinary tract symptoms, and for topics involv- clinical database and a biological samples Head of Department, a.i. Trial Unit supports the investigators of the NSI for ing Neuroradiology with Vita-Salute San Raffaele collection available for current and future re- investigator-initiated and sponsor-initiated studies University, Milan, Italy and Brigham & Women’s search. Our centre has already included 50 of Introduction and participated in several studies which are de- Hospital, Harvard Medical School, Boston, USA. 100 planned patients. The “Neurocentre of Southern Switzerland” com- scribed below. The respective projects in basic and prises the services of neurology, neurosurgery, clinical research that were performed in 2013 or The Multiple Sclerosis Centre focuses on three –– NSI Investigator initiated trials concentrated neuroradiology and neuroanesthesia as well as are still in progress, are summarized in the follow- main research topics: on the management of MS symptoms (in par- the neuroscience research unit. Its primary goal ing sections together with their funding. ticular fatigue, one of the most disabling and is offering the highest quality of treatment to the –– Upcoming MS treatments can be offered to our uncomprehending MS symptom) aiming at patient with the application and promotion of an Main areas of research of the NSI patients through the participation in several in- improving the patients’ quality of life. The latter inter- and multidisciplinary approach. Performance ternational drug trials (Clinical Trials gov Identifi- studies clearly reflect the strong position of the of basic and clinical research as well as education- 2.1 Multiple Sclerosis Centre er: NCT01285401; NCT01405872). Some of NSI as a national centre of excellence in MS al activities are also a priority of the NSI since the (Claudio Gobbi MD and Chiara Zecca MD) them evaluate convenient therapeutic options research and are briefly described below: creation of the centre in 2009. A close interaction The Multiple Sclerosis Centre aims at offering an for relapsing forms of MS such as ocrelizumab between research activities and clinical duties is a optimal care for patients with multiple sclerosis (NCT01247324), CBAF (NCT01185821), • A prospective, randomized, double-blind, key to the success of the NSI. In 2013, numerous (MS) living in Ticino area. A dedicated team of two and laquinimod (NCT01975298). The same placebo-controlled, parallel-group, single scientific projects were performed in both clinical senior neurologists specialised in multiple scle- and other compounds are evaluated in the centre, phase IV study of oral prednisone and animal research. rosis, three assistant physicians, and three MS difficult therapeutic context of progressive taper vs. placebo following intravenous ster- The main focus of scientific activities at the NSI nurses run the outpatient service and at the same MS (CBAF312, NCT01665144; ocrelizumab, oids for the treatment of acute relapses in currently lies on multiple sclerosis, sleep disor- time carry out research activities. Research con- NCT01194570; fingolimod, NCT00731692, multiple sclerosis within the Ticino cohort ders, movement disorders and stroke even though tributes to offering alternative and innovative treat- NCT01779934). (EOC.NC.10.04). active research is also carried out in other fields of ments to patients and to advancing knowledge in Lead investigators: C. Gobbi, C. Zecca. clinical neuroscience. the MS field. We collaborate closely with the Uni- –– MS epidemiology is endorsed by the par- Collaborators: U. Candrian, V. Pifferini. For clinical research, one of the two seats of the versity Hospital Basel (Study SMSC), the Queens ticipation in the Swiss Cohort of MS patients Main funding: ABREOC (hospital competi- Clinical Trial Unit of the Ente Ospedaliero Canton- Square Hospital London concerning treatment of (SMSC), an innovative project to establish a tive fund).

34 Scientific Report 2012 2. Neurocenter of Southern Switzerland (NSI) 35 This double-blind, randomised, placebo-con- evaluate if interferon beta-1b treatment Disability Status Scales, clinically stable, Lead investigator: C. Gobbi. trolled, prospective, parallel group, single may be able to overcome the recurrence of who were given an immunomodulating Collaborators: C. Zecca, M. Manconi, M. Ca- centre trial aims at comparing the efficacy, significant clinical and radiological disease treatment with glatiramer acetate (GA) for porro, G. Riccitelli, C. Cartellina (technician). tolerability and safety of tapering doses of activity after natalizumab cessation and at least 1 year, were eligible. Age and gen- Main funding: Clara-Miller Stiftung (Società oral prednisone and placebo after short- keep disease activity under control better der matched healthy volunteers were also Svizzera Sclerosi multipla – “Swiss Society term high-dose i.v. methylprednisolone than the time prior to natalizumab. Patients included. The study was concluded in Sep- for Multiple Sclerosis”) (private foundation, on the recovery from an acute relapse in with relapsing-remitting multiple sclerosis tember 2013. 30 patients and 17 healthy non-competitive fund). patients with clinically isolated syndrome (RR-MS) being treated for 12 months with volunteers were enrolled. (CIS), relapsing-remitting multiple sclerosis natalizumab and without prior therapy with This cross-sectional, prospective, observa- (RR-MS) and primary (PP-MS) or secondary Interferon-beta 1b were eligible. Interferon- • Tolerability and quality of life in patients with tional, instrumental investigation seeks 1) progressive multiple sclerosis (SP-MS) with beta 1b 250ug was given subcutaneously multiple sclerosis switched to intramuscu- to provide a detailed characterization of fa- superimposed relapses. Female and male every other day (Betaferon®, Bayer Scher- lar interferon beta 1a Autoinjector (Avonex tigue in a cohort of selected MS patients, patients diagnosed with clinically isolated ing Pharma AG) for 12 months. Due to PenTM), SFERA STUDY (EOC.NSI.12.05). including a definition of the boundaries and syndrome (CIS), RR-MS, PP-MS or SP-MS recruitment difficulties, the project was Lead investigators: C. Gobbi, C. Zecca. the overlaps between fatigue, somnolence, and experiencing an acute relapse with closed by the end of 2013. Collaborators: U. Candrian, V. Pifferini. mood disorders and attention dysfunc- clinical worsening (>1 point if EDSS ≤4.5 or Main funding: Biogen (pharmaceutical com- tion; 2) to see how the prevalence and the 0.5 point if EDSS >4.5 or >2 points in one • Brain Default Mode and Attention Network pany, non-competitive fund). overlaps between fatigue, somnolence, de- functional system of the Expanded Disabil- MR Functional Connectivity Changes Af- pression and attention dysfunction are in- ity Status Scale (EDSS), EDSS score 0–8, ter Task-induced Precipitation of Cognitive This prospective single-arm, open-label, in- fluenced by the method of assessment. 3) aged 18–80 years will be enrolled. They Fatigue in Patients with Multiple Sclerosis terventional Phase IV study aimed at evalu- to better characterize the sleep structure will be treated with methylprednisolone for (EOC.NSI.12.02). ating the treatment tolerability, adherence in MS patients with fatigue under both the 3 days and then randomised to receive ei- Lead investigator: C. Gobbi. and quality of life over 1 year in MS patients macro- and microstructural point of view. ther orally decreasing doses of Prednisone Collaborators: C. Zecca, E. Pravatà, N. Na- who have been switched - from a subcuta- It is planned to include 100 patients with for 25 days, or a placebo. 19 patients have darajah, V. Pifferini. neous injectable DMT, given several times a a definite diagnosis of MS (Polman et al. been enrolled so far, 10 of which have con- Main Funding: ABREOC (hospital competi- week (Rebif®, Betaferon® or Copaxone®), 2005, 2011) or clinical isolated syndromes cluded the trial. tive fund); Società Svizzera Sclerosi multipla to once a week Avonex® 30 µg given intra- (CIS) (Miller et al. 2012) according to the (Swiss Society for Multiple Sclerosis) (pri- muscularly. Avonex® will be applied by the current criteria, Expanded Disability Status • Natalizumab de-escalation to interferon- vate foundation, competitive fund). new injection device Avonex PenTM. Female Scale (EDSS) score < 7.0 (Kurtzke 1983) beta-1b in patients with relapsing-remitting and male patients, aged ≥ 18 years, clinical- and with last magnetic resonance imag- multiple sclerosis: A Swiss multicenter This prospective, non-interventional, case- ly and radiologically stable while on therapy ing (MRI) within the previous 12 months. study. Prospective, controlled, single-arm, control, single centre study aims at investi- and qualified for Avonex® according to the Fatigue, sleep, psychiatric and cognitive as- open-label, multi-centre, phase IV study gating the impact of Cognitive Fatigue (CF) approved indication (CIS or RRMS), who sessments will be performed using appro- (EOC.NSI.11.01). induced by an effortful task on the intrinsic were continuously treated with Rebif®, priate questionnaires and methodologies. Lead investigators: C. Gobbi, C. Zecca. brain activity in MS patients, using func- Betaferon® or Copaxone over at least the At present, 5 patients have concluded the Collaborators: U. Candrian, M. Gola. tional MRI, and at further understanding past year but with persistent and bother- assessments. Main funding: Bayer (pharmaceutical com- the mechanisms and neurofunctional cor- some injection site tolerability issues, and pany, non-competitive fund). relation of cognitive fatigue experienced by with well documented neurological history, 2.2 Sleep and Epilepsy group a group of MS patients vs. healthy subjects. at least for the year prior to study entry, are (Mauro Manconi MD) This prospective, controlled, single-arm, Female and male patients aged 18-50 eligible. Eight patients have been enrolled so The sleep and epilepsy laboratory’s scientific mis- open-label, multicenter study aimed at eval- years, diagnosed with relapsing-remitting- far. This project continues with an industry sion is to explore brain function during sleep and uating the concept of natalizumab de-esca- MS (RR-MS) with immunomodulating ther- Sponsor. sleep related disorders in order to achieve im- lation to interferon-beta-1b e.o.d in relaps- apy, with and without cognitive fatigue (as portant pieces of knowledge in the new, intrigu- ing-remitting multiple sclerosis patients, per the Fatigue Scale for Motor and Cogni- • Multidimensional assessment of fatigue in ing and extremely growing field of sleep research. who consider stopping natalizumab due to tion – FSS and FSMC), with a disability equal multiple sclerosis–Observational study – Ti- Our main efforts are devoted to clinical research. a benefit-risk assessment. In particular, to or lower than 4.5 points on the Expanded cino (EOC.NSI.13.02). However, to translate our clinical research find-

36 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 37 ings towards a more basic direction is a part of insomnia (I) are associated with hyperten- The overall purpose of this proposal is to es- Sleep disordered breathing (SDB) is character- our strategic plan. Our group is mainly recognized sion and/or cardio-cerebrovascular morbidity tablish a pharmacological rodent model of RLS ized by repetitive apnoeas and/or hypopnoeas internationally for its results in the field of sleep re- and mortality. Sleep disorders (in particular and PLM using innovative experimental meth- during sleep, associated with oxygen desatu- lated movement disorders, such as restless legs SDB) are frequent after stroke. Their exact ods and analysis tools to further understand rations and sleep disruption. Its prevalence in syndrome, periodic limb movement disorders and frequency and impact on short- and long-term the underlying pathophysiology of the RLS and the adult population of Western countries has parasomnia. In the past few years, also thanks to outcome of stroke remain poorly known. SDB PLM and to test the efficacy and side effects of been estimated as high as 10-25%, and it is significant competitive grants and the develop- has a detrimental effect on the spatial exten- new treatments. The first purpose is to char- becoming more prevalent as the average popu- ment of strong local and external collaborations, sion of ischemic penumbra and reorganization acterize circadian rat limb activity (electrical lation body weight rises. SDB is an independ- we have expanded our interest towards other sci- of functional networks of the brain during the activity of the anterior tibialis muscles) and lo- ent risk factor for cardiovascular morbidity entific hot-topics such as: the impact of sleep dis- first 3 months after stroke; these negative comotor activity (open-field movement) during and mortality, including arterial hypertension, orders on the outcome of stroke, the sleep-related effects are related to haemodynamic and in- wake and different stages of sleep continuously ischemic heart disease/heart failure/atrial fi- eating disorders and obesity, the REM-behaviour flammatory changes e.g. changes in matrix over several 24 hours periods. This first study brillation, sudden death, and stroke. In addition, disorder as an early marker of neurodegenera- metalloproteinases (MMP), tissue inhibitors of will be intended: 1) to monitor the electrical ac- SDB is associated to hypoxia and changes in tion, the mechanism of disperception in primary metalloproteinases (TIMP) and adhesion mol- tivity of the anterior tibialis muscles in rodents the cerebral haemodynamics, which may be insomnia, and the topic of sleep-related disorders ecules that can be reversed with CPAP. Sleep and then 2) compare this electrical activity with detrimental on ischemic brain areas, affecting during pregnancy. We are also attempting to use loss (duration <6h) and sleep disorders (SDB, open-field locomotor behaviour under these eventually the development, the outcome and innovative tools like High-Density EEG to investigate RLS/PLMS, I) have detrimental effects on out- experimental conditions. The second purpose the quality of life after stroke. SDB is present in the microstructure of physiological sleep, trying come and risk of cardiovascular events in the is to test whether a chronic intrathecal injec- 50-70% of patients with acute ischemic stroke to produce a mathematic model able to predict first 12 months after stroke. Two consecutive tion of dopamine receptor D3 antagonist in- and transient ischemic attacks. The purpose of sleep evolution across night both in physiological projects are currently starting in collaboration creases rat limb activity, in general, or induces this study is to assess whether or not SDB has and pathological conditions. To improve knowledge with the University of Bern: a first interventional PLM during sleep and/or circadian locomotor a detrimental 3 months (short-term) effect on on sleep by educational initiatives, such as univer- study in patients with acute non-lacunar, ante- activity. This purpose will specifically test if D3 surrogate markers of atherosclerosis/athero- sity master and courses in sleep medicine, by ex- rior circulation, and moderate to severe (NIH dopamine receptors in the spinal cord play a genesis [blood pressure, heart rate variability, changing scholar and fellowship programs and by stroke scale score 4-20) ischemic stroke, test- significant role in RLS and PLM which has been endothelial function (as assessed by Peripheral promoting sleep education with periodic meetings ing the efficacy of nocturnal CPAP treatment supposed but not tested. The third purpose is Arterial Tonometry/Endo-PAT 2000), and hu- with the general population is also an essential col- in affecting the size and recovery of ischemic to assess the effect of pramipexole (pmx) on moral factors (serum oxidative and inflamma- umn of our activity. penumbra. Independently of the first project, this drug-induced form of animal RLS, in order tory/oxidative/coagulation markers)] after These are the main projects performed or ongoing about 1000 stroke patients will be included to create a D3 receptor competition between stroke. In the second, randomised phase, the in 2013: over 2 years for an observational study in or- dopamine agonist and antagonist. The primary study will assess, whether or not treatment of der to evaluate the impact of sleep-related dis- investigator and the collaborators in this pro- SDB with CPAP has a favourable long-term ef- • Sleep loss and sleep disorders and their Impact orders on the outcome of stroke. This project posed project to integrated human and animal fect (>12 months) on clinical-vascular outcome on the short- and long-term outcome of stroke. will improve our understanding of the frequen- models and techniques in the attempt to fur- after stroke. Lead investigator: C. Bassetti. cy as well as short- and long-term clinical sig- ther understand the pathophysiological basis Co-Applicants: M. Manconi, R. Wiest (University nificance, pathophysiological mechanisms, and of RLS and PLM. • Nocturnal Eating Syndrome and Sleep Related Institute of Diagnostic/Interventional Neurora- treatment implications of sleep loss and sleep Eating Disorder. diology, Inselspital Bern), S. R. Ott (University disorders (SDB, RLS/PLMS, I) after ischemic • SAS CARE 1- study of leg movements in sleep, Lead investigator: M. Manconi. Department of Pulmonary Medicine, Inselspi- stroke. sleep disordered breathing (sdb), cardiovascu- No founds. tal, Bern). lar markers and blood pressure profile in tran- Local investigators: S. Miano, PL Ratti. • A Pharmacogenetic Rodent Animal Model of sient ischemic attacks (tia)/ischemic stroke Nocturnal eating is an unusual behaviour Main funding: Swiss National Science Founda- Restless Legs Syndrome (RLS) and Periodic patients. shared by subjects with Sleep-Related Eating tion (SNSF) 2013. Leg Movements (PLM). Lead investigator: CL. Bassetti. Disorder (SRED) and Night Eating Syndrome Lead investigator: M. Manconi. Collaborators: M. Manconi, I. Pisarenco, C. (NES). The level of awareness during the noc- Sleep loss and sleep disorders (such as sleep Local investigators: A. Salvadè, F. Baracchi. Cereda. turnal food intake represents the main feature disordered breathing (SDB), restless legs with Main funding: UCB Pharma. Main funding: SNSF 2011. that should distinguish SRED from NES. Indeed, periodic limb movements (RLS/PLMS) and the distinction between SRED and NES is still a

38 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 39 controversial matter and some authors consid- preterm birth, low birth weight of the infant, (PLMS). The rationale for this exclusion is the function and cardiovascular risk. er these diseases to be positioned at opposite smoking and substance use, shortening of assumption that respiratory-related leg move- We are conducting a prospective case-control poles of a continuous clinical spectrum. SRED breast-feeding and can have significant nega- ments (RRLM) are different from “real” PLMS, study where daytime and night time autonomic is considered a parasomnia characterized by tive effect on the emotional and cognitive de- possibly mimicking PLMS through their con- function, cardiovascular risk markers and poly- recurrent episodes of nocturnal eating during velopment of the infants. The pathophysiology nection to periodically appearing respiratory somnography will be assessed in all subjects. a variable, usually reduced, state of alertness of PND is currently unknown, and predictors of events. Subsequently, patients with RLS will participate occurring after sleep onset. SRED is usually ac- perinatal depressive symptoms remain poorly The purpose of the study is to (1) to explore in a double-blind, randomised, 4-week treat- companied by consumption of strange items, understood. Sleep is markedly disturbed during whether the distinct time criterion (±0.5 s) of ment study with pramipexole vs. placebo. insomnia, sleep-related injury, occurrence of pregnancy and the postpartum period with up current scoring rules is adequate to exclude dangerous behaviours in the search for food, to 75% of pregnant women experiencing some RRLM by describing the time distribution of leg 2.3 Movement Disorders morning anorexia, and adverse health conse- form of sleep disruption. In particular restless movements in relation to respiratory events; (Salvatore Galati MD PhD, Agnese Salvadè PhD, quences related to nocturnal eating. NES is legs syndrome (RLS) is a very frequent finding (2) to investigate whether the occurrence and Claudio Städler MD, Prof. Carsten Möller MD) considered as an intake with full awareness during the third trimester of pregnancy and frequency of RRLMs is independent of the oc- of at least 25% of daily food after the even- has been correlated with PND. Since in the currence and frequency of PLMS, and (3) to Translational research on movement disorders ing meal or at least twice a week episode of general population, insomnia and sleep dis- explore whether the probability for the occur- represents one of the main research interests nocturnal ingestion for at least three months. orders have been established as risk factors rence of RRLMS is dependent on specific fea- at the Neurocenter of Southern Switzerland. Cur- There are some features that accompany NES, for the development of depression, impaired tures of the respiratory event such as duration rently, the priority of the investigation efforts lies such as: morning anorexia, a strong urge to sleep during the perinatal period could be a or type of breathing event or desaturation as- on the pathogenesis and potential treatment of eat between dinner and bedtime or during the critical mediator for the development of PND. sociated with the event. dyskinesias, involuntary movements that invariably night, insomnia, the belief that eating is neces- A structured and systematic assessment of develop in the course of long-term treatment of sary to fall asleep, patient’s mood is frequently sleep and sleep disorders could help identify • Autonomic function and cardiovascular risk in patients with Parkinson's disease (PD) with levo- depressed or worsens in the evening. Our pur- women at risk for developing depression and, restless legs syndrome (RLS): the AUTOREST dopa. Both clinical research and animal research pose is to challenge the validity of the current therefore, plan preventive and early therapeu- study. are carried out (see also “neuroscience” below). diagnostic criteria in making a differential diag- tic approaches. Treatment of RLS with e.v iron Lead investigator: M. Manconi. According to recent insights into the role of sleep nosis between SRED and NES in terms of sleep supplementation and bright light treatment in Collaborators: CL. Bassetti, Neurology Depart- in synaptic plasticity, several research projects pri- architecture, eating behaviour, and psychopa- insomnia associated with depression are safe, ment, Inselspital Bern; A. Auricchio, Cardiocen- marily on the association between sleep and the thology. low cost, home-based treatments with estab- tro Ticino. pathogenesis of dyskinesias have been launched lished efficacy for other types of depression. and are listed below. • Restless Legs Syndrome and Sleep Disorders The purposes of the current research are: to RLS is one of the most frequent neurological dis- In addition, a database with almost 200 patients of During Pregnancy and Sleep Related Risk Fac- explore sleep and sleep related parameters orders, affecting 3 to 10% of the general popu- Ticino with movement disorders, in particularly PD, tor for Perinatal Depression. during pregnancy systematically and prospec- lation. Epidemiological studies have consistently has been set up and will be useful for the perfor- Lead investigator: M. Manconi. tively in order to identify reliable potential early identified RLS as an independent risk factor for mance of epidemiological and clinical studies. Co-Applicant: F. Cirignotta (University of Bolo- diagnostic markers of perinatal depression; to cardiovascular disease. The candidate mecha- The main studies started or continued in 2013 gna). investigate the effectiveness of light therapy in nisms associated with this autonomic dysfunc- are the following: Collaborators: N. Rizzo (University of Bologna); treating perinatal depression and of iron sup- tion involve repetitive, nocturnal sympathetic A. Cicolin (University of Turin); S. Scarone (Uni- plementation in pregnancy related RLS. system activations associated with periodic • Role of sleep homeostasis in the development versity of Milan). leg movements during sleep (PLMS) which are of levodopa-induced dyskinesias: electrophysio- Main funding: Ricerca Finalizzata Ministero • Respiratory related leg movements during repetitive, stereotyped leg jerks during sleep. logical and molecular analysis in a Parkinsonian della Salute Italiana 2013 (“Finalized Research sleep. The critical question is whether PLMS are rat model. Italian Ministry of Health 2013” - Italian com- Lead investigators: M. Manconi, S. Fulda. the cause, the consequence, or a correlate of Lead investigator: S. Galati. petitive national grant). nocturnal sympathetic hyperactivation in RLS Collaborators: JC. Möller, C. Staedler, A. Sal- Current international sleep scoring rules ex- and whether there is a generalized autonomic vadè, S. Sarasso (University of Milan), P. Stanzi- Perinatal depression (PND) is experienced by clude leg movements that occur near respira- dysfunction in RLS, how this relates to the spe- one (University of Rome). 10% to 20% of females. Untreated pregnan- tory events (apneas and hypopneas) from the cific cardiovascular risk profile of patients, and Main funding: Pharmaceutical company; Fon- cy-related depression increases the risk of scoring of periodic leg movements during sleep whether treatment of RLS affects autonomic dazione malattie neurodegenerative dell’adulto

40 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 41 e dell’anziano Ticino (Foundation for the study cortico-striatal and cortico-thalamic interplay. akinesia given by stimulating the subthalamic sive Care Unit (MST-ICU) – a single centre be- of neurodegenerative diseases in adult and el- Lead investigator: S. Galati. nucleus with the beta band frequency. How- fore-after study (RADIAL). derly people in Ticino). Collaborators: JC. Möller, A. Stefani (University ever, the dissociation of these oscillations and Lead investigator: CW. Cereda. of Rome), A. Salvadè. clinical symptoms is also apparent, since it is Collaborators: LS. Pelloni1), P. Gandolfi-Decris- While, on the one hand, levodopa is the most Main funding: Fondazione malattie neurode- uncorrelated to the clinical state. In order to tophoris1), PM. George2), M. Mlynash2), L. Bian- effective treatment for PD, as a result of the generative dell’adulto e dell’anziano Ticino explain these conflicting results between beta con Montaperto1), C. Limoni1), V. Stojanova1), disease progression and changes induced by (Foundation for the study of neurodegenerative band oscillations and clinical motor symptoms R. Malacrida3), CL. Bassetti4) and C. Städler the pharmacological treatment, its therapeutic diseases in adult and elderly people in Ticino). in PD we are conducting a closer monitoring (principal supervisor) in collaboration with the window becomes narrower, mainly because of of cortical and basal ganglia oscillation in freely Working Group EOC SUN. the development of levodopa-induced dyskine- Spreading of slow cortical rhythms into the ba- moving parkinsonian animals. Main funding: ABREOC (hospital competitive sia. Although the evidence from animal models sal ganglia is a well-demonstrated phenomenon fund). of PD suggested a striatal hyper-plasticity un- in PD. Accordingly, striatal dopamine depletion • Prevalence and genetics of movement disor- 1) Neurocenter of Southern Switzerland, Regional derlying the development of dyskinetic move- drives cortical-basal ganglia slow wave coher- ders in Ticino - database and biobank. Hospital of Lugano, Switzerland. 2) Stanford Stroke Center, Stanford University Medical ments, their pathogenesis remains not entirely ences in urethane-anesthetized rats. The neu- Lead investigator: S. Galati. Centre, Stanford, CA, U.S.A. understood. In recent years, slow homeostatic ronal basis of this pathological synchronization Collaborators: JC. Möller, C. Städler, C. Wider 3) Intensive Care Unit, Regional Hospital of Lugano, tuning of intrinsic excitability occurring during has been the subject of several investigations, (University of Lausanne). Switzerland. sleep has been considered essential for net- and its behavioural relevance is largely debat- Main funding: Fondazione malattie neurode- 4) Neurology Department, Inselspital, Bern, Switzerland. work stabilization by sliding plasticity thresh- ed. The acute pharmacological inactivation of generative dell’adulto e dell’anziano Ticino olds. Assuming an association between these the SNc-striatal pathway led to a fast develop- (Foundation for the study of neurodegenerative The effectiveness of the Stroke Unit (SU) con- sleep processes and dyskinesia, we measured ing coherence between cortex and basal gan- diseases in adult and elderly people in Ticino). cept has been demonstrated by strong evi- the synaptic down-scaling during sleep and our glia time-looked with a significant contralateral dence, but precise mechanisms are not fully results are consistent with an association be- akinesia. This procedure offers the advantage This database was created to capture the spec- established. Most previous studies compared tween synaptic homeostasis and the develop- of detecting electrophysiological changes irre- trum of movement disorders in Ticino Canton dedicated stroke units with conventional care ment of dyskinesias. spectively of chronically developing compensa- community. Currently, we are collecting clinical inward departments. Studies that assess mon- tory mechanisms. data as well as additional examinations. The itored stroke units (semi-intensive type) versus • Role of sleep homeostasis in the development scope is ultimately to capture the mutation a monitored (intensive care unit (ICU) based) of levodopa-induced dyskinesias in PD patients. • Time course of the development of beta-band frequency of genes involved in these diseases, mobile Stroke Team system are lacking. Meth- Lead investigator: S. Galati. oscillations in the basal ganglia of Parkinsonian mainly in the monogenic forms of PD. ods in a single centre setting: we compare Collaborators: JC. Möller, C. Städler, A. Sal- rats. dependency and mortality at 3-months in con- vadè, S. Sarasso (University of Milan). Lead investigator: S. Galati. 2.4 Stroke Center secutive patients with ischemic stroke or spon- Main funding: ABREOC (hospital competitive Collaborators: JC. Möller; A. Stefani (University (Claudio Städler MD and Carlo Cereda, MD) taneous intracerebral haemorrhage admitted fund); Fondazione malattie neurodegenerative of Rome, A. Salvadè, V. D’Angelo (Universtity of to a stroke unit with semi-intensive monitoring dell’adulto e dell’anziano Ticino (Foundation for Rome). With the creation of the “Stroke Center” in 2013 (SI-SU) to a cohort of patients hospitalized in the study of neurodegenerative diseases in Main funding: Fondazione malattie neurode- the NSI was recognized as a Swiss centre of ex- an ICU and followed by a mobile Stroke Team adult and elderly people in Ticino). generative dell’adulto e dell’anziano Ticino cellence for the cure of patients with stroke and (MST-ICU). (Foundation for the study of neurodegenerative the Stroke Center offers an optimal care for pa- Based on the above-mentioned findings in ro- diseases in adult and elderly people in Ticino). tients with cerebrovascular diseases. Its increas- • Rehabilitation combined with bi-hemispheric dents, we are extending our analysis to patients ing research activity is mainly focused on 4 top- transcranial direct current stimulation in affected from PD. In order to demonstrate our The relationship between beta band oscillation ics in clinical research: stroke epidemiology, acute subacute ischemic stroke: a randomised, con- hypothesis, we are conducting a cross-section- and parkinsonian symptoms has been based stroke treatment, stroke prevention, and improv- trolled, double-blind study - The Re.Com.Bi.Ne. al high density polysomnographic study in dif- on their identification in local field potential re- ing stroke recovery in the acute phase. (Rehabilitation Combined with Bihemispheric ferent stages of the disease. cordings from cortex and basal ganglia of pa- The main studies in 2013 were: Neuromodulation) post-stroke study. tients affected from PD. Indeed, a direct causa- Lead iInvestigators: RRM. Müri3), CW. Cereda2). • Electrophysiological effects of an acute block of tive association of beta band oscillations in PD • Impact of a Semi-intensive Stroke Unit (SI-SU) Collaborators: D. Dinacci1), G. Bianco1), V. Stao- the nigrostriatal pathway with respect to the was inferred by the subtle clinical worsening of versus a mobile stroke team system in Inten- janova1), F. Conti2), C. Möller1), L. Petrini1), J.

42 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 43 Frangi1), S. Neumann5), M. Ochsner5), L. Petrillo, in three Swiss centres of neurorehabilitation. abilities: intelligence, executive functions, attention, and aging cohort "The NAMACO study". D. Zutter, CL. Bassetti, A. Uncini. After stratification based on the Fugl-Meyer memory, language and visuo-spatial functions. Investigators: M. Cavassini, S. Simioni, F. Schöni- Main funding: ABREOC (hospital competitive Assessment Upper Extremity according to the The case studies include suspected memory prob- Affolter, S. Clarke, A. Calmy, M. Michel, D. Fasel, fund), Hildebrand Clinic, Brissago, Klinik Ziehls- severity of the deficit, the patient will be rand- lems and dementia; cognitive and behavioural U. Kunsel, A. Cusini, K. Gutbrot, C. Di Benedetto, chlacht. omized to receive in addition to a standardized deficit resulting in various neurological and neuro- R. Pignatti, P. Vernazza, H. Kovari, P. Brugger, 1) Neurocenter of Southern Switzerland, Lugano, physical/occupational treatment, anodal tDCS surgical conditions, such as stroke, epilepsy, Par- R. Du Pasquier. Switzerland. of the ipsilesional motor cortex and cathodal kinson's disease, multiple sclerosis, brain tumours, Main funding: SHCS 2012 (external financial 2) Hildebrand Clinic, Brissago, Switzerland. tDCS of contralesional motor cortex (1.5 mA, traumatic brain injury, learning and developmental support). 3) Cognitive and Restorative Neurology, Departments of Neurology and Clinical Research, University Hospital, 30 minutes) (group 1: 12 patients) or sham disorders. A dedicated team of senior neurologists Inselspital, Bern, Switzerland. stimulation (group 2: 12 patients) at five days/ and two neuropsychologists run the outpatient This study is integrated into the metabolic and 4) Helios Clinic, Zihlschlacht, Switzerland. week. After three weeks of treatment, group laboratory and concomitantly perform research aging cohort whose importance has been ac- 5) Department of Neuroscience and Imaging University 1 and 2 will cross-over and will be treated for activities. The topic of the research is the early di- knowledged by the scientific board and exter- “G. d’Annunzio”, Chieti-Pescara, Italy. other three weeks. Group 3 (12 patients) will agnosis of dementia and HIV-associated neurocog- nal reviewers. The overall purpose of this in- receive physical/occupational treatment and nitive disorders. The research activity involves local vestigation is to expand the current knowledge Rehabilitation after stroke improves motor sham tDCS for six weeks. Assessment will be and national participations. about HIV-associated neurocognitive disorders functions by promoting plastic changes. How- performed before starting tDCS, at week 3, at (HAND) in the HIV aging population. The current ever, after completing standard rehabilitation, week 6, and 6 months after treatment. Out- The main studies in 2013 were: proposal aims at clarifying the global scope and 50–60% of patients still show some degree of come measures are the Fugl-Meyer Assess- 1. A-beta 42, tau and phosphorylated-tau liquor practical issues of the study and asks only for motor impairment and require at least partial ment Upper Extremity, the extended Barthel alterations in patients with mild cognitive the financial support of the neurocognitive as- assistance in activities of day living. Therefore, Index, the Ashworth scale, the Test of Upper impairment (CDR: 0.5) reflect amyloid accu- sessment of non-complaining patients, as well the exploration of other approaches to pro- Limb Apraxia, the grip strength evaluated by mulation and neuronal damage. Are semantic as financial support of the neurological, MRI mote recovery is compulsory. the Jamar Hydraulic Hand dynamometer. memory, ecological memory, and dual task and CSF assessement of control patients. After stroke, according to the model of inter- Potential value of the project: this study is tests coherent with the neurodegeneration? hemispheric rivalry, transcallosal inhibition designed to provide a class I evidence of the Lead investigators: L. Sacco, S. Rossi, R. Pig- 2.6 Neurosurgery becomes asymmetric and motor deficits are possible adjunctive restorative effect of bihemi- natti. (Prof. Michael Reinert MD) also due to reduced output from the damaged spheric tDCS combined with physical/occu- Main funding: ABREOC (hospital competitive In the department of Neurosurgery, there are cur- hemisphere and excess of inhibition of the dam- pational therapy in the subacute phase after fund). rently three projects running together with the In- aged hemisphere from the intact hemisphere. stroke. stitute of Applied Physics University of Bern, the Thus, improvement of motor function may be The purpose of the study is to determine which Veterinary Faculty of the University of Bern, Fach- induced by either up-regulating excitability of Principal Self-Sponsored studies (CW. Cereda): neuropsychological markers (semantic memo- hochschule Muttenz BL, and the Company Karl the affected cortex or down-regulating excit- • Co-investigator in SAS-CARE Study (NCT ry, executive functions, memory-ecological test) Storz GmBH for the CTI Project. ability in the intact one. This may be achieved by 01097967) since 2011. better reflect the neurodegenerative damage The goal of these three projects is to improve the transcranial direct current stimulation (tDCS), Lead investigator: CL. Bassetti, Inselspital, in patients with mild cognitive impairment minimal invasive surgical closure of wounds in dif- a form of non-invasive brain neuromodulation. Bern (see above “sleep research”). (MCI). The primary objective is to determine ferent clinical settings. The CTI Project focuses on In this study we hypothesize that combining • Local Co-investigator in SWISS (Swiss trom- to which neuropsychological tests better allow the mechanical minimal invasive surgical aspects. bihemispheric tDCS (anodal, excitatory, of the bolysis registry), since 2008. discrimination between MCI subjects with AD The NRP 64 Project focuses on the aspect of the ipsilesional motor cortex and cathodal, inhibi- Lead investigator: M. Arnold, Inselspital, markers (MCI CSF AD+) and MCI subjects with- biodegradability of the nanoparticle containing sur- tory, of the contralesional motor cortex) with Bern. out AD markers (MCI CSF AD-). The secondary gical patch used for the tissue fusion. Finally, the simultaneous physical/occupational therapy purpose of the study is to compare at T1, after SNSF project focuses on the specific aspect for su- in the subacute phase of ischemic stroke may 2.5 Neuropsychology one-year follow-up, the proportion of subjects tureless vascular anastomosis for bypass surgery. improve upper limb motor recovery in humans. The Neuropsychology and Behavioural Neurology that convert into AD (CDR≥1) and subjects with The experimental parts are currently undertaken Methods: This study is a randomized, con- laboratory provides a comprehensive assessment stable cognitive status (CDR=0.5) in the two at the University of Bern and IRCAD Strassbourg, trolled, double-blind, cross-over, multicenter, for adult patients with cognitive or behavioural groups (MCI CSF AD+ and MCI CSF AD-). France. clinical trial. Thirty-six ischemic stroke pa- symptoms. Neuropsychological assessment in- tients in the subacute phase will be recruited volves a systematic evaluation of higher cognitive 2. Neurocognitive assessment in the metabolic • CTI Project: Tissue soldering with nanoparticle

44 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 45 scaffold (11478.1 PFLS-LS). predictable denaturation process is possible. scientific research innovation, and upheld its piv- genetic aspects of metastatic tumours. If such Running Time till May 2014. The main goal of the present project is to deter- otal role as a trait-d’union between the clinical a correlation is present, then they could be the Lead investigator: M. Frenz, IAP UNIBE. mine the nanoparticle biodistribution and their and surgical neuroscience disciplines. On these target of future clinical studies of target molec- Co-investigator: M. Reinert. toxicokinetic properties in cell cultures, tissue grounds, the Department of Neuroradiology of the ular therapies to prevent osseous metastases Main funding: Karl Storz GMBH. slices and in vivo. Currently, cell culture studies NSI is currently focusing on the following lines of in subgroups of breast cancer patients. and brain tissue slices studies are running. The research: The purpose of the project is to provide a new in-vivo rat studies with nanoparticle containing –– Advanced Functional and Structural Magnetic • Retrospective study on clinical and technical minimal invasive sutureless tissue fusion tech- patch are envisaged for the coming year. Resonance imaging in Multiple Sclerosis: by complications of vertebroplasty in patients with nique. This kind of tissue fusion is based on the using high-field (3T) scanners, we are carrying osteolytic vertebral metastases with cortical heat denaturation process of proteins, provid- • Sutureless Endoluminal and Transmural Micro- out and designing functional imaging studies erosion of the posterior wall. ing the necessary tissue strength. Basically, vascular Laser-Anastomosis for Minimally Inva- for the detection and clinical characterization Lead investigator: A. Cianfoni. this process is applicable to all tissues contain- sive Microsurgical Procedures in Bypass and of the Cognitive Fatigue neurocorrelates in Mul- ing proteins. This new surgical technique can Revascularization Surgery. tiple sclerosis, and structural imaging projects Percutaneous vertebral cement augmentation replace the standard suturing and microsu- Lead investigator: M. Constantinescu, Plastic to identify peculiar trajectories of parenchymal is performed in the event of lytic vertebral me- turing and revolutionize the minimal invasive Surgery Inselspital Bern, UNIBE, Switzerland. regional volume loss over time across different tastases to palliate pain and for stabilization to surgery. The main goals are to enable minimal Co-investigators: M. Reinert, NSI Lugano and Multiple Sclerosis phenotypes. stop or prevent collapse. Lytic erosion of the invasive sutureless tissue fusion for vascular UNIBE, M. Frenz, IAP UNIBE, Switzerland. –– Language network mapping in Multilingual Pa- posterior wall raises technical challenges and anastomosis, endoscopic ureter anastomosis, Main funding: Swiss National Science Founda- tients undergoing surgical treatment for brain risks of migration of the bone cement into the endoscopic wound barrier and wound closure. tion (SNSF) 133083. lesions: application of pre-operative, non-inva- spinal canal and is considered as a contraindi- We have developed a dye containing a polymer sive functional Magnetic Resonance imaging cation to this procedure. This is a retrospec- patch which is able to suture surgical wounds Sutureless tissue soldering of blood vessels is performed in high-field (3T) scanners, correlat- tive study on 70 consecutive treated vertebrae through a minimal endoscopic approach. We especially difficult to carry out, as the mecha- ed with intra-operative cortical electro-stimula- which showed lytic erosion of the posterior are currently refining the process for different nism for tissue fusion and namely, the denatur- tion, to identify and preserve speech functions wall. The aim was to assess feasibility of the surgical approaches, such as closure of intrac- ation process, has to be restricted to specific in different languages. technique, technical success and complica- ranial dural leaks. tissue layers. Furthermore, sensitive areas, –– Interventional percutaneous minimally invasive tions, along with clinical complications. such as the endothelium, have to be protected spinal procedures for pain palliation and stabi- • NRP 64 Transport of nanoparticles after re- from heat injury in order to prevent long-term lization of lytic metastatic vertebral lesions, in 2.8 Neuroanaesthesia lease from a biodegradable implant (131297). stenosis of blood vessels. Therefore, a special conjunction with the neurosurgery and the IOSI. (Paolo Maino MD) Lead investigator: M. Frenz, IAP Inselspital taskforce for this specific application, initiated Bern, UNIBE. in a first SNSF project in 2005 (107611), • Breast Cancer Osseous Metastases: do The EOC Pain Management Centre promotes the Other investigators: U. Pieles FHNW, M. Rein- demonstrated the feasibility of a sutureless genomic abnormalities stem from the primary highest possible quality of life for patients with per- ert NSI Lugano and Inselspital Bern, UNIBE. vascular anastomosis up to 2 weeks of paten- tumour or are they independently acquired? A sistent pain, providing accurate diagnosis and di- cy. The current project focuses on the aspects pilot study. rect interventions to reduce, eradicate or manage Nanotechnology is expected to change health of intimal and endothelium protection and long- Lead investigators: S. Di Lascio (IOSI), A. Cian- the pain. It provides support particularly around care in a fundamental way. One of these appli- term patency. foni, M. Broggini (Institute M. Negri, Milano). the management of pain problems of high medical cations is laser tissue soldering, a kind of tis- and psychological complexity, and around the use sue fusion which allows tight sealing of surgical 2.7 Neuroradiology This study collects samples of tissue from of controlled drugs, minimal invasive interventions wounds and in particular, vascular lesions. It is (Alessandro Cianfoni MD) breast cancer osseous metastases in vivo, and neuromodulation. The ambulatory service based on a heat induced denaturation process through percutaneous image-guided vertebral which is present in all EOC hospitals, has the mis- of proteins like bovine serum albumin (BSA), The amazing technical advances obtained during biopsies, to analyze their genomic pattern com- sion of providing specialist evidence based consul- providing the necessary acute tissue strength. the last decades with the development of Mag- pared with the primary breast tumour genomic tations, and the most up-to-date treatments to all In this case the nanoparticles are used as a netic Resonance Imaging, Computed Tomography pattern. The purpose of this research is to dis- chronic pain patients in Ticino. vector for the heat transmission for the dena- and Minimally-Invasive Endovascular and Spinal cover genetic aspects which are predictive of A dedicated team of two senior and two junior turation process. The advantage of using nano- Interventional techniques, provided Neuroradiol- propensity to metastatic behaviour of the pri- anaesthesiologists, and four pain nurses run the particles over simple dye is that a quantitative ogy with a tremendous amount of potential in the mary breast cancer, and to analyze common ambulatory with a strict multidisciplinary approach

46 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 47 within the Neurocenter of Southern Switzerland with fluoroscopic-guidance afterwards. The dif- gies used to prevent postoperative pain and re- the pathological mechanisms underlying these and concomitantly perform research activities. ferences between the identification of the punc- duce opioid consumption and side effects such brain disorders and as experimental models for ture site using the two different techniques as postoperative nausea and vomiting (PONV). testing new therapeutic interventions. In Septem- The research activity of our team mainly focused were analyzed. Taking the centre of the fill port Therefore, regional analgesia combined with ber 2013, Dr. Paganetti has joined the laboratory on 3 projects: as the target to hit (point zero), the distance general anesthesia is preferable for breast as a new group leader and coordinator of experi- between the centre and the external border of cancer surgery. In 2011, Blanco described mental research at the NSI. His research takes a • Fluoroscopic-guided intrathecal pump refill and the port is 3.5 millimeters (margin of error). the Pecs II (PECtoral nerveS) block. This block molecular and cellular approach in order to inves- prevention of pocket fill. Therefore, a distance of more than 3.5 millim- is suitable for breast expander insertion/sub- tigate the causes of neurodegenerative diseases, Lead investigator: P. Maino, EOC Pain Manage- eters was considered as a clinically relevant pectoral prostheses, tumour resections, mas- such as Parkinson’s disease, Alzheimer’s disease ment Centre, NSI, Lugano, Switzerland. difference. tectomy, sentinel node dissection and axillary and Huntington’s disease. These disorders are Co-investigators: RSGM. Perez, Department of Results: averaged over all consecutive refill at- clearance. characterized by abnormal proteinaceous depos- Anesthesiology, VU University Medical Centre, tempts, the mean difference distance between The goal of this study is to prospectively evalu- its in the brain. His group has received a starting Amsterdam, The Netherlands; E. Koetsier, EOC identification markings of the target with fluor- ate the efficacy of the Pecs II block combined contribution of CHF 300,000.- from the Gabriele Pain Management Centre, NSI, Lugano, Swit- oscopic guidance and the template was 8.79 with general anesthesia for breast surgery Charitable Foundation. zerland. mm, with limited variance (2.4 mm). For all indi- versus general anesthesia alone. We assume In early 2014, the experimental laboratory of the vidual refill procedures, the port centre identifi- that the Pecs II block offers patients postopera- NSI will move to Taverne in new facilities rented Intrathecal drug therapy with implantable cation accuracy differed significantly from zero tive benefits like superior pain relief, decreased from the Foundation for Cardiological Research drugs delivery systems (IDDS) is being utilized (one sample t-test: all p<0.001), and from the PONV, and less chronic postoperative pain. and Education FCRE. increasingly for the treatment of chronic re- clinically relevant cut-off point of 3.5 mm (one More details on the projects of the experimen- fractory pain and spasticity. However, because sample t-test: all p<0.001). No significant cor- • RELIEF STUDY (A7007): A Global Registry to tal laboratory are given above under “sleep” and of difficulties in finding the puncture site of the relations were found between BMI and fill port Evaluate Long-Term Effectiveness of Neuro- “movement disorders”. reservoir fill port with the commonly performed identification accuracy. stimulation Therapy for Pain. blind refill technique, there is a potential risk of Conclusions: our results demonstrate that for Lead investigator: P. Maino. Peer reviewed publications of NSI in 2013 medication injection into the subcutaneous tis- the refill of an IDDS the commonly performed Funding: Boston Scientific International SA. Cereda CW, Tamisier R, Manconi M, Andreotti J, sue (pocket fill), which can lead to an overdose. blind technique is lacking in accuracy when Frangi J, Pifferini V, Bassetti CL. Endothelial dys- The primary purpose of this study was to as- checked fluoroscopically. Therefore, we recom- Main funding function and arterial stiffness in ischemic stroke: sess the accuracy of the blind technique to mend the routine use of fluoroscopic guidance Funding from private foundations and pharmaceu- the role of sleep-disordered breathing. Stroke. identify the puncture site of the reservoir fill during the refill of an IDDS. tical companies (non-competitive funds). 2013;44(4):1175-1178. port with the use of fluoroscopy. The secondary purpose was to determine if body mass index • Acute and chronic postoperative pain after 2.9 Experimental laboratory Sarikaya H, Mattle H, Michel P, Nedeltchev K, Kägi G, (BMI) had an impact on the margin of error in general anaesthesia with or without a single- (Prof. J. Carsten Möller MD, Paolo Paganetti Fischer U, Cereda CW, Sztajzel R, Fandino J, Nyffel- identification of the puncture site. dose preincisional Pecs II block in female pa- PhD, Agnese Salvadé PhD) er T, Luft A, Tettenborn B, Lyrer P, Arnold M. Primär- Study design: prospective observational meth- tients undergoing breast cancer surgery: a prävention des ischämischen Hirnschlags – was od comparison study. double-blind, randomised trial. Since its creation, the NSI decided to promote hilft, was nicht? Teil 1: Konventionelle Risikofaktoren. Setting: outpatient department for interven- Lead investigators: P. Maino, RSGM. Perez basic research in the field of translational neuro- Forum Med Suisse 2013;13(49):999–1002. tional pain management. (Department of Anesthesiology, VU Univer- sciences. This resulted in the creation of an ex- Yesilot Barlas N1, Putaala J, Waje-Andreassen Methods: twenty-three adult patients carry- sity Medical Centre, Amsterdam, The Nether- perimental laboratory located at the Institute for U, Vassilopoulou S, Nardi K, Odier C, Hofgart G, ing Medtronic Synchromed II pumps for pain lands). Research in Biomedicine in Bellinzona, which has Engelter S, Burow A, Mihalka L, Kloss M, Ferrari J, or spasticity control undergoing regular refills Co-investigator: E. Koetsier, EOC Pain Manage- been directed by Prof. Möller. In 2013, several Lemmens R, Coban O, Haapaniemi E, Maaijwee N, were studied. We compared the difference ment Centre, NSI, Lugano, Switzerland. groups used the facility and the laboratory had in- Rutten-Jacobs L, Bersano A, Cereda CW, Baron P, expressed in millimeters between the identi- creasing research activity. Borellini L, Valcarenghi C, Thomassen L, Grau AJ, fication markings of fill port centre using the Breast cancer surgery can be associated with So far, animal models for Parkinson's disease, Palm F, Urbanek C, Tuncay R, Durukan Tolvanen A, blind technique and fluoroscopic imaging. The significant postoperative pain, nausea, vomiting stroke and restless-legs-syndrome (RLS) have van Dijk EJ, de Leeuw FE, Thijs V, Greisenegger S, patients underwent a double identification of and chronic pain. Peri-operative regional anal- been successfully created and implemented. These Vemmos K, Lichy C, Bereczki D, Csiba L, Michel P, the puncture site, with the template first and gesia is one of the multimodal pain relief strate- research models have been applied to understand Leys D, Spengos K, Naess H, Tatlisumak T, Bahar

48 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 49 SZ. Etiology of First-Ever Ischemic Stroke in Euro- Ferini-Strambi L, Zucconi M. Night-to-night variabil- arousals in spinal cord injury. Oertel WH. Unimpaired postprandial pancre- pean Young Adults: the 15-Cities Young Stroke ity of periodic leg movements during sleep in rest- J Clin Sleep Med. 2013;9(11):1207-1209. atic polypeptide secretion in Parkinson’s disease Study. Eur J Neurol. 2013;20(11):1431-1439. less legs syndrome and periodic limb movement and REM sleep behavior disorder. Mov Disord. disorder: comparison between the periodicity index Ferri R, Manconi M, Aricò D, Punjabi NM, Zucconi 2013;28(4):529-33. Cianfoni A, Caulo M, Cerase A, Della Marca G, Fal- and the PLMS index. Sleep Med. 2013;14(3):293- M. Experimentally induced arousals do not elicit cone C, Di Lella GM, Gaudino S, Edwards J, Colo- 296. periodic leg motor activity during sleep in normal Schenck CH, Montplaisir JY, Frauscher B, Högl simo C. Seizure-induced brain lesions: a wide spec- subjects. Sleep Med. 2013;14(1):85-90. B, Gagnon JF, Postuma R, Sonka K, Jennum P, trum of variably reversible MRI abnormalities. Eur Stefani A, Peppe A, Galati S, Bassi MS, D'Angelo Partinen M, Arnulf I, Cochen de Cock V, Dauvilliers J Radiol. 2013; 82(11); 1964-1972. V, Pierantozzi M. The serendipity case of the pe- Economou NT, Manconi M, Agazzi P, Bassetti CL. Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring dunculopontine nucleus low-frequency brain stimu- Intrusion of rapid eye movement (REM) behavior F, Trenkwalder C, Unger M, Young P, Wing YK, Cianfoni A, Massari F, Dani G, Lena JR, Rumboldt lation: chasing a gait response, finding sleep, and disorder episodes into NREM sleep in a case of Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Inoue Z, Vandergrift WA, Bonaldi G Percutaneous etha- cognition improvement. Front Neurol. 2013;4:68. Lewy body dementia. Sleep Med. 2013;14(1):122- Y, Iranzo A, Santamaria J, Bassetti C, Möller JC, nol embolization and cement augmentation of ag- 4. Boeve BF, Lai YY, Pavlova M, Saper C, Schmidt P, gressive vertebral hemangiomas at two adjacent Galati S, Städler C. Schizophrenia symptoms re- Siegel JM, Singer C, St Louis E, Videnovic A, Oertel vertebral levels. J Neuroradiol. 2013;200(3), 673- lieved by CO-induced pallidal lesion: a case report. Miano S, Tabarrini A, Vitelli O, Mazzotta A, Del W. 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Prosperetti C, Di Giovanni G, Stefani A, Möller JC, Neurological picture. Bilateral thoracic long nerve Case reports of sleep phenotypes of ADHD: from Galati S. Acute nigro-striatal blockade alters corti- involvement in motor multifocal neuropathy. J Neu- Galati S, Di Giovanni G. Intracerebral human mi- hypothesis to clinical practice. J Atten Disord. co-striatal encoding: an in vivo electrophysiological rol Neurosurg Psychiatry, 84(5), 584. crodialysis in Parkinson's disease. Neuromethods 2013;17(7):565-573. study. Exp Neurol 2013;247:730-736. 2013;75:209-223. Weininger M, Mills JC, Rumboldt Z, Bonaldi G, Esposito M, Parisi P, Miano S, Carotenuto M. Mi- Proenca CC, Stoehr N, Bernhard M, Seger S, Ge- Huda W, Cianfoni A. Accuracy of CT guidance of Gobbi C, Meier DS, Cotton F, Sintzel M, Leppert graine and periodic limb movement disorders in noud C, Roscic A, Paganetti P, Liu S, Murphy LO, lumbar facet joint block. AJR Am J Roentgenol. D, Guttmann CR, Zecca C. Interferon beta 1b sleep in children: a preliminary case-control study. Kuhn R, Bouwmeester T and Galimberti I. Atg4b-de- 2013; 200(3); 673-676. following natalizumab discontinuation: one year, J Headache Pain. 2013;14:57. pendent autophagic flux alleviates Huntington’s dis- randomized, prospective, pilot trial. BMC Neurol. ease progression. PLoS One. 2013;8(7):e68357. Fulda S, Plazzi G, Ferri R. Scoring atonia during nor- 2013;13:101. Miano S, Peraita-Adrados R. (Nocturnal frontal mal and pathological rapid eye movement sleep: lobe epilepsy is often misdiagnosed as sleep dis- Paganetti P, Reichwald J, Bleckmann D, visual and automatic quantification methods. Sleep Gobbi C, Zecca C, Linnebank M, Müller S, You X, orders in children: a case series). Rev Neurol. Abramowski D, Ammaturo D, Barske C, Danner S, Biol Rhythms. 2013;11(Suppl. 1):40-51. Meier R, Borter E, Traber M. Swiss analysis of mul- 2013;56(5):257-267. Molinari M, Müller M, Papin S, Rabe S, Schmid P, tiple sclerosis: a multicenter, non-interventional, Staufenbiel M. Transgenic expression of β1 anti- Fulda S, Kloiber S, Dose T, Lucae S, Holsboer F, retrospective cohort study of disease-modifying Villa MP, Paolino MC, Castaldo R, Vanacore N, Riz- body in brain neurons impairs age-dependent amy- Schaaf L, Hennings J. Mirtazapine provokes peri- therapies. Eur Neurol. 2013;70(1-2):35-41. zoli A, Miano S, Del Pozzo M, Montesano M. Sleep loid deposition in APP23 mice. odic leg movements during sleep in young healthy clinical record: an aid to rapid and accurate diag- Neurobiol Aging. 2013;34(12):2866-78. men. Sleep. 2013;36(5):661-669. Manconi M, Fulda S. Restless legs syndrome in the nosis of paediatric sleep disordered breathing. Eur emergency room. Eur J Neurol. 2013;20(2):e36. Respir J. 2013;41(6):1355-61. Papassotiropoulos A, Gerhards C, Heck A, Ack- Fulda S. Gender differences in the prevalence of ermann S, Aerni A, Schicktanz N, Auschra B, De- restless legs syndrome/Willis Ekbom disease. Salminen AV, Manconi M, Rimpilä V, Luoto TM, Unger MM, Ekman R, Björklund AK, Karlsson mougin P, Mumme E, Elbert T, Ertl V, Gschwind L, Somnology. 2013;17:246-251. Koskinen E, Ferri R, Ohman J, Polo O. Disconnec- G, Andersson C, Mankel K, Bohne K, Tebbe JJ, Hanser E, Huynh KD, Jessen F, Kolassa IT, Milnik A, Ferri R, Fulda S, Manconi M, Högl B, Ehrmann L, tion between periodic leg movements and cortical Stiasny-Kolster K, Möller JC, Mayer G, Kann PH, Paganetti P, Spalek K, Vogler C, Muhs A, Pfeifer A,

50 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 51 de Quervain DJ. Human genome-guided identifica- B; Swiss SOS study group (Fathi AR, Winkler K, tion of memory-modulating drugs. Proc Natl Acad Woernle C, Bernays R, Daniel RT, Levivier M, Bau- Sci U S A. 2013;110(46):E4369-4374. mann F, Ahlborn P, Seule M, Zumofen D, Mariani L, Roethlisberger M, D'Alonzo D, Raabe A, Chicherio Luigetti M, Pravatà E, Colosimo C, Sabatelli M, C, Reinert M, Sacco L). Current practice in neu- Masciullo M, Capone F, Lo Monaco M, Monforte ropsychological outcome reporting after aneurys- M, Silvestri G, Ricci E, Pacciani E, Di Lazzaro V. MRI mal subarachnoid haemorrhage. Acta Neurochir neurography findings in patients with idiopathic (Wien). 2013;155(11):2045-51. brachial plexopathy: correlations with clinical-neu- rophysiological data in eight consecutive cases. Mono ML, Steiger I, Findling O, Jung S, Reinert Intern Med. 2013; 52(18); 2031-9. M, Galimanis A, Kuhlen D, Beck J, El-Koussy M, Brekenfeld C, Schroth G, Fischer U, Nedeltchev K, Profice P, Renna R, Pilato F, Sestito A, Infusino F, Mattle HP, Arnold M. Risk of very early recurrent Bruno I, Pravatà E, Di Lazzaro V. Cardiovascular cerebrovascular events in symptomatic carotid ar- impairment in a patient with acute myelitis. Spinal tery stenosis. J Neurosurg. 2013;119(6):1620- Cord. 2013;51(6):511-513. 1626.

Luigetti M, Pravatà E, Bartalena T, Cianfoni A. An Mordasini P, Kraehenbuehl AK, Byrne JV, Vanden- uncommon cause of headache resolution: sponta- berghe S, Reinert M, Hoppe H, Gralla J. In vitro neous ventriculostomy in obstructive hydrocepha- and in vivo imaging characteristics assessment of lus. Headache. 2013;53(8):1356-7. polymeric coils compared with standard platinum tion of Southern Switzerland, FNT” for the best coils for the treatment of intracranial aneurysms. abstract at the annual “Day of Clinical Research Querin G, D'Ascenzo C, Peterle E, Ermani M, AJNR Am J Neuroradiol. 2013;34(11):2177-83. of Italian Switzerland”, entitled “Cementoplastica Bello L, Melacini P, Morandi L, Mazzini L, Silani dell’arco vertebrale posteriore (spinoplastica) per V, Raimondi M, Mandrioli J, Romito S, Angelini Tavarini F, Städler C, Valci L, Bassetti CL, Cereda prevenire la frattura dei processi spinosi dopo im- C, Pegoraro E, Sorarù G. Neurology. Pilot trial of CW. Favourable outcome after aggressive treat- pianto di spaziatori interspinosi”. clenbuterol in spinal and bulbar muscular atrophy. ment of a thrombolysis-associated intra-cerebral 2013;80(23):2095-2098. haemorrhage. Swiss Archive of Neurology and Alessandro Cianfoni MD in July 2013 received Psychiatry 2013;164(6):212–214. the “Best oral communication award” at 3rd Joint Philip P, Chaufton C, Taillard J, Sagaspe P, Léger D, Meeting of ASSR and ESNR for the study entitled Raimondi M, Vakulin A, Capelli A. Maintenance of Awards 2013 “Neoplastic Lytic vertebral lesions with erosion of Wakefulness Test scores and driving performance Carlo Cereda MD received in March 2013 the posterior wall and epidural mass: an absolute con- in sleep disorder patients and controls. Int J Psy- annual price from “Neuroscience Foundation of traindication to vertebroplasty?”. chophysiol. 2013;89(2):195-202. Southern Switzerland, FNT” for the best poster at the annual “Day of Clinical Research of Italian Swit- Querin G, Melacini P, D'Ascenzo C, Morandi L, zerland." Mazzini L, Silani V, Romito S, Mandrioli J, Raimondi M, Pegoraro E, Sorarù G. No evidence of cardio- Stephany Fulda PhD Dipl. Psych. in June 2013 myopathy in spinal and bulbar muscular atrophy. received the “American Academy of Sleep Move- Acta Neurol Scand. 2013 Dec;128(6):e30-2. ment Disorders Section Investigator Award” in recognition of outstanding scientific merit of re- Stienen MN, Weisshaupt R, Fandino J, Fung C, Kel- search in the field of sleep medicine. ler E, Hildebrandt G, Studerus-Germann A, Müri R, Gutbrod K, Bläsi S, Monsch AU, Brugger P, Mon- Alessandro Cianfoni MD in March 2013 received dadori C, Sailer M, Bijlenga P, Schaller K, Schatlo the annual price from “Neuroscience Founda-

52 Scientific Report 2013 2. Neurocenter of Southern Switzerland (NSI) 53 3 EOC Multisite Departments and Services 3. EOC Multisite Departments and Services

The multisite Departments and Services are struc- intended to be the best solution to harmonize and male individuals of 65-80 years of age who are lonidal sinus: a randomized controlled study” and tures which are transversal to all EOC institutes and rationalize the facilities for surgery in the Ticino seen for other reasons at the various outpa- “Feasibility of an ultrasound screening program for are an organizational mode of clinical management. Canton. tient clinics at the Regional Hospital of Lugano. abdominal aorta aneurysm in the population of the The Departments are, as a rule, the functional and Patients are offered a screening ultrasound ex- area of Lugano”: ABREOC; organizational integration of operational units that Main areas of research amination and are included in a database. If the “Isolation and characterisation of tumour stem are homogeneous, similar, or complementary to The following studies are currently underway: program proves to be feasible, its extension to cells in colorectal cancer”: University of Basel. and mutually dependent on one another, sharing • Two surgical techniques for the treatment of the other EOC hospitals will be considered. the same goals – which could not be achieved oth- pilonidal sinus: a randomized controlled study. Peer reviewed publications in 2013 (selection) erwise. They are, however, clinically independent, • Isolation and characterisation of tumoural Christoforidis D, Clerc D, Demartines N. Tran- with their own separate professional responsibility. This study compares the modified Karydakis stem cells in colorectal cancer. srectal specimen extraction after laparoscopic left The Departments are made up of the relevant technique (excision and lateral primary clo- We collaborate in this project, led by the Uni- colectomy: a case-matched study. Colorectal Dis. services, divisions and units, grouped according to sure) vs. simple fistulectomy for the treatment versity of Basel, as clinical consultants and pro- 2013;15(3):347-353. nosology, function and size. The needs of clinical of symptomatic pilonidal disease. The primary viders of human tissue. governance are also taken into account in the or- endpoint is the percentage of patients healed Droeser RA, Hirt C, Viehl CT, Frey DM, Nebiker C, ganization of the Departments. at 3 weeks, secondary endpoints are its total This study has the purpose to determine the Huber X, Zlobec I, Eppenberger-Castori S, Tzankov healing time, infection rate, recurrence rate. phenotype and function of tumour stem cells of A, Rosso R, Zuber M, Muraro MG, Amicarella F, 3.1 EOC Department of Surgery The study accrual has reached approximately colorectal cancer (CD133+), as well as their in- Cremonesi E, Heberer M, Iezzi G, Lugli A, Terrac- Prof. Raffaele Rosso MD 40% of the total sample size. teraction with T lymphocytes infiltrating the tu- ciano L, Sconocchia G, Oertli D, Spagnoli GC, Tornil- Head of Department of Surgery and head surgeon mour. In vitro and in vivo experiments are held lo L. Clinical impact of programmed cell death of the Regional Hospital of Lugano • Feasibility of an ultrasound screening program at the University of Basel using cells extracted ligand 1 expression in colorectal cancer. Eur J for abdominal aorta aneurysm in the popula- from patient blood samples, normal and neo- Cancer. 2013 Jun;49(9):2233-42. The EOC Department of Surgery guarantees high- tion of the area of Lugano. plastic colorectal mucosa. quality localized surgical assistance, either planned Droeser RA, Hirt C, Eppenberger-Castori S, Zlobec or in emergency situations, making use of the spe- This study aims at evaluating the feasibility of Main funding I, Viehl CT, Frey DM, Nebiker CA, Rosso R, Zuber cific specialized skills of the Department, and is screening for abdominal aortic aneurysm in “Two surgical techniques for the treatment of pi- M, Amicarella F, Iezzi G, Sconocchia G, Heberer M,

56 Scientific Report 2012 3. EOC Multisite Departments and Services 57 Lugli A, Tornillo L, Oertli D, Terracciano L, Spagnoli pose of our study is to compare the clinical and Thoracic Surgery Service – Mucinous Cystadenoma of the Lung Mimicking GC. High myeloperoxidase positive cell density in radiological results of the open procedure and Regional Hospital of Bellinzona and Valli Malignancy at 18F-FDG PET/CT. colorectal cancer is an independent favourable the arthroscopically assisted technique. André Dutly MD PD Clin Nucl Med. 2013 Jun 21. prognostic factor. PLoS One. 2013;8(5):e64814. Head Surgeon • The Temporal Progression of Femoral Focal Sterzi S, Cesario A, Cusumano G, Dall'Armi V, Gunnar Ochs B, Stöckle U, Candrian C. Fractures Osteolysis after Total Hip Artroplasty. The Unit guarantees a complete, immediate and Lapenna LM, Cardaci V, Novellis P, Lococo F, around shoulder and elbow arthroplasty – rare but Lead investigators: P. Hoffmeyer, A. Lubbeke, high-quality all-round care for patients suffering Corbo GM, Cafarotti S, Margaritora S, Granone difficult. European Orthopaedics and Traumatol- G. Garavaglia. from lung cancer, chest wall tumours, mediastinal P. Post-operative rehabilitation for surgically re- ogy. 2013; 4(2):111-116. disorders, secondary chest neoplasms, as well as sected non-small cell lung cancer patients: se- Femoral osteolysis is one of the most com- non-neoplastic lung diseases, such as pneumotho- rial pulmonary functional analysis. J Rehabil Med. Bianchi V, Spitale A, Ortelli L, Mazzucchelli L, Bor- mon complications after total hip arthroplasty rax, pleurisy and emphysema deposits. 2013;45(9):911-915. doni A, QC3 CRC Working Group (Christoforidis and may cause aseptic loosening and lead to D and Rosso R). Quality indicators of clinical can- component failure. Although the cellular and The high standard of treatment is guaranteed not Cafarotti S, Cesario A, Margaritora S, Granone P. cer care (QC3) in colorectal cancer. BMJ Open. molecular biology of periprosthetic osteolysis only by the use of mini-invasive surgical techniques Typical bronchial carcinoid tumours: focus on sur- 2013;3(7). pii: e002818. has been extensively studied, many clinical (VATS –Video Assisted Thoracic Surgery) and gical management. aspects remain unclear. Wear is considered state-of-the-art equipment (digital detection of air Ann Thorac Surg. 2013;95(1):385. Orthopaedic Surgery Service – to be mainly responsible for the development loss following lung surgery; microsutures, robotic Regional Hospital of Bellinzona and Valli of osteolysis and implant loosening, but many thoracic surgery), but also by the multidisciplinary Hand Surgery Unit Gianfranco John Petri MD other factors are involved. approach used in thoracic surgery when manag- Daniele De Spirito MD, Head Surgeon In this prospective study, we want to explore ing oncology patients. Regional Hospital of Lugano the clinical parameters that influence the de- Cesare Fusetti MD, Main areas of research velopment and the progression of femoral os- Main areas of research Regional Hospital of Bellinzona and Valli • Comparison of open versus arthroscopically teolysis after total hip arthroplasty. The 2013 Thoracic Surgery research activity con- Stefano Lucchina MD, assisted Latarjet procedure. sists of 9 papers published in international jour- Regional Hospital of Locarno Lead investigators: G. Garavaglia and E. Taverna. Peer reviewed publications in 2013 nals, equipped with impact factor, and 3 additional Alain Thebaud MD, Taverna E, Ufenast H, Broffoni L, Garavaglia G. participations in international conferences. Regional Hospital of Mendrisio The effectiveness of the Latarjet procedure for Arthroscopically assisted Latarjet procedure: A Prospective trials on new management of chest the treatment of anterior glenohumeral insta- new surgical approach for accurate coracoid graft drain after lung resection are ongoing. The Hand Trauma Commission of FESSH HTC bility has been extensively reported. Since the placement and compression. Int J Shoulder Surg. intends to setup a database containing all major description of the original technique by Latar- 2013;7(3):120-123. Peer reviewed publications in 2013 (selection) Trauma Centres in Europe. Based on the data sub- jet, many modifications have been proposed Antonicelli A, Cafarotti S, Indini A, Galli A, Russo A, mitted by the centres the Hand Trauma Commis- and recently the procedure has been per- Brunetti S, Petri GJ, Lucchina S, Garavaglia G, Cesario A, Lococo FM, Russo P, Mainini AF, Boni- sion suggests centres to the national representa- formed arthroscopically. Successful treatment Fusetti C. Should aspirin be stopped before carpal fati LG, Nosotti M, Santambrogio L, Margaritora tives for accreditation. After validating the data by clearly depends on proper patient selection tunnel surgery? A prospective study. World J Or- S, Granone PM, Dutly AE. EGFR-Targeted Therapy the national representatives, accredited centres and pre-operative evaluation, but for the proce- thop. 2013;4(4):299-302. for Non-Small Cell Lung Cancer: Focus on EGFR On- can receive a Diploma of Accreditation. dure itself, one of the most important details is cogenic Mutation. Int J Med Sci. 2013;10(3):320- The EOC Hand Surgery Unit has been accredited an accurate placement of the coracoid graft. Pinto D, Montani E, Bolli M, Garavaglia G, Sal- 30. for the period 2014-2017 (contact person: C. Fu- Besides the correct positioning of the graft lusto F, Lanzavecchia A, Jarossay D. A functional setti MD, Regional Hospital of Bellinzona and Valli). onto the glenoid neck, in order to obtain the BCR in human IgA and IgM plasma cells. Blood. Cafarotti S, Cardillo G, Granone P, Dutly AE. Early best compression between the graft and the 2013;121(20):4110-4114. Stage Non–Small-Cell Lung Cancer: Surgical Impli- The EOC Hand Surgery Unit, together with hospital glenoid, it is of paramount importance that the cations of the New Adenocarcinoma Classification. and health service partners, provides diagnosis, screws are placed parallelly to each other and Lübbeke A, Garavaglia G, Rothman KJ, Bonvin A, J Thorac Oncol. 2013;8(5):e45. treatment and rehabilitation services for upper perpendicularly to the glenoid neck. Therefore Roussos C, Miozzari H, Hoffmeyer P. Statins may limb diseases and injuries. we developed a new drill guide for accurate reduce femoral osteolysis in patients with total Hip Cafarotti S, Treglia G, Bongiovanni M, Ceriani L, placement of the screws and graft. The pur- arthroplasty. J Orthop Res. 2013;31(5):814-820. Paone G, Giovanella L, Dutly AE. A Rare Case of

58 Scientific Report 2013 3. EOC Multisite Departments and Services 59 Main areas of research neurolysis in situ or endoscopy: a prospective sis and Clinica Application. Tech Hand Up Extrem Main areas of research Experimental study in progress: study. Surg. 2013;17(3):134-43. In collaboration with the Cardiovascular Research • Virtual reality interface and grip strength meas- Centre of the Regional Hospital of Bellinzona and uremet: experimental study. Sonographic examination is a useful technique Humanitarian Mission Valli: Lead investigator: C. Fusetti. in the assessment of the follow-up of patients Koforidua St Joseph’s Hospital (Ghana), surgical • Tako-Tsubo Cardiomyopathy and Cardiac Syn- In collaboration with: undergoing surgical treatment for cubital mission (trauma surgery, reconstructive surgery, drome X: New Insights into the pathophysiology the “Laboratoire de systèmes robotiques tunnel syndrome (CTS). Moreover, there is a congenital disorders): of two orphan cardiac diseases. (LSRO)” (multidisciplinary research unit work- direct correlation between the values of the S. Lucchina (surgeon, Regional Hospital of Locar- Lead investigators: M. Cattaneo, G. Moschovi- ing mostly in the fields of robotics, micro- cross section area (CSA) of the ulnar nerve no); B. Schild (anesthesiologist, Regional Hospital tis, A. Gallino (refer to chapter of Cardiovascu- robotics and high precision instrumentation): determined by sonographic examination and of Bellinzona and Valli), hand therapists (Regional lar Research Centre of the Regional Hospital of EPFL-STI-IMT-LSRO (H. Bleuler, M. Bouri), École the clinical pre- and post-operative state in Hospital of Locarno), OR nurses (Regional Hospi- Bellinzona and Valli). Polytechnique Fédérale de Lausanne. patients undergoing ulnar nerve decompres- tal of Bellinzona and Valli and Regional Hospital of sion at the elbow. The purpose of the study is Locarno). • Impact of cardiovascular screening in middle- For our experiments on grip strength testing to compare the clinical results of open release aged athletes (35 to 65 years old). and detection of sub-maximal effort, we use an and endoscopically assisted cubital tunnel re- 3.2 EOC Department of Internal Medicine Lead investigator: A. Menafoglio (refer to chap- instrumented dynamometer that has been de- lease, which encounter decompression of the Prof. Augusto Gallino MD ter of Cardiovascular Research Centre of the signed using pieces of a non-functional Jamar ulnar nerve at the elbow, using the differences Head of the Department of Internal Medicine and Regional Hospital of Bellinzona and Valli). dynamometer. Instead of a hydraulic-based found by sonographic examination of the cross head doctor of the Regional Hospital of Bellinzona sensing device, we choose the piezoresistive section area (CSA) of the ulnar nerve, in quest and Valli. • Swiss cohort atrial fibrillation study" "Swiss AF technology for its reliability and its reproducibil- of an association between the clinical results Cohort. ity from one measurement to another. In order and the CSA. The EOC Department of Internal Medicine is a Lead investigator: D. Conen of the University to keep the isometric measurement guaran- functional type of organizational structure, and Hospital of Basel. teed by the hydraulic Jamar, we are using two Peer reviewed publications in 2013 is managed and coordinated by the Department Main Coordinator and responsible for South- force sensors so that the result is independent Fusetti C, Lazzaro M, Trobia M, Lucchina S, Petri Board. The rules adopted for its operation are ern Switzerland: A. Gallino (refer to chapter of where the subject applies his force on the JGF, Garavaglia G. Patients' Point of View on In- based on the fundamental principles of shared of Cardiovascular Research Centre of the Re- handle (isometric measurement). formed Consent: A Prospective Study in Carpal clinical governance (accountability, participation, gional Hospital of Bellinzona and Valli). The outputs of the sensors go through ampli- Tunnel Surgery. Am J Orthop.2013;42(12):E111- transparency and management), and it is organ- fication and then are sent to the computer via E115. ized using a multisite approach, offering a gateway Collaboration is also underway with the following the acquisition card. The signal is then used to general internal medicine services. and can ad- Swiss Hospital: in one of the two interfaces. We plan to test Brunetti S, Petri J, Lucchina S, Garavaglia G, Fu- vise and direct patients to the appropriate refer- • Evidence Based Treatment in Heart Failure the efficiency of these two interfaces to trick setti C. Should aspirin be stopped before carpal ence centres. (EVITA-HF), Analysis of Iron Deficiency in Heart the patient. The Labview interface is directly in- tunnel surgery? A prospective study. World J Or- Failure (RAID-HF). spired by the "Visual Target Grip Test". thop 2013; 4 (4): 299-302. The EOC Department of Internal Medicine was set Lead investigator in Switzerland: O. Pfister of up to ensure high-quality localized internal medicine the University Hospital of Basel. Clinical studies in progress (lead investigators: C. Fusetti C, Garavaglia G, Thebaud A. Anatomical assistance, either planned or in emergency situa- Fusetti, S. Lucchina): collateral ligament reconstruction in the hand us- tions, making full use of its specific specialized skills, Prospective Multicenter Registry conducted in • Treatment of fractures of the fifth metacarpal ing intraosseous suture anchors and free tendon as the best way of harmonizing and rationalizing Austria, Germany and Switzerland, which aims neck by reduction and MCP-extension cast ver- graft. J Hand Surg Eur Vol 2013; 38(5): 576-577. the facilities for this sector in the Ticino Canton. at collecting data on clinical characteristics of sus soft wrap/buddy taping: a prospective mul- consecutive patients suffering from chronic ticenter study. Lucchina S, Fusetti C. Treatment of type III mid- Department of Internal Medicine, Cardiology heart failure (CHF) with ejection fraction (EF) < In collaboration with HCUG of Geneva and Na- dle phalangeal neck fractures through a palmar Service – Regional Hospital of Lugano 40 %, and to analyze medical and device thera- val Medical Centre of San Diego, CA-USA. approach. Chin Traumatol.2013;16(2): 107-109. Giorgio Moschovitis MD py included ICD and CRT, mortality and non-fa- Head of Service tal complications in-hospital and after one year • Sonographic follow-up of patients with cubi- De Spirito D. Percutaneous Fixation of Hand Frac- follow-up and symptoms and re-hospitalization tal tunnel syndrome (CTS) undergoing open tures Using Locked K-Wires: Mechanical Analy- (EVITA-HF Registry). In the Substudy data about

60 Scientific Report 2013 3. EOC Multisite Departments and Services 61 the ferric state and hemoglobin and their asso- plete repopulation of the gut. In this study, we isting SHCS infrastructure, recruited from national randomized open label study. ciation with prognosis and quality of life of CHF show that CCR6+ and CXCR3+ T-helper cells among the 2000 participants who provide patients are collected (RAID-HF). accumulate in the blood of HIV+ patients on fasting urine and plasma samples. • Protocol GlycoVaxyn EC-4V. long-term ART and that they have a reduced • This is not a research protocol, but a A phase I study in 12 clinical sites in Switzer- Peer reviewed publications in 2013 response to chemotactic stimuli. Moreover, core infrastructure project which aims at land to assess a candidate vaccine against Siclari F, Trunfio R, Moschovitis G, van den Berg findings from this study imply that during HIV enabling, stimulating, and coordinating re- uropathogenic Escherichia coli in women with JC, Cassina T, Regazzoni S. Hybrid treatment of a infection, persistent activation of the immune search on M+A topics in SHCS participants a clinical history of recurrent urinary tract in- case of obliterative hepatocavopathy (Budd-Chiari system leads to alterations in the cofilin-actin through SHCS SB protocol submissions by fection. syndrome). Ann Thorac Surg. 2013; 96(3):1062- pathway which result in a reduced lymphocyte all SHCS-affiliated researchers. 1064. migration that can prevent a complete tissue • Generating and contributing new levels of Main funding obtained in 2013 reconstitution, both in viremic and in ART-treat- data to the field of metabolic and aging-re- SHCS (through SNSF), Infectious Diseases Re- Department of Internal Medicine, Infectious ed HIV+ patients. lated complications. search Fund, pharmaceutical industry. Diseases Service – Regional Hospital of Lugano • Making project submissions more com- Prof. Enos Bernasconi MD • The Swiss HIV Cohort Study Core Project Me- petitive for external funding, including Swiss Peer reviewed publications in 2013 (selection) Deputy-Head of Internal Medicine tabolism and Aging (M + A core project). National Science Foundation (SNSF) ap- Nüesch R, Wang Q, Elzi L, Bernasconi E, Weber Lead investigator: P. Tarr (in Lugano: E. Bernas- plications, SHCS-international, and SHCS- R, Cavassini M, Vernazza P, thurnheer MC, Calmy The Infectious Diseases Service (SMI) is a special- coni). industry collaborations. A, Battegay M, Bucher HD, the Swiss HIV Cohort ized day clinic that deals with patients with infec- Study. Risk of cardiovascular events and blood tious diseases. The Service works in close collabo- Conditions referred to as “metabolic” or poten- The Service of Infectious Diseases is also partici- pressure control in hypertensive HIV-infected pa- ration with local GPs. tially related to premature aging (cardiovascu- pating in multicenter epidemiological, pharmaco- tients: Swiss HIV Cohort Study (SHCS). J Acquir Im- lar and cerebrovascular disease, osteoporosis, logical and vaccine studies: mune Defic Syndr. 2013;62(4):396-404. The SMI is one of the seven reference centres neurocognitive dysfunction, diabetes mellitus, • The PARTNER study. for the Swiss HIV Cohort Study (SHCS), one of the lipodystrophy, endocrinologic disorders) are in- The international, observational multicenter Lozano Becerra JC, Sieber R, Martinetti G, Costa world’s largest epidemiological and clinical stud- creasingly important determinants of the long- PARTNER study prospectively follows serodif- ST, Meylan P, Bernasconi E. Infection of the cen- ies in the HIV field with more than 17,000 partici- term health of HIV-infected individuals. Given the ferent couples (heterosexual (HT) and MSM) tral nervous system caused by varicella zoster vi- pants. The intense scientific activity is reflected in limitations of the current SHCS data collection who had condomless penetrative anal or vagi- rus reactivation: a retrospective case series study. the large number of publications available at the format, the SHCS Scientific Board has recog- nal sex in the month prior to study entry, and Int J Infect Dis. 2013;17(7):e529-534. website www.shcs.ch. nized the need for a major, coordinated effort where the HIV+ve partner is on ART. Every 6 to increase the incisiveness and productivity of months, each partner completes a sexual be- Metzner KJ, Scherrer AU, Preiswerk B, Joss B, Main areas of research metabolic and aging-related research within haviour questionnaire and the negative partner von Wyl V, Leeman C, Rieder P, Braun D, Grube C, • Th 17 cell migration and differentiation in HIV the SHCS. The SHCS has already successfully tests for HIV. Eligibility of follow-up time in this Kuster H, Böni J, Yerly S, Klimkait T, Aubert V, Fur- infection (in collaboration with the IRB). established and is productively conducting 2 transmission rate analysis required: continu- rer H, Battegay M, Vernazza P, Cavassini M, Calmy Lead investigators: V. Cecchinato, E. Bernas- core projects (Resistance and Genetics). ous condomless sex; not using PEP or PrEP; A, Bernasconi E, Weber R, Günthard H, the Swiss coni, R. Speck, M. Uguccioni. Study aims at: and latest VL <200 c/mL. For new diagnoses, HIV Cohort Study. Origin of minority drug-resistant • collecting fasting stored urine and plasma phylogenetic analysis compared HIV-1 pol and HIV-1 variants in primary HIV-1 infection. J Infect CD4+ T-cell depletion, and in particular Th17 samples in 2000 SHCS participants every env sequences by couple, after anonymising Dis. 2013;208(7):1102-1112. cell loss, in the mucosal compartment, is the 2 years, to allow biomarker protocols that the samples. This planned analysis shows the hallmark of HIV-1 infection in humans. Altera- require fasting samples (biomarkers in- rate of occurrence of linked transmissions. Wandeler G, Gsponer T, Bihl F, Bernasconi E, Ca- tions in the integrity of the mucosal barrier volved in glucose metabolism, insulin resist- vassini M, Kovari H, Schmid P, Battegay M, Calmy have been indicated as the causative pathway ance etc.) and discovery protocols based on • Protocol Boehringer Ingelheim BI1220.19. A, Egger M, Furrer H, Rauch A, Swiss HIV Cohort for chronic immune activation and disease pro- metabolomics and other emerging–omics Safety and efficacy of 240mg BI 201335 (fal- Study. Hepatitis B virus infection is associated with gression. Even though anti-retroviral therapy methods. daprevir), once a day, in combination with pe- impaired immunological recovery during antiretro- can suppress plasma viral load, immune activa- • Establishing a nation-wide, longitudinal gylated interferon and ribavirin for the treat- viral therapy in the Swiss HIV Cohort Study. J Infect tion persists in subjects on long-term Anti-ret- “core metabolic and aging (M+A) cohort” ment of chronic hepatitis C genotype 1 in Dis. 2013;208(9):1454-1458. roviral Therapy (ART), thus preventing a com- of 1000 SHCS participants within the ex- hepatitis C/HIV coinfected patients. A multi-

62 Scientific Report 2013 3. EOC Multisite Departments and Services 63 von Wyl V, Klimkait T, Yerly S, Nicca D, Furrer H, tients with 8 dialysis treatments in Lugano, 50 Cooperazione Transfrontaliera Italia-Svizzera/Co- is that an alteration in the autonomic system is the Cavassini M, Calmy A, Bernasconi E, Böni J, Au- patients with 6 dialysis treatments in Lecco), operazione Territoriale Europea) (“Surgical Cross- cause for central apneas that are frequently ob- bert V, Günthard HF, Bucher HC, Glass TR; Swiss and many parameters are registered to de- Border Cooperation Programme Italy-Switzer- served in the acute phase of a cerebral ischemic HIV Cohort Study. Adherence as a predictor of velop an individualized profile of each patient. land/European Territorial Cooperation” - external event. In particular, an alteration in the baroreflex the development of class-specific resistance mu- In the second phase, (9 months) a computer competitive grant). and chemoreflex, expression of a state of activa- tations: the Swiss HIV Cohort Study. PLoS One model will be developed and refined by the Po- “A Multicenter, Multiple-dose, Two-arm, Active-con- tion of the sympathetic nervous system, could be 2013;8(10):e77691. litecnico of Milan. In the third phase (9 months), trolled, Double-blind, Double-dummy Study to Com- a causal factor in the genesis of SDB, as well as the clinical behaviour of hemodynamics during pare the Therapeutic Efficacy and Safety of Oral an independent risk factor for cerebral ischemic Bartha I, Carlson JM, Brumme CJ, McLaren PJ, the dialysis sessions and the quality of life of Doses of Cinecalcet HCl with Intravenous Doses of events.Their joint study will provide useful elements Brumme ZL, John M, Haas DW, Martinez-Picado patients in all four clinical centres will be docu- AMG 416 in Hemodialysis Subjects with Second- of pathophysiological clarification. J, Dalmau J, Lopez-Galindez C, Casado C, Rauch A, mented before and after the implementation of ary Hyperparathyroidism”: Amgen (external grant, Günthard HF, Bernasconi E, Vernazza P, Klimkait the computer model. competitive only for recruitment of patients). Main funding T, Yerly S, O’Brien SJ, Listgarten J, Pfeifer N, Lip- ABREOC. pert C, Fusi N, Kutalik Z, Allen TM, Müller V, Har- • A Multicenter, Multiple-dose, Two-arm, Active- Peer reviewed publications in 2013 rigan PR, Heckerman D, Telenti A, Fellay J. A ge- controlled, Double-blind, Double-dummy Study Gamondi C, Galli N, Schönholzer C, Marone C, Peer reviewed publications in 2013 nome-to-genome analysis of associations between to Compare the Therapeutic Efficacy and Zwahlen H, Gabutti L, Bianchi G, Ferrier C, Cereghe- Caviezel S, Dratva J, Schaffner E, Teynor A, Baum- human genetic variation, HIV-1 sequence diversity, Safety of Oral Doses of Cinecalcet HCl with In- tti C, Giannini O. Frequency and severity of pain stark M, Schindler C, de Groot E, Burdet L, Rothe and viral control. Elife. 2013;2:e01123. travenous Doses of AMG 416 in Hemodialysis symptom distress among patients with chronic T, Pons M, Gaspoz JM, Rochat T, Künzli N, Porb- Subjects with Secondary Hyperparathyroidism. kidney disease receiving dialysis. Swiss Med Wkly. st-Hensch N, Scmidt-Trucksäss A. Variability and Department of Internal Medicine, Nephrology 2013;143:w13750. reproducibility of carotid structural and functional and Haemodialysis Service – Regional Hospital Phase III study: AMG 416 is a calcium receptor parameters assessed with transcutaneous ultra- of Lugano stimulating agent at the level of the parathyroid Department of Internal Medicine, Pneumology sound - Results from the SAPALDIA Cohort Study. Carlo Schönholzer MD gland. Service – Regional Hospital of Lugano Atherosclerosis. 2013;231(2):448-455. Head Doctor Primary objective: to demonstrate that treat- Prof. Marco Pons MD ment with AMG 416 is not inferior to treat- Head Doctor of Internal Medicine of Regional Hos- Department of Internal Medicine, Cardiovas- Main areas of research ment with cinacalcet to lower serum intact pital of Lugano cular Research Centre – Regional Hospital of • DialysIS (Dialysis therapy between Italy and PTH levels by >30%. Bellinzona and Valli Switzerland). Secondary objective: to assess whether treat- Main areas of research Prof. Augusto Gallino MD Lead investigators: ML. Costantino (Politecnico ment with AMG is superior to treatment with Sleep disordered breathing in patients with is- Head of Department and Head Doctor of Milan), F. Locatelli (Hospital of Lecco), G. Pon- cinacalcet as measured by the mean days of chemic stroke: clinical, prognostic and pathophysi- toriero (Hospital of Lecco), C. Schönholzer C vomiting or nausea per week, proportion of ological aspects. Main areas of research (Regional Hospital of Lugano), G. Bonforte (Hos- subjects with >50% decrease in serum iPTH, Lead investigator: M. Pons. • Tako-Tsubo Cardiomyopathy and Cardiac Syn- pital of Como), G. Rambola (Hospital of Varese). change from baseline of serum calcium, mean Co-investigator: A. Riglietti. drome X: New Insights into the pathophysiology Phase 1 of study: Politecnico of Milan, Hospital pre-dialysis phosphorus, mean severity of nau- of two orphan cardiac diseases. of Lecco and Regional Hospital of Lugano; sea and mean episodes of vomiting per week. The respiratory disorders during sleep (SDB) are Lead investigators: M. Cattaneo, G. Moschovi- Phase 2 of study: Politecnico of Milan; Treatment time: 26 weeks. a frequent problem among patients with a first tis, A. Gallino. Phase 3 of study: Politecnico of Milan, Hospital Sample: 600 patients, approximately 300 in ischemic cerebrovascular event. 40% of patients of Lecco, Regional Hospital of Lugano, Hospital each treatment group (Europe, USA, Russia, with SDB, which occurred during the acute phase This project aims at evaluating the possible of Como and Hospital of Varese. AUNZ); 30 patients in CH (Genève, Lausanne, of a stroke, has a breathing pattern characterized pathophysiological mechanisms inducing two Basel, Zürich, Locarno, Lugano), hopefully 5 pa- by central apnea and/or periodic breathing, isolat- orphan diseases: Cardiac Syndrome X and Multicenter Study. The purpose of the study is tients in Lugano. Start: 1.10.2013. ed or associated with obstructive apneas, whose Tako-Tsubo Syndrome. Both diseases affect to develop a computer model that may allow pathogenesis and clinical relevance in terms of im- almost exclusive middle age women. Progno- a more accurate planning of the hemodialysis Main funding pact on morbidity and mortality in the long term, is sis of the diseases is better than in patients treatment. In the first phase (9 months), for “DialysIS (Dialysis therapy between Italy and Swit- still largely unknown. with trivial coronary artery disease and worse 70 hemodynamically unstable patients (20 pa- zerland)”: INTERREG (Programma Operatorio di The assumption which underlies the present study than in the normal corresponding population.

64 Scientific Report 2013 3. EOC Multisite Departments and Services 65 We assess the autonomic function as well as Swiss-AF is a large project at national level, The purpose of this study was to provide a yield search; endothelial vascular function at rest and after and is the continuation of the BEAT-AF Study and cost-analysis of this preventive evaluation. "Impact of cardiovascular screening in middle- standardized mental stress. Almost 30 pa- and aims at assessing the major complication aged athletes (35 to 65 years old)": ABREOC. tients have been already included in the proto- of atrial fibrillation. One of the main points of • Triggers of myocardial infarction two month Biotronik Switzerland: unrestricted research col and preliminary results are submitted and the study is the occurrence of silent cerebral before acute event. Study on preventive cardi- grant. hopefully expected to be presented at the Eu- ischemia, which will be prospectively evaluated ology: TAMI-Study. Medtronic Switzerland: unrestricted research ropean Society Cardiology Meeting, in Septem- by serial cerebral MRI as well as by neuropsy- Lead investigator: M. Di Valentino. grant. ber 2014. chological testing. AstraZeneca Switzerland: unrestricted research This multicenter national prospective clinical The vast majority of acute myocardial infarc- grant. • Plaque neovascularization assessment by con- project has been recently endorsed by the tions are caused by an acute occlusion of trast ultrasounds and plaque magnetic reso- Swiss National Foundation. The BEAT-AF Study coronary branch. Frequently this atherothrom- Peer reviewed publications in 2013 (selection) nance (HR-MRI): ”In Vivo” comparison in human which has been the platform for the current na- botic occlusion is preceded by atherosclerotic Klimusina J, Porretta AP, Segatto JM, Facchini M, carotid atherosclerosis. tional program, has included several hundred plaque instability. Endothelial function plays a Bomio F, Dominé F, Capoferri M, Foglia E, Gallino Lead investigator: A. Gallino. of patients. First inclusions are scheduled by major role immediately before and after the A. Cardiac X syndrome: an overview of the litera- Collaborators: R. Wyttenbach, M. Cattaneo, A. May 2014. acute atherothrombotic occlusion. Cardiac ture and the local experience in Southern Switzer- Porretta, M. Stuber (CHUV, Lausanne). rehabilitation is a non-pharmacological inter- land. Cardiovascular Medicine. 2013;16:20-28. • Impact of cardiovascular screening in middle- vention which is known to improve endothe- This project is a continuation of the over 10 aged athletes (35 to 65 years old). lial function. The objective of this study is to Gallino A. Beinarterienverschluss: Stopp der years research on progression of athero- Lead investigator: A. Menafoglio. investigate trough dedicated questionnaires stillen Gefahr! Eine öffentliche nationale Kampagne sclerosis performed at our Cardiovascular Collaborators: M. Di Valentino, P. Siragusa, G. to patients having had a recent acute myocar- der schweizerischen Herzstiftung. Schweizerische Research Centre and aims at evaluating the Moschovitis. dial infarction and following a rehabilitation pro- MedForum. 2013;13:18. role of plaque neo-vascularisation in the pro- gram, which are the possible triggers preced- gression of atherosclerosis at the level of the Regular physical exercise reduces cardiovascu- ing the acute atherothrombotic complication. Gallino A, Porretta AP, Bianda N, Di Valentino M, carotid artery. It is a joint project between the lar morbidity and mortality. However, vigorous Furthermore, the study aims at evaluating the Klimusina J, Santini P, Limoni C, Segatto JM, Suda- Cardiovascular Research Centre, the Radiol- physical exertion may trigger adverse cardio- endothelial function at the beginning, and at no I, Corti R, Wyttenbach R. Imaging noncoronary ogy Division of the Hospital of Bellinzona, and vascular events in the presence of underlying the end of the cardio-rehabilitation. The project atherosclerosis: a model to understand coronary the Cardiovascular Imaging Research Centre heart diseases. In middle-aged individuals (35 includes patients with previous acute myocar- artery disease in humans. Cardiovascular Medi- at CHUV as well as with Prof. C. Yuan, Univer- to 65 years old) coronary artery disease is the dial infarction and a control cohort of patients. cine. 2013;16:5-10. sity of Seattle. The project is also performed principal cause of cardiac events during sports. So far, 100 patients have been included in the in cooperation with Prof. Daniel Staub, chief of A screening examination has the potential to study, and we are finalizing the inclusion of the Gallino A. The challenge of cardiovascular re- the vascular Division at University Hospital in detect still asymptomatic individuals with heart control patients. search in the province. (Editorial). Cardiovascular Basel. Almost 40 patients have been screened diseases and to protect them from cardiac Medicine. 2013;16:3-4. as possible candidates for this prospective events when playing sports. Main funding study. Several technical issues concerning dy- The European Association of Cardiovascular "Tako-Tsubo Cardiomyopathy and Cardiac Syn- Klimusina J, Rezzonico R, Sartori F, Mazzuc- namic assessment of plaque vascularisation in Prevention and Rehabilitation has recently edit- drome X: New Insights into the pathophysiology of chelli L, Gallino A. An unusual case of systolic order to obtain top images are now undergoing ed the recommendations about cardiovascular two orphan cardiac Disease": ABREOC; murmur and recurrent syncopes. Eur Heart J. a double check at the University in Seattle, USA screening of middle-age individuals participat- "Swiss cohort Atrial fibrillation study": SNSF, (Swiss 2013;34(44):3458. (Imaging centre for Atherosclerosis). ing in sporting activities. The screening con- AF Grant Number: 33CS30_148474/1); sists of history, physical examination, resting "Plaque neovascularization assessment by con- Department of Internal Medicine – • Swiss cohort atrial fibrillation study "Swiss-AF". electrocardiogram and risk stratification ac- trast ultrasounds and plaque magnetic resonance Regional Hospital of Mendrisio Lead investigator: D. Conen. cording to the Systematic Coronary Risk Evalu- (HR-MRI): ”In Vivo” comparison in human carotid Brenno Balestra MD Main Coordinator and responsible for South- ation. Athletes with abnormalities at screening atherosclerosis": Swiss Heart Foundation Re- Head Doctor ern Switzerland: A. Gallino. or with a high risk, are submitted to additional search Grant; Collaborators: M. Di Valentino, G. Moschovitis. cardiac examinations. However, there are very "Triggers of myocardial infarction two month be- The Internal Medicine Service of the Regional Hos- few data on the impact of such a stance. fore acute event": Swiss Heart Foundation Re- pital of Mendrisio is one of the many Services that

66 Scientific Report 2013 3. EOC Multisite Departments and Services 67 make up the EOC’s multisite Department of Inter- Haemodialysis Service of Regional Hospital of Lo- nal Medicine. carno and Coordinator of the EOC’s Nephrology In a cross-over study, the haemodynamic con- This study analyzes the incidence and risk fac- and Haemodialysis Services. sequences of the use of 4 different haemodialy- tors of hypokalemia in EOC hospital inpatients. Main areas of research sis membranes have been analyzed. There will also be an interventional phase to Influence of hemodialysis on physical activity and The head of the Nephrology and Haemodialysis deal more effectively with the problem. motory skills in patients with stage V chronic renal Service of the Regional Hospital of Locarno is the • Coagulation activation using different haemodi- insufficiency (K/DOQI) Coordinator of the network that groups the neph- alysis membranes. • Magnesium in the dialysate and haemodynamics. Lead investigators: O. Giannini, C. Cereghetti, P. rology services of the EOC’s four regional hospi- Lead investigator: L. Gabutti. Lead investigator: L. Gabutti. Quadri. tals. The organisation is aimed at ensuring that medical and nursing care is of a high quality, and In a randomised controlled cross-over study The study aims at analyzing the haemodynamic This is a prospective multicenter observational also that the competences of the specialists are the activation of the coagulation using 3 differ- consequences of changes in the concentration study carried out among an outpatient population capillary available. ent dialysis membranes has been analyzed. of magnesium in the dialysate. of at least 30-50 patients with chronic renal insuf- ficiency (CKD 5, in line with K/DOQI) who were Main areas of research • Citrate pre-and post-filter: a randomized con- Main funding about to receive dialysis at the Haemodialysis and • Estimation of renal function using Cystatin C as trolled trial in a population in chronic haemo- All projects have been funded by Balli and Gianella Nephrology Service day centres or private dialysis a marker in a population study (from the Swiss dialysis. foundations. centres in Ticino. The purposes of the study are Salt Study). Lead investigator: L. Gabutti. to: quantify the changes in the overall level of mo- Lead investigator: L. Gabutti. Peer reviewed publications in 2013 bility and the postural and walking strategies that In a randomized controlled cross-over study, Gamondi C, Galli N, Schönholzer C, Marone accompany entry into dialysis, highlight factors, The determination of Cystatin C on blood sam- the consequences on the quality of dialysis C, Zwahlen H, Gabutti L, Bianchi G, Ferrier C, linked to the fragility of the patients and/or dialy- ples obtained in the Swiss Salt Study is under- following the use of citric acid in the dialysate Cereghetti C, Giannini O. Frequency and sever- sis, which are likely to affect the degree of mobility way. The results will allow a comparison for the have been examined. ity of pain symptom distress among patients with and independence in everyday life, the balance and Swiss population of the estimated renal func- chronic kidney disease receiving dialysis. Swiss walking control of the patients, as well as the dan- tion, obtained using creatinine, 24-hour urine • Temperature of the dialysate and haemody- Med Wkly. 2013;143:w13750. ger of a fall. collection and Cystatin C. namics: a randomized study. Lead investigator: L. Gabutti. Forni V, Bianchi G, Ogna A, Salvadé I, Vuistiner P, Main funding • Swiss Salt Study: secondary analyses of the Burnier M, Gabutti L. Reticulocyte dynamic and ABREOC. data. In a randomized controlled cross-over study, hemoglobin variability in hemodialysis patients Member of the working group: L. Gabutti. the haemodynamic consequences of chang- treated with Darbepoetin alfa and C.E.R.A.: a ran- Peer reviewed publications in 2013 ing the temperature of the dialysate have been domized controlled trial. BMC Nephrol. 2013;14 Reynaldos Canton Migotto T, Balestra B. Ein Fall Numerous secondary analyses of the data of analyzed. (1): 157. von Mastitis non puerperalis. Schweiz Med Forum the “Swiss Salt Study” are currently underway. 2013; 13(1920): 389-390. • Lock on indwelling catheters and permeability: 3.3 EOC Department of Intensive Care • Vascular aging in haemodialysis patients: a pro- a prospective study. Medicine Gamondi C, Galli N, Schönholzer C, Marone spective study. Lead investigator: L. Gabutti. Andreas Perren MD PD C, Zwahlen H, Gabutti L, Bianchi G, Ferrier C, Lead investigator: L. Gabutti. Head of the EOC Department of Intensive Care Cereghetti C, Giannini O. Frequency and severity The study aims to prospectively assess the ef- Medicine and Head Doctor in the Regional Hospi- of pain and symptom distress among patients with In a cohort study involving 4 EOC dialysis units, fect on the permeability of indwelling catheters tal of Bellinzona and Valli chronic kidney disease receiving dialysis. Swiss the pulse wave velocity and the main risk fac- for haemodialysis and the effect of using differ- Med Wkly 2013; 143: w13750. tors for cardio-vascular diseases have been ent filling solutions. The EOC Department of Intensive Care Medicine monitored prospectively for 2 years. comprises the relevant services in the Hospitals Department of Internal Medicine – • Hypokalemia in the internal medicine services: of Bellinzona, Lugano, Mendrisio and Locarno. The Regional Hospital of Locarno • Haemodialysis membranes and haemodynam- retrospective assessment and acceptance Department has a functional type of organizational Prof. Luca Gabutti MD ic impact. project. structure, and is managed and coordinated by the Head Doctor of Internal Medicine, Nephrology and Lead investigator: L. Gabutti. Lead investigator: L. Gabutti. Department Board. The rules adopted for its func-

68 Scientific Report 2013 3. EOC Multisite Departments and Services 69 tioning are based on the fundamental principles of ICUs. The purposes of this study were: 1) to ex- Swiss intensive care units. Peer reviewed publications in 2013 shared clinical governance (accountability, partici- plore SAPS II and NEMS assessment practices Lead investigators: C. Speroni, D. Gobbi, A. Pagnamenta A, Vanderpool R, Brimioulle S, Naeije pation, transparency and management), and it is of the Swiss adult ICUs, including training and Gemperli, P. Merlani, A. Pagnamenta. R. Proximal pulmonary arterial obstruction de- organized using a multisite approach. Here, too, quality management; 2) to identify organization- creases the time constant of the pulmonary circu- the creation of the EOC Department of Intensive al and procedural gaps; 3) to assess accuracy Restrictions on visiting hours in the ICU are lation and increases right ventricular afterload. J Care Medicine was aimed at providing the most and reliability of caregiver-registered NEMS usually adopted worldwide. Current knowledge Appl Physiol 2013; 114(11):1586-1592. suitable response to the need to harmonize and scores and recognize error-prone variables; shows that these limitations are not neces- rationalize the services offered in this sector in our and 4) to conceive an appropriate improve- sary. To date, no data on visiting policies in Awards 2013 Canton. ment intervention. While the first part (NEMS) Swiss ICUs are available and accordingly we The best original article, Joint Annual Meeting of has been finalized and the paper is under re- conducted an observational study on this Swiss Society of Intensive Care Medicine, Geneva, Department of Intensive Care Medicine – view (peer-reviewed journal ), the second part subject. Furthermore, we were interested in September 2013: Regional Hospital of Bellinzona and Valli (SAPS) will be concluded this year. identifying variables that impose a restricted Pagnamenta A, Rabito G, Arosio A, Perren A, visiting policy. We carried out a questionnaire- Malacrida R, Barazzoni F, Domenighetti G. Adverse Main areas of research Main funding based nationwide survey among all adult Swiss event reporting in adult intensive care units and • Physical restraint in the ICU: clinical settings “Physical restraint in the ICU: clinical settings and ICUs. An electronic questionnaire was sent by the impact of a multifaceted intervention on drug- and occurrence of adverse events. occurrence of adverse events”: ABREOC. e-mail between May and June 2012 to all chief related adverse events. Ann Intensive Care 2012; Lead investigators: A. Perren, E. Iapichino, D. “Survey of scoring practices and accuracy in as- nurses. Length of visiting time was taken as the 2(1):47. Corbella, V. Di Bernardo, I. Sperandio, C. Som- sessing SAPS II and NEMS in Swiss ICUs”: Società main endpoint to assess the association with macal, F. Barazzoni, R. Malacrida. Svizzera Medicina Intensiva (SSMI) (2011) (Swiss predictor variables using multiple linear regres- Department of Intensive Care Medicine – Society of Intensive Care Medicine). sion analysis. Regional Hospital of Locarno This multicentre study was planned to depict Michael Llamas, MD the clinical scenario of physical restraint prac- Peer reviewed publications in 2013 • Impact of a communication strategy on family Head of Service tice in adult ICUs and to analyse the relation- Perren A, Brochard L. Managing the apparent and satisfaction on the intensive care unit. ship between its use and the occurrence of hidden difficulties of weaning from mechanical ven- Lead investigators: A. Pagnamenta, A. Chiesa, Main areas of research adverse events. A second purpose was to ana- tilation. Intensive Care Med 2013;39(11):1885- R. Bruno, A. Arosio, M. Llamas, A. Perren, A. Swiss Study for the treatment of COPD-patients lyse the psychological outcome after physical 1895. Merlani, A Gemperli, HU Rothen. with the free combination of indicaterol and gly- restraint. While the first part of the study has copyrroniumbromide (ClinicalTrials.gov Identifier: been finalized and the manuscript submitted Awards 2013 Patients who enter the intensive care unit NCT01699685). to a peer-reviewed journal, the second part is The best original article, Joint Annual Meeting of (ICU) often cannot easily evaluate the quality Lead investigator: M. Brutsche. ongoing and is likely to be completed at the end Swiss Society of Intensive Care Medicine, Geneva, of delivered care due to their critical condition. Participating centre: Regional Hospital of Locarno of 2014. September 2013: Therefore, family satisfaction with care and (G. Domenighetti). Pagnamenta A, Rabito G, Arosio A, Perren A, with decision making becomes a relevant out- • Survey of scoring practices and accuracy in as- Malacrida R, Barazzoni F, Domenighetti G. Adverse come measure. Nowadays, we have validated This is a multicenter, randomized, double-blinded, sessing SAPS II and NEMS in Swiss ICUs. event reporting in adult intensive care units and instruments to systematically assess fam- single-dose, cross-over, placebo-controlled study. Lead investigators: A. Perren, M. Previsdomini, the impact of a multifaceted intervention on drug- ily satisfaction in the ICU. The purpose of this The primary endpoint was chosen to demonstrate M. Kaufmann, P. Massarotto, I. Perren, P. Mer- related adverse events. Ann Intensive Care 2012; study is, after a baseline assessment of family the superiority of a single-dose of the combined lani, HU. Rothen. 2(1):47. satisfaction, to test the hypothesis that a new inhalation vs. the mono inhalation regarding the introduced specific communication strategy Inspiratory Capacity (IC) peak value. A total of 78 SAPS II (disease gravity) and NEMS (nurses' Department of Intensive Care Medicine – will improve the level of satisfaction of the next patients will be randomized to complete two visits workload) are two scores imperatively as- Regional Hospital of Mendrisio of kin in the ICU. with two single doses of treatment. Patients will sessed for all ICU patients, as they are key- Alberto Pagnamenta MD be randomized in a cross-over manner. Treatment components to define the amount of hospital Head of Service Main funding visits will be separated by a study medication wash- reimbursements by means of the SwissDRG. “Impact of a communication strategy on family sat- out period. Treatments will be administered in a Nothing is known concerning the reliability and Main areas of research isfaction on the intensive care unit”: ABREOC. blinded fashion. accuracy of the assessment practices in Swiss • A nationwide survey of visiting hours policies in

70 Scientific Report 2013 3. EOC Multisite Departments and Services 71 Main funding Paediatric Service – Lead investigator: MG. Bianchetti. (in collaboration with the University Children’s Novartis Pharmaceuticals (Competitive recruitment). Regional Hospital of Lugano Hospital of Bern). Valdo Pezzoli MD • Correlation between functional MRI, EEG and Lead investigators: MG. Bianchetti, GP. Ramelli. Peer reviewed publications in 2013 Head Doctor cognitive development in children with rolandic Wise RA, Anzueto A, Cotton D, Dahl R, Devins epilepsy. (in collaboration with the University Projects currently underway: T, Disse B, Dusser D, Joseph E, Kattenbeck S, Main areas of research Children’s Hospital of Basel). a. Vitamin D status among children and ado- Koenen-Bergmann M, Pledger G, Calverley P; TIO- • Oral and anal colonisation by candida species Lead investigator: GP. Ramelli. lescents with and without anticonvulsivant SPIR Investigators (Domenighetti G.). Tiotropium in children: an open, prospective, non interven- • Chromosomal microarray among children with drugs in Southern Switzerland; Respimat inhaler and the risk of death in COPD. N tional, matched case study. mental retardation: a useful diagnostic tool for b. Regional differences in the prescription of Engl J Med. 2013;369(16):1491-1501. Lead investigator: V. Pezzoli (in collaboration the clinical geneticist. vitamin D among pediatricians in Switzer- with O. Petrini, F. Schönherr and the “Istituto (in collaboration with the Centre Hospitalier land. Domenighetti G. Hidden shortness of breath or Cantonale di Microbiologia”, Bellinzona). Universitaire of Lausanne). the difficulty of early diagnosis of pulmonary hyper- Lead investigators: GP. Ramelli, A. Ferrarini. • Influenza virus B-associated acute benign my- tension. Rev Med Suisse. 2013;9(371):225-226. The study objectives are to study the colonisa- algia cruris: an outbreak report and review of tion by Candida spp. of the mouth and the anal • Diagnosis and management of hereditary salt- the literature. Awards 2013 region of children with recurrent candidiasis losing tubular disorders. (in collaboration with the Swiss Italian Society The best original article, Joint Annual Meeting of and healthy, matched controls. (in collaboration with the University Children’s of Pediatrics and the University Children’s Hos- Swiss Society of Intensive Care Medicine, Geneva, Hospital of Milan and the Merate-Lecco Hos- pital of Bern). September 2013: Main funding pital). Lead investigators: A. Ferrarini, MG. Bianchetti, Pagnamenta A, Rabito G, Arosio A, Perren A, Funding from the “Istituto Cantonale di microbio- Lead investigator: MG. Bianchetti. GP. Ramelli. Malacrida R, Barazzoni F, Domenighetti G. Ad- logia” (Cantonal Institute of Microbiology) and from verse event reporting in adult intensive care units ETH Zürich. Projects currently underway: • Non-steroidal anti-inflammatory drugs for and the impact of a multifaceted intervention on a. Parental representations of their children’s croup: preliminary experience. drug-related adverse events. Ann Intensive Care Integrated Paediatric Services in Bellinzona, illness: does “rare” make a difference? A (in collaboration with the University Children’s 2012; 2(1):47. Locarno and Mendrisio qualitative research protocol; Hospital of Bern and with the University Chil- Prof. Mario G. Bianchetti MD and Dr. Gian Paolo b. Phosphate metabolism; dren’s Hospital of Milan). 3.4 Paediatric Department of Southern Ramelli MD PD are responsible for the research c. Interaction between dyselectrolytemias Lead investigator: MG. Bianchetti. Switzerland unit. Dr. Pier Luigi Brazzola MD is responsible for and QT-interval on standard electrocardi- Pediatrics is concerned with the mental, social oncologic projects and Dr. Alessandra Ferrarini ography. • Prevention and management of arterial hyper- and physical health of children from birth to young MD for genetic projects. tension in children and adolescents. adulthood. • Early detection and intervention for Swiss-Ital- (in collaboration with the University Children’s Pediatric care encompasses a wide spectrum of Main areas of research ian children with autism spectrum disorders. Hospital of Milan and the University Children’s health services ranging from preventive health • Cardiovascular health among Swiss-Italian men Lead investigator: GP. Ramelli. Hospital of Bern). care to the diagnosis and treatment of acute and invited to the military entry examination. Lead investigator: MG. Bianchetti. chronic diseases. (in collaboration with the University Children’s Projects currently underway: Pediatrics deals with biological, social and environ- Hospital of Bern, the Department of Internal a. Clinical usefulness of the modified checklist Project currently underway: mental influences on the developing child and with Medicine of Bellinzona, and the Federal Depart- for autism in toddlers, a validated screen- a. Palatability of brand-name and generic the impact of disease and dysfunction on devel- ment of Defence). ing tool; drugs containing antihypertensive agents; opment. Children differ from adults anatomically, Lead investigator: MG. Bianchetti. b. Outcome following early educational and b. Salt and blood pressure among children. physiologically, immunologically, psychologically, behavioural interventions; developmentally and metabolically. Neonatology, • “Chalk and blackboard interactive workshop” c. Usefulness of chromosomal microarray (in • Schönlein-Henoch purpura: genetic factors. the main subspecialty of pediatrics, consists of the training for pediatricians and medical students: collaboration with A. Ferrarini and the Cen- Lead investigators: A. Ferrarini, MG. Bianchetti, medical care of newborn infants, especially the ill a new kind of medical education. tre Hospitalier Universitaire of Lausanne). GP. Ramelli. or premature newborn infant. (in collaboration with the University Children’s Hospital of Milan and the University of Bern). • Hypovitaminosis D. • Symptomatic fever management.

72 Scientific Report 2013 3. EOC Multisite Departments and Services 73 (in collaboration with the Merate-Lecco Hos- of sodium Thiosulphate, it is expected to not be detected even with the most modern lect data regarding diagnostics, treatment pital and the University Children’s Hospital of reduce the risk of damage to the patients' radiological techniques (micrometastases). and outcome in order to develop future Bern). hearing. If the tumour and metastases can be com- treatment strategies. Lead investigator: MG. Bianchetti. pletely eliminated, or reduced to a minimum • AIEOP-BFM-ALL 2009. through a combination of surgery, intensive • SIOP-PNET-5. Projects currently underway: This is a multicenter international clini- chemotherapy and possibly radiotherapy, An international prospective study on clini- a. Management of fever in Switzerland and cal study using polychemotherapy for the then patients with soft tissue sarcomas cally standard-risk medulloblastoma in chil- Northern Italy; treatment of acute lymphoblastic leuke- with an unfavourable constellation have a dren older than 3 to 5 years with low-risk b. Fever phobia among Swiss paediatricians. mias in young children and adolescents. good chance of recovering despite the risk biological profile or average-risk biological Using an optimal stratification in three risk of a relapse. The current study is based on profile. • Systematic reviews of rare conditions in child- groups, the aim is to optimize therapy, while the SoTiSaR study, a registry of all patients For LR-Patiens the aim of the study is to hood. minimizing acute and late occurring side- with newly diagnosed sarcomas and soft confirm the high rate of event-free survival (in collaboration with the University Children’s effects. Currently, the treatment of young tissue tumours. This study proposes stand- in patients between the ages of 3 to 5 years Hospitals of Bern and Basel). children and adolescents with low-grade ard treatment following the guidelines of and less than 22, with ‘standard risk’ medul- Lead investigators: MG. Bianchetti, GP. Ramelli. brain tumours occurs in a non-standardized the CWS study group (CWS guidance) or loblastoma with a low-risk biological profile. way with a variety of study protocols. The of the European study group for paediatric Patients eligible for the study will be those Projects currently underway: rationalization and standardization of treat- soft tissue sarcomas. with non-metastatic medulloblastoma at a. Breastfeeding associated hypernatremia; ment should lead to better diagnostics, the diagnosis and low-risk biological profile, de- b. Central nervous system involvement in identification of acute and long-term side ef- • SIOP-CGT-II. fined as ß-catenin nuclear immuno-positivity rotavirus infections; fects and consequently a better long-term Prospective Trial for the diagnosis and by IHC. Patients will undergo total or near- c. Electrolyte abnormalities in cystic fibrosis; prognosis. treatment of children, adolescents and total tumour resection and will receive con- d. Metabolic disturbances and renal stone young adults with intracranial Germ Cell Tu- ventionally fractionated (once a day) radio- promotion on treatment with topiramate; • HIT-HGG 2007. mours. therapy with a dose of 54 Gy to the primary e. Hyponatremia in children with respiratory International cooperative Phase II trial of For Germinoma: to maintain current high tumour and 23.4 Gy to the craniospinal axis. infections; the HIT-HGG study group for the treatment EFS rates using a risk adapted approach. Following radiotherapy, patients will receive f. Posterior cerebral edema syndrome in of high grade glioma, diffuse intrinsic pon- In localised germinoma: to omit whole brain a reduced-intensity chemotherapy with a to- children and adolescents; tine glioma, and gliomatosis cerebri in chil- and spinal irradiation by using combined tal of 6 cycles of chemotherapy consisting of g. Skin lesions other than erythema mul- dren ≥ 3 years and adolescents < 18 years. treatment with standard chemotherapy 3 courses of cisplatin, CCNU and vincristine tiforme associated with myccoplasma The study is designed as a clinical phase and ventricular irradiation (+/- boost). In alternating with 3 courses of cyclophospha- infections; II trial to evaluate if temozolomide chemo- bifocal tumours (pineal + suprasellar): to mide and vincristine. h. Dobrin syndrome; therapy according to Stupp et al. (2005) treat as non-metastatic disease and to For SR-patients the aim of the study is to i. Ureteral or vesical involvement in Schön- really offers sufficient clinical benefit for omit whole brain and spinal irradiation by test whether concurrent carboplatin during lein-Henoch purpura. paediatric patients with newly diagnosed using combined treatment with standard radiotherapy followed by 8 cycles of mainte- high grade gliomas, diffuse intrinsic pontine chemotherapy and ventricular irradiation nance chemotherapy in patients with ‘stand- Paediatric oncology gliomas, and gliomatosis cerebri and may, (+/- boost). In metastatic disease: to main- ard risk’ medulloblastoma with an average- 1. Participation in several phase II/III interna- therefore, be further investigated as treat- tain current excellent EFS in metastatic ger- risk biological profile may improve outcome. tional, multicenter studies (lead investigator: ment backbone of a future phase III trial in minoma with craniospinal irradiation. Patients eligible for the study will be those Dr. Pierluigi Brazzola): late 2009. For malignant non-germinoma: to improve with non-metastatic medulloblastoma (by EFS in high risk patients by intensifying CSF cytology and centrally reviewed MRI im- • SIOPEL 6. • CWS-2007-HR. treatment by dose escalation of standard aging) at diagnosis and average-risk biologi- This international multicenter clinical study Soft tissue sarcomas can arise in practi- chemotherapy in patients identified as high cal profile, defined as ß-catenin nuclear im- uses chemotherapy combined with surgery cally any part of the body, with the risk that risk at diagnosis by standardising the sur- muno-negativity by IHC. Patients will undergo for the treatment of standard-risk hepato- at the time of diagnosis the disease is al- gical approach for residual disease after total or near-total tumour resection and will blastomas in young children and adoles- ready present and has metastasized. The treatment. receive conventionally fractionated (once a cents. By randomizing as regards the use metastases may be so small that they can- For Teratoma: to register patients and col- day) radiotherapy with a dose of 54 Gy to the

74 Scientific Report 2013 3. EOC Multisite Departments and Services 75 primary tumour and 23.4 Gy to the cranio- • SoTiSar Registry. lecular genetic characterization of rhabdoid Ferrarini A, Bianchetti AA, Fossali EF, Faré PB, Si- spinal axis. Following radiotherapy, patients Soft tissue tumours, which include sarco- tumours. To render support to existing tu- monetti GD, Lava SAG, Bianchetti MG. What can will receive a modified-intensity chemother- mas, gastrointestinal stromal tumours, mour banks and to perform biological stud- we do to make antihypertensive medications taste apy with a total of 8 cycles of chemotherapy very aggressive juvenile fibromatosis and ies, to identify future therapeutic targets. better for children? Int J Pharm. 2013; 457(1): consisting of 4 courses of cisplatin, CCNU hamartomas, are a very heterogeneous, To cooperate with: Groups specialized in 333-336. and vincristine alternating with 4 courses of rare category of tumours with an annual paediatric Soft Tissue Sarcoma (e.g. CWS, cyclophosphamide and vincristine. incidence in Europe of around 2-4 cases EPSSG) and Nephroblastoma, in studying Gualco G, Lava SAG, Garzoni L, Simonetti GD, Bet- per 100,000 inhabitants. Only with a com- similarities between extra- (RTK and MRT) tinelli A, Milani GP, Provero MC, Bianchetti MG. • Kraniopharyngeom 2007. prehensive non-selective collection of all pa- and intra-CNS (AT/RT) rhabdoid tumours Transient benign hyperphophatasemia. J Pediatr This is a prospective international multi- tients can there be a thorough understand- and in defining common treatment elements Gastroenterol Nutr. 2013; 57(2): 167-171. center clinical study to assess the results ing of the epidemiology and biology of this used in AT/RT and extra-CNS rhabdoid tu- of using radiotherapy in craniofaringiomas group of tumours, which can then lead to mours. To communicate with groups in the Jörg R, Milani GP, Simonetti GD, Bianchetti MG, that have not been completely removed, de- a quicker and easier identification of new USA and Australia, to define points of mutual Simonetti BG. Peripheral facial nerve palsy in se- pending on when it was used. forms of treatment and prognostic param- interest and potential for cooperation. vere systemic hypertension: a systematic review. eters. The main purpose of the project is Am J Hypertens. 2013; 26(3): 351-356. • HR-NBL-1.5. to obtain a prospective collection of epide- • GPOH-MET. Open, multicentre randomised Phase III miological, diagnostics and treatment data Registry for rare malignant endocrinological Lava SAG, Simonetti GD, Ragazzi M, Guarino Trial; therapy optimisation study for high for young children, adolescents and young tumours. Registration of diagnostic approach Gubler S, Bianchetti MG. Juvenile spring eruption: risk neuroblastoma. To test the hypothesis adults <21 years with soft tissue tumours, and therapies. Identification of new risk or an outbreak report and systematic review of the that the modified N7 induction regimen will and create a database for clinical and basic prognostic factors. Long term follow-up. literature. Br J Dermatol. 2013; 168(5): 1066- improve the metastatic response rates or epidemiological studies. 1072. event free survival (EFS) as compared to • STEP Registry for rare tumours (e.g. carci- Rapid COJEC. To test the hypothesis that • EuroNet-PHL-C1 Registry for Hodgkin Lym- noma). Dell’Orto VG, Bianchetti MG, Brazzola P. Hyper- the addition of subcutaneous aldesleukin phoma. Better epidemiological and clinical prospec- chloraemic metabolic acidosis induced by the iron (IL-2, (Proleukin®) to immunotherapy with tive data collection about rare tumours. De- chelator deferasirox: a case report and review of chimeric 14.18 anti-GD2 monoclonal an- • SIOP-LGG 2004 Registry for Low Grade velopment of guidelines for rare tumours the literature. J Clin Pharm Ther. 2013; 38(6): tibody in addition to differentiation therapy Glioma. diagnostic and treatment. Definition and 526-527. with isotretinoin (13-cis-RA) following my- This is an international multicenter clini- classification of rare tumours. eloablative therapy (MAT) and autologous cal registry using surgical approaches, ra- Brazzola P, Rossi MR. High weekly doses of liposo- SCR, will improve EFS in patients with high- diotherapy and known drugs in the field of • PI Pathfinder 5 Study. mal amphotericin B as secondary prophylaxis after risk neuroblastoma (stage 4 disease or paediatric oncology. The study is aimed at A phase III Study of a new recombinant fac- cerebral aspergillosis in a paediatric patient. Med stages 2 and 3 with MYCN amplification, all young children and adolescents with brain tor VIII for the prophylaxis and therapy for Mycol Case Rep. 2013; 3: 1-3. over the age of one, or infants with MYCN tumours such as low-grade gliomas. haemophilia A. New factor with a prolonged amplification). half life. Paediatric Surgery Service – • HIT 2000 Registry for cerebral tumours. Regional Hospital of Bellinzona and Valli • End of Life. Main funding Mario Mendoza Sagaon MD To evaluate the possibility to involve young • EU-RHAB. ABREOC, Funding from the University of Milan, the Head Doctor patients in the decision process about end A multinational registry for rhabdoid tu- Universities of Basel and Bern and Private funds. of life treatment. Evaluation of motivation mours of any anatomical site. Creation of a The Pediatric Surgery Service cares for children and possible obstacles. Quantitative and comprehensive database for patients with Peer reviewed publications in 2013 (selection) up to 16 years of age who require surgery or qualitative evaluation with interview of pa- rhabdoid tumours of any anatomical site Datta AN, Oser N, Bauder F, Maier O, Martin F, are suffering from diseases that frequently need tients, parents and doctors. diagnosed in European countries. Develop- Ramelli GP, Steinlin M, Weber P, Penner IK. Cog- surgery. It is a full service, including all the main ment of a structured plan for central review nitive impairment and cortical reorganization in surgical specializations, with a preference for mini- 2. Participation in international registries: of histology and molecular genetics. To im- children with benign epilepsy with centrotemporal invasive, orthopaedic and often outpatient surgery. • COSS Registry for bone tumours. prove (neuro-) pathological, clinical and mo- spikes. Epilepsia. 2013; 54(3): 487-494.

76 Scientific Report 2013 3. EOC Multisite Departments and Services 77 Main areas of research Diagnosis of DTC includes TSH-measurement, thy- Main areas of research first two of which are in collaboration with the Le fratture dell'omero distale in età pediatrica roid ultrasound and thyroid scintigraphy as well as Regional anesthesia and acute postoperative pain Mario Negri Pharmacological Research Institute trattate con chiodi di Métaizeau (Distal humerus fine-needle-aspirate of the most suspected nod- treatment, ultrasound in anesthesia care. in Milan, Department of Neurosciences, geriatric fractures in paediatic age treated with Métaizeau ules for cytology. neuropsychiatry: nails). Treatment of these types of carcinoma includes Peer reviewed publications in 2013 (selection) • The feasibility of physiotherapy associated with the Lead investigator: V. De Rosa. total thyroidectomy as well as thyroid-residual ab- Saporito A, Petri GJ, Sturini E, Borgeat A, Aguirre cognitive approach (Imagery) for elderly patients lation with I-131. JA. Safety and effectiveness of bilateral continu- with a fear of falling: observational pilot study. Distal humerus fractures are usually treated with The prognosis is good; however, 20-30% of pa- ous sciatic nerve block for bilateral orthopedic foot Lead investigators: F. Meroni, P. Quadri, R. Pez- Kirchner pins but the treatment is sometimes dif- tients develops a local/metastasis relapse. It is surgery: A cohort study. Eur J Anaesthesiol. 2013; zati, C. Celeste, L. Curia, F. Gallina, S. Chiari, S. ficult. therefore crucial to propose a long-term follow-up 30: 1-6. Ambrogio, E. Biglia, F. Bianchi, D. Zemp, M. Tet- This technique provides a stable and easy stabilisa- that includes monitoring of specific tumuor mark- tamanti, S. Avesani, N. Schiavone. tion of fracture and avoids opening the fractures. ers like, e.g., the thyroglobulin molecule. Saporito A, Lo Piccolo A, Franceschini D, Toma- The purpose of the study is to break the vicious Today, new promising markers, such as BRAF-mu- setti R, Anselmi L. Thoracic ultrasound confir- circle brought on by the fear of falling and to im- 3.5 EOC Department of Laboratory Medicine tations, hTSHR and oncofoetal fibronectin, seem mation of correct lung exclusion before one lung prove mobility (and consequently the functional Franco Keller MD to be more sensitive in the detection of relapsing ventilation during thoracic surgery. J Ultrasound. capacity of elderly patients), considering cog- Head of Department disease. 2013;16(4):195-199. nitive interventions (imagery) alongside physi- The purpose of this study is to evaluate the analyti- otherapy in elderly patients (with or without The Department of Laboratory Medicine (EOLAB) cal superiority of these new markers by compar- Saporito A, Sturini E. Incidence of postoperative previous falls without serious consequences) was set up to meet the needs of modern medicine ing the classical approach in detecting relapsing delirium is high even in a population without known who have a fear of falling. as regards laboratory services, and also because disease. risk factors. J Anesth. 2013; Sep 26. of the need to contain costs and make more ra- • Influence of haemodyalisis on physical activity tional use of resources, including increasingly so- Main funding Saporito A. Dorsal scapular nerve injury: a compli- and motor skills of patients with chronic kidney phisticated and expensive equipment. ABREOC. cation of ultrasound guided interscalene block. Br disease, stage 5 (K/DOQI). Although EOLAB operates in different parts of J Anaesth. 2013; 111(5); 840-841. Lead investigators: O. Giannini, D. Zemp, C. Canton Ticino, it is centralized from a technical, Peer reviewed publications in 2013 Cereghetti, M. Tettamanti, P. Quadri. scientific and administrative point of view, thus giv- Giovanella L, Verburg FA, Imperiali M, Valabrega 3.7 Geriatric Service ing the Department its unified image. This form of S, Trimboli P, Ceriani L. Comparison of serum cal- Pierluigi Quadri MD The purpose of this study is to assess the organization also offers greater potential for a ra- citonin and procalcitonin in detecting medullary Coordinator of the EOC Geriatric Service changes in the degree of autonomy and overall tional development. The Department is the result thyroid carcinoma among patients with thyroid mobility that accompany the entry into dialysis of an innovative project, which has also aroused nodules. Clin Chem Lab Med. 2013;51(7):1477- The EOC Geriatrics Service, which is present in the and to highlight any risk factors associated interest outside Ticino Canton, and can be consid- 1481. Regional Hospitals of Lugano, Bellinzona and Valli, with altered strategies of postural control and ered one of the major public institutions of medical Mendrisio and Locarno, offers a multidisciplinary walking, the fragility of patients and/or dialysis analysis in Switzerland. Giovanella L, Imperiali M, Verburg FA, Ceriani L. approach with specialist day clinics and wards to treatment, which are likely to affect the degree Evaluation of the BRAHMS Kryptor(®) thyroglobu- assess and intervene at an early stage, or prevent of mobility and autonomy in everyday life, con- Main areas of research lin mini recovery test in patients with differenti- these geriatric problems. trol of balance and gait, as well as the risk of Studio marcatori biochimici tiroidei (Study of thy- ated thyroid carcinoma. Clin Chem Lab Med. The Service also operates in a network together falling. roid biochemical markers). 2013;51(2):449-453. with other local dedicated geriatric structures. Lead investigators: M. Imperiali and L. Giovanella • A longitudinal and observational registry of pa- (EOC Nuclear Medicine Service and PET/CT Centre). 3.6 Anaesthesiology Services 3.7.1 Sottocenerino Geriatric Service, tients with memory disorders (Ticino Canton Anaesthesiology Service – Regional Hospital of Lugano and Mendrisio Study) in the Sottocenerino Geriatriacs Service Thyroid carcinoma is the most frequent endocrine Regional Hospital of Bellinzona and Valli Pierluigi Quadri MD day clinics. tumour. 90% of thyroid carcinoma is represented Luciano Anselmi MD Head of Service by papillary and follicular carcinoma that are com- Head Doctor This is a database of patients with balance mon defined as differentiated thyroid carcinomas Main areas of research disorders and gait abnormalities and/or with (DTC). The following studies are currently underway, the a history of falls assessed anamestically, func-

78 Scientific Report 2013 3. EOC Multisite Departments and Services 79 tionally and using quantitative tools. center study: Peer reviewed publications in 2013 Dell'Utri C, Vijaya G, Khullar V. Prevalence of pubo- Ovarian function after routine removal of the Digesu GA, Derpapas A, Hewett S, Tubaro A, Puc- visceral muscle avulsion in a general gynecology Main funding fallopian tubes subsequent to the hysterec- cini F, Fernando R, Khullar V. Does the onset or cohort: a computed tomography (CT) study. Neu- ABREOC, Fondo per la Ricerca Geriatrica (Fund tomy. bother of mixed urinary incontinence symptoms rourol Urodyn. 2013;32(4):359-62. for Geriatric Research) of the Regional Hospital of Lead investigator: M. Müller (Gynaecology and help in the urodynamic diagnosis? Eur J Obstet Gy- Mendrisio. Obstetrics Service of the UNISPITAL of Berna) necol Reprod Biol. 2013;171(2):381-4. 3.9 Radiology Services Contact person for Ticino Canton: C. Polli. Radiology Service – 3.8 Gynaecology and Obstetrics Services Digesu GA, Sadenghi P, Sharma S, Puccini F, Tu- Regional Hospital of Lugano The Services of Gynaecology and Obstetrics are a • Study of the enrichment techniques of the fat baro A, Fernando R, Khullar V. The importance of Filippo Del Grande MD point of reference for women's health and guar- transplantation with Stromal Vascular Fraction cystoscopy and bladder biopsy in women with re- Head Doctor antee a service for women during pregnancy and in oncoplastic breast surgery: clinical trial. fractory overactive bladder: the urogynaecologist's childbirth. It also deals with urogenital dysfunctions Lead investigators: T. Gyr, C. Calabrese, M. De point of view? Eur J Obstet Gynecol Reprod Biol. Main areas of research and breast pathologies. The Breast Cancer Centre Monti, F. Meani, V. Vitale, V. Albertini, O. Pagani 2013;169(2):408-11. • In collaboration with Johns Hopkins Hospital, of Southern Switzerland (CSSI), which is present in and A. Costa. Baltimore, USA: the Regional Hospitals of Bellinzona and Valli and Bhide AA, Cartwright R, Khullar V, Digesu GA. Bio- SPACE project: technical evaluation with 3 Te- Lugano, was specifically set up in 2004 to deal Gynaecology and Obstetrics Service – markers in overactive bladder. Int Urogynecol J. sla MRI of SPACE sequences of the peripheral with breast pathologies. Regional Hospital of Mendrisio (OBV) 2013;24(7):1065-72. joints. Giorgio Caccia MD Gynaecology and Obstetrics Service – Head Doctor Bhide AA, Puccini F, Khullar V, Elneil S, Digesu • In collaboration with University Hospital Zürich, Regional Hospital of Lugano GA. Botulinum neurotoxin type A injection of the Switzerland: Thomas Gyr MD Main areas of research pelvic floor muscle in pain due to spasticity: a re- LSOS: Multicentric imaging evaluation of spinal Head Doctor Collaboration with the Neurocenter of Southern view of the current literature. Int Urogynecol J. canal stenosis. Switzerland in the field of neuro-urological disor- 2013;24(9):1429-34. Main areas of research ders, specialist diagnostics (video urodynamics) • In collaboration with Balgrist University clinic, • Participation in the following prospective multi- and treatment, particularly with PTNS. Derpapas A, Digesu AG, Hamady M, Gallo P, Zürich, Switzerland: SEMAC project: WARP imag-

80 Scientific Report 2013 3. EOC Multisite Departments and Services 81 ing evaluation in patients with knee replacement. Imaging: Explanation and Tips for Radiologists". to local Paclitaxel delivery without initial photoa- van den Berg JC. Three-dimensional image over- blative atherectomy. lay to assist endovascular procedures. VDM. Several sports imaging projects are currently un- • Del Grande F, D Dreizin D, Fayad LM. “3 Tesla Primary outcome is Target Lesion Percent Di- 2013;10:179-184. derway, in particular: Chemical Shift MR Imaging: Technique, Clinical ameter Stenosis (% DS) at 1 Year defined as • 3 T shoulder and elbow MR features in asymp- Utility and Pitfalls for Imaging the Skeleton”. the narrowest point of the target lesion divided Siclari F, Trunfio R, Moschovitis G, van den Berg tomatic baseball players. by the estimated native vessel diameter at that JC, Cassina T, Regazzoni S. Hybrid treatment of a Service of Interventional Radiology – location, as determined by the ACL. case of obliterative hepatocavopathy (Budd-Chiari • 3 T diagnostic accuracy for labral tear and par- Regional Hospital of Lugano syndrome). Ann Thorac Surg. 2013;96(3):1062- tial lesions of the supraspinatus. Josua C. van Den Berg MD • CIRCULATE study: Bone Marrow Derived Cell 1064. Head of Service Therapy in Peripheral Arterial Disease (Phase Peer reviewed publications in 2013 (selection) Most of the interventional activities include vascu- I/II study). Ferrarello S, Moccetti T, van den Berg JC, Pe- Cianfoni A, Pravatà E, De Blasi R, Tschuor CS, lar interventional radiology (including, for example, Trial Participants: JC. van den Berg, R. Ca- drazzini GB. Aortic root rupture with giant thoracic Bonaldi G. Clinical presentation of cerebral aneu- carotid arterial stenting and the positioning of en- nevascini, R. Rosso, H. Stricker, T. Moccetti, D. haematoma: transient improvement after percu- rysms. Eur J Radiol. 2013;82(10):1618-22. doprosthesis for abdominal aortic aneurysm). Sürder. taneous closure with ASD-amplatzer device. Eur Trial design: an open-labeled prospective feasi- Heart J. 2013 ;34(48):3706. Del Grande F, Carrino JA, Nagy P. Performance Main areas of research bility phase and a second phase in which pa- quality improvement projects in musculoskeletal • Participation in the following multicenter study: tients will be randomly assigned to an open- Radiology Service – radiology. J Am Coll Radiol. 2013;10(6):475-6. PHOTOPAC study: Photoablative Atherectomy labeled control group or will be treated with Regional Hospital of Bellinzona and Valli Followed by a Paclitaxel-Coated Balloon to In- VASASTIM. Prof. Rolf Wyttenbach MD Fayad LM, Mugera C, Soldatos T, Flammang A, hibit Restenosis in Instent Femoro-popliteal Primary Objective: to determine whether the Head Doctor Del Grande F. Technical innovation in dynamic Obstructions. administration of bone marrow-derived autolo- contrast-enhanced magnetic resonance imaging Co-lead investigators: T. Zeller (Department of gous progenitor cells (VASASTIM) reduces the Main areas of research of musculoskeletal tumours: an MR angiographic Angiology, Universitäts Herzzentrum Freiburg incidence of major amputations (defined as be- • Multi-parametric evaluation of liver perfusion sequence using a sparse k-space sampling strat- Bad Krozingen, Bad Krozingen, Germany), D. ing sited through or above the ankle joint) after by MR-Dwl under fasting and postprandial con- egy. Skeletal Radiol. 2013;42(7):993-1000. Scheinert (Centre of Vascular Medicine, Heart 1 year. ditions in healthy volunteers: correlation with Centre Leipzig/Park Hospital, Leipzig, Germany). Secondary Objectives: to determine the inci- quantitative phase-contrast portal venous flow Chhabra A, Del Grande F, Soldatos T, Chalian M, Participating centres: Bad Krozingen, Leipzig, dence of minor amputations (sited more distal measurements. Belzberg AJ, Williams EH, Jalali FS, Thawait GK, Bern and Lugano. than the ankle joint), changes in the number Lead investigator: R. Wyttenbach. Eng J, Carrino JA. Meralgia paresthetica: 3-Tesla and extent of leg ulcers, resolution of rest pain Collaborators: F. Regini, S. Colagrande of the magnetic resonance neurography. Skeletal Radiol. This is a prospective, two-arm randomized or improvement of pain free walking distance, University Hospital Careggi of Florence. 2013;42(6):803-808. study. The control cohort (PTX PTA group, improvement of ankle-brachial index (ABI) and Inpact Admiral or Inpact Pacific, Medtronic- transcutaneous oxygen pressure (TcPO2). The purpose of the current study is to verify in Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Invatec) is treated with a PTX-coated PTA vivo, the bi-exponential model of signal decay Del Grande F, Chalian M, Carrino JA. High-resolu- balloon. The experimental cohort (Laser + Main funding in diffusion weighted imaging (DWI) measur- tion 3T MR neurography of the brachial plexus and PTX PTA group) is treated with photoablative “PHOTOPAC study”: funding from Universitäts Her- ing apparent (ADC), slow (D), fast diffusion co- its branches, with emphasis on 3D imaging. AJNR atherectomy, followed by a PTX-coated PTA zzentrum Freiburg Bad Krozingen (Bad Krozingen, efficients (D*) and perfusion fraction (PF) of Am J Neuroradiol. 2013;34(3):486-497. balloon. Subjects matching with the definitions Germany); healthy liver parenchyma in volunteers (n=40) of Rutherford Clinical Categories 1 to 5 with “CIRCULATE study”: funding from EOC and co-fi- both under fasting and post-prandial condi- Awards 2013 instent lesions located in superficial femoral nancing with Cardiocentro Ticino. tions. These DWI measurements are correlat- The following posters, presented at the Annual artery and the popliteal artery above the knee ed to Phase-Contrast (PC) flow measurements Meeting of Radiological Society of North America joint, are eligible for enrollment. Peer reviewed publications in 2013 (selection) using high-field (3 Tesla) Magnetic Resonance (RSNA 2013, Chicago, USA, 1-6 December 2013) The purpose of this feasibility study is to evalu- van den Berg JC. Laser debulking and drug-eluting Imaging in the portal vein in both conditions. were awarded a Certificate of merit: ate the safety and effectiveness of preparing balloons for in-stent restenosis: a light at the end In a second step, the results of this study may • Del Grande F, Santini F, Edelstein WA, Carrino an instent lesion with photoablative atherec- of the tunnel? J Endovasc Ther. 2013;20(6):815- have possible clinical applications in patients J. "Radiofrequency Coils for Musculoskeletal MR tomy prior to local Paclitaxel delivery compared 818. with pathological conditions of the liver involv-

82 Scientific Report 2013 3. EOC Multisite Departments and Services 83 ing perfusional changes, such as fibrosis/cir- man carotid atherosclerosis. rhosis. Lead investigators: A. Gallino, R. Wyttenbach, D. Staub of University of Basel and C. Yuan of • Differences of plaque phenotypes in the carotid the Washington University of Seattle (USA). and femoral arteries: an in vivo study using MRI plaque imaging. This project is a continuation of over 10 years Lead investigators: R. Wyttenbach together of research on progression of atherosclerosis with T. Saam of the University of Grosshadern performed at our Cardiovascular Research in Munich (D) Centre and the Department of Radiology. The Collaborators: A. Helck of the University of study is aimed at evaluating the role of plaque Grosshadern in Munich (D) and C. Yuan of the neo-vascularisation in the progression of ather- Washington University of Seattle (USA). osclerosis at the level of the carotid artery. The investigation is a joint project between the Car- The aim of the study is to evaluate differences diovascular Research Centre, the Radiology in plaque composition and morphology within Division of the Regional Hospital of Bellinzona the same patient in different vascular beds us- and Valli, and the Vascular Research Labora- ing non-invasive MR-plaque imaging. tory of Prof. C. Yuan, Washington University, 28 patients (67.8± 7.4 years, 8 females) with Seattle, USA. The project is also performed in high Framingham general cardiovascular dis- cooperation with Prof. Daniel Staub, Chief of ease 10-year risk score and mild-to-moderate the Vascular Division at University Hospital in atherosclerosis were consecutively included in Basel. Almost 40 patients have been screened ation of the vascular disrupting agent ombrabulin the study. All subjects underwent a dedicated as possible candidates for this prospective (AVE8062) in patients with advanced solid tumour. MRI-plaque imaging protocol using TOF- and study. Several technical issues for performing Clin Cancer Res. 2013; 19(17):4832-42. T1w and T2w black-blood-sequences with fat dynamic assessment of plaque vascularisation suppression (1.5 T). The scan was centred in order to obtain top images, are now under- Alerci M, Giamboni A, Wyttenbach R, Porretta on the carotid bulb of the carotid and on the going with double check with the Institution for AP, Antonucci F, Bogen M, Toderi M, Guerra A, most stenotic lesion of the femoral arteries, Atherosclerosis imaging in Seattle. Sartori F, Tutta P, Inglese L, Limoni C, Gallino A, respectively. Plaques were classified accord- Von Segesser LK. Endovascular abdominal aneu- ing to the American Heart Association lesion Main funding rysm repair and impact of systematic preopera- type classification and area measurements of “Multi-parametric evaluation of liver perfusion by tive embolization of collateral arteries: endoleak lumen, wall and the major plaque components, MR-Dwl under fasting and postprandial conditions analysis and long-term follow-up. J Endovasc Ther. such as calcification, necrotic core and haem- in healthy volunteers: correlation with quantita- 2013; 20(5):663-71. orrhage were determined in consensus by two tive phase-contrast portal venous flow measure- blinded reviewers using dedicated software ments”: ABREOC. (MR Plaque View, VP Diagnostics, Seattle, “Plaque Neovascularization: assessment by Con- USA). Plaque components were recorded as trast Ultrasounds and plaque magnetic resonance maximum percentages of the wall area. (HR-MRI): In vivo comparison in human carotid ath- Clinical relevance statement: the ability of in erosclerosis”: Grant SHS (Schweizerische Herzstif- vivo MRI to display plaque composition across tung). distinct vascular beds might help improve risk stratification in patients with atherosclerosis. Peer reviewed publications 2013 Sessa C, Lorusso P, Tolcher A, Farace F, Lassau • Plaque Neovascularization: assessment by N, Delmonte A, Braghetti A, Bahleda R, Cohen P, Contrast Ultrasounds and plaque magnetic Hospitel M, Veyrat-Follet C, Soria JC. Phase I safe- resonance (HR-MRI): In vivo comparison in hu- ty, pharmacokinetic and pharmacodynamic evalu-

84 Scientific Report 2013 3. EOC Multisite Departments and Services 85 4 Swiss Clinical Trial Organization 4. Swiss Clinical Trial Organization

The Swiss Clinical Trial Organization (Organizzazi- 4.1 EOC Clinical Trial Unit (CTU-EOC) Collaborators The services provided were: study design and statisti- one svizzera di ricerca clinica or SCTO) is the cen- In 2013 Mrs. Irene Corradino was hired as a Medi- cal analysis in 12 cases, monitoring in 5, documents tral platform for cooperation in patient-oriented General introduction cal Writer to replace Dr. Liliane Petrini who had review in 5, eCRF preparation in 5, data entry in 3. clinical research in Switzerland. Its main objective In February 2012, the EOC Board of Directors resigned. Monitoring is to make Swiss clinical research more competi- approved the setup of the EOC Clinical Trial Unit Five contracts were signed. tive as regards innovation and quality. (CTU-EOC) to offer qualified support to research- Activities ers, both within and outside the EOC, carrying out The CTU provides the following services: project Other activities The SCTO intends to achieve this through: clinical trials and supporting them in all activities management, implementation and coordination of Training –– promoting a culture of studies and high quality related to clinical research. The CTU-EOC provides clinical studies, preparation of documents including In 2013, the CTU-EOC organized a course in Good of care at a national level; services for the carrying out of observational and protocols, safety reports and manuscripts, prepa- Clinical Practice, module 1 in May and, respective- –– supporting the creation of a national network; interventional studies. ration and submission of documents to competent ly, module 2 in November, a course on biostatis- –– promoting the integration of national clinical re- The CTU-EOC is similar to the other CTUs in Swit- authorities, registration in a public database, moni- tics, divided in 2 separate sessions, and a course search in international networks; zerland and collaborates with the Clinical Trial Cen- toring, preparation of eCRF and data entry. on medical writing. –– building bridges between academia, industry tre of the University Hospital of Zürich. and the public authorities. Projects Clinical Research Day Functional Units The Project Manager is responsible for all re- The CTU-EOC organized the third Clinical Research The SCTO generally promotes favourable condi- The CTU-EOC is a two-centre structure led by a quests for the supply of services. Day which was held in Lugano on 22 March 2013. tions in the field of clinical research and coordi- Steering Committee. One centre is located at In 2013, 21 projects were started, 19 of which nates multicenter studies byacting as an interme- Regional Hospital of Bellinzona and Valli (San Gio- were proposed by collaborators of EOC and 2 by Intra/internet website diary between different studies. vanni) (Director: Prof. Sessa); the other at Regional external companies. Projects were in the fields of The CTU-EOC is present on the EOC’s intra- and in- The SCTO is a joint initiative of the Swiss National Hospital of Lugano (Director Prof. Kaelin). In spe- oncology, neurology, intensive care and internal ternet, where the aims of the unit and the services Fund (FNS) and the Swiss Academy of Medical Sci- cific cases, the CTU-EOC requests the opinion of medicine. it offers are described. ences (ASSM). the Scientific Committee.

88 Scientific Report 2013 4. Swiss Clinical Trial Organization 89 5 Scientific Research Advisory Board (ABREOC) 5. Scientific Research Advisory Board (ABREOC)

The Scientific Research Advisory Board of the EOC ABREOC has the following specific tasks: The Members of ABREOC are as follows: • Prof. Raffaele Rosso MD, Head of the EOC’s Sur- (ABREOC) was set up in October 2007 as an ad- a. propose general guidelines for the research to • Fabrizio Barazzoni MD, MPH, Head Officer of gery Department, Regional Hospital of Lugano; visory body and to coordinate the research in EOC be carried out in the hospitals, taking into ac- the EOC and Medical Area, Chairman; • Manuela Sarti MD, Oncology Specialist, ABRE- hospitals. count local interests, competences, initiatives • Colette Balice, MSc, Specialist Nurse and Sci- OC Secretary, EOC Medical Area. ABREOC is aimed at improving knowledge in the and activities; entific Collaborator of EOC Nursing Area; medical and nursing fields by: b. identify the sectors or new areas in which to • Prof. Enos Bernasconi MD, Deputy-Head of In- Between 2008 and 2013, 62 of the 101 clinical • favouring research within the EOC; promote or continue research; ternal Medicine, Regional Hospital of Lugano; and translational studies submitted to the EOC’s • promoting collaboration with both national and c. create the necessary general conditions to fos- • Prof. Franco Cavalli MD, Scientific Director of Scientific Research Advisory Board were funded international research institutions; ter research; the IOSI, Bellinzona; by the Scientific Fund. • encouraging the creation of research centres d. provide an assessment of the scientific value • Paola Di Giulio, member of the professional in specific sectors; of research projects for which EOC funding is skills teaching staff (SUPSI) at the Department The projects that received funding are listed in the • creating the right conditions for the greatest requested, paying special attention to how the of Health (DSAN); table attached to the “Report” (Appendices 1, 2, 3, possible integration between research and its project fits in with the EOC’s vision and mission; • Prof. Augusto Gallino MD, Head of the EOC’s In- 4 and 5) with the state of progress indicated for clinical applications; e. inform, in line with the available budget, the ternal Medicine Department, Regional Hospital each project: either concluded (with a publication • encouraging interdisciplinary research. awarding of funding for research projects not of Bellinzona and Valli; or final report) or underway. covered by external funding; • Piergiorgio Mombelli MD, Consultant in Inter- ABREOC operates in accordance with the current f. fassess, when consulted by the EOC head of- nal Medicine, Regional Hospital of Locarno; The funds allocated by ABREOC since 2008, when legislation, taking into account the recommenda- fice or local management, the scientific value • Prof. Carsten Möller MD, Head of Neurology the first funding was awarded, are shown below: tions of the Swiss Academy of Medical Sciences of studies or scientific research not funded by Service, NSI, Regional Hospital of Lugano; ABREOC notices of competition 2008 – 2013 and the Canton’s Ethics Committee. The EOC’s the EOC and their consistency with the EOC’s • Alberto Pagnamenta MD, Head of Intensive medical staff may submit research projects requir- vision and mission; Care Medicine Service, Regional Hospital of No. projects submitted 101 ing funding to ABREOC to be carried out in EOC g. regularly collect from the Canton’s Ethics Com- Mendrisio; No. projects approved 62 hospitals. mittee all necessary information regarding the • Gian Paolo Ramelli MD PD, Head doctor of No. projects rejected 39 research authorized by and carried out within Paediatrics, Regional Hospital of Bellinzona and Total sum requested by researchers CHF 8,060,045 the EOC. Valli; Sum awarded CHF 2,781,147

92 Scientific Report 2013 5. Scientific Research Advisory Board (ABREOC) 93 6 The new Federal Act on research involving humans (HRA) and General Authorization for research studies granted to the EOC by the Berne Panel of Experts on Professional Confidentiality in Medical Research ics Committees, notifications and procedures; all Therefore, the General Authorization to disclose these aspects are regulated in detail in the imple- professional secrets for research studies car- menting ordinances. The HRA additionally envisag- ried out at EOC institutes (www.admin.ch/ch/i/ es an obligation for clinical trials to be registered, ff/2012/6191.pdf), granted by the Berne Panel data-protection provisions and criminal provisions. of Experts on Professional Confidentiality in Medi- cal Research on 7th May 2012, will remain valid One of the new principles in the legislation govern- until the expiration of May 2017. ing research involving humans is the classification of research projects on the basis of the risk to the Fabrizio Barazzoni, MPH, Head of the Medical Area individuals participating in them. The category of of the EOC Head Office, is in charge of EOC General research project (e.g. Category A, B or C clinical Authorization No. 035.0003-43. trials of drug products) determines the procedure which must be adopted and the requirement for This Authorization grants EOC medical staff per- documentation to be submitted with the applica- mission to access, under specific and binding con- tion, for liability guarantees and for notification. It ditions, non-anonymized patients’ personal data also releases the investigator from the obligation to carry out research in the fields of medicine or to apply to Swissmedic for approval for Category health care. 6. The new Federal Act on research involving humans (HRA) A clinical trials. The new legislation also foresees and General Authorization for research studies granted to an additional obligation to enter clinical trials in a As a result of this Authorization, non-anonymized the EOC by the Berne Panel of Experts on Professional publicly accessible register and the supplementary data can be accessed without being in breach of database operated by the Confederation. The new professional confidentiality. This is possible only Confidentiality in Medical Research law also allows investigators to apply for approval within EOC structures as the EOC is the holder of simultaneously to Swissmedic and to the compe- the Authorization. tent Ethics Committee, the latter acquiring the The article 118b of the Federal Constitution, which ceased individuals, embryos and foetuses in vivo status. Before a research project begins, every research- was approved by a 77.2% vote of the people on or which are the product of terminated pregnan- er involved in the project must sign a “Declaration 7th March 2010, invested the Confederation with cies or spontaneous abortions, biological material Furthermore, one of the provisions related to the concerning the obligation to respect confidential- increased powers to regulate research involv- or personal health-related data. Conversely, it nei- use of biological material and personal health data ity in medical research”, according to the “Regu- ing humans. This was the constitutional basis for ther apply to research projects involving embryos (Art. 34) specifically authorizes their use of the lations on access to patients’ data by staff of the the Federal Act on research involving humans in vitro, which are governed by the Federal Act on same terms as specified in the Article 321bis of Ente Ospedaliero Cantonale conducting research (HRA), which was adopted by Parliament on 30th Research Involving Embryonic Stem Cells, nor to the Penal Code (PC; CCFL (Classified Compilation studies” in order to start clinical studies that can- September 2011, and the associated ordinances research projects involving anonymized biological for Federal Law) 311.0), in case it is not possible not be carried out with the patient’s informed con- – the Ordinance on Human Research with the Ex- material or health-related data which have been to obtain the consent of the patients or to give the sent. ception of Clinical Trials (Human Research Ordi- collected anonymously or anonymized. The body of information to them on the right of opposition. The nance, HRO), the Ordinance on Clinical Trials in Hu- the HRA defines the general principles that must law gives to the cantonal ethics commissions the A detailed description of the studies carried out in man Research (Ordinance on Clinical Trials, ClinO) be observed in the course of research projects in- power to grant permission for the research (Art. 2013 at the EOC following the General Authoriza- and the Ordinance on Organisational Aspects of volving humans, such as the obligation to inform 45, annex 1, let. b, HRA). tion can be found in Appendix 6. the Human Research Act (HRA Organisation Ordi- participants and to obtain their free and informed The Panel of Experts on Professional Confidentiality nance, OrgO-HRA). These four pieces of legislation consent to participation. It also contains special in Medical Research terminated the task with the entered into force on 1st January 2014. provisions for specific types of research, such as entry into force of the HRA. As per authorization research involving individuals who are incapable of issued by the end of December 2013, the transi- This new Act applies to "research into human dis- judgement, research involving individuals in prison tional provision of the law (Art. 67, annex 3, HRA) eases and the structure and functioning of the and research involving deceased individuals. It also states that all (special and general) authorizations human body" (Art. 2 HRA) which is performed regulates in general terms questions relating to to disclose professional secrets for research stud- in Switzerland and involves living individuals, de- approvals granted by the cantonal Research Eth- ies, will remain valid until their expiration.

96 Scientific Report 2013 6. The new Federal Act on research involving humans (HRA) and General Authorization for research studies granted to the EOC by the 97 Berne Panel of Experts on Professional Confidentiality in Medical Research 7 Publications in 2013 Publications in peer-reviewed journals in 2013 Dell'Utri C, Vijaya G, Khullar V. Prevalence of pubovisceral muscle avulsion Anaesthesiology in a general gynecology cohort: a computed tomography (CT) study. Saporito A, Petri GJ, Sturini E, Borgeat A, Aguirre Neurourol Urodyn. 2013;32(4):359-362. IF JA. 2.674; Ranking 0.74. Safety and effectiveness of bilateral continuous sciatic nerve block for bilateral orthopedic foot Digesu GA, Derpapas A, Hewett S, Tubaro A, surgery: A cohort study. Puccini F, Fernando R, Khullar V. Eur J Anaesthesiol. 2013; 30: 1-6. IF 2.792; Does the onset or bother of mixed urinary Ranking 0.733. incontinence symptoms help in the urodynamic diagnosis? Saporito A, Lo Piccolo A, Franceschini D, Eur J Obstet Gynecol Reprod Biol. Tomasetti R, Anselmi L. 2013;171(2):381-384. IF 1.843; Ranking 0.569. Thoracic ultrasound confirmation of correct lung exclusion before one lung ventilation during Digesu GA, Sadenghi P, Sharma S, Puccini F, thoracic surgery. Tubaro A, Fernando R, Khullar V. 7. Publications in 2013 J Ultrasound. 2013;16(4):195-199. The importance of cystoscopy and bladder biopsy in women with refractory overactive bladder: the Saporito A, Sturini E. urogynaecologist's point of view? The scientific activity carried out within the EOC The Table below shows the number of peer-re- Incidence of postoperative delirium is high even in Eur J Obstet Gynecol Reprod Biol. Services in 2013 resulted in scientific publica- viewed articles published in 2013 for each Hos- a population without known risk factors. J Anesth. 2013;169(2):408-411. IF 1.843; Ranking 0.569. tions or communications. pital: 2013; Sep 26. IF 0.867; Ranking 0.267. Haematology EOC institution Number of More in detail there were: publications Saporito A. • 244 original articles published in peer-reviewed in 2013 Dorsal scapular nerve injury: a complication of Millard AL, Valli PV, Stussi G, Mueller NJ, Yung journals; The Regional Hospital of Lugano 36 ultrasounf guided interscalene block. GP, Seebach JD. • 12 books or chapters in books; The Regional Hospital of Bellinzona Br J Anaesth. 2013; 111(5); 840-841. IF 4.237; Brief Exercise Increases Peripheral Blood • 12 original articles published in non-peer-re- and Valli 45 Ranking 0.933. NK Cell Counts without Immediate Functional viewed journals; The Regional Hospital of Mendrisio 8 Changes, but Impairs their Responses to ex vivo • 175 communications at national and interna- Gynaecology Stimulation. The Regional Hospital of Locarno 3 tional conferences. Front Immunol. 2013;4:125. Oncological Institute of Southern Switzerland 96 Bhide AA, Cartwright R, Khullar V, Digesu GA. Neurocenter of Southern Biomarkers in overactive bladder. von Hohenstaufen KA, Conconi A, de Campos CP, Switzerland 56 Int Urogynecol J. 2013;24(7):1065-1072. IF Franceschetti S, Bertoni F, Margiotta Casaluci G, Total publications 244 2.169; Ranking 0.722. Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano G, Zucca E. Bhide AA, Puccini F, Khullar V, Elneil S, Digesu GA. Prognostic impact of monocyte count at Botulinum neurotoxin type A injection of the pelvic presentation in mantle cell lymphoma. floor muscle in pain due to spasticity: a review of Br J Haematol. 2013;162(4):465-473. IF 4.942; the current literature. Ranking 0.848. Int Urogynecol J. 2013;24(9):1429-1434. IF 2.169; Ranking 0.722. Lobetti-Bodoni C, Bertoni F, Stussi G, Cavalli F, Zucca E. The changing paradigm of chronic lymphocytic Derpapas A, Digesu AG, Hamady M, Gallo P,

100 Scientific Report 2013 7. Publications in 2013 101 leukemia management. impact of systematic preoperative embolization HIV cohort study. Sudano I, Corti R, Wyttenbach R. Eur J Intern Med. 2013;24(5):401-410. IF of collateral arteries: Single centre long-term J Acquir Immune Defic Syndr. 2013;64(5):472- Imaging non coronary atherosclerosis: a model to 2.049; Ranking 0.748. follow-up. 478. IF 4.653; Ranking 0.868. understand coronary artery disease in humans. J Endovasc Ther. 2013;20:663-671. IF 2.699; Cardiovascular Medicine. 2013;16:5-10. IF Mian M, Rinaldi A, Mensah AA, Rossi D, Ladetto Ranking 0.848. Di Valentino M, Muzzarelli S, Limoni C, Rigoli A, 2.657; Ranking 0.6. M, Forconi F, Marasca R, Uhr M, Stussi G, Kwee I, Barazzoni F, Pedrazzini G, Moccetti T, Gallino A. Cavalli F, Gaidano G, Zucca E, Bertoni F. Bartha I, Carlson JM, Brumme CJ, McLaren Second hand smoke, public smoking ban and Gamondi C, Galli N, Schönholzer C, Marone Large genomic aberrations detected by SNP PJ, Brumme ZL, John M, Haas DW, Martinez- acute myocardial infarction. C, Zwahlen H, Gabutti L, Bianchi G, Ferrier C, array are independent prognosticators of Picado J, Dalmau J, Lopez-Galindez C, Casado C, Cardiovascular Medicine 2013;16:29-34. IF Cereghetti C, Giannini O. a shorter time to first treatment in chronic Rauch A, Günthard HF, Bernasconi E, Vernazza P, 2.657; Ranking 0.6. Frequency and severity of pain symptom distress lymphocytic leukemia patients with normal FISH. Klimkait T, Yerly S, O’Brien SJ, Listgarten J, Pfeifer among patients with chronic kidney disease Ann Oncol. 2013;24(5):1378-84. IF 7.384; N, Lippert C, Fusi N, Kutalik Z, Allen TM, Müller V, Fenner L, Egger M, Bodmer T, Furrer H, Ballif M, receiving dialysis. Ranking 0.911. Harrigan PR, Heckerman D, Telenti A, Fellay J. Battegay M, Helbling P, Fehr J, Gsponer T, Rieder Swiss Med Wkly. 2013;143:w13750. IF 1.821; A genome-to-genome analysis of associations HL, Zwahlen M, Hoffmann M, Bernasconi E, Ranking 0.682. Intensive Care Medicine between human genetic variation, HIV-1 sequence Cavassini M, Calmy A, Dolina M, Frei R, Janssens diversity, and viral control. JP, Borrell S, Stucki D, Schrenzel J, Böttger EC, Huber X, Bernasconi E, Tschuor-Costa S, Rosso R. Domenighetti G. Elife. 2013;2:e01123. Gagneux S, Swiss HIV Cohort and Molecular Exceptional dissemination of perineal tuberculosis Hidden shortness of breath or the difficulty of Epidemiology of Tuberculosis Study Groups. up to the right flank: a tribute to J.P. early diagnosis of pulmonary hypertension. Beerenwinkel N, Montazeri H, Schuhmacher HIV Infection disrupts the sympatric host- Nesselrod’s study on the anatomy of pelvic Rev Med Suisse. 2013;9(371):225-226. H, Knupfer P, von Wyl V, Furrer H, Battegay M, pathogen relationship in human tuberculosis. lymphatics published in 1936 in the Annal of Hirschel B, Cavassini M, Vernazza P, Bernasconi PLoS Genet. 2013;9(3):e1003318. IF 8.517; Surgery. Pagnamenta A, Vanderpool R, Brimioulle S, Naeije R. E, Yerly S, Böni J, Klimkait T, Cellerai C, Günthard Ranking 0.93. Int J Colorectal Dis. 2013;28(5):723-726. IF Proximal pulmonary arterial obstruction H, the Swiss HIV Cohort Study. 2.238; Ranking 0.746. decreases the time constant of the pulmonary The individualized genetic barrier predicts Forni V, Bianchi G, Ogna A, Salvadé I, Vuistiner P, circulation and increases right ventricular treatment response in a large cohort of HIV-1 Burnier M, Gabutti L. Klimusina J, Porretta AP, Segatto JM, Facchini M, afterload. infected patients. Reticulocyte dynamic and hemoglobin variability Bomio F, Dominé F, Capoferri M, Foglia E, Gallino A. J Appl Physiol 2013; 114(11):1586-1592. IF PLoS Comput Biol 2013;9(8):e1003203. IF in hemodialysis patients treated with Darbepoetin Cardiac X syndrome: an overview of the literatur 3.484; Ranking 0.914. 4.867; Ranking 1. alfa and C.E.R.A.: a randomized controlled trial. and the local experience in Southern Switzerland. BMC Nephrol. 2013;14(1):157. IF 1.644; Cardiovascular Medicine. 2013;16:20-28. IF Wise RA, Anzueto A, Cotton D, Dahl R, Devins Caviezel S, Dratva J, Schaffner E, Teynor A, Ranking 0.452 2.657; Ranking 0.6. T, Disse B, Dusser D, Joseph E, Kattenbeck Baumstark M, Schindler C, de Groot E, Burdet L, S, Koenen-Bergmann M, Pledger G, Calverley Rothe T, Pons M, Gaspoz JM, Rochat T, Künzli N, Gallino A. Klimusina J, Rezzonico R, Sartori F, Mazzucchelli P; TIOSPIR Investigators (Domenighetti G.). Porbst-Hensch N, Scmidt-Trucksäss A. Beinarterienverschluss: Stopp der stillen L, Gallino A. Tiotropium Respimat inhaler and the risk of death Variability and reproducibility of carotid structural Gefahr! Eine öffentliche nationale Kampagne der An unusual case of systolic murmur and in COPD. and functional parameters assessed with schweizerischen Herzstiftung. recurrent syncopes. N Engl J Med. 2013;369(16):1491-1501. IF transcutaneous ultrasound - Results from the Schweizerische MedForum. 2013;13:18. Eur Heart J. 2013;34(44):3458. IF 14.097; 51.658; Ranking 1. SAPALDIA Cohort Study. Ranking 0.992. Atherosclerosis. 2013;231(2):448-455. IF Gallino A. Internal Medicine 3.706; Ranking 0.791. The challenge of cardiovascular research in the Lozano Becerra JC, Sieber R, Martinetti G, Costa province. (Editorial). ST, Meylan P, Bernasconi E. Alerci M, Giamboni A, Wyttenbach R, Porretta Conen A, Wang Q, Glass TR, Fux CA, Thurnheer Cardiovascular Medicine. 2013;16:3-4. IF 2.657; Infection of the central nervous system caused by APP, Antonucci F, Bogen M, Toderi M, Guerra A, MC, Orasch C, Calmy A, Bernasconi E, Vernazza Ranking 0.6. varicella zoster virus reactivation: a retrospective Sartori F, Tutta P, Inglese L, Limoni C, Gallino A, P, Weber R, Bucher HC, Battegay M, Fehr J. case series study. von Segesser L. Association of alcohol consumption and HIV Gallino A, Porretta AP, Bianda N, Di Valentino Int J Infect Dis. 2013;17(7):e529-534. IF 2.357; Endovascular abdominal aneurysm repair and surrogate markers in participants of the swiss M, Klimusina J, Santini P, Limoni C, Segatto JM, Ranking 0.441.

102 Scientific Report 2013 7. Publications in 2013 103 Lubomirov R, Arab-Alameddine M, Rotger M, Acute interstitial nephritis due to Leptospira Study. van den Berg JC. Fayet-Mello A, Martinez R, Guidi M, di Iulio J, grippotyphosa in the absence of Weil’s disease. The prevalence of erectile dysfunction and its Optimal technique for common femoral artery Cavassini M, Günthard HF, Furrer H, Marzolini Can J Infect Dis Med Microbiol. association with antiretroviral therapy in HIV- access. C, Bernasconi E, Calmy A, Buclin T, Decosterd 2013;24(1):e26-e28. IF 1.02; Ranking 0.172. infected men: the Swiss HIV Cohort Study. EVToday 2013;vol 1, no 1:58-61. LA, Csajka C, Telenti A and the Swiss HIV Cohort Antivir Ther. 2013;18(3):337-344. IF 3.073; Study. Siclari F, Trunfio R, Moschovitis G, van den Berg Ranking 0.724. Posabella A, Rosso R, Giovannacci L, van den Pharmacogenetics-based population JC, Cassina T, Regazzoni S. Berg JC. pharmacokinetic analysis of etravirine in HIV-1 Hybrid treatment of a case of obliterative Weber R, Ruppik M, Rickenbach M, Spoerri A, Covered stents in peripheral vascular aneurysms infected individuals. hepatocavopathy (Budd-Chiari syndrome). Furrer H, Battegay M, Cavassini M, Calmy A, and emergencies. Pharmacogenet Genomics 2013;23(1):9-18. IF Ann Thorac Surg. 2013; 96(3):1062-1064. IF Bernasconi E, Schmid P, Flepp M, Kovalska J, EVToday 2013;vol 1, no 5:18-23. 3.608; Ranking 0.802. 3.454; Ranking 0.929. Ledergerber B and the Swiss HIV Cohort Study (SHCS). Laboratory Medicine Menafoglio A, Di Valentino M, Segatto J-M, Uçkay I, Sax H, Gayet-Ageron A, Ruef C, Decreasing mortality and changing patterns of Siragusa P, Pezzoli R, Maggi M, Romano GA, Mühlemann K, Troillet N, Petignat C, Bernasconi causes of death in the Swiss HIV Cohort Study. Giovanella L, Imperiali M, Verburg FA, Ceriani L. Moschovitis G, Gallino A. E, Balmelli C, Widmer A, Boubaker K, Pittet D, HIV Med. 2013;14(4):195-207. IF 3.155; Evaluation of the BRAHMS Kryptor(®) Cardiovascular screening in young athletes: Swiss-NOSO network. Ranking 0.735. thyroglobulin minirecovery test in patients with controversies and feasibility. High proportion of healthcare-associated urinary differentiated thyroid carcinoma. Cardiovascular Medicine 2013;16:11-19. IF tract infection in the absence of prior exposure to Interventional Radiology Clin Chem Lab Med. 2013;51(2):449-453. IF 2.657; Ranking 0.6. urinary catheter: a cross-sectional study. 3.009; Ranking 0.871. Antimicrob Resist Infect Control. 2013;2(1):5. Ferrarello S, Moccetti T, van den Berg JC, Metzner KJ, Scherrer AU, Preiswerk B, Joss B, Pedrazzini GB. Giovanella L, Verburg FA, Imperiali M, Valabrega von Wyl V, Leeman C, Rieder P, Braun D, Grube von Wyl V, Klimkait T, Yerly S, Nicca D, Furrer Aortic root rupture with giant thoracic S, Trimboli P, Ceriani L. C, Kuster H, Böni J, Yerly S, Klimkait T, Aubert V, H, Cavassini M, Calmy A, Bernasconi E, Böni J, haematoma: transient improvement after Comparison of serum calcitonin and procalcitonin Furrer H, Battegay M, Vernazza P, Cavassini M, Aubert V, Günthard HF, Bucher HC, Glass TR; percutaneous closure with ASD-amplatzer device. in detecting medullary thyroid carcinoma among Calmy A, Bernasconi E, Weber R, Günthard H, the Swiss HIV Cohort Study. Eur Heart J. 2013 ;34(48):3706. IF 14.097; patients with thyroid nodules. Swiss HIV Cohort Study. Origin of minority drug- Adherence as a predictor of the development of Ranking 0.992. Clin Chem Lab Med. 2013;51(7):1477-1481. IF resistant HIV-1 variants in primary HIV-1 infection. class-specific resistance mutations: the Swiss HIV 3.009; Ranking 0.871. J Infect Dis. 2013;208(7):1102-1112. IF 2.357; Cohort Study. Siclari F, Trunfio R, Moschovitis G, van den Berg Ranking 0.441. PLoS One 2013;8(10):e77691.IF 3.73; Ranking JC, Cassina T, Regazzoni S. Neurology 0.882. Hybrid treatment of a case of obliterative Nüesch R, Wang Q, Elzi L, Bernasconi E, Weber hepatocavopathy (Budd-Chiari syndrome). Brusa L, Orlacchio A, Stefani A, Galati S, R, Cavassini M, Vernazza P, thurnheer MC, Calmy Wandeler G, Gsponer T, Bihl F, Bernasconi E, Ann Thorac Surg. 2013;96(3):1062-1064. IF Pierantozzi M, Iani C, Mercuri NB. A, Battegay M, Bucher HD, the Swiss HIV Cohort Cavassini M, Kovari H, Schmid P, Battegay M, 3.454; Ranking 0.929. Tetrabenazine improves levodopa-induced peak- Study. Calmy A, Egger M, Furrer H, Rauch A, Swiss HIV dose dyskinesias in patients with Parkinson's Risk of cardiovascular events and blood pressure Cohort Study. van den Berg JC. disease. control in hypertensive HIV-infected patients: Hepatitis B virus infection is associated with Laser debulking and drug-eluting balloons for in- Funct Neurol. 2013;28(2):101-105. IF 1.037; Swiss HIV Cohort Study (SHCS). impaired immunological recovery during stent restenosis: a light at the end of the tunnel? Ranking 0.132. J Acquir Immune Defic Syndr. 2013;62(4):396- antiretroviral therapy in the Swiss HIV Cohort J Endovasc Ther. 2013;20(6):815-818. IF 2.699; 404. IF 4.653; Ranking 0.868. Study. Ranking 0.848. Carducci F, Onorati P, Condoluci C, Di Gennaro G, J Infect Dis. 2013;208(9):1454-1458. IF 5.848; Quarato PP, Pierallini A, Sarà M, Miano S, Cornia Reynaldos Canton Migotto T, Balestra B. Ranking 0.941. van den Berg JC. R, Albertini G. Ein Fall von Mastitis non puerperalis. Three-dimensional image overlay to assist Whole-brain voxel-based morphometry study of Schweiz Med Forum 2013; 13(1920): 389-390. Wang Q, Young J, Bernasconi E, Cavassini M, endovascular procedures. children and adolescents with Down syndrome. Vernazza P, Hirschel B, Weber R, Furrer H, VDM. 2013;10:179-184. Funct Neurol. 2013;28(1):19-28. IF 1.037; Schmidhauser T, Curioni S, Bernasconi E. Stoeckle M, Bucher HC, Fux C. Swiss HIV Cohort Ranking 0.132.

104 Scientific Report 2013 7. Publications in 2013 105 Cereda CW, Tamisier R, Manconi M, Andreotti Scoring atonia during normal and pathological Gobbi C, Meier DS, Cotton F, Sintzel M, Leppert D, Metzger S, Walter C, Riess O, Roos RA, Nielsen J, Frangi J, Pifferini V, Bassetti CL. Endothelial rapid eye movement sleep: visual and automatic Guttmann CR, Zecca C. JE, Craufurd D, REGISTRY Investigators of the dysfunction and arterial stiffness in ischemic quantification methods. Interferon beta 1b following natalizumab European Huntington’s Disease Network, Nguyen stroke: the role of sleep-disordered breathing. Sleep Biol Rhythms. 2013;11(Suppl. 1):40-51. IF discontinuation: one year, randomized, HP. Stroke. 2013;44(4):1175-1178. IF 6.158; 1.052; Ranking 0.915. prospective, pilot trial. The V471A polymorphism in autophagy-related Ranking 0.946. BMC Neurol. 2013;13:101. IF 2.564; Ranking gene ATG7 modifies age at onset specifically in Fulda S. 0.6. Italian Huntington disease patients. Economou NT, Manconi M, Agazzi P, Bassetti CL. Gender differences in the prevalence of restless PLoS One. 2013;8(7):e68951. IF 3.73; Ranking Intrusion of rapid eye movement (REM) behavior legs syndrome/Willis Ekbom disease. Somnology. Gobbi C, Zecca C, Linnebank M, Müller S, You X, 0.882. disorder episodes into NREM sleep in a case of 2013;17:246-251. Meier R, Borter E, Traber M. Lewy body dementia. Swiss analysis of multiple sclerosis: a multicenter, Miano S, Donfrancesco R, Parisi P, Rabasco J, Sleep Med. 2013;14(1):122-124. IF 3.487; Frohnhofen H, Fulda S, Frohnhofen K, Popp R. non-interventional, retrospective cohort study of Mazzotta AR, Tabarrini A, Vitelli O, Villa MP. Ranking 0.789. Validation of the Essener Questionnaire of disease-modifying therapies. Case reports of sleep phenotypes of ADHD: from Age and Sleepiness (EQAS) in the elderly using Eur Neurol. 2013;70(1-2):35-41. IF 1.5; Ranking hypothesis to clinical practice. Esposito M, Parisi P, Miano S, Carotenuto M. pupillometry. 0.33. J Atten Disord. 2013;17(7):565-573. IF 2.163; Migraine and periodic limb movement disorders Adv Exp Med Biol. 2013;755:125-132. IF 1.825; Ranking 0.662. in sleep in children: a preliminary case-control Ranking 0.646. Hubers AA, van Duijn E, Roos RA, Craufurd D, study. Rickards H, Landwehrmeyer BG, van der Mast Miano S, Peraita-Adrados R. J Headache Pain. 2013;14:57. IF 2.779; Ranking Frohnhofen H, Popp R, Frohnhofen K, Fulda S. RC, Giltay EJ, REGISTRY investigators of the [Nocturnal frontal lobe epilepsy is often 0.643. Impact of daytime sleepiness on rehabilitation European Huntington’s Disease Network. misdiagnosed as sleep disorders in children: a outcome in the elderly. Suicidal ideation in a European Huntington's case series]. Ferri R, Fulda S, Manconi M, Högl B, Ehrmann L, Adv Exp Med Biol. 2013: 755: 103-110. IF disease population. Rev Neurol. 2013;56(5):257-267. IF 1.179; Ferini-Strambi L, Zucconi M. 1.825; Ranking 0.646. J Affect Disord 2013;151(1):248-258. IF 3.295; Ranking 0.211. Night-to-night variability of periodic leg movements Ranking 0.787. during sleep in restless legs syndrome and Galati S, Städler C. Miano S, Tabarrini A, Vitelli O, Mazzotta A, Del periodic limb movement disorder: comparison Schizophrenia symptoms relieved by CO-induced Hutchison WD, Galati S. Pozzo M, Rabasco J, Barreto M, Parisi P, Ferretti between the periodicity index and the PLMS index. pallidal lesion: a case report. Introduction to Festschrift/special issue: A, Villa MP. Sleep Med. 2013;14(3):293-296. IF 3.487; J Neuropsychiatry Clin Neurosci. normal and abnormal neuronal oscillations in The cooccurrence of interictal discharges and Ranking 0.789. 2013;25(2):E52-53. IF 2.397; Ranking 0.64. sensorimotor pathways. seizures in pediatric sleep-disordered breathing. Exp Neurol. 2013;245:1-4. IF 4.645; Ranking Epilepsy Behav. 2013; 29(3):508-512. IF 1.844; Ferri R, Manconi M, Aricò D, Punjabi NM, Zucconi M. Galati S, Di Giovanni G. 0.816. Ranking 0.539. Experimentally induced arousals do not elicit Intracerebral human microdialysis in Parkinson's periodic leg motor activity during sleep in normal disease. Maestri M, Giorgi FS, Pizzanelli C, Fabbrini M, Orban G, Pierucci M, Benigno A, Pessia M, Galati subjects. Neuromethods 2013;75:209-223. Di Coscio E, Carnicelli L, Iacopini E, Manconi M, S, Valentino M, Muscat R, Di Giovanni G. Sleep Med. 2013;14(1):85-90. IF 3.487; Ranking Iudice A, Galli R, Bonanni E. High dose of 8-OH-DPAT decreases maximal 0.789. Garcia-Borreguero D, Kohnen R, Silber MH, Daytime sleepiness in de novo untreated patients dentate gyrus activation and facilitates granular Winkelman JW, Earley CJ, Högl B, Manconi M, with epilepsy. cell plasticity in vivo. Fulda S, Kloiber S, Dose T, Lucae S, Holsboer F, Montplaisir J, Inoue Y, Allen RP. Epilepsy Behav. 2013;29(2):344-348. IF 1.844; Exp Brain Res. 2013;230(4):441-451. IF 2.221; Schaaf L, Hennings J. The long-term treatment of restless legs Ranking 0.539. Ranking 0.335. Mirtazapine provokes periodic leg movements syndrome/Willis-Ekbom disease: evidence-based during sleep in young healthy men. guidelines and clinical consensus best practice Manconi M, Fulda S. Paganetti P, Reichwald J, Bleckmann D, Sleep. 2013;36(5):661-669. IF 5.1; Ranking guidance: a report from the International Restless Restless legs syndrome in the emergency room. Abramowski D, Ammaturo D, Barske C, Danner S, 0.914. Legs Syndrome Study Group. Eur J Neurol. 2013;20(2):e36. IF 1.5; Ranking Molinari M, Müller M, Papin S, Rabe S, Schmid P, Sleep Med. 201314(7):675-684. IF 3.487; 0.33. Staufenbiel M. Fulda S, Plazzi G, Ferri R. Ranking 0.789. Transgenic expression of β1 antibody in brain

106 Scientific Report 2013 7. Publications in 2013 107 neurons impairs age-dependent amyloid Exp Neurol 2013;247:730-736. IF 4.645; Videnovic A, Oertel W. 2013;164(6):212–214. deposition in APP23 mice. Ranking 0.816. Rapid eye movement sleep behavior disorder: Neurobiol Aging. 2013;34(12):2866-2878. IF devising controlled active treatment studies for Unger MM, Ekman R, Björklund AK, Karlsson 6.166; Ranking 1. Querin G, D'Ascenzo C, Peterle E, Ermani M, symptomatic and neuroprotective therapy - a G, Andersson C, Mankel K, Bohne K, Tebbe JJ, Bello L, Melacini P, Morandi L, Mazzini L, Silani V, consensus statement by the International Rapid Stiasny-Kolster K, Möller JC, Mayer G, Kann PH, Papassotiropoulos A, Gerhards C, Heck A, Raimondi M, Mandrioli J, Romito S, Angelini C, Eye Movement Sleep Behavior Disorder Study Oertel WH. Ackermann S, Aerni A, Schicktanz N, Auschra B, Pegoraro E, Sorarù G. Group. Unimpaired postprandial pancreatic polypeptide Demougin P, Mumme E, Elbert T, Ertl V, Gschwind Pilot trial of clenbuterol in spinal and bulbar Sleep Med. 2013;14(8):795-806. IF 3.487; secretion in Parkinson’s disease and REM sleep L, Hanser E, Huynh KD, Jessen F, Kolassa IT, muscular atrophy. Ranking 0.789. behavior disorder. Milnik A, Paganetti P, Spalek K, Vogler C, Muhs A, Neurology. 2013;80(23):2095-2098. IF 8.249; Mov Disord. 2013;28(4):529-533. IF 4.558; Pfeifer A, de Quervain DJ. Human genome-guided Ranking 0.962. Silber MH, Becker PM, Earley C, Garcia- Ranking 0.876. identification of memory-modulating drugs. Borreguero D, Ondo WG; Medical Advisory Proc Natl Acad Sci U S A. 2013;110(46):E4369- Querin G, Melacini P, D'Ascenzo C, Morandi Board of the Willis-Ekbom Disease Foundation Villa MP, Paolino MC, Castaldo R, Vanacore N, 4374. IF 9.737; Ranking 0.941. L, Mazzini L, Silani V, Romito S, Mandrioli J, (Silber MH, Becker PM, Buchfuhrer MJ, Earley Rizzoli A, Miano S, Del Pozzo M, Montesano M. Raimondi M, Pegoraro E, Sorarù G. CJ, Garcia-Borreguero D, Hensley JG, Högl B, Sleep clinical record: an aid to rapid and Papoff P, Guelfi G, Cicchetti R, Caresta E, Cozzi No evidence of cardiomyopathy in spinal and Manconi M, Ondo W, Picchietti D, Rana AQ, accurate diagnosis of paediatric sleep disordered DA, Moretti C, Midulla F, Miano S, Cerasaro C, bulbar muscular atrophy. Walters AS). breathing. Cascone P. Acta Neurol Scand. 2013;128(6):e30-2. IF Willis-Ekbom Disease Foundation revised Eur Respir J. 2013;41(6):1355-1361. IF 6.355; Outcomes after tongue-lip adhesion or mandibular 2.474; Ranking 0.573. consensus statement on the management of Ranking 0.96. distraction osteogenesis in infants with Pierre restless legs syndrome. Robin sequence and severe airway obstruction. Salminen AV, Manconi M, Rimpilä V, Luoto Mayo Clin Proc. 2013;88(9):977-986. IF 5.79; Yesilot Barlas N, Putaala J, Waje-Andreassen Int J Oral Maxillofac Surg. 2013;42(11):1418- TM, Koskinen E, Ferri R, Ohman J, Polo O. Ranking 0.934. U, Vassilopoulou S, Nardi K, Odier C, Hofgart G, 1423. IF 1.521; Ranking 0.627. Disconnection between periodic leg movements Engelter S, Burow A, Mihalka L, Kloss M, Ferrari and cortical arousals in spinal cord injury. Stefani A, Marzetti F, Pierantozzi M, Petrucci S, J, Lemmens R, Coban O, Haapaniemi E, Maaijwee Philip P, Chaufton C, Taillard J, Sagaspe P, Léger J Clin Sleep Med. 2013;9(11):1207-1209. IF Olivola E, Galati S, Bassi MS, Imbriani P, Valente N, Rutten-Jacobs L, Bersano A, Cereda CW, D, Raimondi M, Vakulin A, Capelli A. 2.928; Ranking 0.67. EM, Pastore FS. Baron P, Borellini L, Valcarenghi C, Thomassen L, Maintenance of Wakefulness Test scores and Successful subthalamic stimulation, but levodopa- Grau AJ, Palm F, Urbanek C, Tuncay R, Durukan driving performance in sleep disorder patients Sarikaya H, Mattle H, Michel P, Nedeltchev K, Kägi induced dystonia, in a genetic Parkinson's disease. Tolvanen A, van Dijk EJ, de Leeuw FE, Thijs V, and controls. G, Fischer U, Cereda CW, Sztajzel R, Fandino J, Neurol Sci. 2013;34(3):383-386. IF 1.412; Greisenegger S, Vemmos K, Lichy C, Bereczki D, Int J Psychophysiol. 2013;89(2):195-202. IF Nyffeler T, Luft A, Tettenborn B, Lyrer P, Arnold Ranking 0.303. Csiba L, Michel P, Leys D, Spengos K, Naess H, 2.036; Ranking 0.614. M. Tatlisumak T, Bahar SZ. Primärprävention des ischämischen Hirnschlags Stefani A, Peppe A, Galati S, Bassi MS, D'Angelo Etiology of First-Ever Ischemic Stroke in European Proenca CC, Stoehr N, Bernhard M, Seger S, – was hilft, was nicht? Teil 1: Konventionelle V, Pierantozzi M. Young Adults: the 15-Cities Young Stroke Study. Genoud C, Roscic A, Paganetti P, Liu S, Murphy Risikofaktoren. The serendipity case of the pedunculopontine Eur J Neurol. 2013;20(11):1431-1439. IF LO, Kuhn R, Bouwmeester T and Galimberti I. Forum Med Suisse 2013;13(49):999–1002. nucleus low-frequency brain stimulation: chasing 4.162; Ranking 0.838. Atg4b-dependent autophagic flux alleviates a gait response, finding sleep, and cognition Huntington’s disease progression. Schenck CH, Montplaisir JY, Frauscher B, Högl improvement. Neuroradiology PLoS One. 2013;8(7):e68357. IF 3.73; Ranking B, Gagnon JF, Postuma R, Sonka K, Jennum P, Front Neurol. 2013;4:68. 0.882. Partinen M, Arnulf I, Cochen de Cock V, Dauvilliers Cianfoni A, Caulo M, Cerase A, Della Marca G, Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring Tavarini F, Städler C, Valci L, Bassetti CL, Cereda Falcone C, Di Lella GM, Gaudino S, Edwards J, Prosperetti C, Di Giovanni G, Stefani A, Möller JC, F, Trenkwalder C, Unger M, Young P, Wing YK, CW. Colosimo C. Galati S. Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Favourable outcome after aggressive treatment Seizure-induced brain lesions: a wide spectrum Acute nigro-striatal blockade alters cortico- Inoue Y, Iranzo A, Santamaria J, Bassetti C, of a thrombolysis-associated intra-cerebral of variably reversible MRI abnormalities. Eur J striatal encoding: an in vivo electrophysiological Möller JC, Boeve BF, Lai YY, Pavlova M, Saper haemorrhage. Radiol. 2013; 82(11); 1964-1972. IF 2.512; study. C, Schmidt P, Siegel JM, Singer C, St Louis E, Swiss Archive of Neurology and Psychiatry Ranking 0.664.

108 Scientific Report 2013 7. Publications in 2013 109 Cianfoni A, Massari F, Dani G, Lena JR, Rumboldt Cardiovascular impairment in a patient with acute Nursing Medicine Ranking 0.648. Z, Vandergrift WA, Bonaldi G. myelitis. Percutaneous ethanol embolization and Spinal Cord. 2013;51(6):511-513. IF 1.899; Valcarenghi D, Pedrazzani C, Bianchi M. Caldarella C, Isgrò MA, Treglia G. cement augmentation of aggressive vertebral Ranking 0.796. To know to change: the nurses of the Oncology POEMS Syndrome: The Role of Positron Emission hemangiomas at two adjacent vertebral levels. Institute of Southern Switzerland (IOSI) and their Tomography-Computed Tomography using J Neuroradiol. 2013;200(3), 673-676. IF 1.237; Weininger M, Mills JC, Rumboldt Z, Bonaldi G, relationship with the Evidence based Practise Fluorine-18-Fluorodeoxyglucose (FDG PET-CT). Ranking 0.303. Huda W, Cianfoni A. Accuracy of CT guidance of (EBP) and Nursing Research. Professioni J Bone Marrow Res. 2013. doi: 10.4172/2329- lumbar facet joint block. Infermieristiche. 2013;66(3):159-167. 8820.1000e108. Cianfoni A, Pravatà E, De Blasi R, Tschuor CS, AJR Am J Roentgenol. 2013; 200(3); 673-676. Bonaldi G. IF 2.897; Ranking 0.773. Nuclear Medicine Caldarella C, Treglia G. Treatment Response Clinical presentation of cerebral aneurysms. Monitoring in Patients with Multiple Myeloma: Eur J Radiol. 2013; 82(10): 1618-1622. IF Neurosurgery Beheshti M, Treglia G, Zakavi RS, Langsteger W, The Role of Positron Emission Tomography- 2.512; Ranking 0.664. Ghodsi Rad MA, Dabbagh Kakhki VR, Sadeghi R. Computed Tomography using Fluorine-18- Mono ML, Steiger I, Findling O, Jung S, Reinert Application of (11) C-acetate positron-emission Fluorodeoxyglucose. De Simone M, Muccio CF, Pagnotta SM, Esposito M, Galimanis A, Kuhlen D, Beck J, El-Koussy M, tomography (PET) imaging in prostate cancer: J Bone Marrow Res. 2013;1:e103. G, Cianfoni A. Comparison between CT and MR Brekenfeld C, Schroth G, Fischer U, Nedeltchev K, systematic review and meta-analysis of the in perfusion imaging assessment of high-grade Mattle HP, Arnold M. literature. Castaldi P, Treglia G, Rufini V. gliomas. Radiol Med. 2013;118(1):140-151. IF Risk of very early recurrent cerebrovascular BJU Int. 2013;112(8):1062-1072. IF 3.046; Multifocal Head and Neck Paraganglioma 1.461; Ranking 0.445. events in symptomatic carotid artery stenosis. Ranking 0.808. Evaluated with Different PET Tracers: Comparison J Neurosurg. 2013;119(6):1620-1626. IF Between Fluorine-18-Fluorodeoxyglucose and Luigetti M, Cianfoni A, Servidei S, Mirabella M. 3.148; Ranking 0.898. Bertagna F, Treglia G. Gallium-68-Somatostatin Receptor PET/CT. Neurological picture. Bilateral thoracic long nerve Comment on Minamimoto: incidental focal FDG Nucl Med Mol Imaging. 2013:47:218-219. involvement in motor multifocal neuropathy. Mordasini P, Kraehenbuehl AK, Byrne JV, uptake in heart is a lighthouse for considering J Neurol Neurosurg Psychiatry, 84(5), 584. IF Vandenberghe S, Reinert M, Hoppe H, Gralla J. cardiac screening. Ceriani L, Treglia G, Paone G, Bongiovanni M, 4.924; Ranking 0.985. In vitro and in vivo imaging characteristics Ann Nucl Med. 2013;27(9):870-871. IF 1.41; Franscella S, Giovanella L. assessment of polymeric coils compared with Ranking 0.429. Unusual muscular metastases from papillary Luigetti M, Pravatà E, Bartalena T, Cianfoni A. standard platinum coils for the treatment of thyroid carcinoma detected by fluorine-18- An uncommon cause of headache resolution: intracranial aneurysms. Bianchi V, Spitale A, Ortelli L, Mazzucchelli L, fluorodeoxyglucose PET/MRI. spontaneous ventriculostomy in obstructive AJNR Am J Neuroradiol. 2013;34(11):2177- Bordoni A; QC3 CRC Working Group. J Clin Endocrinol Metab. 2013;98(6):2208- hydrocephalus. 2183. Quality indicators of clinical cancer care (QC3) in 2209. IF 6.43; Ranking 0.902. Headache. 2013;53(8):1356-1357. IF 2.937; colorectal cancer. Ranking 0.681. Stienen MN, Weisshaupt R, Fandino J, Fung C, BMJ Open. 2013;3(7). doi:10.1136/ Cistaro A, Treglia G, Pagano M, Fania P, Bova V, Keller E, Hildebrandt G, Studerus-Germann A, bmjopen-2013-002818 Basso ME, Fagioli F, Ficola U, Quartuccio N. Luigetti M, Pravatà E, Colosimo C, Sabatelli M, Müri R, Gutbrod K, Bläsi S, Monsch AU, Brugger IF 1.583; Ranking 0.609. A comparison between ¹8F-FDG PET/CT imaging Masciullo M, Capone F, Lo Monaco M, Monforte P, Mondadori C, Sailer M, Bijlenga P, Schaller and biological and radiological findings in M, Silvestri G, Ricci E, Pacciani E, Di Lazzaro V. K, Schatlo B; Swiss SOS study group (Fathi AR, Bongiovanni M, Paone G, Ceriani L, Pusztazeri M. restaging of hepatoblastoma patients. MRI neurography findings in patients with Winkler K, Woernle C, Bernays R, Daniel RT, Cellular and molecular basis for thyroid cancer Biomed Res Int. 2013;2013:709037. doi: idiopathic brachial plexopathy: correlations Levivier M, Baumann F, Ahlborn P, Seule M, imaging in nuclear medicine. 10.1155/2013/709037. IF 2.880. with clinical-neurophysiological data in eight Zumofen D, Mariani L, Roethlisberger M, D'Alonzo Clin Transl Imaging. 2013;1:149-161. consecutive cases. D, Raabe A, Chicherio C, Reinert M, Sacco L). Giovanella L. Intern Med. 2013; 52(18); 2031-2039. IF 0.087; Current practice in neuropsychological outcome Bongiovanni M, Piana S, Frattini M, Giovanella L, Letter to the editor: Lymph nodes thyroglobulin Ranking 0.04. reporting after aneurysmal subarachnoid Spitale A, Ragazzi M, Ciarrocchi A. measurement after rhTSH stimulation. Head haemorrhage. CDX2 expression in columnar variant of papillary Neck. 2013 Jan;35(1):146. IF 2.833; Ranking Profice P, Renna R, Pilato F, Sestito A, Infusino F, Acta Neurochir (Wien). 2013;155(11):2045- thyroid carcinoma. 0.955. Bruno I, Pravatà E, Di Lazzaro V. 2051. IF 1.546; Ranking 0.574. Thyroid. 2013;23(11):1498-1499. IF 3.544;

110 Scientific Report 2013 7. Publications in 2013 111 Giovanella L, Bongiovanni M, Trimboli P. 880. IF 5.114; Ranking 0.941. E, Bongiovanni M, Grassi P, Giovanella L, Gardini Slavikova K, Montravers F, Treglia G, Kunikowska Diagnostic value of thyroglobulin assay in cervical G, Piana S. J, Kaliska L, Vereb M, Talbot JN, Balogova S. lymph node fine-needle aspirations for metastatic Giovanella L, Verburg FA, Imperiali M, Valabrega Thyrotropin values in patients with micropapillary What is currently the best radiopharmaceutical differentiated thyroid cancer. S, Trimboli P, Ceriani L. thyroid cancer versus benign nodular disease. for the hybrid PET/CT detection of recurrent Curr Opin Oncol. 2013;25(1):6-13. IF 4.027; Comparison of serum calcitonin and procalcitonin Endocr Pract. 2013;19(4):651-655. IF 2.327; medullary thyroid carcinoma? Ranking 0.733. in detecting medullary thyroid carcinoma among Ranking 0.443. Curr Radiopharm. 2013;6(2):96-105. patients with thyroid nodules. Giovanella L, Ceriani L, Bongiovanni M. Clin Chem Lab Med. 2013;51(7):1477-1481. IF Paone G, Treglia G, Bongiovanni M, Ruberto T, Tehranian S, Treglia G, Krag DN, Dabbagh Kakhki Calcitonin measurement on fine needle washouts: 3.009; Ranking 0.871. Ceriani L, Giovanella L. VR, Zakavi SR, Sadeghi R, Keshtgar M. preanalytical issues and normal reference values. Incidental detection of Hürthle cell adenoma Sentinel node mapping in anal canal cancer: Diagn Cytopathol. 2013;41(3):226-229. IF Hassanzade M, Attaran M, Treglia G, Yousefi Z, by 18F-choline PET/CT scan in a patient with systematic review and meta-analysis. 1.487; Ranking 0.484. Sadeghi R. prostate cancer. J Gastrointestin Liver Dis. 2013;22(3):321-328. Lymphatic mapping and sentinel node biopsy in Rev Esp Med Nucl Imagen Mol. 2013;32(5):340- IF 1.855; Ranking 0.329. Giovanella L, Imperiali M, Verburg FA, Ceriani L. squamous cell carcinoma of the vulva: systematic 341. IF 0.863; Ranking 0.168. Evaluation of the BRAHMS Kryptor(®) review and meta-analysis of the literature. Treglia G, Annunziata S, Muoio B, Salvatori M, thyroglobulin minirecovery test in patients with Gynecol Oncol. 2013;130(1):237-245. IF 3.929; Quartuccio N, Treglia G, Salsano M, Mattoli MV, Ceriani L, Giovanella L. differentiated thyroid carcinoma. Ranking 0.944. Muoio B, Piccardo A, Lopci E, Cistaro A. The role of fluorine-18-fluorodeoxyglucose Clin Chem Lab Med. 2013;51(2):449-453. IF The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in aggressive 3.009; Ranking 0.871. Kakhki VR1, Shahriari S, Treglia G, Hasanzadeh M, positron emission tomography in staging and histological subtypes of thyroid cancer: an Zakavi SR, Yousefi Z, Kadkhodayan S, Sadeghi R. restaging of patients with osteosarcoma. overview. Giovanella L, Piccardo A, Paone G, Foppiani L, Diagnostic performance of fluorine 18 Radiol Oncol. 2013;47(2):97-102. IF 1.602; Int J Endocrinol. 2013;2013:856189. doi: Treglia G, Ceriani L. fluorodeoxyglucose positron emission tomography Ranking 0.236. 10.1155/2013/856189. Thyroid lobe ablation with iodine- ¹³¹I in patients imaging for detection of primary lesion and IF 2.518; Ranking 0.484. with differentiated thyroid carcinoma: a staging of endometrial cancer patients: Sadeghi R, Zakavi SR, Hasanzadeh M, Treglia G, randomized comparison between 1.1 and 3.7 systematic review and meta-analys is of the Giovanella L, Kadkhodayan S. Treglia G, Bertagna F. GBq activities. literature. Diagnostic performance of fluorine-18- Factors influencing the sensitivity of 18F-FDG Nucl Med Commun. 2013;34(8):767-770. IF Int J Gynecol Cancer. 2013;23(9):1536-1543. IF fluorodeoxyglucose positron emission tomography PET/CT in the detection of infective endocarditis. 1.379; Ranking 0.387. 1.941; Ranking 0.611. imaging in uterine sarcomas: systematic review Eur J Nucl Med Mol Imaging. 2013;40(7):1112- and meta-analysis of the literature. 1113. IF 5.114; Ranking, 0.941. Giovanella L, Suriano S, Lunghi L, Bongiovanni M, Khalesi M, Nakhaei A, Seyed AJ, Treglia G, Zakavi Int J Gynecol Cancer. 2013;23(8):1349-1356. IF Ceriani L. SR, Sadeghi R, Kianifar HR. 1.941; Ranking 0.611. Treglia G, Bertagna F, Piccardo A, Giovanella L. Radioguided surgery of thyroid carcinoma Diagnostic accuracy of nuclear medicine imaging 131I whole-body scan or 18FDG PET/CT for recurrences: the role of preoperative (99m)Tc- in protein losing enteropathy: systematic review Salsano M, Treglia G. patients with elevated thyroglobulin and negative labeled human serum albumin macroaggregates- and meta-analysis of the literature. PET imaging using radiolabeled antibodies: ultrasound? SPECT/CT mapping. Acta Gastroentero Belg. 2013;76(4):413-422. IF future direction in tumor diagnosis and correlate Clin Transl Imaging. 2013;1:175-183. Clin Nucl Med. 2013;38(4):e207-209. IF 2.955; 0.581; Ranking 0.082. applications. Ranking 0.79. Research and Reports in nuclear Medicine. Treglia G, Bertagna F, Sadeghi R, Verburg FA, Lococo F, Cafarotti S, Treglia G. 2013;3:9-17. Ceriani L, Giovanella L. Giovanella L, Trimboli P, Verburg FA, Treglia G, Is 18F-FDG-PET/CT really able to differentiate Focal thyroid incidental uptake detected by Piccardo A, Foppiani L, Ceriani L. between malignant and benign solitary fibrous Salvatori M, Treglia G, Perotti G, Giovanella L. ¹8F-fluorodeoxyglucose positron emission Thyroglobulin levels and thyroglobulin doubling tumor of the pleura? Iodine-131 administration and risk of cancer: tomography. Meta-analysis on prevalence and time independently predict a positive 18F-FDG Clin Imaging. 2013;37(5):976. IF 0.648; Ranking "appearances can be deceptive". malignancy risk. PET/CT scan in patients with biochemical 0.118. Hormones (Athens). 2013;12(2):312-314. IF Nuklearmedizin. 2013;52(4):130-136. IF 1.322; recurrence of differentiated thyroid carcinoma. 2.43. Ranking 0.345. Eur J Nucl Med Mol Imaging. 2013;40(6):874- Negro R, Valcavi R, Riganti F, Toulis KA, Colosimo

112 Scientific Report 2013 7. Publications in 2013 113 Treglia G, Caldarella C, Castaldi P, Muoio B, Hormones (Athens). 2013;12(3):327-333. IF Foot (Edinb). 2013;23(4):140-148. German, Austrian and Swiss consensus Bertagna F, Giovanella L. 2.43. conference on the diagnosis and local treatment A Papillary Thyroid Tumor Detected by 18F-FDG- Treglia G, Versari A, Giovanella L, Pipitone N, of the axilla in breast cancer. PET/CT in a Pediatric Patient with Cowden Treglia G, Giovannini E, Bertagna F, Giovanella L, Salvarani C. Eur J Cancer. 2013;49(10):2277-2283. IF Syndrome. Malaggese M. Is 18F-FDG PET a 'potentially hazardous' or an 5.061; Ranking 0.817. Nucl Med Mol Imaging. 2013: 47:143-145. An unusual case of metastatic extramammary effective tool in evaluating patients with large- Paget's disease of the vulva identified by 18F-FDG vessel vasculitis? Bianchi V, Spitale A, Ortelli L, Mazzucchelli L, Treglia G, Caldarella C, Saggiorato E, Ceriani L, PET/CT. Clin Exp Rheumatol. 2013;31(1 Suppl 75):S93.IF Bordoni A; QC3 CRC Working Group. Orlandi F, Salvatori M, Giovanella L. Rev Esp Med Nucl Imagen Mol. 2013;32(6):402- 2.655; Ranking 0.552. Quality indicators of clinical cancer care (QC3) in Diagnostic performance of (99m)Tc-MIBI scan 403. IF 0.863; Ranking 0.168. colorectal cancer. in predicting the malignancy of thyroid nodules: a Trimboli P, La Torre D, Ceriani L, Condorelli E, BMJ Open 2013;3(7). pii: e002818. IF 1.583; meta-analysis. Treglia G, Kakhki VR, Giovanella L, Sadeghi R. Laurenti O, Romanelli F, Ventura C, Signore A, Ranking 0.609. Endocrine. 2013;44(1):70-78. IF 2.25; Ranking Diagnostic performance of fluorine-18- Valabrega S, Giovanella L. 0.418. fluorodeoxyglucose positron emission tomography High sensitive thyroglobulin assay on thyroxine Brugger W, Ghielmini M. in patients with Merkel’s cell carcinoma: a therapy: can it avoid stimulation test in low Bendamustine in indolent non.Hodgkin's Treglia G, Ceriani L, Giovanella L. systematic review and meta-analysis. and high risk differentiated thyroid carcinoma lymphoma: a practice guide for patient Thyroid Incidentaloma at F-18-FDG Positron Am J Clin Dermatol. 2013;14(6):437-447. IF patients? management. Emission Tomography: A Challenge for the 1.844; Ranking 0.667. Horm Metab Res. 2013;45(9):664-668. IF Oncologist. 2013;18(8):954-964. IF 4.095; Clinicians. 2.145; Ranking 0.337. Ranking 0.738. J Thyroid Disord Ther. 2013, 2:e109. Treglia G, Muoio B, Del Ciello A, Bertagna F. Usefulness of 18F-FDG-PET/CT in Evaluating Verburg FA, Hartmann D, Grelle I, Giovanella L, Cardoso F, Bese N, Distelhorst SR, Bevilacqua Treglia G, Giovanella L. a Brainstem Glioma in an Adult Patient with Buck AK, Reiners C. JL, Ginsburg O, Grunberg SM, Gralla RJ, Steyn Could 68Ga-somatostatin analogues replace Neurofibromatosis Type 1. Relationship between antithyroglobulin A, Pagani O, Partridge AH, Knaul FM, Aapro MS, other PET tracers in evaluating extra-adrenal Nucl Med Mol Imaging. 2013:47(3):212-213. autoantibodies and thyroglobulin recovery rates Andersen BL, Thompson B, Gralow JR, Anderson BO. paragangliomas? using different thyroglobulin concentrations in the Supportive care during treatment for breast Eur J Nucl Med Mol Imaging. 2013;40(12):1797- Treglia G, Muoio B, Giovanella L, Salvatori M. recovery buffer. cancer: Resource allocations in low- and middle- 1799. IF 5.114; Ranking 0.941. The role of positron emission tomography and Horm Metab Res. 2013;45(10):728-735. IF income countries. A Breast Health Global positron emission tomography/computed 2.145; Ranking 0.377. Initiative 2013 consensus statement. Breast. Treglia G, Giovanella L. tomography in thyroid tumours: an overview. 2013;22(5):593-605. IF 1.967; Ranking 0.653. Usefulness of ¹8F-FDG PET/CT in syphilitic aortitis. Eur Arch Otorhinolaryngol. 2013;270(6):1783- Verburg FA, Luster M, Cupini C, Chiovato L, Clin Rheumatol. 2013;32(8):1247. IF 2.037; 1787. IF 1.458; Ranking 0.614. Duntas L, Elisei R, Feldt-Rasmussen U, Rimmele Cavalli F. Ranking 0.414. H, Seregni E, Smit JW, Theimer C, Giovanella L. An appeal to world cancer leaders: stop cancer Treglia G, Sadeghi R. Implications of thyroglobulin antibody positivity now. Treglia G, Giovanella L, Bertagna F, Di Franco D, Meta-analyses and systematic reviews on PET in patients with differentiated thyroid cancer: a Lancet. 2013;381(9865):425-426. IF 39.06; Salvatori M. and PET/CT in oncology: the state of the art. clinical position statement. Ranking 0.993. Prevalence and risk of malignancy of Clin Transl Imaging. 2013;1:73-75. Thyroid. 2013;23(10):1211-1225. IF 3.544; thyroid incidentalomas detected by (18) Ranking 0.648. Christinat A, Di Lascio S, Pagani O. f-fluorodeoxyglucose positron-emission Treglia G, Sadeghi R, Annunziata S, Zakavi SR, Hormonal therapies in young breast cancer tomography. Caldarella C, Muoio B, Bertagna F, Ceriani L, Oncology patients: when, what and for how long? Thyroid. 2013 Jan;23(1):124-126. IF 3.544; Giovanella L. J Thorac Dis. 2013;5(Suppl 1):S36-46. IF 4.473; Ranking 0.648. Diagnostic performance of Fluorine-18- AGO; DGS; SGS; ÖGS; Panelists; Executive Board Ranking 0.9. Fluorodeoxyglucose positron emission Members, Hoffmann J, Souchon R, Lebeau A, Treglia G, Giovanella L, Rufini V. tomography for the diagnosis of osteomyelitis Öhlschlegel C, Gruber G, Rageth C, Weber W, Christinat A, Pagani O. PET and PET/CT imaging in thyroid and adrenal related to diabetic foot: A systematic review and a Harbeck N, Janni W, Kreipe H, Fitzal F, Resch A, Practical Aspects of Genetic Counseling in Breast diseases: an update. meta-analysis. Costa A, Bago-Horvath Z, Peintinger F. Cancer: lights and shadows.

114 Scientific Report 2013 7. Publications in 2013 115 Breast. 2013;22(4):375-82. IF 1.967; Ranking Goldhirsch A, Winer EP, Coates AS, Gelber RD, activates NF-κB and drives prostate cancer breast cancer subtypes. 0.653. Piccart-Gebhart M, Thürlimann B, Senn HJ, Costa A. progression. Oncol Rep. 2013;30(2):824-32. IF 2.297; Personalizing the treatment of women with Cancer Res. 2013;73(14):4533-47. IF 8.65; Ranking 0.44. Civenni G, Malek A, Albino D, Garcia-Escudero R, early breast cancer: highlights of the St Gallen Ranking 0.948. Napoli S, Di Marco S, Pinton S, Sarti M, Carbone International Expert Consensus on the Primary Sessa C, Del Conte G, Christinat A, Cresta S, GM, Catapano CV. RNAi-mediated silencing of Myc Therapy of Early Breast Cancer 2013. Ann Oncol. Martin V, Landi L, Molinari F, Fountzilas G, Geva Perotti A, Gallerani E, Lardelli P, Kahatt C, Alfaro transcription inhibits stem-like cell maintenance 2013;24(9):2206-2223. R, Riva A, Saletti P, De Dosso S, Spitale A, Tejpar V, Iglesias JL, Fernández-Teruel C, Gianni L. and tumorigenicity in prostate cancer. S, Kalogeras KT, Mazzucchelli L, Frattini M, Phase I clinical and pharmacokinetic study of Cancer Res. 2013;73(22):6816-27. IF 8.65; Ledermann JA, Raja FA, Fotopoulou C, Gonzalez- Cappuzzo F. trabectedin and cisplatin given every three weeks Ranking 0.948. Martin A, Colombo N, Sessa C; ESMO Guidelines HER2 gene copy number status may influence in patietns with advanced solid tumors. Working Group. clinical efficacy to anti-EGFR monoclonal Invest New Drugs. 2013;31(5):1236-43. IF Colombo N, Preti E, Landoni F, Carinelli S, Newly Diagnosed and Relapsed Epithelial Ovarian antibodies in metastatic colorectal cancer 3.498; Ranking 0.778. Colombo A, Marini C & Sessa C. on behalf of the Carcinoma: ESMO Clinical Practice Guidelines. patients. ESMO Guidelines Working Group. Ann Oncol. 2013;24 (Suppl 6):vi24-32. IF 7.384; Br J Cancer. 2013;108(3):668-75. IF 5.082; Sessa C, Lorusso P, Tolcher A, Farace F, Lassau Endometrial cancer: ESMO Clinical Practice Ranking 0.911. Ranking 0.882. N, Delmonte A, Braghetti A, Bahleda R, Cohen P, Guidelines for diagnosis, treatment and follow-up. Hospitel M, Veyrat-Follet C, Soria JC. Ann Oncol. 2013;24(Suppl 6):vi33-vi38. IF 7.384; Lin NU, Thomssen C, Cardoso F, Cameron D, Pagani O, Gelber S, Colleoni M, Price KN, Phase I Safety, Pharmacokinetic and Ranking 0.911. Cufer T, Fallowfield L, Francis PA, Kyriakides S, Simoncini E. Pharmacodynamic Evaluation of the Vascular Pagani O, Senkus E, Costa A, Winer EP; ESO-MBC Impact of SERM adherence on treatment effect: Disrupting Agent Ombrabulin (AVE8062) in Conconi A, Franceschetti S, Lobetti-Bodoni C, Task Force. International Breast Cancer Study Group Trials Patients with Advanced Solid Tumors. Stathis A, Casaluci GM, Ramponi A, Mazzucchelli International guidelines for management of 13-93 and 14-93. Clin Cancer Res. 2013;19(17):4832-4842. IF L, Bertoni F, Ghielmini M, Gaidano G, Cavalli F, metastatic breast cancer (MBC) from the Breast Cancer Res Treat. 2013;142(2):455-9. IF 7.837; Ranking 0.942. Zucca E. European School of Oncology (ESO)-MBC Task 4.469; Ranking 0.78. Risk factors of central nervous system relapse in Force: Surveillance, staging, and evaluation of Sessa C, Shapiro GI, Bhalla KN, Britten C, Jacks Mantle cell lymphoma. patients with early-stage and metastatic breast Pascale M, Pracella D, Barbazza R, Marongiu B, KS, Mita M, Papadimitrakopoulou V, Pluard T, Leuk Lymphoma. 2013;54(9):1908-1914. IF cancer. Roggero E, Bonin S, Stanta G. Samuel TA, Akimov M, Quadt C, Fernandez-Ibarra 2.301; Ranking 0.455. Breast. 2013;22(3):203-210. IF 1.967; Ranking Is human papillomavirus associated with prostate C, Lu H, Bailey S, Chica S, Banerji U. 0.653. cancer survival? First-in-Human Phase I Dose-Escalation Study of De Dosso S, Zanellato E, Nucifora M, Boldorini Dis Markers. 2013; 35(6):607-613. IF 2.14; the HSP90 Inhibitor AUY922 in Patients with R, Sonzogni A, Biffi R, Fazio N. Bucci E, Beretta Longoni N, Kunderfranco P, Pellini S, Albino D, Ranking 0.584. Advanced Solid Tumors. O, Crippa S, Saletti P, Frattini M. ERCC1 predicts Mello-Grand M, Pinton S, D’Ambrosio G, Sarti M, Clin Cancer Res. 2013;19(13):3671-3680. IF outcome in patients with gastric cancer treated Sessa F, Chiorino G, Catapano CV, Carbone GM. Regan MM, Pagani O, Fleming GF, Walley BA, 7.837; Ranking 0.942. with adjuvant cisplatin-based chemotherapy. Aberrant expression of the neuronal-specific Price KN, Rabaglio M, Maibach R, Ruepp B, Cancer Chemother Pharmacol. 2013;72(1);159- protein DCDC2 promotes malignant phenotypes Coates AS, Goldhirsch A, Colleoni M, Gelber RD, Zucca E, Conconi A, Laszlo D, López-Guillermo 165. IF 2.795; Ranking 0.661. and is associated with prostate cancer Francis PA; International Breast Cancer Study; A, Bouabdallah R, Coiffier B, Sebban C, Jardin progression. GroupSOFT and TEXT Investigators. F, Vitolo U, Morschhauser F, Pileri SA, Copie- Gallerani E, Zucchetti M, Brunelli D, Marangon Oncogene. 2013;32(18):2315-24, 2324.e1-4. IF Adjuvant treatment of premenopausal women Bergman C, Campo E, Jack A, Floriani I, Johnson P, E, Noberasco C, Hess D, Delmonte A, Martinelli 7.357; Ranking 0.911. with endocrine-responsive early breast cancer: Martelli M, Cavalli F, Martinelli G, Thieblemont C. G, Böhm S, Driessen C, De Braud F, Marsoni S, Design of the TEXT and SOFT trials. Addition of rituximab to chlorambucil produces Cereda R, Sala F, D’Incalci M, Sessa C, Longoni N, Sarti M, Albino D, Civenni G, Malek Breast. 2013;22(6):1094-1100. IF 1.967; superior event-free survival in the treatment of A first in human phase I study of the proteasome A, Ortelli E, Pinton S, Mello-Grand M, Ostano Ranking 0.653. patients with extranodal marginal-zone B-Cell inhibitor CEP-18770 in patients with advanced P, D'Ambrosio G, Sessa F, Garcia-Escudero R, lymphoma: 5-year analysis of the IELSG-19 solid tumours and multiple myeloma. Thalmann GN, Chiorino G, Catapano CV, Carbone GM. Sarti M, Pinton S, Limoni C, Carbone GM, Pagani Randomized Study. Eur J Cancer, 2013, 49(2):290-296. IF 5.061; ETS transcription factor ESE1/ELF3 orchestrates O, Cavalli F, Catapano CV. J Clin Oncol. 2013;31(5):565-572. IF 1.727; Ranking 0.817. a positive feedback loop that constitutively Differential expression of testin and survivin in Ranking 0.272.

116 Scientific Report 2013 7. Publications in 2013 117 von Hohenstaufen KA, Conconi A, de Campos CP, Bettinelli A, Provero MC, Cogliati F, Villella A, Ferrarini A, Bianchetti AA, Fossali EF, Faré PB, Lava SA, Simonetti GD, Ferrarini A, Ramelli GP, Franceschetti S, Bertoni F, Margiotta Casaluci G, Marinoni M, Saettini F, Bianchetti MG, Nespoli L, Simonetti GD, Lava SA, Bianchetti MG. Bianchetti MG. Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano Galluzzo C, Lava SA. What can we do to make antihypertensive Regional differences in symptomatic fever G, Zucca E. Symptomatic fever management among 3 medications taste better for children? management among paediatricians in Prognostic impact of monocyte count at different groups of pediatricians in Northern Int J Pharm. 2013;457(1):333-336. IF 3.458; Switzerland: The results of a cross-sectional Web- presentation in mantle cell lymphoma. Lombardy (Italy): results of an explorative cross- Ranking 0.767. based survey. Br J Haematol. 2013;162(4):465-473. IF 4.942; sectional survey. Br J Clin Pharmacol. 2013; 75(1):236-243. IF Ranking 0.848. Ital J Pediatr. 2013;39:51. IF 1.344; Ranking Gervasini C, Russo S, Cereda A, Parenti I, 3.578; Ranking 0.798. 0.477. Masciadri M, Azzollini J, Melis D, Aravena T, Orthopaedics Doray B, Ferrarini A, Garavelli L, Selicorni A, Lucchini B, Simonetti GD, Ceschi A, Lava SA, Faré Brazzola P, Rossi MR. Larizza L. PB, Bianchetti MG. Taverna E, Ufenast H, Broffoni L, Garavaglia G. High weekly doses of liposomal amphotericin B as Cornelia de Lange individuals with new and Severe signs of hyponatremia secondary Arthroscopically assisted Latarjet procedure: secondary prophylaxis after cerebral aspergillosis recurrent SMC1A mutations enhance delineation to desmopressin treatment for enuresis: a A new surgical approach for accurate coracoid in a paediatric patient. of mutation repertoire and phenotypic spectrum. systematic review. graft placement and compression. Med Mycol Case Rep. 2013;3:1-3. Am J Med Genet A. 2013;161A(11):2909-2919. J Pediatr Urol. 2013; 9(6):1049-1053. IF 1.368; Int J Shoulder Surg. 2013;7(3):120-123. IF 2.304; Ranking 0.411. Ranking 0.495. Bucher BS, Ferrarini A, Weber N, Bullo M, Brunetti S, Petri GJ, Lucchina S, Garavaglia G, Bianchetti MG, Simonetti GD. Gualco G, Lava SA, Garzoni L, Simonetti GD, Melera FP, Borsari A, Lava SA, Simonetti GD, Fusetti C. Primary hypertension in childhood. Bettinelli A, Milani GP, Provero MC, Bianchetti Bianchetti MG. Should aspirin be stopped before carpal tunnel Curr Hypertens Rep. 2013;15(5): 444-452. IF MG. Image of the month: eruption over both ears. surgery? A prospective study. 3.744; Ranking 0.806. Transient benign hyperphophatasemia. J Paediatr Child Health. 2013;49(3):251–252. IF World J Orthop. 2013;4(4):299-302. J Pediatr Gastroenterol Nutr. 2013;57(2):167- 1.254; Ranking 0.459. Datta AN, Oser N, Bauder F, Maier O, Martin F, 171. IF 2.196; Ranking 0.761. Pinto D, Montani E, Bolli M, Garavaglia G, Sallusto Ramelli GP, Steinlin M, Weber P, Penner IK. Milani GP, Dellepiane RM, Castellazzi ML, Mazzoni F, Lanzavecchia A, Jarossay D. Cognitive impairment and cortical reorganization Jörg R, Milani GP, Simonetti GD, Bianchetti MG, MBM, Bianchetti MG, Fossali EF. Episodic A functional BCR in human IgA and IgM plasma cells. in children with benign epilepsy with Simonetti BG. idiopathic systemic capillary leak syndrome in a Blood. 2013;121(20):4110-4114. IF 9.06; centrotemporal spikes. Peripheral facial nerve palsy in severe systemic girl. Ranking 0.97. Epilepsia. 2013; 54(3):487-494. IF 3.909; hypertension: a systematic review. Pediatr Int. 2013; 55(4):e81-e82. IF 0.875; Ranking 0.832. Am J Hypertens. 2013; 26(3):351-356. IF Ranking 0.257. Lübbeke A, Garavaglia G, Rothman KJ, Bonvin A, 3.665; Ranking 0.776. Roussos C, Miozzari H, Hoffmeyer P. Datta AN, Oser N, Ramelli GP, Gobbin NZ, Lantz Spagnolo A, Giussani M, Ambruzzi AM, Bianchetti Statins may reduce femoral osteolysis in patients G, Penner IK, Weber P. Lava SA, Simonetti GD, Bianchetti AA, Ferrarini A, MG, Maringhini S, Matteucci MC, Menghetti with total Hip arthroplasty. BECTS evolving to Landau-Kleffner Syndrome Bianchetti MG. E, Salice P, Simionato L, Strambi M, Virdis R, J Orthop Res. 2013;31(5):814-820. IF 2.875; and back by subsequent recovery: a longitudinal Prevention of vitamin D insufficiency in Genovesi S. Ranking 0.906. language reorganization case study using fMRI, Switzerland: A never-ending story. Focus on prevention, diagnosis and treatment of source EEG, and neuropsychological testing. Int J Pharm. 2013 457(1):353-356. IF 3.458; hypertension in children and adolescents. Paediatrics Epilepsy Behav. 2013; 27(1):107-114. IF 1.844; Ranking 0.767. Ital J Pediatr. 2013;39:20. IF 1.344; Ranking Ranking 0.539. 0.477. Antonini U, Soldini EA, D'Apuzzo V, Brunner R, Lava SA, Simonetti GD, Ragazzi M, Guarino Gubler Ramelli GP. Dell’Orto VG, Bianchetti MG, Brazzola P. S, Bianchetti MG. Viganò C, Amoruso C, Barretta F, Minnici G, Longitudinal neurodevelopmental evolution Hyperchloraemic metabolic acidosis induced by Juvenile spring eruption: an outbreak report and Albisetti W, Syrèn ML, Bianchetti MG, Bettinelli A. in children with severe non-progressive the iron chelator deferasirox: a case report and systematic review of the literature. Renal phosphate handling in Gitelman syndrome - encephalopathy. review of the literature. Br J Dermatol. 2013;168(5):1066-1072. IF the results of a case-control study. Brain Dev. 2013;35(6):548-554. IF 1.668; J Clin Pharm Ther. 2013;38(6):526-527. IF 3.759; Ranking 0.93. Pediatr Nephrol. 2013;28(1):65–70. IF 2.939; Ranking 0.384. 2.104; Ranking 0.467. Ranking 0.927.

118 Scientific Report 2013 7. Publications in 2013 119 Palliative Care Del Grande F, Chalian M, Carrino JA. Clin Cancer Res. 2013;19(17):4832-4842. IF Lobefalo F, Bignardi M, Reggiori G, Tozzi A, High-resolution 3T MR neurography of the 7.837; Ranking 0.942. Tomatis S, Alongi F, Fogliata A, Gaudino A, Gamondi C, Pott M, and Payne S. brachial plexus and its branches, with emphasis Navarria P, Cozzi L, Scorsetti M, Mancosu P. Families' experiences with patients who died after on 3D imaging. Shiga NT, Del Grande F, Lardo O, Fayad LM. Dosimetric impact of inter-observer variability assisted suicide: a retrospective interview study in AJNR Am J Neuroradiol. 2013;34(3):486-497. Imaging of primary bone tumors: determination of for 3D conformal radiotherapy and volumetric southern Switzerland. IF 3.167; Ranking 0.807. tumor extent by non-contrast sequences. modulated arc therapy: the rectal tumor target Ann Oncol 2013;24(6):1639-44. IF 7.384; Pediatr Radiol. 2013;43(8):1017-1023. IF definition case. Ranking 0.911. Cianfoni A, Pravatà E, De Blasi R, Tschuor CS, 1.565; Ranking 0.578. Radiat Oncol, 2013; 8:176. IF 4.524; Ranking Bonaldi G. 0.933. Gamondi C, Larkin P, Payne S. Clinical presentation of cerebral aneurysms. Radiation Oncology Core competencies in palliative care: an EAPC Eur J Radiol. 2013;82(10):1618-1622. IF 2.512; Navarria P, Ascolese AM, Mancosu P, Alongi F, White Paper on palliative care education. Ranking 0.664. Alongi F, Cozzi L, Fogliata A, Iftode C, Comito T, Clerici E, Tozzi A, Iftode C, Reggiori G, Tomatis S, European Journal of Palliative Care, 2013;20(2). Clivio A, Villa E, Lobefalo, F, Navarria P, Reggiori Infante M, Alloisio M, Testori A, Fogliata A, Cozzi Del Grande F, Carrino JA, Nagy P. G, Mancosu P, Clerici E, Tomatis S, Taverna G, L, Morenghi E, Scorsetti M. Volumetric modulated Gamondi C, Galli N, Schönholzer C, Marone Performance quality improvement projects in Graziotti P, Scorsetti M. arc therapy with flattening filter free (FFF) beams C, Zwahlen H, Gabutti L, Bianchi G, Ferrier C, musculoskeletal radiology. Hypofractionation with VMAT versus 3DCRT in for stereotactic body radiation therapy (SBRT) in Cereghetti C, Giannini O. J Am Coll Radiol. 2013;10(6):475-476. IF 2.096; post-operative patients with prostate cancer. patients with medically inoperable early stage non Frequency and severity of pain and symptom Ranking 0.63. Anticancer Res, 2013;33(10):4537-43. IF small cell lung cancer (NSCLC). distress among patients with chronic kidney 1.713; Ranking 0.262. Radiother Oncol. 2013;107(3):414-418. IF 4.52; disease receiving dialysis. Del Grande M, Del Grande F, Carrino J, Bingham Ranking 0.924. Swiss Med Wkly. 2013;143:w13750. IF 1.821; CO 3rd, Louie GH. Clivio A, Kluge A, Cozzi L, Köhler C, Neumann O, Ranking 0.682. Cervical spine involvement early in the course of Vanetti E, Wlodarczyk W, Marnitz S. Nicolini G, Abraham S, Fogliata A, Jordaan A, rheumatoid arthritis. Intensity Modulated Proton Beam Radiation Clivio A, Vanetti E, Cozzi L. Radiology Semin Arthritis Rheum. 2013; pii: S0049- for Brachytherapy in Patients With Cervical Critical appraisal of volumetric-modulated 0172(13)00264-3. Carcinoma. arc therapy compared with electrons for the Alerci M, Giamboni A, Wyttenbach R, Porretta doi: 10.1016/j.semarthrit.2013.12.001. IF Int J Radiat Oncol Biol Phys. 2013;87(5):897- radiotherapy of cutaneous Kaposi's sarcoma of AP, Antonucci F, Bogen M, Toderi M, Guerra A, 3.806; Ranking 0.759. 903. IF 4.524; Ranking 0.933. lower extremities with bone sparing. Sartori F, Tutta P, Inglese L, Limoni C, Gallino A, Br J Radiol. 2013;86(1023):20120543. IF von Segesser LK. Fayad LM, Mugera C, Soldatos T, Flammang A, Fogliata A, Clivio A, Vanetti E, Nicolini G, Belosi MF, 1.217; Ranking 0.286. Endovascular abdominal aneurysm repair and Del Grande F. Cozzi L. impact of systematic preoperative embolization of Technical innovation in dynamic contrast- Dosimetric evaluation of photon dose calculation Mancosu P, Navarria P, Castagna L, Reggiori G, collateral arteries: endoleak analysis and long- enhanced magnetic resonance imaging of under jaw and MLC shielding. Sarina B, Tomatis S, Alongi F, Nicolini G, Fogliata term follow-up. musculoskeletal tumors: an MR angiographic Med Phys. 2013; 40(10):101706. IF 2.911; A, Cozzi L, Scorsetti M. J Endovasc Ther. 2013; 20(5):663-671. IF sequence using a sparse k-space sampling Ranking 0.782. Interplay effects between dose distribution 2.699; Ranking 0.848. strategy. quality and positioning accuracy in total marrow Skeletal Radiol. 2013;42(7):993-1000. IF 1.741; Fogliata A, Scorsetti M, Navarria P, Catalano M, irradiation with volumetric modulated arc therapy. Chhabra A, Del Grande F, Soldatos T, Chalian M, Ranking 0.529. Clivio A, Cozzi L, Lobefalo F, Nicolini G, Palumbo V, Med Phys, 2013; 40(11): 111713. IF 2.911; Belzberg AJ, Williams EH, Jalali FS, Thawait GK, Pellegrini C, Reggiori G, Roggio A, Vanetti E, Alongi Ranking 0.782. Eng J, Carrino JA. Sessa C, Lorusso P, Tolcher A, Farace F, Lassau F, Pentimalli S, Mancosu P. Meralgia paresthetica: 3-Tesla magnetic N, Delmonte A, Braghetti A, Bahleda R, Cohen P, Dosimetric comparison between VMAT with Nicolini G, Clivio A, Vanetti E, Krauss H, Fenoglietto resonance neurography. Hospitel M, Veyrat-Follet C, Soria JC. different dose calculation algorithms and protons P, Cozzi L, Fogliata A. Skeletal Radiol. 2013;42(6):803-808. IF 1.741; Phase I safety, pharmacokinetic and for soft-tissue sarcoma radiotherapy. Evaluation of an aSi-EPID with flattening filter Ranking 0.529. pharmacodynamic evaluation of the vascular Acta Oncol. 2013;52(3):545-552. IF 2.867; free beams: applicability to the GLAaS algorithm disrupting agent ombrabulin (AVE8062) in Ranking 0.571. for portal dosimetry and first experience for Chhabra A, Thawait GK, Soldatos T, Thakkar RS, patients with advanced solid tumor. pretreatment QA of RapidArc.

120 Scientific Report 2013 7. Publications in 2013 121 Med Phys. 2013; 40(11): 111719. IF 2.911; Bianchi V, Spitale A, Ortelli L, Mazzucchelli Colorectal Dis. 2013;15(3):347-353. IF 2.081; Gunnar Ochs B, Stöckle U, Candrian C. Ranking 0.782. L, Bordoni A, QC3 CRC Working Group Ranking 0.425. Fractures around shoulder and elbow (Christoforidis D and Rosso R). arthroplasty – rare but difficult. Sassowsky M, Gut P, Hölscher T, Hildebrandt Quality indicators of clinical cancer care (QC3) in De Spirito D. European Orthopaedics and Traumatology. G, Müller AC, Najafi Y, Kohler G, Kranzbühler colorectal cancer. Percutaneous Fixation of Hand Fractures Using 2013;4(2):111-116. H, Guckenberger M, Zwahlen DR, Azinwi NC, BMJ Open. 2013;3(7). pii: e002818. IF 1.583; Locked K-Wires: Mechanical Analysis and Clinica Plasswilm L, Takacs I, Reuter C, Sumila M, Ranking 0.609. Application. Huber X, Bernasconi E, Tschuor-Costa S, Rosso R. Manser P, Ost P, Böhmer D, Pilop C, Aebersold Tech Hand Up Extrem Surg. 2013;17(3):134- Exceptional dissemination of perineal tuberculosis DM, Ghadjar P. Brunetti S, Petri J, Lucchina S, Garavaglia G, 143. up to the right flank: a tribute to J.P. Use of EORTC target definition guidelines for Fusetti C. Nesselrod’s study on the anatomy of pelvic dose-intensified salvage radiation therapy for Should aspirin be stopped before carpal tunnel Droeser RA, Hirt C, Viehl CT, Frey DM, Nebiker C, lymphatics published in 1936 in the Annal of recurrent prostate cancer: results of the quality surgery ? A prospective study. Huber X, Zlobec I, Eppenberger-Castori S, Tzankov Surgery. assurance program of the randomized trial SAKK World J Orthop 2013; 4 (4): 299-302. A, Rosso R, Zuber M, Muraro MG, Amicarella Int J Colorectal Dis. 2013;28(5):723-726. IF 09/10. F, Cremonesi E, Heberer M, Iezzi G, Lugli A, 2.238; Ranking 0.746. Int J Radiat Oncol Biol Phys. 2013;87(3):534-41. Cafarotti S, Cardillo G, Granone P and Dutly AE. Terracciano L, Sconocchia G, Oertli D, Spagnoli IF 4.524; Ranking 0.933. Early Stage Non–Small-Cell Lung Cancer: Surgical GC, Tornillo L. Lococo F, Cafarotti S, Treglia G. Implications of the New Adenocarcinoma Clinical impact of programmed cell death ligand 1 Is 18F-FDG-PET/CT really able to differentiate Scorsetti M, Arcangeli S, Tozzi A, Comito T, Alongi Classification. expression in colorectal cancer. between malignant and benign solitary fibrous F, Navarria P, Mancosu P, Reggiori G, Fogliata A, J Thorac Oncol. 2013;8(5):e45. IF 4.473; Eur J Cancer. 2013 Jun;49(9):2233-2242. IF tumor of the pleura? Torzilli G, Tomatis S, Cozzi L. Ranking 0.9. 5.061; Ranking 0.817. Clin Imaging. 2013;37(5):976. Is stereotactic body radiation therapy an attractive option for unresectable liver Cafarotti S, Cesario A, Margaritora S, Granone P. Droeser RA, Hirt C, Eppenberger-Castori S, Lucchina S, Fusetti C. metastases? A preliminary report from a phase Typical bronchial carcinoid tumors: focus on Zlobec I, Viehl CT, Frey DM, Nebiker CA, Rosso Treatment of type III middle phalangeal neck 2 trial. surgical management. R, Zuber M, Amicarella F, Iezzi G, Sconocchia fractures through a palmar approach. Int J Radiat Oncol Biol Phys. 2013;86(2):336- Ann Thorac Surg. 2013;95(1):385. IF 3.454; G, Heberer M, Lugli A, Tornillo L, Oertli D, Chin Traumatol .2013;16(2):107-109. 342. IF 4.524; Ranking 0.933. Ranking 0.929. Terracciano L, Spagnoli GC. High myeloperoxidase positive cell density in Passoni S, Regusci L, Peloni G, Brenna M, Fasolini F. Wang PM, Hsu WC, Chung NN, Chang FL, Cafarotti S, Cesario A, Porziella V, Leuzzi G, Vita colorectal cancer is an independent favorable A giant adrenal pseudocyst mimicking an adrenal Fogliata A, Cozzi L. ML, Meacci E, Congedo MT, Granone P. prognostic factor. cancer: case report and review of the literature. Radiotherapy with volumetric modulated arc Post-esophagectomy anastomotic leaks The role PLoS One. 2013;8(5):e64814. IF 3.73; Ranking Urol Int. 2013;91(2):245-248. IF 1.065; Ranking therapy for hepatocellular carcinoma patients of the anastomotic location. 0.882. 0.219. ineligible for surgery or ablative treatments. Ann Ital Chir. 2013;84:137-41.IF 0.29; Ranking Strahlenther Onkol. 2013; 189(4): 301-7. IF 0.081. Fusetti C, Garavaglia G, Thebaud A. Posabella A, Rosso R, Giovannacci L, van den 4.163; Ranking 0.908. Anatomical collateral ligament reconstruction in Berg JC. Cafarotti S, Treglia G, Bongiovanni M, Ceriani L, the hand using intraosseous suture anchors and Covered stents in peripheral vascular aneurysms Surgery Paone G, Giovanella L, Dutly A. free tendon graft. and emergencies. A Rare Case of Mucinous Cystadenoma of the J Hand Surg Eur Vol. 2013; 38(5): 576-577. IF EVToday 2013;vol 1,no 5:18-23. Antonicelli A, Cafarotti S, Indini A, Galli A, Russo Lung Mimicking Malignancy at 18F-FDG PET/CT. 1.223; Ranking 0.469. A, Cesario A, Lococo FM, Russo P, Mainini Clin Nucl Med. 2013 Jun 21. IF 2.955; Ranking Potocnik P, Puig L, Candrian C. AF, Bonifati LG, Nosotti M, Santambrogio L, 0.79. Fusetti C, Lazzaro M, Trobia M, Lucchina S, Petri Periprosthetic fractures of the proximal femur – Margaritora S, Granone PM, Dutly AE. JGF, Garavaglia G. Vancouver A type fracture. EGFR-Targeted Therapy for Non-Small Cell Lung Christoforidis D, Clerc D, Demartines N. Patients' Point of View on Informed Consent: A European Orthopaedics and Traumatology. Cancer: Focus on EGFR Oncogenic Mutation. Transrectal specimen extraction after Prospective Study in Carpal Tunnel Surgery. 2013;4(2):73-75. Int J Med Sci. 2013;10(3):320-30. IF 2.065; laparoscopic left colectomy: a case-matched Am J Orthop. 2013;42(12):E111-E115. IF 1.6; Ranking 0.762. study. Ranking 0.438.

122 Scientific Report 2013 7. Publications in 2013 123 Sterzi S, Cesario A, Cusumano G, Dall'Armi V, Surgery and One-Carbon Metabolism - HCY2013. Salvadé I, Burnier M, Gabutti L. Lapenna LM, Cardaci V, Novellis P, Lococo F, Homocysteine and B vitamins and the risk of Annual Meeting of the Swiss Society of Corbo GM, Cafarotti S, Margaritora S, Granone P. Balzarotti RC. cognitive decline in mildly cognitively impaired Nephrology. Post-operative rehabilitation for surgically Multidisciplinarietà e multimodalità in oncologia: elderly: the Canton Ticino prospective study. Assessment of subjective and hemodynamic resected non-small cell lung cancer patients: l'esempio della malattia metastatica del fegato. Trinity College Dublin, Ireland, 8-12th September tolerance of different high- and low-flux dialysis serial pulmonary functional analysis. Tribuna Medica Ticinese 2013;78: 227-230. 2013. membranes in patients undergoing chronic J Rehabil Med. 2013;45(9):911-915. IF 2.134; Published in: J Inherit Metab Dis. intermittent hemodialysis: a randomized Ranking 0.852. Candrian C, Schiavone N, Del Grande F, Walch G. 2013;36(Suppl.1):S31-S32. controlled trial. La periartrite omero-scapolare non esiste più ! Zurich, Switzerland, 4-6th December 2013. Publications in non-peer-reviewed journals in Tribuna medica ticinese 2013; 2. Gynaecology 2013 Bresin E, Noris M, Bettoni S, Zito A, Gamba S, Candrian C, Schiavone N, Del Grande F, Marbach Filippakos F, Polli C, Barizzi J, Panettella F, Gyr T. Gabutti L, Remuzzi G, Daina E. Geriatrics F, Walch G. Congresso Società Svizzera di Ginecologia ed 4th International Conference HUS-MPGN-TTP & Artrosi della spalla e l’artropatia della cuffia dei Ostetricia – SGGG 2013. related diseases. Bopp I, Démonet JF, Ibach B, Gold G, Gut UE, rotatori. Recurrent acute abdomen in pregnancy caused Over year of Eculizumab treatment in two patients Kressig RW, Landis T, Monsch A, Mosimann U, Tribuna medica ticinese 2013; 10. by deciduosis of the appendix. with primary MPGN and high levels of sc5b-9. Quadri P, Savaskan E, Vuillemin P. Lugano, Switzerland, 27-29 th June 2013. Innsbruck, Austria, 9-11th June 2013. Stratégie nationale en matière de pathologies Candrian C, Schiavone N, Del Grande F, Walch G. démentielle en Suisse: une priorité de la politique La periartrite omero-scapolare non esiste più! La Lauria F, Polli C, Filippakos F, Andreoli I, Jemec M, Della Badia C, Melchiorre P, Moschovitis G. de santé. sindrome da conflitto sottoacromiale. Biedermann K, Gyr T. Congress of the Swiss Society of Cardiology Rev Med Suisse 2013;9:838-847. Tribuna medica ticinese 2013; 3. Congresso Società Svizzera di Ginecologia ed 2013. Ostetricia – SGGG 2013. Cardiovascular emergency during pregnancy: a Nursing Medicine Candrian C, Schiavone N, Del Grande F, Walch G. Gravidanza dopo trattamento laparoscopico di un case report. La periartrite omero-scapolare non esiste più! carcinoma della cervice. Lugano, Switzerland, 13-15th June 2013. Cattaneo A, Valcarenghi D, Bianchi M. Lesione del caput longum del tendine bicipite. Lugano, Switzerland, 27-29 th June 2013. Published in: Cardiovascular Medicine 2013; 14 Antitumoral oral drugs: clinical risk in oral Tribuna medica ticinese 2013; 4. (suppl. 22): 60. antitumoral drugs intake. Meani F, Skrivanek R, Di Lascio S, Richetti L, Onkologiepflege Soins en oncologie. 2013;4:20-21. Candrian C, Schiavone N, Del Grande F, Walch G. Pagani O, Costa A, Gyr T. De Marchi S, Zuliani E, Cereghetti C, Gaspert A, La periartrite omero-scapolare non esiste più ! Le Congresso Società Svizzera di Ginecologia ed Fehr T, Schönholzer C. Manzambi-Maggi L. lesioni della cuffia dei rotatori. Ostetricia – SGGG 2013. Annual Meeting of the Swiss Society of What about Moral Distress? Tribuna medica ticinese 2013; 6. Does centralized care reduce the number of Nephrology. Onkologiepflege Soins en oncologie. 2013;1:18- patients with locally advanced breast cancer? Polyomavirus nephropathy caused by JCV in renal 19. Salmoiraghi F, Rosso R, Giovannacci L. Lugano, Switzerland, 27-29 th June 2013. allograft recipients. Degenerazione cistica avventiziale! Una rara Zurich, Switzerland, 4-6th December 2013. Puliatti A. causa di claudicatio intermittens. Zgraggen L, Filippakos F, Melchiorre-Mayer P, Published in: Swiss Med Wkly. 213; 143(Suppl Burn out:"To care without caring" - A personal Tribuna medica ticinese 2013;1:5-7. Zamprogno E, Chegai M, Polli C, Gyr T. Congresso 202): 14S. and professional challange. Società Svizzera di Ginecologia ed Ostetricia – Onkologiepflege Soins en oncologie. 2013; 2: 28-29. Publications of medical congress abstracts in SGGG 2013. Di Valentino M, Siragusa S, Moschowitis G, Gallino 2013 Dissezione aortica in gravidanza in assenza di JM, Costanzo L, Gallino A, Menafoglio A. Radiaton Oncology fattori di rischio. Congress of the European Society of Cardiology Geriatrics Lugano, Switzerland, 27-29th June 2013. 2013. Pittoni P, Marchese R, Valli MC, Richetti A. The characteristics of infero-lateral early Il tumore filloide della mammella. Quadri P, Zanda E, Rocchi S, Meroni F, Tettamanti Internal Medicine repolarisation are different between young males Tribuna medica ticinese 2013; 78:155-158. M, Recchia A, Lucca U. and females athletes. 9th International Conference On Homocysteine Bianchi G, Salvadé V, Lucchini B, Schätti-Stählin S, Amsterdam, The Netherlands, 31th August-4th

124 Scientific Report 2013 7. Publications in 2013 125 September 2013. Porretta AP, Di Valentino M, Limoni L, Gallino A. Leipzig, Germany, 23-26th January 2013. 35th International Symposium Charing Cross. Published in : Eur Heart J 2013; 34 (suppl. 1): ESC (European Society of Cardiology). Embolisation of a small residual pseudo-aneurysm 1904 Impact of troponin I cut-off values on the incidence van den Berg JC. at the level of the entry tear in a type B dissection of Myocardial infarction with non-St-Segment Does debulking for DEB make sense? London, UK, 6-8th April 2013. Di Valentino M, Siragusa P, Moschovitis G, Gallino Elevation: from a Higher sensitivity to a true LINC2013. JM, Costanzo L, Gallino A. greater predictive value? Leipzig, Germany, 23-26th January 2013. van den Berg JC. Congress of the Swiss Society of Cardiology Amsterdam, The Netherlands, 31th August-4th BIRD 2013. 2013. September 2013. van den Berg JC. Drug eluting balloons in endovascular treatment The characteristics of early repolarisation are International Symposium: Masterclass critical of limb ischemia. different between young males and females Porretta AP, Di Valentino M, Limoni L, Gallino A. ischaemia diabetic foot. Bratislava, Slovakia, 19th April 2013. athletes. AHA (American Heart Association). Endovascular treatment of the critical ischaemic Lugano, Switzerland, 13-15th June 2013. Impact of troponin I cut-off values on the incidence diabetic foot. van den Berg JC. Published in: Cardiovascular Medicine 2013; 14 of Myocardial infarction with non-St-Segment Almelo, The Netherlands, 31st January 2013. 10th SITE. (suppl. 22): 60. Elevation: from a Higher sensitivity to a true The best imaging techniques for the diagnosis greater predictive value? van den Berg JC. and therapeutic planning of visceral artery Manconi M, Zavalko I, Bassetti C, Colamartino E, Dallas, Texas, USA, 19-20th November 2013. iCON2013: International Congress for disorders. Pons M, Ferri R. Endovascular Specialists. Barcelona, Spain, 9-10 th May 2013 5th World Congress on Sleep Medicine. Rahod A, Bonny O, Guessous I, Suter P, Conen Update on 3D navigational tools. Respiratory-related leg movements and periodic D, Erne P, Binet I, Gabutti L, Gallino A, Muggli F, Scottsdale, AZ, U.S.A., 24-28 th February 2013. van den Berg JC. leg movements during sleep. Meier P, Hayoz D, Péchère-Bertschi A, Paccaud F, 10th SITE. Valencia, Spain, 28th September-2nd October Burnier M, Bochud M. van den Berg JC. Endovascular treatment of deep venous 2013. Swiss Public Health Conference 2013. iCON2013: International Congress for thrombosis. Published in: Sleep Medicine. 2013; 14(Suppl 1): Association of serum Calcium and serum Vitamin Endovascular Specialists. Barcelona, Spain, 9-10th May 2013 e195-e196. D with 24h-urinary Calcium excretion in a Swiss Treatment of in-stent restenosis using laser population-based study. debulking and drug-eluting balloons. van den Berg JC. Noris M, Bresin E, Piras R, Sorosina A, Valoti E, Zurich, Switzerland, 15-16th August 2013. Scottsdale, AZ, U.S.A., 24-28th February 2013. 10th SITE. Alberti M, Bettoni S, Uka R, Donadelli R, Zito A, How to deal with superior vena cava and Gamba S, Fremeaux-Bacchi V, Gabutti L, Remuzzi Salvadé I, Schätti-Stählin S, Cereghetti C, van den Berg JC. subclavian recanalizations. G, Daina E. Schönholzer C, Violetti E, Zwahlen H, Berwert L, 35th International Symposium Charing Cross. Barcelona, Spain, 9-10th May 2013 Convention Telethon. Burnier M, Gabutti L. 3D image overlay to assist peripheral Complement Abnormalities In Primary Annual Meeting of the Swiss Society of endovascular procedures. van den Berg JC. Membranoproliferative Glomerulonephritis. Nephrology. London, UK, 6-8 th April 2013. 8th ESVB 2013. Riva del Garda, Italy, 11-13th March 2013. A multicentric prospective observational study Fusion imaging, a system to import existing CT analysing arterial stiffness in a hemodialysis van den Berg JC. and MR images to the angiosuite. Porretta AP, Di Valentino M, Muzzarelli S, Limoni cohort. 35th International Symposium Charing Cross. Strasbourg, France, 10-11th May 2013. C, Pedrazzini G, Kaiser C, Moccetti T, Osswald S, Zurich, Switzerland, 4-6th December 2013. Radiation protection for non-radiologists. Gallino A. Published in: Swiss Med Wkly. 2013; 143(Suppl London, UK, 6-8th April 2013. van den Berg JC. ESC (European Society of Cardiology). 202): 7S. EuroPCR 2103. Long-term implications on the incidence van den Berg JC. Visceral artery stenting: how do I do it. of ST-Elevation Myocardial Infarction after Interventional Radiology 35th International Symposium Charing Cross. Paris, France, 21-24 th May 2013. implementation of a public smoking ban: a A complex type 2 endoleak case (using comparison between cantons in Switzerland. van den Berg JC. neuroradiological tools). van den Berg JC. Amsterdam, The Netherlands, 31th August-4th LINC2013. London, UK, 6-8th April 2013. EuroPCR 2103. September 2013. Atherectomy/laser + DEB: a safe and effective When and how to exclude internal iliac? solution. van den Berg JC. Paris, France, 21-24 th May 2013.

126 Scientific Report 2013 7. Publications in 2013 127 van den Berg JC. Barcelona, Spain, 14-18th September 2013. endovascular procedures. Combined with Bihemispheric Neuromodulation) EuroPCR 2103. New York, NY, 19-23rd November 2013. post stroke study. Gelfoam-PVA particles. van den Berg JC. Lugano, Switzerland, 22nd March 2013. Paris, France, 21-24 th May 2013. London Cardiovascular Symposium 2013. van den Berg JC. Plaque excision by atherectomy is going to be the 40th VEITH symposium. Codipietro L, Cristofano A, Maino P. van den Berg JC. future treatment of choice. Prevention and treatment of A-V fistulas after 8th Congress of the European Federation of IASP EuroPCR 2103. London, UK, 7-8th October 2013. Fogarty embolectomy and PTA. Chapters (EFIC) - PAIN IN EUROPE VIII. Microspheres and other new embolic agents. New York, NY, 19-23rd November 2013. Aseptic myelitis in a patient treated with Paris, France, 21-24th May 2013. van den Berg JC. intrathecal opioid infusion: switch to ziconotide SIVEC 2013. van den Berg JC. and symptoms resolution. A case-report. van den Berg JC. How I survived to endovascular revolution? The 40th VEITH symposium. Florence, Italy, 9-12th October 2013. 14th NCVH Annual Conference 2013. history of a radiologist. Hydrogel coated coils for a more dependable PHOTOPAC trial for in-stent restenosis. Siena, Italy, 24-25th October 2013. arterial occlusion: why they work better. Fulda S. New Orleans, LA, U.S.A., 5-7th June 2013. New York, NY, 19-23rd November 2013. SLEEP 2013, the 27th Annual Meeting of the van den Berg JC. Associated Professional Sleep Societies, LLC van den Berg JC. 14th Unionstagung SGG. van den Berg JC. (APSS). AMP 3rd Annual 2013. Treatment of deep venous thrombosis (DVT) with Perspectives 2013. The RLS treatment conundrum: when and how? Laser atherectomy followed by DEB. the Trellis device. Stent couvert dans les rénales:technique. Baltimore, Maryland, USA, 3rd June 2013. Chicago, Illinois, U.S.A., 8-10 th August 2013. Montreux, Switzerland, 30th October 2013. Bordeaux, France, 13th December 2013. Fulda S. Walker C, van den Berg JC. van den Berg JC. van den Berg JC. Meeting of the International Restless Legs AMP 3rd Annual 2013. 14th Unionstagung SGG. Perspectives 2013. Syndrome Study Group (IRLSSG). Roundtable laser atherectomy workshop. Complications of endovascular treatment of Laser + DEB pour les resténoses intra-stents. PLM and apnea. Chicago, Illinois, U.S.A., 8-10th August 2013. visceral malperfusion syndrome. Bordeaux, France, 13th December 2013. Valencia, Spain, 28th September 2013. Montreux, Switzerland, 30th October 2013. van den Berg JC. Neurology Fulda S. CIRSE 2013. van den Berg JC. 5th World Congress on Sleep Medicine. Essential dedicated tools for BTK treatment. 14th Unionstagung SGG. Cereda CW. Measuring periodic leg movements on the Barcelona, Spain, 14-18th September 2013. CLI and cell therapy: clinical evidence. Annual Meeting American Accademy of polysomnogram: current standards and Montreux, Switzerland, 30th October 2013. Neurology. problems. van den Berg JC. Endothelial Dysfunction and Arterial Stiffness in Valencia, Spain, 29th September 2013. CIRSE 2013. van den Berg JC. Ischemic Stroke: the role of Sleep Disordered The V12 RX covered stent as a problem solver VIBE2013. Breathing. Fulda S. for the renal and visceral arteries. Acute arterial occlusions. New Orleans, Louisiana, U.S.A., April 2013. 5th World Congress on Sleep Medicine. Barcelona, Spain, 14-18th September 2013. Bruxelles, Belgium, 16th November 2013. PLMs are associated with disturbed sleep – Con Cereda CW, Bianco G, Conti FM, Dinacci D, speaker. van den Berg JC. van den Berg JC. Petrillo M, Zutter D, Staedler C, Möller JC, Valencia, Spain, 1st October 2013. CIRSE 2013. 40th VEITH symposium. Bassetti CL, Uncini A, Müri R. Workshop embolization. Atherectomy or laser and DEB’s are the best Terza Giornata della Ricerca Clinica della Svizzera Fulda S, Manconi M, Zavalko I, Mathis J, Nobili L, Barcelona, Spain, 14-18th September 2013. treatment for ISR: good results are durable. Italiana. Bassetti CL. New York, NY, 19-23rd November 2013. Riabilitazione combinata alla stimolazione SLEEP 2013, the 27th Annual Meeting of the van den Berg JC. biemisferica transcranica con corrente continua Associated Professional Sleep Societies, LLC CIRSE 2013. van den Berg JC. diretta in pazienti con ictus subacuto al fine (APSS). Controversies in endoleak management TEVR: 40th VEITH symposium. di aumentare il recupero motorio degli arti REM sleep reduction identifies patients with a Type II endoleak require treatment: PRO. Update on new tools for 3D navigation in superiori – Lo studio Re.Com.Bi.Ne (Rehabilitation poor recovery after stroke.

128 Scientific Report 2013 7. Publications in 2013 129 Baltimore, Maryland, USA, 3rd June 2013. Maestri M, Fulda S, Zucconi M, Ferini-Strambi L, Tabarrini A, Miano S, Mazzotta AR, Bianchi S, contraindication to vertebroplasty? Marelli S, Bassetti CL, Manconi M. Ferretti A, Brasili L, Cecili M, Villa MP. Liverpool, UK, 2nd-4th October 2013. Fulda S, Zavalko I, Ferri R, Manconi M. 5th World Congress on Sleep Medicine. European Respiratory Society Annual Congress. SLEEP 2013, the 27th Annual Meeting of the Recovery of augmentation in restless legs Neurocognitive impairment in children with Cianfoni A, Bonaldi G. Associated Professional Sleep Societies, LLC syndrome with extended-release dopamine obesity and sleep disordered breathing, 3rd Joint Meeting of ASSR and ESNR. (APSS). agonist. Barcelona, Spain, 7-11th September 2013. Neoplastic Lytic Vertebral lesions with erosion Respiratory-related leg movements: what is the Valencia, Spain, 30th September 2013. of posterior wall and epidural mass: an absolute evidence behind the rules? Zanini C, Maino P, Möller JC, Gobbi C, Raimondi contraindication to vertebroplasty? Baltimore, Maryland, USA, 4th June 2013. Maino P, E. Koetsier E. M, Rubinelli S. Milan, Italy, 5-7th July 2013. 8th Congress of the European Federation of IASP Terza giornata della Ricerca Clinica della Svizzera Fulda S, Zavalko I, Ferri R, Manconi M. Chapters (EFIC) - PAIN IN EUROPE VIII. italiana. Cianfoni A, Raz E, Bonaldi G, Pravatà E. 5th World Congress on Sleep Medicine. Topical high-concentration capsaicin (8%) relieves Facilitare l’intesa con il paziente: cinque domande Radiological Society of North America (RSNA). Respiratory-related leg movements: what is the persistent postsurgical pain (PPSP). per capire il suo punto di vista. Neoplastic Lytic Vertebral lesions with erosion evidence behind the rules? Florence, Italy, 9-12th October 2013. Lugano, Switzerland, 22nd March 2013. of posterior wall and epidural mass: an absolute Valencia, Spain, 30th September 2013. contraindication to vertebroplasty? Maino P, Koetsier E, Ross V, Codipietro L. Zanini C, Maino P, Möller JC, Gobbi C, Raimondi Chicago, Illinois, USA, 1st-6th December 2013. Galati S, Pace M, Baracchi F, Sarasso S, 8th Congress of the European Federation of IASP M, Rubinelli S. Prosperetti C, Bassetti CL, Staedler C, Möller JC. Chapters (EFIC) - PAIN IN EUROPE VIII. 6th Geneva conference on Person-centered Nolte J, Gupta P, Davis M, Matheus M, Cianfoni A, 23rd Meeting of the European Neurological Dorsal root ganglions stmulation versus classic Medicine. Chaudry I, Yeatts S, Rumboldt Z, Turan T. Society. SCS for intractable neuropathic pain in difficult to A conceptualization of the patient’s perspective by International Stroke Conference. Evidence of impaired synaptic homeostasis target anatomical locations. doctors. Association Between Low CBV and ICH in underlying the appearance of levodopa-induced Florence, Italy, 9-12th October 2013. Geneva, Switzerland, 27th April-1st May 2013. Acute Stroke Patients Undergoing Intra-Arterial dyskinesia: an electrophysiological and molecular Therapy. study in a rat model for Parkinson’s disease (PD). Maino P, Möller JC. Zanini C, Maino P, Möller JC, Gobbi C, Raimondi Honolulu, Hawaii, USA, 6-8th February 2013. Barcelona, Spain, 8-11th June 2013. Terza Giornata della Ricerca Clinica della Svizzera M, Rubinelli S. Italiana. Conference on Communication Medicine and Pravatà E, Rocca MA, Riccitelli G, Pagani E, Galati S, Sarasso S, Pace M, Salvadè A, Baracchi Iniezione accidentale nei tessuti molli di Ethics (COMET). Radaelli M, Martinelli-Boneschi F, Falini A, Comi G, F, Möller JC. medicamenti per riempimento pompe intratecali: Five-questions to facilitate agreement with Filippi M. Terza Giornata della Ricerca Clinica della Svizzera rischio aumentato senza controllo radioscopico. the patient: results from a qualitative study. AINR Congress of Neuroradiology 2013. Italiana. Lugano, Switzerland, 22nd March 2013. Melbourne, Australia, 11th-13th July 2013. Brain WHITE MATTER Tracts Microstructural Un’alterazione del sonno ad onde lente sottende Alterations in nMultiple Sclerosis Patients with la comparsa delle discinesie indotte dalla Maino P, Möller JC. Zanini C, Maino P, Möller JC, Gobbi C, Raimondi Depression and Fatigue: a Diffusion Tensor MRI levodopa: evidenze da uno studio traslazionale Terza Giornata della Ricerca Clinica della Svizzera M, Rubinelli S. Study. nella malattia di Parkinson. Italiana. Conference on Interpersonal Communication and l’Aquila, Italy, 18th-21st September 2013. Lugano, Switzerland, 22nd March 2013. Stimolazione dei gangli dorsali per il trattamento Social Interaction (ICSI). di dolori neuropatici refrattari in aree Patients’ knowledge and beliefs in doctor-patient Pravatà E, Tavernier J, Parker R, Vavro H, Mintzer Maestri M, Fulda S, Zucconi M, Ferini-Strambi L, anatomicamente difficili da coprire. relationship. JE, Spampinato MV. Marelli S, Bassetti CL, Manconi M. Lugano, Switzerland, 22nd March 2013. Lugano, Switzerland, 3rd- 4th October 2013. European Congress of Radiology. SLEEP 2013, the 27th Annual Meeting of the The neural correlates of anomia in the conversion Associated Professional Sleep Societies, LLC Mazzotta AR, Tocci G, Miano S, Bianchi S, Neuroradiology from mild cognitive impairment to Alzheimer’s (APSS). Tabarrini A, Forlani M, Villa MP. disease. Recovery of augmentation in restless legs European Respiratory Society Annual Congress. Cianfoni A, Bonaldi G. Vienna, Austria, 8th March 2013. syndrome with extended-release dopamine The effects of obstructive sleep apnea on Euro Spine 2013. agonist. cardiovascular functioning in children with obesity, Neoplastic Lytic Vertebral lesions with erosion Spampinato MV, Pravatà E, Patrick, Parker KR. Baltimore, Maryland, USA, 4th June 2013. Barcelona, Spain, 7-11th September 2013. of posterior wall and epidural mass: an absolute European Congress of Radiology.

130 Scientific Report 2013 7. Publications in 2013 131 Gender Differences in Gray Matter atrophy realization. functional parameter in primary mediastinal Prevalence and malignancy risk of focal areas of patterns in amnestic mild cognitive impairment Zurich, Switzerland, 30th October – 2nd diffuse large B-cell lymphoma (PMLBCL). incidental F-18-FDG uptake in the colon-rectum: A with progression to Alzheimjer’s Disease. November 2013. Lucerne, Switzerland, 30th May -1st June 2013. meta-analysis. Vienna, Austria, 8th March 2013. Lucerne, Switzerland, 30th May -1st June 2013. Bianchi M, Valcarenghi D. Ceriani L. Neurosurgery Terza Giornata della Ricerca Clinica della Svizzera 12th International Conference on Malignant Treglia G. Italiana. Lymphomas. Annual Congress of the European Association of Valci L, Kuhlen D, Pravatà E, Gobbi C, Reinert M. Research-action: The use of Peripherally Inserted Prognostic value of the 18FDG PET baseline Nuclear Medicine. 4th Congress International Society of Central Catheters (PICC) at the Oncology Institute functional parameters in primary mediastinal I-123-MIBG cardiac scintigraphy in Lewy body Intraoperative Neurophysiology and Educational of Southern Switzerland and the first results. diffuse large B-cell lymphoma (PMLBCL). dementia. Course. Lugano, Switzerland, 22nd March 2013. Lugano, Switzerland, 19-22th June 2013. Lyon, France, 19-23th October 2013. A case of intradiploic encephalocele of the primary motor area: electrophysiological Pedrazzani C, Valcarenghi D, Bianchi M. Ceriani L, Zucca E, Zinzani PL, Ferreri A, Vitolo Treglia G. implications during surgery. ECCO17 - ESMO38 - ESTRO32 - European Cancer U, Stelitano C, Brusamolino E, Cabras G, Rigacci X European Neuro-Endocrine Tumours Society CapeTown, South Africa, 11-16th November Congress - Reinforcing Multidisciplinarity. L, Salvi F, Gargantini L, Balzarotti M, Merli F, (ENETS). 2013. The multidisciplinary approach to elder cancer Pinotti G, Montoto S, Lopez-Guillermo A, Cavalli F, Diagnostic accuracy of F-18-DOPA PET or PET/ patients: geriatric assessment and nursing Giovanella L, Johnson PW, Martelli M. CT in neuroendocrine tumors: a meta-analysis. Nursing Medicine decision making. Lugano Conference on Malignant Lymphoma Barcelona, Spain, 6-8 th March 2013. Amsterdam, Holand, 27th September – 1st 2013. Bender N, Masullo A, Ghielmini M, Mauri S. October 2013. Prognostic value of 18FDG Baseline functional Treglia G. ECCO17 - ESMO38 - ESTRO32 - European Cancer PET parameter in Primary Mediastinal Diffuse Annual Congress of the Swiss Society of Radiology Congress - Reinforcing Multidisciplinarity. Valcarenghi D, Pedrazzani C, Bianchi M. Large B-Cell Lymphoma. (SSR) and Nuclear Medicine (SGNM). The establishment of a oncologic rehabilitation 8^ conferenza Nazionale GIMBE: Evidence, Lugano, Switzerland, 18th- 22nd June 2013. Cost-effectiveness of F-18-FDG PET and PET/CT network. Governance, Performance. in tumors other than lung cancer: A systematic Amsterdam, Holand, 27th September – 1st Iniziative per lo sviluppo del "pensiero critico"fra Giovanella L. review. October 2013. gli infermieri dell’Istituto Oncologico della Svizzera Schildrusse Kongress 2013. Lucerne, Switzerland, 30th May -1st June 2013. Italiana (IOSI). Differentiated thyroid carcinoma. Bianchi M, Lussu S, Pedrazzani C, Servida P, Bologna 15th March 2013. Bolzano, Italy, 15th March 2013. Treglia G. Valcarenghi D. Annual Congress of the Swiss Society of Radiology ECCO17 - ESMO38 - ESTRO32 - European Cancer Valcarenghi D, Pedrazzani C, Broggini L, Bianchi Giovanella L. (SSR) and Nuclear Medicine (SGNM). Congress - Reinforcing Multidisciplinarity. M. Annual Congress of the European Association of Prevalence and malignancy risk of focal areas of The constitution of a “Peripherally Inserted ECCO17 - ESMO38 - ESTRO32 - European Cancer Nuclear Medicine. incidental F-18-FDG uptake in the thyroid: A meta- Central Catheters Team” (PICC team) at the Congress - Reinforcing Multidisciplinarity. Challenges in differentiated thyroid carcinoma analysis. Oncology Institute of Southern Switzerland (IOSI): The introduction of an art-therapy program for follow-up. Lucerne, Switzerland, 30th May -1st June 2013. a multidisciplinary approach. oncological patients in care at the Oncology Lyon, France, 19-23th October 2013. Amsterdam, Holand, 27th September – 1st Institute of Southern Switzerland: a pilot study. Treglia G. October 2013. Amsterdam, Holand, 27th September – 1st Giovanella L. Annual Congress of the European Association of October 2013. Annual Congress of the Finnish Society of Nuclear Medicine. Bianchi M, Pedrazzani C, Valcarenghi D. Endocrinology. Clinical impact of (18)F-FDG PET-CT in the ENDA Congress 2013. Nuclear Medicine High-sensitive Thyroglobulin in DTC. management of patients with carcinoma of Nursing in the Stream of Excellence. Abstract Helsinki, Finland, 15-16th October 2013. unknown primary: our experience. and poster: "The development of a research Ceriani L. Lyon, France, 19-23th October 2013. and “evidence based practice” (EBP) -oriented Annual Congress of the Swiss Society of Radiology Treglia G. culture among the Oncology Institute of Southern (SSR) and Nuclear Medicine (SGNM). Annual Congress of the Swiss Society of Radiology Treglia G. Switzerland (IOSI) nurses: from the idea to the Prognostic value of the 18FDG PET: Derived (SSR) and Nuclear Medicine (SGNM). Annual Congress of the European Association of

132 Scientific Report 2013 7. Publications in 2013 133 Nuclear Medicine. Moosmann P, Kollar A, Saletti P, Roth A, Frueh Lugano Conference on Malignant Lymphoma Gamondi C, Pott M, Payne S. A multicentre retrospective study on the M, Kueng M, Popescu R, Schacher S, Hess V, 2013. The 13th World Congress of the EAPC. additional value of 18F-FDG-PET/CT findings Herrmann R. Chlorambucil plus Rituximab produces better Families’ experiences of assisted suicide in over conventional imaging in the follow-up of 2013 ASCO Annual Meeting. event-free and progression-free survival in Switzerland: a qualitative study. hepatoblastoma patients. Bevacizumab continuation versus no continuation comparison with Chlorambucil or Rituximab alone Prague, Czech Republic, 30th May-2nd June Lyon, France, 19-23th October 2013. after first-line chemo-bevacizumab therapy in in extranodal marginal zone B-cell lymphoma 2013. patients with metastatic colorectal cancer: A (MALT lymphoma): final results of the IELSG-19 Oncology randomized phase III noninferiority trial (SAKK study. Radiation Oncology 41/06). Lugano, Switzerland, 18th- 22nd June 2013. Azinwi NC, Stoffel F, Mazzola B, Peyer P, Llado Chicago, Illinois, U.S.A., 31st May- 4thJune 2013. Azinwi NC, Presta G, Picardi C, Pittoni P, Martucci A, Puligheddu C, Crippa S, Bordoni A, Bianchi V, Published in: J Clin Oncol. 2013;31(suppl; abstr Stanta G, Barbazza R, Pracella D, Sulfaro S, F, Valli MC, Richetti A, Pesce G. Marongiu B, Pascale M, Roggero E, Richetti A, 3503). Pascale M, Marongiu B, Roggero E, Bonin S. 17th Annual SASRO Meeting. Wyttenbach R, Pesce G. Terza Giornata della Ricerca Clinica della Svizzera QART: Evaluating the correlation between 17th Annual SASRO Meeting. Martelli M, Zucca E, Zinzani PL, Ferreri AJM, Italiana. percentage rate of fall of PSA and positioning The EOC Uroboard, a multidisciplinary approach Vitolo U, Porro E, Stelitano C, Brusamolino E, Il virus del papilloma umano nel carcinoma della accuracy. to the management of patients with urogenital Cabras MG, Rigacci L, Balzarotti M, Salvi F, Pinotti prostate. Davos, Switzerland, 4-6th July 2013. cancer. G, Russo E, Merli F, Rusconi C, Montoto S, Davies Lugano, Switzerland, 22nd March 2013. Davos, Switzerland, 4-6th July 2013. A, Di Rocco A, Paesano A, Lopez-Guillermo A, Azinwi NC, Stoffel F, Mazzola B, Peyer P, Lladò Cavalli F, Giovanella L, Johnson PWM, Ceriani L. Palliative Care A, Puligheddu C, Crippa S, Bordoni A, Bianchi V, Bender N, Masullo A, Ghielmini M, Mauri S. 18th Congress of the European Hematology Marongiu B, Pascale M, Roggero E, Richetti A, ECCO17 - ESMO38 - ESTRO32 - European Cancer Association. Gamondi C. Wyttenbach R, Pesce G. Congress - Reinforcing Multidisciplinarity. Role of 18FDG-PET/CT in post-chemotherapy National Research Conference on Palliative Care. 17th Annual SASRO Meeting. The establishment of a oncologic rehabilitation evaluation of primary mediastinal large B-cell Le suicide assisté: l’expérience des familles dans The EOC Uroboard, a multidisciplinary approach network. lymphoma (PMLBCL): results of an international la prise de décision et dans le processus de deuil. to the management of patients with urogenital Amsterdam, Holand, 27th September – 1st phase II trial (IELSG-26 study) conducted on behalf Bern, Switzerland, 26th November 2013. cancer. October 2013. of the International Extranodal Lymphoma Study Davos, Switzerland, 4-6th July 2013. Group (IELSG-26 trial). Gamondi C. Espeli V. Stockolm, Sweden, 13-16th June 2013. The 15ème Journee regionale de soins palliatifs. Belosi F, Brualla L, Nicolini G, Clivio A, Vanetti E, ICHNO 2013. Les soignants confrontés aux personnes qui Cozzi L, Rodriguez M, Sempau J, Fogliata A. Safety and effectiveness of prolonged nasogastric Saletti P, Nucifora M, De Dosso S, Spitale A, demandent une assistance au suicide. SGSMP Meeting. tube for head and neck cancer undergoing Sahnane N, Riveiro M, Bertolini V, Bucci E, Crippa Saint Brieuc, France, 22nd November 2013. Monte Carlo simulations of TrueBeam FFF beams radiotherapy. S, Ghielmini M, Frattini M. using Varian phase space files: comparison with Barcelona, Spain, 7-9th February 2013. 2013 ASCO Annual Meeting. Gamondi C. experimental data. Influence of KRAS mutations on outcome in The 13th World Congress of the EAPC. Neuchâtel, Switzerland, 14-15th November Giurgiu I, Pascale M, Azinwi NC, Marongiu B, patients with curatively resected stage III colon Palliative Care – The Right Way Forward. 2013. Pittoni P, Picardi C, Martucci F, Valli MC, Richetti cancer treated with adjuvant chemotherapy. Prague, Czech Republic, 30th May-2nd June A, Roggero E, Pesce G. Chicago, Illinois, U.S.A., 31st May- 4thJune 2013. 2013. Bianchi Galdi V, Franzetti-Pellanda A, Spitale 17th Annual SASRO Meeting. Published in: J Clin Oncol. 2013;31(suppl; abstr A, Valli MC, Ortelli L, Mazzola P, Peverelli S, Single Institution Analysis of Pelvic Radiotherapy e14536). Gamondi C, Pott M, Payne S. Mazzucchelli L, Bordoni A. for High Risk Prostate Cancer. The 13th World Congress of the EAPC. 2nd ESTRO Forum. Davos, Switzerland, 4-6th July 2013. Zucca E, Conconi A, Martinelli G, Tucci A, Vitolo U, Issues of control and perceived disruption of Quality Indicators in radiation therapy for rectal Russo E, Coiffier B, Ghesquieres H, Morschhauser the self are main reasons for choosing assisted cancer. A population based study in Southern Koeberle D, Betticher D, Von Moos R, Dietrich F, Pettengell R, Pinotti G, Devizzi L, Bouabdallah suicide, despite the provision of palliative care. Switzerland 2011-12. D, Brauchli P, Baertschi D, Matter-Walstra R, Copie-Bergman C, Pileri S, Jack A, Campo E, Prague, Czech Republic, 30th May-2nd June Geneve, Switzerland, 19th-23rd April 2013. K, Winterhalder RC, Borner M, Anchisi S, Lopez-Guillermo A, Johnson PW, Thieblemont C. 2013.

134 Scientific Report 2013 7. Publications in 2013 135 Fogliata A. (SIB) in bilateral syncronous breast cancer. Radiology X, Herczak J, Fujita H, Carrino JA, Del Grande F, 2nd ESTRO Forum. Davos, Switzerland, 4-6th July 2013. Thawait GK, and Farahani SJ. Flattening Filter Free beams: treatment planning. Chalian M, Del Grande F, Farahani Jalali S, Eng J, ISMRM 2013. Geneve, Switzerland, 19th-23rd April 2013. Poortmans P, Struikmans H, Kirkove C, Budach John A Carrino JA, Chhabra A. 3T transmit and 16 channel receive array coil for V, Maingon P, Valli MC, Collette S, Fourquet A, AUR 2013. Hand/Wrist imaging. Fogliata A. Bartelink H, Van den Bogaert W. Radial Neuropathy: Reliability and Accuracy of 3T Salt Lake City, UT, USA, 20-26th April 2013. BHPA Symposium 2013. Joint ECCO 17, 38th ESMO and 32nd ESTRO MR Neurography. Dose calculation algorithms accuracy, dose to Multidisciplinary Congress. Los Angeles, California, USA, 9-12th April 2013. Helck A, Bianda N, Yuan C, Gallino A, Saam T, medium and dose to water issues. Irradiation of the internal mammary and medial Wyttenbach R et al. Mechelen, Belgium, 1st-2nd February 2013. supraclavicular lymph nodes in stage I to III breast Chalian M, Del Grande F, Thakkar RS, Farahani SJ, Meeting Annuale Società Svizzera di Radiologia cancer: 10 years results of the EORTC Radiation Chhabra A, Demehri S, Carrino J. (SGR - SSR) 2013. Fogliata A. Oncology and Breast Cancer Groups phase III trial RSNA 2013. Differences of plaque phenotypes in the carotid BHPA Continuing Education on Dose calculation 22922/10925. Second-opinion Consultations in Musculoskeletal and femoral arteries: an in vivo study using MRI algorithms used in Radiotherapy Treatment Amsterdam, The Netherlands, 27th September- Radiology. plaque imaging. Planning. 1st October 2013. Chicago, Illinois, USA, 1-6th December 2013. Lucerne, Switzerland, 31th May 2013. Linear Boltzmann Transport Equation solver for external beam dose calculations: accuracy and Valli MC. Del Grande F, Aro RM, Wilckens J, Chhabra A, Regini F, Colagrande S, Mazzoni LN, Busoni S, implications in the clinical application. A new era Senoforum 2013. Carrino J. Santini P, Wyttenbach R et al. of dose calculation algorithms? Postmastectomy radiotherapy. RSNA 2013. Meeting Annuale Società Svizzera di Radiologia Bruxelles-Charleroi, Belgium, 6th May 2013. Lugano, Switzerland, 11th-12th September 3 Tesla MRI Imaging of the Shoulder in (SGR - SSR) 2013. 2013. Asymptomatic Major League Baseball Pitcher Multi-parametric assessment of liver perfusion by Giurgiu I, Pascale M, Azinwi NC, Marongiu B, Drafts. MR-DWI: correlation with phase-contrast portal Pittoni P, Picardi C, Martucci F, Valli MC, Richetti Valli MC. Chicago, Illinois, USA, 1-6th December 2013. venous flow measurements. A, Roggero E, Pesce G. IV Incontro Italo-Francese sul Carcinoma Lucerne, Switzerland, 31th May 2013. 17th Annual SASRO Meeting. Mammario: problematiche attuali. Del Grande F, Dreizin D, Fayad LM. Single Institution Analysis of Pelvic Radiotherapy RT della mammella/parete toracica e stazioni RSNA 2013. Regini F, Colagrande S, Mazzoni LN, Busoni S, for High Risk Prostate Cancer. linfonodali con tecnica 3D-CRT o IMRT Linac 3 Tesla Chemical Shift MR Imaging: Technique, Santini P, Wyttenbach R et al. Davos, Switzerland, 4-6th July 2013. based. Clinical Utility and Pitfalls for Imaging the Skeleton. European Society of Gastrointestinal and Assisi, Italy, 22nd-23rd November 2013. Chicago, Illinois, USA, 1-6th December 2013. Abdominal Radiology (ESGAR) 2013. Pesce G. Assessment of liver perfusion by multi-parametric The Swiss-Italian Neuro-Oncology Meeting. Valli MC, Nicolini G, Pittoni P, Richetti A, Picardi C, Del Grande F, Santini F, Edelstein WA, Carrino J. MR-DWI: correlation with phase-contrast portal Controversies in the treatment of low-grade Martucci F, Azinwi NC, Pesce G, Clivio A, Vanetti E, RSNA 2013. venous flow measurements. gliomas: Radiotherapy: adjuvant or at relapse? Cozzi L, Fogliata-Cozzi A. Radiofrequency Coils for Musculoskeletal MR Barcelona, Spain, 4-7th June 2013. Lugano, Switzerland, 5-7th September 2013. 17th Annual SASRO Meeting. Imaging: Explanation and Tips for Radiologists. External beam accelerated partial breast Chicago, Illinois, USA, 1-6th December 2013. Regini F, Colagrande S, Mazzoni LN, Busoni S, Richetti A. irradiation (APBI): techniques comparison. Santini P, Wyttenbach R et al. Senoforum 2013. Davos, Switzerland, 4-6th July 2013. Del Grande F, Subhawong T, Weber K, Aro RM, Associazione Italiana di Fisica Medica (AIFM) Breast cancer in young women, individualised Mugera CM, Fayad LM. 2013. strategies in radiotherapy. Vanetti E, Clivio A, Fogliata A, Fenoglietto P, RSNA 2013. Perfusion influence on Diffusion Weighted Lugano, Switzerland, 18th October 2013. Krauss H, Cozzi L, Nicolini G. Detection of Soft Tissue Sarcoma Recurrence: Imaging (DWI) of the liver: mathematical DWI 17th Annual SASRO Meeting. Added Value of Functional MR Imaging signal models sensitivity to portal flow variations. Pittoni P, Martucci F, Picardi C, Azinwi NC, Pesce Pre-treatment QA for VMAT flattening filter free Techniques at 3T. Torino, Italy, 16-19th November 2013. G, Richetti A, Valli MC. beams with portal imager using GLAaS algorithm. Chicago, Illinois, USA, 1-6th December 2013. 17th Annual SASRO Meeting. Davos, Switzerland, 4-6th July 2013. Stoffel F, Mazzola B, Peyer P, Pesce G, IMRT/RapidArc Simoultaneous Integrated Boost Handa S, Finnerty M, Lawrie C, Zheng T, Yang Wyttenbach R, Puligheddu C et al.

136 Scientific Report 2013 7. Publications in 2013 137 Terza Giornata della Ricerca Clinica della Svizzera Bern, Switzerland, 12-14th June.2013. 100e Congrès annuel de la Société Suisse de Maladies Vasculaires, Complications. Italiana. Chirurgie; Congrès du Jubilé. Complications of surgical management of limb Uroboard EOC, un approccio multidisciplinare nel Brunetti S, Lucchina S, Fusetti C. Purse-string closure of the stoma site leads acute ischemia. trattamento dei pazienti con neoplasie urogenitali. 46 Jahreskongress SGH-SSCM. to fewer wound infections: results from a Montreux, Switzerland, 30th October-1st Lugano, Switzerland, 23 March 2013. Decompressive surgery in patients with multicenter randomized controlled trial. November 2013. hereditary neuropathy with liability to pressure Bern, Switzerland, 12-14th June 2013. Vitale VA. palsies (HNPP). Lee J, Marquez T, Clerc D, Rothenberger D, Gie O, Journées Internationales d’Echographies Biel, Switzerland, 13-14th November 2013. Corni V, Fusetti C, Lucchina S. Demartines N, Madoff R, Christoforidis D. Gynécologiques et Obstétricales. Does endoscopic-assisted fascial forearm release The American Society of Colon and Rectal Diagnostic imaging now and beyond. Cafarotti S, Giuliani M, Mattarelli E, Schnaiter worth the efforts in bilateral compartment Surgeons meeting. Lugano, Switzerland, 4th October 2013. D, Karoubi G, Carboni G, Dutly AE on behalf of syndrome ? A purse-string closure of the stoma site leads Pneumoclub Ticino. Biel, Switzerland, 46 Jahreskongress SGH-SSCM to fewer wound infections: results from a Vitale VA, De Jong M. 21st European Conference on General Thoracic 13-14th November 2013. multicenter randomized controlled trial. Senoforum 2013. Surgery (ESTS). Phoenix, AZ, U.S.A. 27th April-1st May 2013. Challenges of radiological assessment. Thoracoscopic outpatient wedge lung resection: Draenert C, Pravini B, Christoforidis D, Rosso R. Lugano, Switzerland, 18th October 2013. is it a safe and effective procedure? 100e Congrès annuel de la Société Suisse de Marbach F. Birmingham, UK, 26-29th May 2013. Chirurgie; Congrès du Jubilé. Corso di perfezionamento in ortopedia e Vitale VA. Laparoscopic peritoneal lavage for perforated traumatologia geriatrica dell’associazione Italiana Riunione del gruppo PMB. Cafarotti S, Giuliani M, Mattarelli E, Schnaiter diverticulitis with peritonitis. di Traumatologia ed Ortopedia Geriatrica. Approccio diagnostico senologico per il medico di D, Karoubi G, Carboni G, Dutly AE on behalf of Bern, Switzerland, 12-14th June 2013. Fratture femore prossimale, esperienza a famiglia. Pneumoclub Ticino. confronto: l’esperienza Svizzera. Lugano, Switzerland, 12th November 2013. European Multidisciplinary Conference in Thoracic Draenert C, Rosso R, Christoforidis D. Milan, Italy, 29th November 2013 Oncology (EMCTO). 100e Congrès annuel de la Société Suisse de Vitale VA. Thoracoscopic outpatient wedge lung resection: Chirurgie; Congrès du Jubilé. Mezzetto L, Giovannacci L, Rosso R. Centro di Senologia della Svizzera Italiana – CSSI. is it a safe and effective procedure? Reccurent appendagitis: a rare mimic for 14° Congrès de l’Union des Sociétés Suisses des Risk related to breast density. Lugano, Switzerland, 9-11th May 2013. recurrent sigmoid diverticulitis. Maladies Vasculaires, Complications. Lugano, Switzerland, 20th Novembre 2013. Bern, Switzerland, 12-14th June 2013. EVAR Solution in an infective aortitis: an open Cafarotti S, Giuliani M, Mattarelli E, Schnaiter discussion. Zhao F, Demehri S, Del Grande F, Kompe Al, D, Karoubi G, Carboni G, Dutly AE on behalf of Galetti K, Salmoiraghi F, Rosso R, Christoforidis D. Montreux, Switzerland, 30th October-1st Farahani, Thakkar RS, Carrino J. Pneumoclub Ticino. 100e Congrès annuel de la Société Suisse de November 2013. RSNA 2013. SGP (Schweizerischen Gesellschaft für Chirurgie; Congrès du Jubilé. Grading Focal and Diffuse Articular Cartilage Pneumologie). Laparoscopic transabdominal pre-peritoneal Mezzetto L, Giovannacci L, Rosso R. Lesions of the Knee Joint as Correlated with Thoracoscopic outpatient wedge lung resection: mesh repair of Spigelian Hernia. 14° Congrès de l’Union des Sociétés Suisses des Arthroscopy: Comparison of 3D Dual-echo Steady is it a safe and effective procedure? Bern, Switzerland, 12-14th June 2013. Maladies Vasculaires, Complications. State and Fat-saturated Proton Density-weighted Bern, Switzerland, 17-19th April 2013. In situ cryopreserved homograft revascularization Fast Spin Echo Sequences on 3T MR Imaging. Giovannacci L. for an atypical presentation. Chicago, Illinois, USA, 1-6th December 2013. Christoforidis D. 100e Congrès annuel de la Société Suisse de Montreux, Switzerland, 30th October-1st 14th International Colorectal Forum. Chirurgie; Congrès du Jubilé. November 2013. Surgery Beyond the technique: patient related risk factors Verpasste Ischämie und Compartment Syndrom and optimal perioperative care for fistula surgery: / Ischémie jambière sévère et syndrome de Mezzetto L, Dessi K, van den Berg J, Giovannacci Bernasconi M, Christoforidis D, Rosso R. what’s the evidence? loges. L, Rosso R. 100e Congrès annuel de la Société Suisse de Verbier, Switzerland, 27-29th January 2013. Bern, Switzerland, 12-14th June 2013. 100e Congrès annuel de la Société Suisse de Chirurgie; Congrès du Jubilé. Chirurgie; Congrès du Jubilé. Small bowel intussusception due to primary Clerc D, Lee J, Marquez T, Gie O, Demartines N, Giovannacci L. EVAR solution in an infective aortitis: an open intestinal melanoma. Rothenberger D, Madoff R, Christoforidis D. 14° Congrès de l’Union des Sociétés Suisses des discussion.

138 Scientific Report 2013 7. Publications in 2013 139 Bern, Switzerland, 12-14th June 2013. Chirurgie; Congrès du Jubilé. Neurology Nursing Medicine Carotis TEA. Tips and Tricks. Mezzetto L, Rosso R, Celio D, Giovannacci L. Bern, Switzerland, 12-14th June 2013. Bassetti CL, Fulda S. Willems Cavalli Y. 100e Congrès annuel de la Société Suisse de Types of hypersomnia. La riabilitazione vive: professioni infermieristiche Chirurgie; Congrès du Jubilé. Rosso R. In: Kushida C, editor. Encyclopedia of Sleep. confrontate con nuove sfide. In situ cryopreserved homograft revascularization 30th International Gastrointestinal Surgery Elsevier, Burlington, MA, 2013: 413-417. In: Oggier W, Pellanda G, Rossi GR, editors. La for a graft infection with atypical presentation. Workshop. riabilitazione vive Rehabilitation lebt. Verlag Hans Bern, Switzerland, 12-14th June 2013. Open abdomen - therapeutic options for closure Cereda CW, Lavie L, Bassetti CL. Huber, Bern, Switerland, 2013: 133-139. of laparostomy. Sleep disordered breathing (SDB) and stroke. Popeskou S, Gavillet M, Demartines N, Davos, Switzerland, 23rd February-1st March In Sleep in neurological diseases, Nova Sciences Paediatrics Christoforidis D. 2013. Publishers. Stroke 2013: 324. 100e Congrès annuel de la Société Suisse de De Rosa V. Chirurgie; Congrès du Jubilé Stasakova S, Guerra A, Rosso R. Fulda S, Bassetti CL. Delayed diagnosis of spondylodiscitis in a toddler. Hemophagocytic lymphohistiocytosis and Congrès annuel de la Société Suisse de Chirurgie; Idiopathic hypersomnia with long sleep time. In Contentworx editor. Challenging Cases in Back gastrointestinal bleeding: what a surgeon should Congrès du Jubilé. In: Kushida C, editor. Encyclopedia of Sleep. and Low Back Pain. New Delhi, India, 2013: 227- know. Abdominal wall hernia during laparoscopic gastric Elsevier, Burlington, MA, 2013: 443-446. 234. Bern, Switzerland, 12-14th June 2013. bypass. What to do? Bern, Switzerland, 12-14th June 2013. Fulda S, Manconi M. Palliative Care Potocnik P, Arigoni M, Candrian C. Idiopathic REM sleep behaviour disorder as 100e Congrès annuel de la Société Suisse de Valente P, Balzarotti R, Rosso R. a long-term predictor of neurodegenerative Gamondi C. Chirurgie; Congrès du Jubilé. 100e Congrès annuel de la Société Suisse de disorders. Quand l’assistance au suicide s’invite dans Positioning of sacroiliac screws using an Chirurgie; Congrès du Jubilé. In: Mandel S, editor. Neurodegenerative Diseases: l’accompagnement de fin de vie. intraoperative 3 D CT (O-Arm©) guided navigation A case of hyperkalemia during CO2 insufflation for Integrative PPPM Approach as the Medicine of In Pott M, Dubois J, editors. Parcours de fin de in posterior pelvic ring fractures. laparoscopic right colectomy. the Future; Advances in Predictive, Preventive and vie. Editions à la carte, 2013: 99-112. Bern, Switzerland, 12-14th June 2013. Bern, Switzerland, 12-14th June 2013. Personalised Medicine, Vol. 2. Springer, Berlin, 2013: 31-44. Radiation Oncology Potocnik P, Arigoni M, Candrian C. Vallet C, Rosso R, Christoforidis D. 73° congresso annuale della Società Svizzera di 100e Congrès annuel de la Société Suisse de Manconi M, Fulda S. Aristei C, Guenzi M, Amichetti M, Ciabattoni A, Ortopedia e Traumatologia. Chirurgie; Congrès du Jubilé. Etiology of sleep-related movement disorders. Cucciarelli L, Fusco V, Huscher A, Leonardi MC, Positioning of sacroiliac screws using an Single-incision laparoscopic sigmoidectomy: a In: Kushida C, editor. Encyclopedia of Sleep. Lozza L, Nardone L, Perrucci E, Valli MC, Vidali C. intraoperative 3 D CT (O-Arm©) guided navigation novel approach through a McBurney incision. Elsevier, Burlington, MA, 2013: 17-21. La Radioterapia dei Tumori della Mammella: in posterior pelvic ring gractures. Bern, Switzerland, 12-14th June 2013. Indicazioni e Criteri Guida. Lausanne, Switzerland, 26- 28th June 2013. Neuroradiology AIRO 2013, chapter VII: 65-70. Publications in books in 2013 Potocnik P, Christoforidis D, Salmoiraghi F, Rosso Bonaldi G, Cianfoni A. Surgery R. Interventional Radiology Percutaneous Lumbar Posterior Stabilization for 100e Congrès annuel de la Société Suisse de Low Back Pain. Fusetti C. Chirurgie; Congrès du Jubilé. van den Berg JC, Grünhagen T. In: Interventional Neuroradiology of the Spine. Extra-articular phalanx fractures. Abdominal wall component separation in Image fusion: a system to import existing CT and Muto M Editor. Springer, 2013: 185-199. in Acute and chronic finger injuries in ball sports. combination with biological mesh used for closure MR images to the angiosuite Chick G, editor. Springer Verlag 2013. of a giant ventral hernia with colostomy. In: Chafké N, Durand B, Meichelboeck W, editors. Bern, Switzerland, 12-14th June 2013. New endovascular technologies from bench test to clinical practive. Strasbourg, GEPROVAS, Potocnik P, Mezzetto L, Giovannacci L, Rosso R. 2013: 229-236. 100e Congrès annuel de la Société Suisse de

140 Scientific Report 2013 7. Publications in 2013 141 8 Appendices 8. Appendices

Appendix 1 - Research projects funded by ABREOC in 2008

Lead Investigator Other researchers Institute Study title Status report (December 2013) Andreas Perren Roberto Malacrida / Elena Iapichino / Davide Corbella / Fabrizio Barazzoni / Regional Hospital of Bellinzona Physical vs. drug restraint in the intubated patient: in progress Valentina di Bernardo / Ines Sperandino / Cristina Sommacal and Valli - Intensive Care Medicine clinical consequences Gianfranco John Petri Fabio Garofalo / Robin Chanda / Mario Lazzaro / Luca Deabate / Regional Hospital of Bellinzona Diabetes in orthopedics: perioperative management of in progress Francesco Strano / Paola Genini / Ivana Roguljic and Valli - Orthopaedics the diabetic patient - a continuous intravenous infusion of rapid insulin (IEC) versus corrections with subcutane- ous insulin (standard regimen) Piercarlo Saletti Sara De Dosso / Milo Frattini / Luca Mazzucchelli / Emanuele Zucca IOSI Oncology Analysis of molecular markers ERCC-1, TS, p53 and closed and published in Cancer Chemother PTEN in patients affected by gastric or esophagogastric Pharmacol, 72(1):159-65, 2013: "ERCC1 predicts junction adenocarcinoma, who are radically operated outcome in patients with gastric cancer treated with and have undergone a preventive chemotherapy adjuvant cisplatin-based chemotherapy" Olivia Pagani Monica Taborelli / Gabriella Bianchi-Micheli / Manuela Sarti IOSI Oncology Analysis of the quality of information in genetic coun- in progress seling for predisposition to cancer diseases Luca Giovanella Luca Ceriani / Franco Keller IOSI Nuclear Medicine Calcium metabolism in Basedow disease closed and published in Eur J Clin Invest, 41(1):93-7, 2011: "Evaluation of serum parathyroid hormone- related peptide in hyperthyroid patients" Luca Giovanella / Luca Mazzucchelli / Luca Ceriani / Sergio Suriano IOSI Nuclear Medicine/Oncology Prognostic significance of 18fdg-PET/CT in progress Emanuele Zucca Mario Bianchetti Peter Johannes Schulz / Maria Caiata Zufferey Regional Hospital of Bellinzona Living with a chronic and genetic disease: the Gitelman closed and published in Nephrol Dial Transplant, and Valli - Paediatrics syndrome 27(8): 3196-3201, 2012: "Living with Gitelman dis- ease: an insight into patients' daily experiences" Michele Ghielmini Jürg Stamm / Alden Moccia / Alessandra Fusconi IOSI Oncology Fertility preservation through cryopreservation of ovar- in progress ian tissue

144 Scientific Report 2013 8. Appendices 145 Appendix 2 - Research projects funded by ABREOC in 2009

Lead Investigator Other researchers Institute Title Status report (December 2013) Olivia Pagani Aron Goldhirsch / Franco Cavalli / Laura Richetti IOSI - Oncology CARMA database: collection of retrospective and pro- in progress spective clinical data in breast cancer patients to as- sess the impact on outcome of prognostic and predic- tive factors identified at the diagnosis Luca Giovanella Franco Keller / Sergio Suriano IOSI Nuclear Medicine Procalcitonin and medullary thyroid carcinoma closed and published in Clin Chem Lab Med, 51(7):1477-81, 2013: "Comparison of serum calci- tonin and procalcitonin in detecting medullary thyroid carcinoma among patients with thyroid nodules" Gian Paolo Ramelli Alessandra Ferrarini Regional Hospital of Bellinzona Database creation of pediatric patients with mental re- "closed and published in Dev Med Child Neurol, and Valli - Paediatrics tardation assisted by neuropaediatrics Service of San 56(3):290, 2014: ""Chromosomal microarray Giovanni Hospital of Bellinzona among children with intellectual disability: a useful di- agnostic tool for the clinical geneticist"" Martin Bolli Riccardo Vandoni / Luca Mazzucchelli / Milo Frattini Regional Hospital of Bellinzona Expression and prognostic role of molecular, biological closed (presented final report) and Valli - Surgery and clinical markers in hepatocarcinoma Carlo Cereda Claudio Bassetti / Claudio Staedler / Laura Zampieri / Antonio Carota Regional Hospital of Lugano - Health impact of a structure of continuous neurological in progress Neurocenter of Southern treatment (stroke unit) within the Neurocenter (EOC) of Switzerland (NSI) Southern Switzerland- observational community-based study of acute cerebrovascular diseases in Ticino Pierluigi Quadri Fabiano Meroni /Rita Pezzati / Damiano Zemp / Lorena Curia/ Carola Regional Hospital of Mendrisio - Fear of falling in the elderly: physiotherapy intervention in progress Celeste / Silvia Ambrogio / Simona Chiari / Francesca Gallina / Nicola Geriatrics and cognitive approach (imagery) Schiavone / Gianluca Guffanti Claudia Gamondi Maria Caiata Zufferey / Joyce Pellandini IOSI Oncology (Palliative Care Unit) Assisted Suicide: attitudes and experiences of bereaved closed and published in Ann Oncol, 24(6):1639-44, families and beloved ones. An exploratory study 2013: "Families’ experiences with patients who died after assisted suicide: a retrospective interview study in southern Switzerland" Emanuele Zucca Francesco Bertoni / Marco Zaffalon / Cassio Polpo de Campos IOSI Oncology Development of new algorithms for the identification of in progress prognostic models in patients with lymphomas by opti- mizing the management of missing data Marcello Di Valentino Augusto Gallino / Stefano Muzzarelli Regional Hospital of Bellinzona No Smoke Pub Study closed and the manuscript is being edited for publica- and Valli - Cardiology tion in European Journal of Public Health Michele Ghielmini Oreste Mora / Lucia Marelli / Carla Pedrazzani / Monica Bianchi / Mauro IOSI Oncology Feasibility and acceptability of a quick multidimensional in progress Tettamanti / Pierluigi Quadri assessment for the elderly cancer patient: an observa- tional pilot study

146 Scientific Report 2013 8. Appendices 147 Appendix 3 - Research projects funded by ABREOC in 2010

Lead Investigator Other researchers Institute Study title Status report (December 2013) Rolf Wyttenbach Zsolt Szücs-Farkas / Nathalie Médioni Regional Hospital of Bellinzona Extracardiac Findings on Cardiac Magnetic Resonance closed and published in Eur Radiol, 22(6):1295-302, and Valli - Radiology Imaging Studies 2012:"Extracardiac findings detected by cardiac magnetic resonance imaging"

Luca Giovanella Franco Keller / Sergio Suriano / Luca Ceriani IOSI Nuclear Medicine Dosage of calcitonin in thyroid fine-needle aspiration "closed and published in Diagn Cytopathol, 41(3):226- 9, 2013: "Calcitonin measurement on fine needle washouts: preanalytical issues and normal reference values" and in Clin Endocrinol (Oxf), 80(1):135-40, 2014: "Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study" Luca Giovanella Luca Ceriani / Sergio Suriano / Riccardo Ricci IOSI Nuclear Medicine Differential diagnosis of thyroid nodules with non-diag- in progress nostic cytology by 18FDG-PET/CT Luca Giovannacci Raffaele Rosso / Filippo Del Grande / Reto Canevascini / Stephane Regional Hospital of Lugano - Feasibility of a abdominal aortic aneurysm ultrasound in progress Schlunke / Josua van den Berg / Hans Stricker Vascular Surgery screening program in the population served by Regional Hospital of Lugano Gian Paolo Ramelli Tamara Gonzalez / Nadia Zanda / Emanuelle Rossini ORBV Paediatrics Database creation of paediatric patients with autism closed (final report and presented as scientific com- spectrum disorder assisted by neuropaediatrics Service munications at national and international confer- of San Giovanni Hospital of Bellinzona ences) Michele Ghielmini Andrea Bordoni / Luca Mazzucchelli / Alessandra Spitale IOSI Oncology Indicators of Quality of Cancer Care in Southern Switzer- in progress land Augusto Gallino Marcello Di Valentino / Julija Klimusina / Regional Group of Ticino cardiologists Regional Hospital of Bellinzona "Cardiac X Syndrome: role of endothelial function: a sub- in progress and Valli - Cardiology study of the swiss-italian cohort of the italian Registry on X Syndrome Andrea Menafoglio Marcello Di Valentino / Reto Pezzoli / Julija Klimusina / Augusto Gallino Regional Hospital of Bellinzona Impact of cardiovascular screening with ECG in young "closed and published in Cardiovascular Medi- and Valli - Cardiology (12-35 years) competitive athletes cine,16:11-19, 2013: "Cardiovascular screening in young athletes: controversies and feasibility" Dario Valcarenghi Paola Di Giulio / Monica Bianchi / Carla Pedrazzani / Sonia Tosi Casado / IOSI Nursing Service Pain monitoring at the IOSI: where are we? closed (presented final report) Christa Pedrazzoli Hutz Claudio Gobbi Chiara Zecca / Ursula Candrian / Marta Garcia Calle / Mara Gola / Regional Hospital of Lugano - A prospective, randomized, double-blind, placebo-con- in progress Costanzo Limoni / Liliane Petrini Neurocenter of Southern trolled, parallel-group, phase IV study of oral prednisone Switzerland (NSI) taper vs. placebo following intravenous steroids for the treatment of acute relapses in multiple sclerosis within the Ticino cohort Piercarlo Saletti Milo Frattini / Luca Mazzucchelli / Sara De Dosso IOSI Oncology Predictive role of EGFR, PIK3CA and PTEN in the re- in progress sponse to preoperative radio-chemotherapy in patients with locally advanced rectal carcinoma Roberto Malacrida Valentina Di Bernardo / Nicola Grignoni / Chantal Marazia / Andreas Regional Hospital of Lugano - Intimacy in the intensive care unit of the Canton Ticino in progress Perren / Michael Llamas / Alberto Pagnamenta / Ines Sperandio / Intensive Care Medicine Rosanna Di Nocolantonio / Attilio Sicilia / Barbara Schulte Alberto Pagnamenta Moreno Doninelli / Michael Llamas / Andreas Perren / Roberto Malacrida / Regional Hospital of Mendrisio - Impact of a communication strategy on the relatives' in progress Kurt Schmidlin / Hans Ulrich Rothen Intensive Care Medicine satisfaction in intensive care medicine Manuela Sarti Sandra Pinton / Pina Carbone / Carlo Catapano / Enrico Roggero / IOSI Oncology Expression analysis of putative stem cell markers in hu- in progress (the preliminary results were presented Franco Cavalli man malignant prostate tumour and prognostic implica- as scientific communications at national and interna- tions tional conferences) Dario Valcarenghi Monica Bianchi / Claudia Gamondi Palmesino / Sonia Tosi Casado / IOSI Nursing Service / Oncology Introduction of art therapy program for cancer patients closed (presented final report) Christa Pedrazzoli Hutz / Carla Pedrazzani admitted to the IOSI: a pilot study Enrico Roggero Barbara Marongiu / Mariarosa Pascale / Andrea Alimonti / Flavio Stoffel / IOSI Oncology Pilot study comparing genomic and metabolomic profil- in progress Franco Cavalli ing of patients with prostate cancer at diagnosis and during disease progression to find specific intra-individu- al genetic and metabolic alterations

148 Scientific Report 2013 8. Appendices 149 Appendix 4 - Research projects funded by ABREOC in 2011

Lead Investigator Other researchers Institute Study title Status report (December 2013) Luca Giovanella Massimo Bongiovanni / Sergio Suriano IOSI Nuclear Medicine Thyroid nodules with indeterminate cytology: diagnostic in progress role of elastography and immunocytochemical markers Claudia Gamondi Chantal Corti Polti / Murielle Pott IOSI Oncology (Palliative Care Unit) Parteciper à un suicide assisté: étude exploratoire sur in progress l'expérience des proches et leurs représentations de la fin de vie, de la mort et du deuil. (The experience of the family in assisted suicide) Claudia Gamondi Paola Di Giulio / Michele Egloff IOSI Oncology (Palliative Care Unit) Epidemiology of dying in Southern Switzerland: circum- in progress stances of death. Dimitri Christoforidis Mike Schmalzbauer / Alberto Posabella / Raffaele Rosso Regional Hospital of Lugano - Surgery Two surgical techniques for the treatment of sacro-coc- in progress cygeal cysts: a randomized and controlled study Florian Bihl Antonio Lanzavecchia Regional Hospital of Bellinzona Evaluation of the cellular immune response against the in progress and Valli - Gastroenterology hepatitis B virus in various stages of infection: char- acterization of responses of T and B lymphocytes and analysis of new viral epitopes Christina Caporale / Claudio Bassetti / Fabio Conti / Claudio Petrillo / René Müri / Thomas Regional Hospital of Lugano - Rehabilitation combined with bihemispheric transcranial in progress Carlo Cereda Nyffeler / Antonino Uncini / Daniel Zutter Neurocenter of Southern direct current stimulation in subacute ischemic stroke Switzerland (NSI) to increase upper limb motor recovery The Re.Com.Bi.Ne. (Rehabilitation Combined with Bihem- ispheric Neuromodulation) post stroke study Piercarlo Saletti Milo Frattini / Luca Mazzucchelli / Sara De Dosso IOSI Oncology Treatment with Herceptin in gastric carcinomas: best in progress selection of patients through molecular markers analy- sis Franco Keller Mauro Imperiali / Roberto Della Bruna/ Luca Martinolli EOLAB Department Evaluation of the introduction of POCT devices for blood closed (presented at "congresso Svizzero di medicina gas analysis in the hospital and pre-hospital emergency di laboratorio -Swiss conference of laboratory medi- cine (Swiss medLab)" Marco Pons Andrea Azzola / Alessia Riglietti / Claudio Bassetti / Mauro Manconi / Carlo Regional Hospital of Lugano - The central apneas during the TIA / ischemic stroke: in progress Cereda / Liliane Petrini / Guido Ferretti / Massimo Pagani / Fabio Esposito / Internal Medicine clinical, prognostic and physiopathological elements Costanzo Limoni Rolf Wyttenbach Stefano Colagrande / Francesco Regini / Elisa Ardemagni Regional Hospital of Bellinzona Multi-parametric evaluation of liver perfusion by MR-Dwl in progress and Valli - Radiology under fasting and postprandial conditions in healthly volunteers: correlation with quantitative phase-contrast portal venous flow measurements Salvatore Galati Carsten Möller / Claudio Städler/ Chiara Prosperetti / Mauro Manconi / Regional Hospital of Lugano - Role of sleep homeostasis in the development of dyskine- in progress Simone Sarasso / Marcello Massimini Neurocenter of Southern sias induced by L-dopa in patients with advanced stage Switzerland (NSI) of Parkinson's disease Gianfranco Pesce Azinwi Ngwa Che / Antonella Richetti / Jolanda De Jong IOSI Radio-Oncology Hypofractionated cerebral irradiation protocol or ra- in progress diosurgery (IGRT or stereotaxic mode) of the resection cavity in patients undergoing surgical removal of single cerebral metastasis from solid tumours

150 Scientific Report 2013 8. Appendices 151 Appendix 5 - Research projects funded by ABREOC in 2012-2013

Lead Investigator Other researchers Institute Study title Status report (December 2013) Andrea Menafoglio Marcello Di Valentino / Patrick Siragusa / Gian-Antonio Romano / Reto Regional Hospital of Bellinzona Pre-participation Screening in progress Pezzoli / Giorgio Moschovitis and Valli - Cardiology and Assessment of Cardiovascular diseases in Masters Athletes (PSA-Masters Study) Leonardo Sacco Leonardo Sacco / Guido Ongaro / Fabiano Meroni / Riccardo Pignatti / Regional Hospital of Lugano - The alteration of A-BETA 42, TAU and PHOSPHO-TAU in the cerebrospinal fluid of patients in progress Claudio Staedler / Franco Keller Neurocenter of Southern with mild cognitive impairment (CDR 0.5) are an indirect sign of amyloid accumulation and Switzerland (NSI) neuronal damage. Are semantic memory, ecological memory and dual task tests consist- ent with the neurodegenerative process? Enos Bernasconi Francesco Bertoni / Emanuele Zucca / Stephan Dirnhofer Regional Hospital of Lugano - A survey of treatment modalities and outcome analysis of HIV-related B-cell lymphomas in progress Infectious Diseases from the Swiss HIV Cohort Study Dario Valcarenghi Monica Bianchi / Carla Pedrazzani / Agostino Chiriatti / Massimiliano IOSI Nursing Service Patient education to oral cancer therapy in progress Zanon Luciano Wannesson Milo Frattini / Luca Mazzucchelli / Francesca Molinari IOSI Oncology Gene expression analysis of ROR1 in lung carcinomas: a new marker in view of new target- in progress specific therapies Manuela Sarti Gianluca Civenni / Flavio Stoffel / Carlo Catapano / Giuseppina Carbone IOSI Oncology Isolation and characterization of epithelial stem cells from human prostate biopsies in progress Cristiana Sessa Sara De Dosso / Anastasios Stathis IOSI Oncology Phase I study evaluating indomethacin in combination with platinum-based chemotherapy in progress Claudio Gobbi Emanuele Pravatà / Chiara Zecca / Valeria Pifferini / Navarajah Nadarajah / Regional Hospital of Lugano - Brain Default Mode and Attention Network MR Functional Connectivity Changes After in progress Alessandro Cianfoni / Leonardo Sacco / Riccardo Pignatti Neurocenter of Southern Task-induced Precipitation of Cognitive Fatigue in Patients with Multiple Sclerosis Switzerland (NSI) Mauro Imperiali / Franco Keller EOLAB Department / Studio di marcatori biochimici tiroidei (Study of thyroid biochemical markers) in progress Luca Giovanella IOSI Nuclear Medicine Olivier Giannini Damiano Zemp / Claudio Cereghetti / Mauro Tettamanti / Pierluigi Quadri Regional Hospital of Mendrisio - Influenza dell'emodialisi sull'attività fisica e sulle capacità motorie in pazienti con insuffi- in progress Internal Medicine cienza renale cronica stadio 5 (K/DOQI) (Influence of haemodyalisis on physical activity and motor skills of patients with chronic kidney disease, stage 5 (K/DOQI). Mario G. Bianchetti Giacomo D. Simonetti / Alberto Bettinelli / Francesco Barretta Regional Hospital of Bellinzona Meccanismi soggiacenti l'iponatriemia della polmonite del bambino acquisita in comunità in progress and Valli - Paediatrics (Mechanisms underlying hyponatremia of community-acquired pneumonia in children) Alessandra Pia Augusto Gallino / Peter J. Schwartz / Isabella Sudano /Juljia Klimusina Regional Hospital of Bellinzona Cardiomiopatia di Tako-Tsubo e Sindrome X Cardiaca: nuove prospettive patofisiologiche in progress Porretta and Valli - Cardiology nell'ambito di due cardiopatie orfane (Tako-Tsubo Cardiomyopathy and Cardiac Syndrome X: New Insights into the pathophysiology of two orphan cardiac diseases) Manuela Sarti Carlo Catapano / Giuseppina Carbone / Enrico Roggero / Sandra Pinton / IOSI Oncology Circulating microRNAs in plasma/serum as biomarkers for prostate cancer in progress Ramon Garcia-Escudero / Flavio Stoffel / Brunello Mazzola / Fernando Jermini / Mauro Castelnuovo Michele Ghielmini Vilma Ratti / Cristina Marini / Carla Pedrazzani IOSI Oncology Studio caso-controllo dell'impatto di una scelta terapeutica basata sulla valutazione multi- in progress dimensionale del paziente oncologico in età geriatrica (Case-control study of the impact of a therapeutic choice based on multi-dimensional assessment of elderly cancer patients)

Appendix 6 - EOC Projects 2012 subject to General Authorisation (AG)

No. Study title Lead Investigator (LI) Other researchers Collaborators that Expected study duration Approval by Ethics have access to non- Committee of Canton anonymized data Ticino (besides the LI) 1/AG13 Studio caso-controllo dell'impatto di una scelta terapeutica basata sulla Michele Ghielmini Vilma Ratti, Cristina Vilma Ratti, Cristina 36 months approved valutazione multidimensionale del paziente oncologico in età geriatrica Marini, Carla Pedrazzani Marini, Carla Pedrazzani, (12th December, 2013) (Case-control study of the impact of a therapeutic choice based on multi- Sheila Gaggetta Ref. EC 2756 dimensional assessment of elderly cancer patients)

152 Scientific Report 2013 8. Appendices 153 Impressum

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