Scientific Report Index

2012 2012 Scientific Report Index

Preface 5

1. Oncology Institute of Southern Switzerland (IOSI) 11 1.1 Medical Oncology Service 14 1.2 Radiation Oncology Service 16 1.3 Nuclear Medicine Service and PET/CT Center 19 1.4 Palliative Care Service 21 1.5 Haematology Service 23 1.6 Research Division 24 1.7 IOSI Nursing Service 33

2. Neurocenter of Southern Switzerland (NSI) 37 2.1 Neurology Service 38 2.2 Neurosurgery Service 41 2.3 Neuroradiology Service 42 2.4 Pain Management Center 42 2.5 Neurosciences 42

3. EOC Multisite Departments and Services 45 3.1 EOC Department of Surgery 46 3.2 EOC Department of Internal Medicine 50 3.3 EOC Department of Intensive Care Medicine 60 3.4 EOC Department of Laboratory Medicine 62 3.5 Breast Cancer Center of Southern Switzerland (CSSI) 63 3.6 Emergency Services – Emergency Medicine 65 3.7 Radiology Services 65 3.8 EOC Geriatric Service 68 3.9 Services of Gynaecology and Obstetrics 70 3.10 Paediatrics Services 71

Together for a better care 4. Swiss Clinical Trial Organization 77 4.1 EOC Clinical Trial Unit (CTU-EOC) 78

5. Scientific Research Advisory Board (ABREOC) 83

6. Panel of Experts on Professional Confidentiality in Medical Research and General Authorisation granted to the EOC 87

7. Publications in 2012 91 Publications in peer-reviewed journals 93 Publications in non-peer-reviewed journals 114 Medical conference abstracts 115 Publications in books 129

8. Appendices 133 Appendix 1 - Research projects funded by ABREOC in 2008 134 Appendix 2 - Research projects funded by ABREOC in 2009 136 Appendix 3 - Research projects funded by ABREOC in 2010 138 Appendix 4 - Research projects funded by ABREOC in 2011 140 Appendix 5 - Research projects funded by ABREOC in 2012 142 Appendix 6 - EOC Projects 2012 subject to General Authorisation (AG) 143

Preface Preface

It was Friday, 13th June 1997 – a date I shall keeping up-to-date. It is, in fact, impossible to carry never forget, and not just out of superstition. That out research without being completely up-to-date was the day that the Board of Directors approved or there would be no hope of receiving funding for the first "Strategic plan for scientific research in the research projects". We are all fully aware of EOC Hospitals", which I now consider to be a mile- the fact that constantly keeping up-to-date in our stone for our organization as for the first time its different fields and activities is an essential prereq- visions, aims and strategic goals were outlined in a uisite to ensure that our patients receive the cor- clear, structured way, together with the resulting rect treatment in an efficient and effective man- operational activities. ner. And this created a virtuous circle.

Following this decision scientific research finally But this meant that everything had to be further came out of the shadows and acquired the impor- improved, and better structured and consolidated. tance and relevance it deserved, resulting in an important change in paradigm, namely that the work On 25th February 2005 the Board of Directors, of a hospital is not just to care for patients, leaving therefore, approved the "Concept of scientific re- universities the task of carrying out research. search in EOC Hospitals" which, importantly and Therfore, research became a fundamental part of for the first time, created a centralized organiza- a hospital’s activities in order to guarantee the qual- tional model that enabled this sector to be devel- ity and safety of the services provided to patients. oped in a coordinated, structured way. In the document mentioned it was stated that "the mere fact of carrying out research is the best As a result the Scientific Research Advisory Board (and frequently also the most cost-effective) way of of the EOC (ABREOC) was created, together with a

6 Scientific Report 2012 permanent secretariat, both of which were part of This was still not sufficient, however. It was also and came under the Medical Area of the Head Of- necessary to offer researchers, "under one roof", fice. Setting up and running this facility was made easily accessible high added-value services and possible also thanks to the indispensable support facilities that are nowadays so necessary for sci- provided by USI-SUPSI Research Service, run by Dr entific research, above all in the clinical field, in or- Benedetto Lepori, on the basis of a specific agree- der to be able to continuously develop and grow, ment1. and compete with the best national and interna- This "joint-venture" enabled us to organize the ac- tional centres. That is why in 2011 a project was tivities of ABREOC and above all prepare ourselves drawn up to create the Clinical Trial Unit of the for the first open competition for the submission of EOC (CTU-EOC), with its two separate branches applications by EOC medical staff for the funding of – one in the Oncology Institute of Southern Swit- scientific research2,3. zerland (IOSI) and one in the Neurocenter of South- ern Switzerland (NSI) – although both branches Between 2008 – the year of the first annual open are integrated from an operational point of view. competition promoted by ABREOC – and 2012, On 17th February 2012 the Board of Directors ABREOC selected 62 out of more than 100 sci- – showing great awareness and far-sightedness entific projects submitted to it, for a total funding – not only authorized the setting up of the CTU- of over 2.5 million Swiss francs. This funding was EOC but also decided to support it financially by awarded to projects that had been approved, but providing it with "start-up" credit, with the explicit were not supported, or only in part, by external goal, however, of the Unit becoming self-financing grants. within three years. The CTU-EOC began operating officially on 1st October 2012.

1 Collaboration agreement between the Ente Ospedaliero Cantonale in Bellinzona and the University of Southern Switzerland in Lugano of 15th June 2005. 2 Directive concerning the creation of the Scientific Research Advisory Board of the EOC (ABREOC) of 8th October 2007. 3 Regulations concerning the awarding of funding for research in the Ente Ospedaliero Cantonale of 26th May 2008.

Preface 7 It was with great satisfaction, therefore, that we since 2011 the EOC – in collaboration with the learned on 7th May 2012 – after complex and University of Southern Switzerland, the Canton’s demanding preparatory work – that we had been Institute of Pathology (Microbiology) and the Car- granted general authorisation to disclose profes- diocentro Ticino – has organized the "Clinical Re- sional secrets for research studies carried out search in Southern Switzerland Day". At San Gio- at EOC institutes by the Berne Panel of Experts on vanni Hospital in Bellinzona on 23rd March 2012 Professional Confidentiality in Medical Research4. was held the second edition. This authorisation allows our medical staff to access, under specific and binding conditions, non- It was also decided, in order to attach the neces- anonymized personal data of patients to carry out sary importance to everything that has been done research in the field of medicine and public health and published in a year in the field of scientific re- without violating medical confidentiality. search – not just in one sector, but globally – to publish the 1st "EOC Scientific Report 2012"5, so The best way of assessing the scientific research as to include in a single document, in a structured, – both clinical and basic-translational – is undoubt- organized way, all of the most important work that edly by looking at the number and quality of publi- has been carried out. This significant effort ena- cations in peer-reviewed biomedical journals pro- bled us to have, for the first time, an overall picture duced each year by our Services. There were 194 of the research being carried out as well as the as- publications in 2012 (2011: 170 publications). sociated or collateral activities. Precisely because this is the first such report, there may be slight In order to highlight the clinical research activity differences in the different parts of the report and carried out in Southern Switzerland, every year perhaps some omissions, shortcomings that we

4 The Panel of Experts on Professional Confidentiality in Medical Research was set up in 1993 when Article 321bis of the Swiss Criminal Code (CPS) entered into force. 5 The English version is available in both hard copy and at the website www.eoc.ch, while the Italian version is only available at the EOC website.

8 Scientific Report 2012 shall endeavor to eliminate with experience in the I should finally like to thank all those people, who future. through their silent hard work and passion in their different fields, contribute day after day to the pro- I should like to thank all those people who have congress made in this fundamental sector, thereby tributed to the 1st Scientific Report by providing enabling our Canton’s health services to provide us with all the necessary information and docu- our patients with the highest quality treatment mentation. A special thanks goes to Dr Manuela and to compete at an ever higher level with our Sarti – ABREOC Secretary and collaborator from national and international competitors, contribut- the Medical Area of the Head Office – who has ing towards the devolpment of a course leading to worked tirelessly and with tremendous devotion to a Master in Human Medicine, fully aware, however produce the report and coordinate its publication, – to quote Albert Einstein – that "the process of with the quality of the English version guaranteed scientific discovery is, in effect, a continual flight by Paolo Jacomelli. from wonder".

Fabrizio Barazzoni MD MPH FMH Prevention and Public Health Head of the Medical Area of the EOC Head Office Chairman of the Scientific Research Advisory Board Director a.i. of the Neurocenter of Southern Switzerland

Bellinzona, 23rd August 2013

Preface 9

1 Oncology Institute of Southern Switzerland (IOSI) 1. Oncology Institute of Southern Switzerland (IOSI)

Introduction oncology, haematology, nuclear medicine, palliative The IOSI unites in a single organizational structure care and research. Each service has its own re- all the specializations within the EOC that deal with search program coordinated by the IOSI’s Scien- oncology. The IOSI has been devised on the basis tific Board, which meets once every two months of the North American model of "comprehensive and decides on common research guidelines. cancer centres", but has its own particular struc- The research laboratories of the Institute for Re- ture as it has a horizontal structure throughout search in Biomedicine (IRB) are part of the Insti- the EOC. tute of Oncology Research (IOR) and are run by the "Fondazione ticinese per la ricerca e la cura dei The IOSI is, therefore, intended to be an all-inclusive linfomi" (Ticino Foundation for the research and structure, containing all the specializations that treatment of lymphomas), although functionally, deal with the diagnosis, treatment and research in they are part of the IOSI’s research division. the field of tumour diseases. Research The IOSI guarantees a holistic approach for all its Research is a strategic sector for the IOSI, which patients with the most recent developments in on- dedicates more than 15% of its annual budget to cological research. As a result the IOSI has now be- this sector. No modern oncological service can ex- come an important centre of reference far beyond ist without an important research sector, not least the borders of Switzerland. because many of the forms of treatment offered to patients are constantly being improved thanks The IOSI has six Services: medical oncology, radio- to oncological research protocols.

12 Scientific Report 2012 The IOSI has from the very beginning focused on studies to laboratory research. Sometimes, as in three main areas of research: the case of gastrointestinal tumours, the labora- • malignant lymphomas, tory research is carried out in the structures of • new drugs, the Canton’s Institute of Pathology in Locarno, with • breast cancer. which the IOSI has very close ties. In all the other areas of research, however, laboratory research In the last few years research has also been car- is carried out in the structures of the IOR. In the ried out in gastro-intestinal and prostate cancer. field of clinical research the ties with international research groups are of particular importance, ei- For every research topic, the IOSI has a database ther directly managed by the IOSI – as in the case containing the records of all patients. In the case of lymphomas with the International Extranodal of malignant lymphomas, the current database Lymphoma Study Group (IELSG) whose "operation- includes more than 2,000 patients treated since al office" is in the IOSI at San Giovanni Hospital in 1980, for whom all the diseased tissue has been Bellinzona – or through studies carried out within re-examined by the same team of pathologists. the IOSI, as in the case of the International Breast These databases are essential for the develop- Cancer Study Group. ment of new research ideas and also for a quality check of the results achieved. The IOSI has always been one of the most active centres in Switzerland for the assessment of new Another specific feature of the research carried oncological drugs. This requires laboratory re- out by the IOSI is to constantly try to link clinical search (pharmacogenomics, pharmacokinetics

1. Oncology Institute of Southern Switzerland (IOSI) 13 and pharmacodynamics) and structures for clini- 1.1 Medical Oncology Service cal coordination which can, where necessary, inde- Prof. Michele Ghielmini MD pendently carry out Phase I and II trials. The Trial Medical Director of the IOSI and Head Doctor Unit Sponsor of the IOSI has been integrated into the CTU-EOC. Main areas of research The research activity carried out consists mainly in As far as new drugs are concerned, it should be the involvement in the studies of the Swiss Group highlighted that, at present, the main focus is on for Clinical Cancer Research (SAKK), which in- the so-called "targeted therapies", namely forms cludes every year around 50-60 patients, in par- of treatment based on "intelligent" drugs that are ticular in studies concerning the optimization of gradually replacing standard chemotherapy. treatment for breast, bowel and lung tumours in lymphomas and leukaemias. At a national level most of the clinical studies are carried out within the structures of the Swiss Collaboration is also underway with the Canton’s Group for Clinical Cancer Research (Schweizeri- Institute of Pathology and the Canton’s Cancer sche Arbeitsgruppe für klinische Krebsforschung, Registry in Locarno for studies of an epidemiologi- SAKK). cal and translational nature. The IOSI spends around 6.5 million Swiss francs each year on research (the last available budget). Together with the Canton’s Cancer Registry, four Two thirds of this sum are spent on laboratory re- assessment studies are being carried out on the search, while one third is spent on clinical research. quality of the diagnosis and treatment of tumours

14 Scientific Report 2012 (lung tumours, gynaecological tumours, rectal can- Peer reviewed publications in 2012 (selection) cer and prostate tumours). • Ghielmini M, Vitolo U, Kimby E, Montoto S, Walewski J, Pfreundschuh M, Federico M, Research projects are also underway in the field of Hoskin P, McNamara C, Caligaris-Cappio F, cancer rehabilitation and geriatric oncology. In the Stilgenbauer S, Marcus R, Trneny M, Dreger latter field a pilot feasibility study was concluded in- P, Montserrat E, Dreyling M; On behalf of the volving 150 cases, the data of which are currently Panel Members of the 1st ESMO Consensus being analysed, aimed at establishing a rapid as- Conference on Malignant Lymphoma. "ESMO sessment process for elderly patients in order to Guidelines consensus conference on malignant define their frailty and to decide on the most suit- lymphoma 2011 part 1: diffuse large B-cell able forms of treatment. lymphoma (DLBCL), follicular lymphoma (FL) Another important study currently being carried and chronic lymphocytic leukemia (CLL)". Ann out is related to "preserving fertility in young women Oncol 2012 Nov 21. [Epub ahead of print] exposed to chemotherapy" in collaboration with the fertility service of the Regional Hospital of Locarno. • Stathis A, Ghielmini M. "New agents for the treatment of lymphoma". Ann Oncol 2012; 23 Main funding obtained in 2012 Suppl 10: x92-8. ABREOC, SAKK, Oncosuisse and Lega Ticinese Contro il Cancro. • Renner C, Zinzani PL, Gressin R, Klingbiel D, Dietrich PY, Hitz F, Bargetzi M, Mingrone W, Martinelli G, Trojan A, Bouabdallah K, Lohri A,

1. Oncology Institute of Southern Switzerland (IOSI) 15 Gyan E, Biaggi C, Cogliatti S, Bertoni F, Ghielmi- Guidelines Working Group. "Cervical cancer: ni M, Brauchli P, Ketterer N; Swiss SAKK and ESMO Clinical Practice Guidelines for diagno- French GOELAMS group from European Man- sis, treatment and follow-up†". Annals of Oncol- tle Cell Lymphoma Network. "A multicenter ogy 2012; 23 (Supplement 7): vii27–vii32. phase II trial (SAKK 36/06) of single-agent everolimus (RAD001) in patients with relapsed 1.2 Radiation Oncology Service or refractory mantle cell lymphoma". Haema- Antonella Richetti MD tologica 2012; 97(7):1085-91. doi: 10.3324/ Head Doctor haematol.2011.053173. Epub 2012 Feb 7. Radiation oncology activities are carried out to- • Espeli V, Zucca E, Ghielmini M, Giannini O, gether with surgery, chemotherapy and other Salatino A, Martucci F, Richetti A. "Weekly and forms of treatment (such as receptor therapy) 3-weekly cisplatin concurrent with intensity- to improve the possibility of treating patients with modulated radiotherapy in locally advanced cancer. Clinical cases are discussed by multidisci- head and neck squamous cell cancer". Oral On- plinary tumour boards, comprising different pro- col 2012, 48(3): 266-71. doi: 10.1016/j.ora- fessionals involved in treating the patients. loncology.2011.10.005. Epub 2011 Nov 11. The increasing use of conformal techniques – • Rosell R, Wannesson L. "A genetic snapshot of high-precision techniques based on the three-di- small cell lung cancer". Cancer Discov. 2012; mensional volumetric definition of tumours and the 2(9): 769-71. anatomy of critical organs – such as three-dimensional conformal radiation therapy (3D-CRT), inten- • Zappa F, Droege C, Betticher D, von Moos R, sity-modulated radiation therapy (IMRT), volumet- Bubendorf L, Ochsenbein A, Gautschi O, Oppliger ric modulated arc therapy (VMAT) or image-guided Leibundgut E, Froesch P, Stahel R, Hess T, radiation therapy (IGRT) – has made radiation Rauch D, Schmid P, Mayer M, Crowe S, Brauchli therapy much more accurate, making it possible P, Ribi K, Pless M; Swiss Group for Clinical Can- to increase its therapeutic value by modulating the cer Research (SAKK). "Bevacizumab and er- dose applied to tumours and at the same time re- lotinib (BE) first-line therapy in advanced non- ducing the dose applied to healthy tissue. This has squamous non-small-cell lung cancer (NSCLC) significantly improved chances of recovery and has (stage IIIB/IV) followed by platinum-based reduced the frequency of complications. chemotherapy (CT) at disease progression: a multicenter phase II trial (SAKK 19/05)". Lung The Bellinzona hospital, which also includes an in- Cancer 2012; 78(3): 239-44. patient unit located at the IOSI, is equipped with a Varian linear accelerator, a dedicated CT scanner • Colombo N, Peiretti M, Garbi A, Carinelli S, and an advanced system for the planning of treat- Marini C & Sessa C on behalf of the ESMO ments, allowing the use of the most sophisticated Guidelines Working Group. "Non-epithelial ovar- forms of therapies, such as modulated radiation ian cancer: ESMO Clinical Practice Guidelines therapy (IMRT), dynamic arc therapy (RapidArc) for diagnosis, treatment and follow-up†". An- and the on-line monitoring of treatment (CBCT- nals of Oncology 2012; 23 (Supplement 7): IGRT). There is also a high-dose-rate (HDR) brachy- vii20–vii26. therapy unit with 3-D planning for endocavitary treatments. • Colombo N, Carinelli S, Colombo A, Marini C, Rollo D & Sessa C on behalf of the ESMO The Regional Hosital of Lugano - Italiano has a True-

16 Scientific Report 2012 Beam linear accelerator (Varian), one of the first of 2. Neurooncology this type of accelerators to be installed in Switzer- • EORTC 22033-26033 land. The machine was designed using completely Lead investigator: G.A. Pesce. new concepts and represents an important step Primary chemotherapy with Temozolomide forward in oncological treatment. This accelerator versus radioterapy in patients with low-grade is able to deliver in a much shorter space of time gliomas after stratification following the loss of four times as much radiation as the current stand- chromosome arm 1p: phase III study. ard with extremely high precision. This means that The recruitment has been closed and the study treatment sessions are much shorter and in vir- is continuing with the follow-up. tually every form of treatment lasts less than two minutes. • EORTC 26082 Lead investigator: G.A. Pesce. Main areas of research Randomized phase II trial with radiotherapy 1. Breast combined with Temsirolimus versus radiother- • IRMA apy combined with Temozolomide in the treat- Lead investigator: M.C. Valli. ment of patients with newly diagnosed glioblas- Breast cancer with low risk of local recurrence: toma without the presence of hypermethylation partial and accelerated radiation using three- of the MGMT gene promoter. dimensional conformal radiation therapy (3D- The study has been completed. CRT) versus standard radiotherapy after conservative surgery (phase III trial). • EORTC 26112-22115 The study is currently underway. The Radiation Lead investigator: G.A. Pesce. Oncology Division of the IOSI is the reference International randomized double-blind phase II centre for Switzerland. study to assess the use of Rindopepimut/GM- CSF concurrent with adjuvant temozolomide • IBCSG 38-10 / BIG 3-07 / TROG 07.01 (TMZ) chemotherapy in patients with newly Lead investigator: A. Richetti. diagnosed EGFRvIII-positive glioblastoma after Randomized phase III study on radiation doses surgical resection. The study is just starting and fractionated radiation treatment in ductal after being submitted to the Canton’s Ethical carcinomas in situ (DCIS) of the breast for pa- Committee in February 2013. tients not at low risk. Patients began to be recruited for the study • ABREOC BRAIN on 4 April 2011. The study was temporarily Lead investigator: G.A. Pesce. closed while waiting for an amendment to in- Protocol for cerebral hypofractionated radia- crease the number of patients and to find new tion therapy or radiosurgery (IGRT or stere- funding. The study was reopened on 25th Sep- otaxic) of the resection cavity in patients under- tember 2012. going the surgical removal of brain metastases from solid tumours. • MAMMOSITE The study is currently being developed together Lead investigator: A. Richetti. with the CTU-EOC. Partial radiation of the breast in breast cancer at an early stage: feasibility study on the use 3. Urogenital system of the "Mammosite" device in intracavitary • EORTC 22043-30041 brachytherapy. Phase III study. Lead investigator: G.A. Pesce. The study has been completed. Phase III trial with post-operational radiotherapy

1. Oncology Institute of Southern Switzerland (IOSI) 17 combined with adjuvant hormonal therapy ver- "Outcome, quality of life and cognitive func- sus adjuvant radiotherapy alone in patients un- tion of patients with brain metastases from dergoing radical prostatectomy in pathological non-small cell lung cancer treated with whole pT3a-b R0-1 N0M0 / pT2 R1 N0M0, Gleason brain radiotherapy combined with gefitinib or score 5-10. Phase III trial. temozolomide. A randomised phase II trial of The study is currently underway. the Swiss Group for Clinical Cancer Research (SAKK 70/03)". Eur J Cancer 2012; 48(3): • SAKK 01/10 377-84. doi: 10.1016/j.ejca.2011.10.016. Lead investigator: G.A. Pesce. Epub 2011 Nov 15. Chemotherapy based on carboplatin and radiotherapy of affected lymph nodes in patients • Espeli V, Zucca E, Ghielmini M, Giannini O, Sala- with seminoma IIA/B. tino A, Martucci F, Richetti A. "Weekly and The study is currently underway. 3-weekly cisplatin concurrent with intensity- modulated radiotherapy in locally advanced • SAKK 09/10 head and neck squamous cell cancer". Oral On- Lead investigator: G.A. Pesce. col 2012, 48(3): 266-71. doi: 10.1016/j.ora- Dose-intensified salvage radiotherapy of the loncology.2011.10.005. Epub 2011 Nov 11. pelvic region in treating patients with relapsed prostatic adenocarcinoma without macroscopic Conference communications in 2012 disease. Phase III study. • Richetti A. Congresso Senoforum di Lugano. The study is currently underway. Oral communication: "Radioterapia la rivoluzione di tempi, dosi e modalità". 4. Lung • EORTC 22055-08053 • Pesce GA. Seconda Giornata della Ricerca Cli- Lead investigator: A. Richetti. nica della Svizzera Italiana di Bellinzona. Poster: Phase III study comparing post-operational con- "Radioterapia ipofrazionata a modulazione di in- formal radiotherapy to non post-operative ra- tensità volumetrica del letto tumorale, dopo re- diotherapy in patients with completely resected sezione di metastasi cerebrali da tumori solidi". non-small-cell lung cancer and mediastinal N2 involvement ("Lung-ART"). • Azinwi NC, Fanti P, Martucci F, Pittoni P, Rich- Study sponsored by the Institut Gustave Roussy etti A, Valli MC, Pesce GA. XVI SASRO Annual in France. The study has just started after be- Meeting. Poster: "Accuracy evaluation in IGRT/ ing submitted to the Canton’s Ethical Commit- RAPIDARC for brain metastases (BM)". tee in January 2013. • Valli M, Pittoni P, Fanti P, Pesce GA, Azinwi C, Main funding obtained in 2012 Martucci F, Ceriani L, Richetti A. XII Congresso ABREOC, EORTC, SAKK, and the pharmaceutical Nazionale Associazione Italiana Radioterapia company "Celldex Therapeutics, Inc". Oncologica. Oral communication: "La 18FDG- PET/CT può modificare la strategia terapeu- Peer reviewed publications in 2012 (selection) tica nel trattamento delle neoplasie mammarie • Pesce GA, Klingbiel D, Ribi K, Zouhair A, von localmente avanzate o ad alto rischio?" Moos R, Schlaeppi M, Caspar CB, Fischer N, Anchisi S, Peters S, Cathomas R, Bernhard • Valli M. Congresso Senoforum di Lugano. Oral J, Kotrubczik NM, D'Addario G, Pilop C, We- communication: "18FDG PET-CT nella pianifica- ber DC, Bodis S, Pless M, Mayer M, Stupp R. zione e nel trattamento radioterapico".

18 Scientific Report 2012 • Valli M, Martucci F, Azinwi NC, Pesce GA, Can- lymphomas, bone metastases and arthritis/syno- ziani L, Richetti A. VIII European Breast Can- vitis (radiosynoviorthesis). cer Conference. Poster: "3D-conformal Partial Breast Irradiation (3D-CRT PBI): how to opti- There are numerous forms of collaboration un- mize its reproducibility". derway as regards both teaching and research, above all in the fields of thyroid cancer, hyperthy- • Martucci F, Pittoni P, Valli M, Pesce GA, Azin- roidism, radiometabolic therapy, PET/CT in oncol- wi NC, Fanti P, Richetti A. XVI SASRO Annual ogy, the diagnosis/treatment of lymphomas and Meeting. Poster: "Image Guided radiotherapy nuclear cardiology (in collaboration with the SAKK, for set-up margin in lung cancer". the Canton’s Institute of Pathology in Locarno, the Cardiocentro Ticino, the University of Zürich and • Valli M, Fanti P, Leva S, Rottoli G, Martucci F, the University Hospital "Fondazione Macchi" in Va- Pittoni P, Azinwi NC, Pesce GA, Richetti A. XVI rese). SASRO Annual Meeting. Poster: "Respiratory gating RT in breast cancer: light and shade". Main areas of research 1. Thyroid disorders and radiometabolic therapy 1.3 Nuclear Medicine Service and PET/CT • Development of highly sensitive methods for Centre Thyroglobulin assay Luca Giovanella MD PD Lead investigators: L. Giovanella, M. Imperiali, Head Doctor L. Ceriani. Highly sensitive methods for Thyroglobulin (Tg) Nuclear medicine employs substances emitting a assay could prevent the need to suspend thy- low level of radiation (radiopharmaceuticals) and roxine treatment or to administer ricombinant technologically very advanced equipment (gamma human TSH in the follow-up of differentiated cameras, PET machines) to carry out diagnostic thyroid cancer. On the basis of retrospective tests (scintigraphy, tomoscintigraphy, SPET/CT studies international multicenter prospective and PET/CT) in every branch of medicine. Moreo- studies are now underway with the highly sen- ver, special radiopharmaceuticals are used in the sitive Tg assay carried out at EOLAB. treatment of benign thyroid disease (hyperthyroidism and goitre), thyroid carcinomas, bone metas- • Role of PET/CT and molecular markers in the tases, neuroendocrine tumours and certain types differential diagnosis of thyroid nodules of lymphomas. Lead investigators: L. Giovanella, G. Treglia, L. The Service is located in the Regional Hospital of Ceriani, G. Paone, M. Bongiovanni. Bellinzona and Valli (San Giovanni) and the Region- 20% of thyroid nodules removed using fine-nee- al Hospital of Lugano - Civico. In both hospitals all dle aspiration fall into the TIR 3 category (in- nuclear medicine diagnostic tests and treatment determinate) and need to be removed in order are carried out using iodium-131. There is also a to have a definite histological diagnosis (benign day clinic for thyroid diseases (where both diagnos- in 80% of cases). These studies examine and tic medical ultrasound and diagnostic cytology are compare, adopting an international multicent- available). er prospective approach, the role of PET/CT with 18FDG molecular markers (e.g. BRAF) on The PET/CT Center is located in the Bellinzona cytology and of circulating molecular markers hospital and there are three rooms available for (e.g. TSHR-mRNA) in differentiating between treatment using iodium-131 (inpatients). Isotope benign and malignant nodules without the need treatment is also available in the day clinic for for surgical removal.

1. Oncology Institute of Southern Switzerland (IOSI) 19 • Prognosis predictors and radio sensitivity in ad- Lead investigators: vanced thyroid cancer L. Ceriani, G. Paone, G. Treglia, L. Giovanella. Lead investigators: L. Giovanella, M. Bongiovanni. The role of PET/CT in assessing patients with In the field of metastatic differentiated thyroid lymphomas has increased greatly over the last cancer non-responsive to radioiodine there are few years. IELSG studies 26 and 37 are aimed forms with a rapid progression, while in many at focusing on the clinical advantages of PET cases the development of the disease is very in primary mediastinal large B-cell lymphomas, slow and asymptomatic for many years. The investigating whether a complete metabolic treatments available in these cases (e.g.TKIs) response after chemotherapy can prevent the can stabilize the disease for 1-2 years, but have need for subsequent consolidation radiotherapy. important side-effects. Using the findings of ret- Other evidence highlights the potential role of rospective studies, the current studies are ex- metabolic imaging in defining the prognosis for amining, adopting an international multicenter the disease at its outset by helping to deter- prospective approach, the role of tissue mark- mine the most efficient form of treatment (e.g. ers (e.g. BRAF), circulating markers (e.g. Cyfra "risk adapted therapy"). Under this assumption, 21.1 – to measure the doubling-time of Thy- the prognostic role of certain metabolic param- roglobulin), and molecular imaging (e.g. uptake eters, which can be calculated by means of a 18FDG and 99mTc-sestaMIBI) for patients at basic PET, is being studied in patients with dif- risk requiring urgent treatment. fuse large B-cell lymphomas and its mediastinal variant. • Individual dosage in radiometabolic therapy Lead investigator: L. Giovanella. 3. SPECT/CT and PET/CT imaging Comparative studies are currently underway • Optimization of acquisition protocols in cardiol- into the efficacy and cost effectiveness of radio- ogy, neurology and oncology metabolic therapy with clinical protocols (fixed- Lead investigators: dose; adapted-dose) versus standard dose pro- L. Ceriani, T. Ruberto, G. Treglia, G. Paone. tocols (hyperthyroidism) or precautionary dose The need to balance the criteria for the speed protocols (thyroid cancer). of acquisition and reduction of the dose given to patients can be efficiently addressed by the • Early diagnostic markers for medullary thyroid introduction of iterative reconstruction algo- carcinoma rithms. These algorithms are able to guarantee Lead investigator: L. Giovanella. a good resolution and contrast of the images MTC screening by measuring circulating cal- at average density acquisitions, thereby making citonin has been proposed by many authors, it possible to reduce the level of radiation ad- but criticized by others as a result of the lack ministered and the image acquisition time. The of specificity of this marker. Using the findings studies completed and those currently under- of previous retrospective studies, international way assess the impact of the development of multicenter prospective studies have begun on the procedures for the acquisition and elabora- the use of complementary markers in the early tion of SPET/CT and PET/CT in terms of their diagnosis of MTC (e.g. procalcitonin, calcitonin diagnostic efficacy and cost effectiveness, and in washout fluid). also the reduced exposure to radiation.

2. PET/CT and Lymphomas Main funding obtained in 2012 • Role of interim-PET/CT in non-Hodgkin’s lym- ABREOC, ROCHE MALLINKRODT-COVIDIEN, SAKK phomas and IELSG.

20 Scientific Report 2012 Peer reviewed publications in 2012 (selection) • Giovanella L. International Diagnostic Course • Giovanella L, Ceriani L, De Palma D, Suriano 2012 - Davos (CH). S, Castellani M, Verburg FA. "Relationship between serum thyroglobulin and (18)FDG-PET/ • Giovanella L. European Thyroid Association CT in (131)I-negative differentiated thyroid car- and Thyroid Cancer Network 2012 - Pisa (I). cinomas". Head Neck 2012; 34: 626-631. • Giovanella L. German Society of Nuclear Medi- • Trimboli P, Nigri G, Romanelli F, Cicciarella Mod- cine Thyroid Symposium 2012 - Wuerzburg (D). ica DD, Crescenzi A, Valabrega S, Giovanella L. "Medullary thyroid nodules by measurement 1.4 Palliative Care Service of calcitonin (Ct) in aspiration needle washout Hans Neuenschwander MD in patients with multinodular goiter and mod- Head Doctor erately elevated serum Ct". Exp Clin Endocrinol Metab 2012; 120 (4): 234-237. Palliative care involves looking after a patient and his family adopting a more global approach aimed • Ceriani L, Suriano S, Ruberto T, Zucca E, Gio- at trying to maintain or re-establish the best pos- vanella L. "18FDG uptake changes in liver and sible quality of life through an interdisciplinary ap- mediastinum during chemotherapy in patients proach, involving doctors, nurses, psychologists with diffuse large B-cell lymphoma". Clin Nucl and social workers, all with highly specialized skills. Med 2012; 37: 949.952. Palliative Care Service (SCP - Servizio di Cure Pal- liative), which is present in all EOC hospitals, has • Giovanella L, Treglia G, Verburg FA, Salvatori the mission of promoting this philosophy and dis- M, Ceriani L. "Serum cytokeratin 19 frag- seminating the specific know-how of palliative care ments: a de-differentiation marker". Eur J Endo- to hospital teams through specialist consultation crinol 2012; 167: 793-797. at the patient’s bedside and by developing the necessary training programs. • Giovanella L, Verburg FA, Imperiali M, Vala- brega S, Trimboli P, Ceriani L. "Comparison of The Palliative Care Unit (UCP - Unità di Cure Pallia- serum calcitonin and procalcitonin in detecting tive) is equipped with seven beds and a specialist medullary thyroid carcinoma among patients team as part of the IOSI’s inpatient units at San with thyroid nodules". Clin Chem Lab Med Giovanni Hospital in Bellinzona. The unit admits 2012; 25: 1-5. patients in need of palliative care in a specialized ward. • Bongiovanni M, Suriano S, Bolli M, Cattaneo F, Fasolini F, Giovanella L. "Ectopic substernal thy- To provide continuity in treatment SCP and UCP roid tissue: a challenging differential diagnosis". collaborate closely with Hospice Ticino, an associa- J Clin Endocrinol Metab 2012; 97(3): 719-20. tion providing assistance in palliative care at home.

Conference communications in 2012 The IOSI’s palliative care program is considered a • Giovanella L. European Association of Nuclear highly advanced pioneering model, both nationally Medicine and Molecular Imaging 2012 - Milan (I). and internationally. In 2009 it was certified as a centre of excellence by the European Society of • Ceriani L. International Workshop of interim- Medical Oncology (ESMO). PET in Lymphomas 2012 - Menton (F).

1. Oncology Institute of Southern Switzerland (IOSI) 21 Main areas of research ment of patients whose death is expected com- 1. Cross-sectional non interventional multicenter pared to those whose death is not expected; clinical study for the evaluation of the preva- and assessing the perception of doctors and lence of nausea in hospitalized patients admit- nurses as regards the quality of the care pro- ted to a palliative care unit vided before death. Lead investigator: C. Gamondi. This is a two-year observational study which 5. Meaning of life, personal values and spirituality involves submitting questionnaires to patients at the end of life admitted to a palliative care unit suffering from Lead investigator: G. Borasio (CHUV). nausea when initially assessed. The aim of the This is an 18-month mixed prospective study study is to evaluate the prevalence of nausea aimed at studying the connection between peo- and to examine the multifaceted aspect of this ple’ s questioning themselves as to the mean- symptom, assessing the different spheres it af- ing of life and spirituality at the end of their lives fects. in an end-of-life context.

2. Participer à un suicide assisté: étude explora- 6. Advanced directives in patients with advanced toire sur l’expérience des proches et leurs oncological disease: patients' right or health représentations de la fin de vie, de la mort et professionals’ duty du deuil Lead investigator: S. Pautex (HUG). Lead investigator: C. Gamondi. This is an open multicenter observational quan- This is a three-year open multicenter qualitative titative study, the primary aim of which is to study (phase II) aimed at describing the charac- understand which characteristics of a patient teristics of the mourning of relatives of patients (socio-cultural, physical, psychological and spir- who die through assisted suicide. itual), expectations and attitudes towards being informed about and included in decisions, which 3. Indications as to the procedures and out- therapeutic representatives have an impact on comes of sedation: retrospective study in a the decision of whether or not to complete the hospital setting specializing in palliative care expected directives. The secondary aims of the Lead investigator: C. Gamondi. study are to understand the degree of author- This is a one-year retrospective study aimed at ity that patients expect from their representa- characterizing the sedation procedures in an tives and health professionals, and to identify acute care setting in a hospital specializing in the needs and expectations of the representa- palliative care. The data collected will make it tives as regards their involvement in end-of-life possible to check the traceability of the proce- decisions. A further aim is to study the experi- dure and the clinical reasoning behind the pro- ence of health professionals regarding end-of- cedures adopted. life decisions and issues relating to "Advanced Health Care Directives (AHCDs)" with patients 4. FIT (Fine Vita Ticino) study. Epidemiology of and their relatives/representatives. death in Ticino’s public hospitals Lead investigator: C. Gamondi. 7. Supervising the administering of concomitant This is a one-year observational prospective medicines in Palliative Care Units study aimed at describing how adult patients Lead investigator: C. Gamondi. die in public hospitals in Ticino and, in particu- This is a one-year open, observational phase lar, how they are assisted as they approach IV study aimed at collecting data on miscibility, death; identifying any differences in the treat- safety and efficacy of mixtures of drugs admin-

22 Scientific Report 2012 istered in the same infusion to advanced can- used in standard induction chemotherapy for cer patients. patients aged ≥ 66. The aim of the study is to check whether the administration of different Main funding obtained in 2012 experimental drugs has advantages compared ABREOC, Swiss National Science Foundation to standard chemotherapy based on cytara- (SNSF), SAMW and Helsinn. bine and daunorubicin.

Peer reviewed publications in 2012 2. The effect of cryopreservation on the function Neuenschwander H, Gamondi C. "Palliative Care of thrombocytes in patients Network - 20 years of experiences from Ticino, Lead investigators: B. Gerber, L. Alberio, G. Southern Switzerland". Ther Umsch. 2012 Feb; Stüssi. 69(2):126-31. This is a study on the functionality of cryopreserved platelets. The main aim of the study is to Conference communications in 2012 measure the clinical and laboratory functional Gamondi C. The 19th Annual International Pallia- activity of cryopreserved platelets. tive Care Conference on Teaching and Learning in Palliative Care: Lessons for the Future. Oral com- Peer reviewed publications in 2012 (selection) munication: Developing competencies for special- • Ossenkoppele GJ, Stussi G, Maertens J, van ists in palliative care in Switzerland: a national con- Montfort K, Biemond BJ et al. "Addition of beva- sensus. Dublin, March 2012. cizumab to chemotherapy in acute myeloid leukemia at older age: a randomized phase 2 trial 1.5 Haematology Service of the Dutch-Belgian Cooperative Trial Group Georg Stüssi MD PD for Hemato-Oncology (HOVON) and the Swiss Head Doctor Group for Clinical Cancer Research (SAKK)". Blood 2012; 120(24): 4706-11. The work of the Haematology Service is divided up into one part dealing principally with laboratory • Gerber B, Guggenberger R, Fasler D, Nair G, diagnostics (morphological microscopic analyses Manz MG, Stussi G, Schanz U. "Reversible skel- and flow cytometry) and a clinical part dealing etal disease and high fluoride serum levels in with patients. The Haematology Division is the only hematologic patients receiving voriconazole". centre in Ticino able to provide a global haemato- Blood 2012; 120(12): 2390-4. logical diagnosis by integrating all the technologies currently available in the most advanced centres. • Berger MD, Gerber B, Arn K, Senn O, Schanz U, The Haematology Service also treats, freezes and Stussi G. "Significant reduction of red blood cell stores peripheral stem cells for autologous trans- transfusion requirements by changing from a plants. double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy Main areas of research or stem cell transplantation". Haematologica 1. Clinical research into acute leukaemia in elderly 2012; 97(1): 116-22. patients Lead investigators: G. Ossenkoppele, B. Löwen- • Bettens F, Passweg J, Schanz U, Chalandon Y, berg, G. Stüssi. Heim D, Güngör T, Stussi G, Nicoloso G, Bal- This is an international multi-centres rand- domero H, Gratwohl A, Tiercy JM. "Impact of omized Phase II study aimed at assessing the HLA-DPB1 haplotypes on outcome of 10/10 efficacy and toxicity of new antileukaemia drugs matched unrelated hematopoietic stem cell do-

1. Oncology Institute of Southern Switzerland (IOSI) 23 nor transplants depends on MHC-linked micro- The IOR is an important training centre in the field satellite polymorphisms". Biol Blood Marrow of biomedical and cancer research for PhD stu- Transplant. 2012; 18(4): 608-16. dents, postdoctoral fellows and students in Ticino in collaboration with various Swiss and Italian uni- • Wahrmann M, Schiemann M, Marinova L, versities. The laboratory range of competencies Körmöczi GF, Derfler K, Fehr T, Stussi G, Böh- currently available in the laboratory include cellular mig GA. "Anti-A/B antibody depletion by sem- and molecular biology, molecular pharmacology, iselective versus ABO blood group-specific functional genomics, pharmacogenomics and bio- immunoadsorption". Nephrol Dial Transplant informatics. 2012; 27(5): 2122-9. From a structural point of view Professor Cavalli, 1.6 Research Division Director of the IOSI-IOR research division, coordi- Prof. Franco Cavalli MD nates scientific research for the whole of the IOSI. Scientific Director For this reason he chairs the IOSI Scientific Board, which sits every three months. The IOSI Research Division functionally unites two From an operational point of view, IOSI clinical re- closely linked units: the clinical research centre, search is divided principally into four units: which is located at the IOSI in the Regional Hospital a. New Drug Development Unit, under the direc- of Bellinzona and Valli - San Giovanni and the In- tion of Prof. Cristiana Sessa MD. This group of- stitute of Oncology Research (IOR), which is in the fers patients the possibility of receiving therapy IRB and IRBIS. The close intellectual and physical with experimental drugs that are still being proximity of the IOR and the IOSI clinical research tested. At present the Unit is coordinating nine sectors is fundamental to guarantee the quality of phase I studies (seven in solid tumours and two the work and the continuous flow of information in lymphomas) and six phase II studies. Some- between the laboratory sector and the dedicated times, as in the case of one of the phase I stud- research sector for patients. It is rare to find func- ies in lymphomas, the new experimental drug tional units like this in Switzerland, which is why the was previously assessed in the preclinic mod- IOR – the only oncological institute in Switzerland els available to the IOR and then subsequently – has been receiving Federal grants since 2013 passed on to the evaluation phase with pain pursuance of Article 16 of Federal Law on the tients in the IOSI. Currently all of these studies promotion of research and innovation. with new anti-cancer molecules are carried out under very strict conditions and with rigorous The IOR and main areas of research assessment, and they have all been previously This is the basic translational research unit at the approved by both the Canton’s Ethics Commit- IOSI. Originally opened at the IRB in Bellinzona in tee and Swissmedic - the Swiss Agency for April 2003, this research department currently Therapeutic Products. employs around thirty-five researchers. Iinitially, it was called the IOSI Experimental Cancer Labo- b. The Lymphoma Unit, coordinated by Emanuele ratory and administratively was run by the EOC. Zucca MD PD. This Unit manages the lympho- To become eligible for Confederation funds and ma database, dating back to 1980, where in- grants on 1 September 2011 it was turned into formation is stored about over 2,000 patients the IOR, which is currently managed by the Fon- and is updated continuously. The Unit also man- dazione Ticinese per la Ricerca e la Cura dei Lin- ages the scientific, logistic and IT divisions of fomi, although from a functional point of view the the International Extranodal Lymhoma Study IOR is still part of the research division of the IOSI. Group (IELSG), a cooperative group spanning

24 Scientific Report 2012 five continents with currently over 200 insti- Kramer D, Laurent J, Speiser DE, Stupp R. "A tutions (further information on IELSG can be phase I dose-escalation study of the immuno- found at www.ielsg.org). IELSG is also one of the cytokine EMD 521873 (Selectikine) in patients few institutions in Switzerland that can obtain with advanced solid tumours". Eur J Cancer funding for clinical studies from the National Epub 2012 Aug 20. Research Fund (FNR), which usually only funds laboratory research. • Bellei M, Chiattone CS, Luminari S, Pesce EA, Cabrera ME, de Souza CA, Gabús R, Zoppeg- c. Breast Cancer Unit, coordinated by Olivia Pa- no L, Zoppegno L, Milone J, Pavlovsky A, Con- gani MD. This Unit is particularly active in the nors JM, Foss FM, Horwitz SM, Liang R, Mon- research being carried out by the International toto S, Pileri SA, Polliack A, Vose JM, Zinzani Breast Cancer Study Group (IBCSG) and man- PL, Zucca E, Federico M. "T-cell lymphomas ages a database on Ticino patients with breast in South America and Europe". Rev Bras He- cancer. It is currently expanding and looking for matol Hemoter. 2012; 34(1):42-7. PMID: permanent headquarters. 23049383. d. Gastrointestinal Cancer Group, coordinated by • Ceriani L, Suriano S, Ruberto T, Zucca E, Gio- Piercarlo Saletti MD. The group promotes clini- vanella L. "18F-FDG Uptake Changes in Liver cal and translational research into tumours of and Mediastinum During Chemotherapy in Pa- the gastrointestinal tract in close collaboration tients With Diffuse Large B-cell Lymphoma". with the Canton’s Institute of Pathology di Lo- Clin Nucl Med. 2012 Oct; 37(10): 949-52. carno (ICP). PMID: 22955068.

Peer reviewed publications in 2012 of the Re- • Ferreri AJ, Govi S, Pasini E, Mappa S, Bertoni F, search Division (clinical sector – selection) Zaja F, Montalbán C, Stelitano C, Cabrera ME, • Fasolo A, Sessa C. "Targeting mTOR pathways Giordano Resti A, Politi LS, Doglioni C, Cavalli F, in human malignancies". Curr Pharm Des Zucca E, Ponzoni M, Dolcetti R. "Chlamydophila 2012; 18: 2766-77. Psittaci Eradication With Doxycycline As First- Line Targeted Therapy for Ocular Adnexae Lym- • Fasolo A, Sessa C, Gianni L, Broggini M. "Semi- phoma: Final Results of an International Phase nars in clinical pharmacology: an introduction II Trial". J Clin Oncol. 2012 Aug 20; 30(24): to MET inhibitors for the medical oncologist". 2988-94. PMID: 22802315. Ann Oncol Epub 2012 Oct 30. • Li ZM, Rinaldi A, Cavalli A, Mensah AA, Ponzoni • Gallerani E, Zucchetti M, Brunelli D, Marangon M, Gascoyne RD, Bhagat G, Zucca E, Bertoni F. E, Noberasco C, Hess D, Delmonte A, Martinelli "MYD88 somatic mutations in MALT lympho- G, Böhm S, Driessen C, De Braud F, Marsoni mas". Br J Haematol. 2012 Sep;158(5): 662- S, Cereda R, Sala F, D’Incalci M, Sessa C. "A 4. PMID: 22640364. first in human phase I study of the proteasome inhibitor CEP-18770 in patients with advanced • Nicolosi Guidicelli S, Lopez-Guillermo A, Falcone solid tumours and multiple myeloma". Eur J U, Conconi A, Christinat A, Rodriguez-Abreu D, Cancer Epub 2012 Oct 8. Grisanti S, Lobetti-Bodoni C, Piffaretti JC, John- son PW, Mombelli G, Cerny A, Montserrat E, • Gillessen S, Gnad-Vogt U, Gallerani E, Beck J, Cavalli F and Zucca E. "Hepatitis C virus and Sessa C, Omlin A, Mattiacci MR, LIedert B, GBV-C virus prevalence among patients with B-

1. Oncology Institute of Southern Switzerland (IOSI) 25 cell lymphoma in different European regions: a of histological transformation in follicular lym- case-control study of the International Extran- phoma". Br J Haematol. 2012 Apr;157(2): odal Lymphoma Study Group". Hematol Oncol. 188-96. PMID: 22348437. 2012 Sep; 30(3):137-42. PMID: 22105737. • Martinez A, Ponzoni M, Agostinelli C, Hebeda • Boi M, Stathis A, Zucca E, Inghirami G, Bertoni KM, Matutes E, Peccatori J, Campidelli C, Es- F. "Genetic alterations in systemic nodal and pinet B, Perea G, Acevedo A, Mehrjardi AZ, extranodal non-cutaneous lymphomas derived Martinez-Bernal M, Gelemur M, Zucca E, from mature T- and natural killer-cells". Can- Pileri S, Campo E, López-Guillermo A, Rozman cer Sci. 2012 Aug;103(8):1397-404.PMID: M. "International Extranodal Lymphoma Study 22568409. Group. Primary bone marrow lymphoma: an uncommon extranodal presentation of aggres- • Mensah AA, Rinaldi A, Ponzoni M, Canzonieri V, sive Non-Hodgkin’s Lymphomas". Am J Surg Uccella S, Rossi D, Bhagat G, Gaidano G, Zucca Pathol. 2012 Feb; 36(2): 296-304. PMID: E, Bertoni F. "Absence of NOTCH1 gene mu- 22251943. tations in MALT lymphomas". Br J Haematol. 2012 May;157(3): 382-4. PMID: 22171922. • Kwee I, Rinaldi A, Rancoita P, Rossi D, Capello D, Forconi F, Giuliani N, Piva R, Inghirami G, • Espeli V, Zucca E, Ghielmini M, Giannini O, Gaidano G, Zucca E, Bertoni F. "Integrated Salatino A, Martucci F, Richetti A. "Weekly and DNA copy number and methylation profiling of 3-weekly cisplatin concurrent with intensity- lymphoid neoplasms using a single array". Br J modulated radiotherapy in locally advanced Haematol. 2012 Feb; 156(3): 354-357. PMID: head and neck squamous cell cancer". Oral 22118580. Oncol. 2012 Mar;48(3): 266-71. PMID: 22079100. • Bulian P, Rossi D, Forconi F, Del Poeta G, Ber- toni F, Zucca E, Montillo M, Pozzato G, D'Arena • Joerger M, Ferreri AJ, Krähenbühl S, Schel- G, Efremov DG, Marasca R, Lauria F, Gaidano lens JH, Cerny T, Zucca E, Huitema AD. "Dos- G, Gattei V, Laurenti L. "IGHV gene mutational ing algorithm to target a predefined AUC in status and 17p deletion are independent mo- patients with primary central nervous system lecular predictors in a comprehensive clinical- lymphoma receiving high-dose methotrexate". biological prognostic model for overall survival Br J Clin Pharmacol. 2012 Feb;73(2):240-7. prediction in chronic lymphocytic leukemia". PMID: 21838788. J Transl Med. 2012 Jan 30;10:18. PMID: 22289136. • Thieblemont C, Davi F, Noguera ME, Brière J, Bertoni F, Zucca E, Traverse-Glehen A, Felman • Kwee I, Capello D, Rinaldi A, Rancoita PM, Bha- P, Berger F, Salles G, Coiffier B. "Splenic mar- gat G, Greiner TC, Spina M, Gloghini A, Chan ginal zone lymphoma: current knowledge and WC, Paulli M, Zucca E, Tirelli U, Carbone A, future directions". Oncology (Williston Park). Gaidano G, Bertoni F. "Genomic aberrations 2012 Feb; 26(2):194-202. PMID: 22489356. affecting the outcome of immunodeficiency- related diffuse large B-cell lymphoma". Leuk • Conconi A, Ponzio C, Lobetti-Bodoni C, Motta Lymphoma. 2012 Jan; 53(1) :71-6. PMID: M, Rancoita PM, Stathis A, Moccia AA, Maz- 21787262. zucchelli L, Bertoni F, Ghielmini M, Cavalli F, Zucca E. "Incidence, risk factors and outcome • Stathis A, Ghielmini M. "New agents for the

26 Scientific Report 2012 treatment of lymphoma". Ann Oncol. 2012; 23 This allowed us to activate new studies in each of Suppl 10: x92-8. the two groups, the IOSI actively participates in, and to prepare four new proposals for phase I studies 1.6.1 New Drug Development Unit in collaboration with SAKK tumour specific groups. Prof. Cristiana Sessa MD Deputy Head Doctor at IOSI In 2012, 9 Phase I studies (7 in solid tumours and 2 in lymphomas), with a total of 47 patients In 2012 the main activity of the Unit for New treated and 6 Phase II studies (3 in solid tumours Drugs Development has been the definition of the and 3 in lymphomas) with a total of 13 patients required operating standards and procedures treated, were activated or were already underway (SOP) to act as sponsor to perform clinical studies. in the Unit. This has allowed the unit to pass inspection (Audit) by Swissmedic (July 2012) which recognized the Peer reviewed publications in 2012 (selection) role of Unit for the conduct of clinical trials (CTU) • Fasolo A, Sessa C. "Targeting mTOR pathways with the necessary competences to sponsor Inves- in human malignancies". Curr Pharm Des tigator Promoted Studies (IIT). This qualification al- 2012;18: 2766-77. lows performing trials according to "Good Clinical Practice" (GCP), designed and carried out by inves- • Fasolo A, Sessa C, Gianni L, Broggini M. "Semi- tigators outside a direct control of pharmaceutical nars in clinical pharmacology: an introduction companies. to MET inhibitors for the medical oncologist". Ann Oncol Epub 2012 Oct 30. In 2012 the CTU IOSI has been therefore estab- lished and two IIT Phase I trial, one in patients with • Gallerani E, Zucchetti M, Brunelli D, Marangon non-Hodgkin Lymphomas and one in patients with E, Noberasco C, Hess D, Delmonte A, Martinelli solid tumours in collaboration with the University G, Böhm S, Driessen C, De Braud F, Marsoni of Utrecht, have been activated. S, Cereda R, Sala F, D’Incalci M, Sessa C. "A first in human phase I study of the proteasome This structural work has been also the basis for inhibitor CEP-18770 in patients with advanced the set up the CTU-EOC, active in the two comple- solid tumours and multiple myeloma". Eur J mentary sites, at the IOSI in Bellinzona and at Neu- Cancer Epub 2012 Oct 8. rocenter of Southern Switzerland (NSI) in Lugano, under the direction of Prof. Sessa at IOSI and Prof. • Gillessen S, Gnad-Vogt U, Gallerani E, Beck J, Möller at NSI. The activities are shared between Sessa C, Omlin A, Mattiacci MR, LIedert B, the two sites according to the requests and the Kramer D, Laurent J, Speiser DE, Stupp R. "A competences available. phase I dose-escalation study of the immuno- The purpose of CTU-EOC is to provide structures cytokine EMD 521873 (Selectikine) in patients and competences to foster the development of qual- with advanced solid tumours". Eur J Cancer ified clinical research within the EOC. This activity is Epub 2012 Aug 20. part of a project with the Medical Master School sponsored by the Swiss Italian University (USI). • Colombo N, Peiretti M, Garbi A, Carinelli S, Marini C & Sessa C on behalf of the ESMO Guidelines In the Unit for New Drugs Development a major Working Group. "Non-epithelial ovarian cancer: commitment has been devoted to promote and ESMO Clinical Practice Guidelines for diagnosis, improve the performance of the New Drugs Group treatment and follow-up†". Annals of Oncology of SAKK and of the Gynaecological Group of SAKK. 2012; 23 (Supplement 7): vii20–vii26.

1. Oncology Institute of Southern Switzerland (IOSI) 27 • Colombo N, Carinelli S, Colombo A, Marini therapy of malignant lymphomas C, Rollo D & Sessa C on behalf of the ESMO a. Assessing new anti-tumour agents in lym- Guidelines Working Group. "Cervical cancer: phomas: ESMO Clinical Practice Guidelines for diagno- • phase I and II clinical studies; sis, treatment and follow-up†". Annals of Oncol- • pre-clinical assessment in collabora- ogy 2012; 23 (Supplement 7): vii27–vii32. tion with the IOR laboratory. b. Program of phase I and II clinical studies of 1.6.2 Lymphoma Unit – IELSG the SAKK "Project Group" with translational Emanuele Zucca MD PD studies together with the IOR laboratory. Deputy Head Doctor at IOSI c. Management of the studies of the Interna- tional Extranodal Lymphoma Study Group The topics for research involve the clinical-patho- (phases II and III). logical, biomolecular and epidemiological study of lymphomas and new therapeutic strategies for 2. Management of the IOSI lymphoma database these tumours, as well as the clinical development (2000 patients) of new drugs. a. Retrospective studies on individuals, also in Malignant lymphomas are tumours diseases international collaboration. which originate from cells of the immune system. b. Studies for the creation of prognostic mod- The most common site is the lymph glands, but all els with optimal management of missing organs of the body can be affected. data (in collaboration with IDSIA mathema- Over the past thirty years the frequency of these ticians and bioinformatics). tumours has increased steadily in Western coun- c. Using the database for internal audits and tries. quality control of clinical results.

Ongoing research projects at a clinical level involve: 3. Prognostic models in lymphomas • participation in SAAK national clinical research a. Integration of molecular and clinical pa- protocols; rameters in the evaluation of patients with • collaboration with the New Drug Group; lymphomas; • collaboration with SENDO (Southern Europe b. The role of PET. New Drug Organization) to study new drugs to combat lymphomas; The following studies are currently underway: • coordination of the international research pro- 1. OSI-LND-001 - Phase I study of Inotuzumab tocols group IELSG, primarily concerned with Ozogamicin (CMC-544) in combination with the study of extranodal lymphomas or those Temsirolimus (CCI-779) in patients with re- arising outside the immune system; lapsed or refractory CD22-positive B-cell Non • a series of national and international collabo- Hodgkin’s Lymphomas. rations to study the biological and molecular Lead investigator: A. Stathis. characteristics of lymphomas together with Phase I study for patients with lymphomas the IOR and, in particular, with the research promoted by the IOSI, with the participation of group of Dr Francesco Bertoni, internationally three Swiss centres (IOSI, St Gallen and Berne). famous for studies in the molecular biology of lymphomas. 2. IELSG – Prospective studies • IELSG 30 Main areas of research Phase II study of R-CHOP with intensive CNS 1. Clinical studies to identify new strategies in prophylaxis and scrotal irradiation in patients

28 Scientific Report 2012 with primary testicular diffuse large B-cell lym- A. Gullermo Lopez. phoma Lead investigators: U. Vitolo, E. Zucca. Main funding obtained in 2012 • ELSG 32 ABREOC, SNSF, Lega svizzera contro il cancro, On- Randomized phase II trial on primary chemo- cosuisse, Mundipharma and Novartis. therapy with high-dose methotrexate and high- dose cytarabine with or without thiotepa, and Peer reviewed publications in 2012 (selection) with or without rituximab, followed by brain irra- • Conconi A, Ponzio C, Lobetti-Bodoni C, Motta diation vs high-dose chemotherapy supported M, Rancoita PM, Stathis A et al. "Incidence, by autologous stem cell transplants for immu- risk factors and outcome of histological trans- nocompetent patients with newly diagnosed formation in follicular lymphoma". Br J Haema- primary CNS lymphoma tol 2012; 157(2): 188-96. Lead investigators: A. Ferreri, G. Illerhaus, E. Zucca. • Ribrag V, Caballero D, Ferme C, Zucca E, Ar- • IELSG 34 ranz R, Briones J et al. "Multicenter phase II Multicenter phase II study to assess the clini- study of plitidepsin in patients with relapsed/ cal activity and safety profile of everolimus refractory non-Hodgkin's lymphoma". Haema- (RAD001) in marginal zone B-cell lymphomas tologica 2013; 98(3): 357-63 Epub 2012 Oct (MZL) 12. Lead investigators: E. Zucca, A. Conconi. • IELSG 36 – BRISMA. • Ferreri AJ, Govi S, Pasini E, Mappa S, Bertoni Bendamustine and Rituximab for the treat- F, Zaja F et al. "Chlamydophila Psittaci Eradica- ment of Splenic Marginal Zone Lymphoma - An tion With Doxycycline As First-Line Targeted IELSG phase II prospective study Therapy for Ocular Adnexae Lymphoma: Final Lead investigators: E. Iannitto, C. Thieblemont, Results of an International Phase II Trial". J Clin C. Montalban. Oncol. 2012; 30(24): 2988-94. • IELSG 37 Randomized open-label multicenter two-arm • Nicolosi Guidicelli S, Lopez-Guillermo A, Falcone phase III comparative study assessing the U, Conconi A, Christinat A, Rodriguez-Abreu D, role of involved mediastinal radiotherapy after et al. "Hepatitis C virus and GBV-C virus preva- Rituximab containing chemotherapy regimens lence among patients with B-cell lymphoma to patients with newly diagnosed Primary Medi- in different European regions: a case-control astinal Large B-Cell Lymphoma (PMLBCL) study of the International Extranodal Lympho- Lead investigators: M. Martelli, A.J. Davies, M. ma Study Group". Hematol Oncol 2012; 30(3): Gospodarowicz, E. Zucca. 137-42.

3. IELSG – Retrospective studies • Joerger M, Ferreri AJ, Krähenbühl S, Schellens • IELSG 17 JH, Cerny T, Zucca E et al. "Dosing algorithm to Multi-institutional retrospective analysis of in- target a predefined AUC in patients with prima- travascular lymphomatosis ry central nervous system lymphoma receiving Lead investigators: A. Ferreri e M. Ponzoni. high-dose methotrexate". Br J Clin Pharmacol. • IELSG 31 2012; 73(2): 240-7. Retrospective international study of primary extranodal follicular lymphoma Chapters of books in 2012 Lead investigators: E. Zucca, B. Pro, M. Federico. Ponzoni M, Glass J. Zucca E. Intravascular Lym-

1. Oncology Institute of Southern Switzerland (IOSI) 29 phoma of the CNS. Chapter 14 in Batchelor This guarantees the most up-to-date and cutting- T, DeAngelis L.M. (eds). Lymphoma and Leuke- edge therapies in this important sector of oncol- mia of the Nervous System. Second Edition. ogy for patients referring to the IOSI. Moreover, Springer Science+Business Medi, LLC 2012 doi the Group has also developed research projects 10.1007/978-14. to clarify fundamental aspects of the biology of this tumour, with the collaboration of the Canton’s In- Conference communications in 2012 stitute of Pathology in Locarno and the IOSI’s ex- • Ceriani L, Zucca E, Zinzani PL, Ferreri AJM, perimental oncology laboratories. Vitolo U, Stelitano C, et al. Poster (No.1566): "Role of positron emission tomography (PET/ Main areas of research CT) in primary mediastinal large B cell lym- Lead investigators: O. Pagani, A. Christinat, S. Di phoma (PMLBCL): preliminary results of an Lascio. international phase II trial (IELSG-26 study) conducted on behalf of the International Ex- 1. Three adjuvant clinical studies coordinated tranodal Lymphoma Study Group (IELSG), the by IBCSG (International Breast Cancer Study Fondazione Italiana Linfomi (FIL) and the UK Group) and one clinical study in collaboration NCRI Lymphoma Group". ASH, Atlanta 8-11th with Roche December 2012. a. IBCSG 22-00: Randomized phase III study with low-dose maintainance chemotherapy • Govi S, Pasini E, Mappa S, Bertoni F, Zaja F, following precautionary chemotherapy for Montalbán C, et al. on behalf of the Internation- breast cancer patients with estrogene and al Extranodal Lymphoma Study Group (IELSG). progesterone receptors negative. 17th Annual Congress European Haematol- b. IBCSG 25-02 (TEXT Bone Substudy): sub- ogy Association (EHA). Oral communication study to assess the effect of the study (No.1116): "Chlamydophila psittaci eradication drugs (ovarian suppression + Tamoxifen or with doxycycline is an active first-line targeted Exemestane) on bone density. therapy for ocular adnexae lymphoma: final c. IBCSG 35-07 (SOLE): randomized phase III results of an international phase II prospective study with continuous or intermittent Letro- study (IELSG-27)". EHA, Amsterdam 14-17th zole, after 4-6 years of adjuvant therapy, in June 2012. post-menopausal women with breast cancer with hormone receptors positive. 1.6.3 Breast Cancer Unit d. SAFE-HER: Phase III non-randomized study Olivia Pagani MD to assess the safety of administering sub- Head Service at IOSI cutaneously adjuvant Herceptin® in patients with HER2 positive breast cancer. The group promotes clinical research into breast cancer, developing and participating in national 2. Three clinical studies with the disease at an and international clinical studies for the preven- advanced stage and two of prevention coordi- tion, treatment and precautionary post-operative nated by SAKK therapy at advanced stages of the disease. a. SAKK 22/99: Randomized phase III study with Herceptin alone, followed by Herceptin The research is carried out within the SAKK and plus chemotherapy versus Herceptin and the International Breast Cancer Study Group (IBC- chemotherapy in patients with metastatic SG), where the doctor in charge of the Group (Dr HER-2 positive breast cancer. Pagani) is a member of the Scientific Committee. b. SAKK 24/09: Randomized Phase III study

30 Scientific Report 2012 comparing the tolerability and safety of bev- Inst. 2012; 104(6): 441-51. acizumab and paclitaxel versus bevacizumab, capecitabine and cyclophosphamide in • Cardoso F, Costa A, Norton L, Cameron D, patients with metastatic cancer. Cufer T, Fallowfield L, Francis P, Gligorov J, c. SAKK 21/08: Double blind randomized Kyriakides S, Lin N, Pagani O, et al. "1st Inter- phase II study, with Fulvestrant with or with- national consensus guidelines for advanced out AZD6244 or placebo, in patients with breast cancer (ABC 1)". The Breast 2012; 21: breast cancer in progression with an aro- 242-252. matase inhibitor. d. IBIS II: International preventive study with • Cardoso F, Loibl S, Pagani O, et al. "The Euro- Anastrozolo vs placebo in postmenopausal pean Society of Breast Cancer Specialists rec- women with an increased risk of breast ommendations for the management of young cancer. women with breast cancer". Eur J Cancer e. IBIS II: International study with Anastrozolo 2012; 48: 3355–77. vs Tamoxifen in menopausal patients with DCIS. • Ribi K, Aldridge J, Phillips KA, Thompson A, Harvey V, Thürlimann B, Cardoso F, Pagani O, 3. Observational study in young patients coordi- et al. "Subjective cognitive complaints one year nated by FSE (Frontier Southern Europe) after ceasing adjuvant endocrine treatment for Helping Ourselves, Helping Others: analyzing early-stage breast cancer". Br J Cancer 2012; and monitoring various aspects (medical, de- 106(10): 1618-25. mographic, psychological and social) linked to breast cancer at an early age. • Pagani O, Azim HA Jr. "Pregnancy after breast cancer: myths and facts". Breast Care 2012; 4. Data Base CARMA 7: 210–4. Collection of histopathological and clinical information from IOSI patients until 2007 to assess Conference communications in 2012 the impact of prognostic and predictive factors • Pagani O. Breast Cancer in Young Women identified at diagnosis with the outcome. Conference. Oral communication: "Endocrine therapy for early breast cancer: standards 5. International research program on pregnancy and controversies". Dublin, 8-10th November after breast cancer 2012. Collaboration between BIG (Breast Internation- al Group) and NABCG (North American Breast • Pagani O. Program for Oncology Leaders in Eu- Cancer Group). rope. Oral communication: "How to set-up and run a multidisciplinary tumour board". Milan, Main funding obtained in 2012 7-9th September 2012. ABREOC and non-competitive external funding. • Pagani O. 17th SIS World Congress on Breast Peer reviewed publications in 2012 (selection) Diseases. Oral communication: "Managing • Regan MM, Leyland-Jones B, Bouzyk M, Pagani breast patients in the era of molecular medi- O, et al. "CYP2D6 Genotype and Tamoxifen Re- cine: adjuvant adjustment based on genetic sponse in Postmenopausal Women with Endo- signatures". Salvador, Bahia, 10-13th October crine-Responsive Breast Cancer: The Breast 2012. International Group 1-98 Trial". J Natl Cancer

1. Oncology Institute of Southern Switzerland (IOSI) 31 • Pagani O. 8th European Breast Cancer panies (pancreas) Conference (EBCC-8). Oral communication: "Advanced BC Clinics: more questions than an- 6. Clinical studies of phase I with molecular tar- swers". 21st-23rd March 2012. geted therapy, oriented towards tumours of the gastrointestinal tract • Pagani O. Summer School in Public Health Policy, Economics and Management. Oral com- Main funding obtained in 2012 munication: "Prevention strategies against ABREOC and non-competitive external funding. cancer". Lugano, 20-25th August 2012. Peer reviewed publications in 2012 (selection) 1.6.4 Gastrointestinal Cancer Group • Crippa S, Saletti P, Barizzi J, Mazzucchelli L. Piercarlo Saletti MD "The clinical management in familial adenoma- Deputy Head Doctor of Medical Oncology Service tous polyposis deserves continuous monitoring for thyroid carcinoma". BMJ Case Rep. 2012 The group promotes clinical and translational re- Nov 15; 2012. doi:pii: bcr2012007046. search into cancers of the gastrointestinal tract. 10.1136/bcr-2012-007046. In addition, thanks to the collaboration with the Cantonal Institute of Pathology in Locarno (ICP), • Helbling D, Bodoky G, Gautschi O, Sun H, Bos- the possible predictive role of specific molecular man F, Gloor B, Burkhard R, Winterhalder R, markers are being assessed for this type of tu- Madlung A, Rauch D, Saletti P, Widmer L, mour. Borner M, Baertschi D, Yan P, Benhattar J, Leibundgut EO, Bougel S, Koeberle D. "Neoadju- Main areas of research vant chemoradiotherapy with or without panitu- 1. Molecular predictive factors in patients under- mumab in patients with wild-type KRAS, locally going surgery for gastric cancer who under- advanced rectal cancer (LARC): a randomized, went adjuvant chemotherapy based on cispl- multicenter, phase II trial SAKK 41/07". Ann atin (in collaboration with ICP) Oncol. 2012 Nov 8. [Epub ahead of print].

2. Molecular predictive factors in patients oper- • Christensen J, El-Gebali S, Natoli M, Seng- ated on for colon cancer receiving adjuvant stag T, Delorenzi M, Bentz S, Bouzourene H, chemotherapy based on oxoplatino (in collabo- Rumbo M, Felsani A, Siissalo S, Hirvonen J, ration with ICP) Vila MR, Saletti P, Aguet M, Anderle P. "De- fining new criteria for selection of cell-based 3. Molecular characterization (EGFR pathway) in intestinal models using publicly available da- adenocarcinomas of the small intestine (in col- tabases". BMC Genomics 2012; 13:274. doi: laboration with ICP) 10.1186/1471-2164-13-274.

4. Overexpression of HER2 as a mechanism of re- • Miranda C, Nucifora M, Molinari F, Conca E, sistance in patients with metastatic carcinoma Anania MC, Bordoni A, Saletti P, Mazzucchelli of the colon and treated with anti-EGFR (in col- L, Pilotti S, Pierotti MA, Tamborini E, Greco A, laboration with ICP) Frattini M. "KRAS and BRAF mutations predict primary resistance to imatinib in gastrointesti- 5. Clinical phase II/III studies as part of the GI nal stromal tumours". Clin Cancer Res 2012; SAKK group (hepatocellular, colorectal, es- 18(6): 1769-76. doi: 10.1158/1078-0432. ophageal), promoted by pharmaceutical com- CCR-11-2230. Epub 2012 Jan 26.

32 Scientific Report 2012 • Reni M, Balzano G, Aprile G, Cereda S, Passoni December 2011. The patients recruited were P, Zerbi A, Tronconi MC, Milandri C, Saletti P, invited to carry out a program of art therapy Rognone A, Fugazza C, Magli A, Di Muzio N, Di during their time in hospital and the reasons Carlo V, Villa E. "Adjuvant PEFG (cisplatin, epi- for their choices (positive or negative) were rubicin, 5-fluorouracil, gemcitabine) or gemcit- collected using a questionnaire. The patients abine followed by chemoradiation in pancreatic who then took part in the program were given cancer: a randomized phase II trial". Ann Surg another questionnaire with open questions in Oncol 2012; 19(7): 2256-63. doi: 10.1245/ order to analyze the benefits they felt they had s10434-011-2205-2. Epub 2012 Jan 12. received. While there was a low level of adherence to the program (14%), those who took • Dienstmann R, De Dosso S, Felip E, Tabernero part felt that the program was very useful. The J. "Drug development to overcome resist- art-therapist went on to carry out a thematic ance to EGFR inhibitors in lung and colorectal analysis of the drawings. The research has cancer". Mol Oncol. 2012; 6(1): 15-26. doi: been completed, but not yet published in full. 10.1016/j.molonc.2011.11.009. 2. Pain monitoring at IOSI: what stage are we at? 1.7 IOSI Nursing Service Lead investigator: D. Valcarenghi. In recent years the EOC Nursing Service has The purpose of this study was to assess how gradually been moving from a functional to a more well the IOSI pain monitoring program was patient-centred system. The nursing situation is working some years after it was first set up. As- continually evolving with the goal of creating a true sessment was carried out on the prevalence of system of global treatment based on relationships. this symptom among oncology inpatients, the In addition research into nursing is being devel- percentage of cases involving pain that was oped to further improve the treatment of patients. difficult to control and as regards the role of It is only possible to promote and fully support the nurses, how the specific evaluation forms for role, image and professionality of nurses as an this problem were administered and filled in. indispensible element in ensuring personalized, Than a retrospective analysis of the medical re- competent treatment in the health sector through cords of all patients admitted to the IOSI in the multidisciplinary relations and the development of last three months of 2010 (198 patients was the necessary expertise in dealing with patients. carried out). 57% of the patients suffered pain, but this was successfully dealt with, especially With this in mind, a Nursing Research and De- through the use of drugs, although there is still velopment Office has been set up within the IOSI room for improvement as regards the moni- Nursing Service, headed by Monica Bianchi MSc, toring of the symptom by nurses. The research nursing and obstetrics, under the responsability of has been completed, but not yet published in Dario Valcarenghi MSc, nursing and obstetrics. full.

Main areas of research 3. The use of central venous catheters for periph- 1. The inclusion of a program of art therapy for eral insertion (PICC) in IOSI: assessment of the cancer patients admitted to the IOSI: a pilot effects study Lead investigator: M. Bianchi. Lead investigator: D. Valcarenghi. The purpose of this study, which began in May The purpose of the study was to assess the 2011, is to monitor the effects of the use of impact of a program of art therapy on cancer PICC in patients, especially cancer patients, patients admitted to the IOSI between May and who have had the vascular aid inserted.

1. Oncology Institute of Southern Switzerland (IOSI) 33 The data were collected systematically in a condition this learning process. The study is database and will be used periodically for the mixed, in terms of both quantity and quality, assessment and correction of ongoing pro- and should take one year to complete. It will be cedures. For each complication detected, in- carried out in two IOSI day clinics (Lugano and depth analysis will be performed to identify the Bellinzona), and the data will be collected from possible causes and the data obtained will be both patients (using questionnaires and semi- compared with those in international literature. structured interviews) and nursing staff (using By the end of 2012, 112 PICCs had been ap- a focus group). plied and the study is still ongoing. Main funding obtained in 2012 4. Look Good – Feel Better workshops: an oppor- ABREOC. tunity for cancer patients at IOSI? Lead investigator: M. Bianchi. Peer reviewed and non-peer reviewed publications The purpose of the study, which began in Janu- in 2012 (selection) ary 2012, is to assess the effects of voluntary • Pedrazzani C, Valcarenghi D, Bianchi M. 91 participation in the Look Good – Feel Better Comprehensive Geriatric Assessment (CGA) workshops, where patients learn under the in the Elder Cancer Patient – Implications in advice of expert beauticians to enhance their Nursing Decision-making Process. European body image, offset in part by changes deter- Journal of Oncology Nursing 2012; 16 (S1): mined by the physical oncological pathology S32. and/or treatment received. The assessment is carried out by twice administering the Body • Bianchi M, Valcarenghi D. Establishing a PICC Image Scale (BIS), an internationally validated (Peripherally Inserted Central Catheters) Team scale which has already been translated into at the Oncology Institute of Southern Switzer- Italian. The scale is first applied to patients land - an opportunity for patients, nurses and prior to their participation in the workshops health service. Schweizer Krebsbulletin 2012; and then approximately 8 weeks afterwards. 3: 226-228. In 2012, six workshops were carried out and 30 women agreed to participate in the study, Conference communications in 2012 which is still underway. • Willems Cavalli Y. 2° Congresso Infermier- istico EOC. Infermieri EOC: co-protagonisti nel 5. Educating patients regarding oral drug treat- sistema sanitario che cambia. Oral communi- ment for cancer cation: "Cure infermieristiche in movimento, Lead investigator: D. Valcarenghi. quale futuro?". Lugano, May 2012. The aim of this study is to investigate how well the IOSI has activated an educational pro- • Willems Cavalli Y. SVPL-Kongress 2012. Trans- gram for new out-patients being treated with formation in der Führung. Oral communication: oral anti-tumour drugs. In particular we will "Von Transformation in der Führung zur Trans- be looking at the educational approach used formation der Pflegepraxis: von Inspiration zu by nursing staff (content and methods, and Ergebnissen". Berne, October 2012. the significance they attribute to them) to see whether it is considered effective and meets • Bianchi M, Broggini L, Pedrazzoli-Hutz C, Tosi- the patients’ educational needs. Secondly, we Casado S, Valcarenghi D. 2a Giornata della will be endeavouring to understand whether Ricerca Clinica della Svizzera Italiana 2012. other factors (organizational or cultural) could Abstract (abstract book, No. 46) and poster:

34 Scientific Report 2012 "L'inserimento di un programma di arte-terapia • Zanon M, Foletti F, Bianchi M. 2° Congresso per pazienti ricoverati allo the IOSI: uno studio Infermieristico EOC "Infermieri EOC:co-protag- pilota". Bellinzona, 23rd March 2012. onisti nel sistema sanitario che cambia". Ab- stract e poster: "Progetto d'implementazione • Valcarenghi D, Di Giulio P, Pedrazzani C, Bi- del Primary Nursing presso l'ambulatorio the anchi M. 2a Giornata della Ricerca Clinica della IOSI di Bellinzona". Bellinzona, 9th May 2012. Svizzera Italiana 2012. Abstract (abstract book, No. 16): "La sorveglianza del dolore allo Awards 2012 the IOSI: a che punto siamo?" Bellinzona, 23rd Förderpreis 2012 der Onkologiepflege Schweiz March 2012. - First prize for the project: "The development of nursing care: the creation of a PICC Team at the • Bianchi M, Pedrazzani C, Valcarenghi D. 2a Oncology Institute of Southern Switzerland"; pub- Giornata della Ricerca Clinica della Svizzera lished in: Bianchi M, Pedrazzani C, Pedrazzoli C, Italiana 2012. Abstract (abstract book, No. Tosi S, Zanon M, Valcarenghi D, et al. "I cateteri 18) e poster: "Le esigenze e le proposte degli venosi centrali a impianto periferico: un'opportunità infermieri dell’Oncology Institute of Southern per lo sviluppo delle cure infermieristiche?" Onkolo- Switzerland rispetto all'EBP: presentazione di gieplege - Soins en oncologie 2012; 3:23-24. alcuni risultati". Bellinzona, 23rd March 2012.

• Pedrazzani C, Valcarenghi D, Bianchi M. 8 EONS Spring Convention 2012. Abstract e poster: "Comprehensive Geriatric Assessment (CGA) in the elder cancer patient: implications in nursing decision-making process". Geneva, 26-27th April 2012.

1. Oncology Institute of Southern Switzerland (IOSI) 35

2 Neurocenter of Southern Switzerland (NSI) 2. Neurocenter of Southern Switzerland (NSI)

Fabrizio Barazzoni MD MPH With the creation of the NSI, it was decided to Head of Department, a.i. fund clinical and basic research in the field of the neurosciences. This resulted in the creation of an Introduction experimental laboratory IRB and the setting up of The NSI is a functional-type organizational struc- the CTU, which, under Prof J. C. Möller, Head of ture which operates transversally between hospi- Neurology, together with a similar structure, the tals, grouping together the services of neurology, IOSI, under Prof. C. Sessa, make up the CTU-EOC. neurosurgery, neuroradiology, neuroanesthesia, early neurorehabilitation and neurosciences (clini- The NSI also collaborates with the Hildebrand Re- cal and basic research), to promote and apply an habilitation Clinic in Brissago in the field of neu- inter- and multi-disciplinary approach to diagnosis rorehabilitation. and treatment, as well as carrying out teaching and research in the field of diseases of the nerv- The research is financed by competitive funding ous system, while at the same time aiming to cre- (such as the National Research Fund) and non- ate highly-specialized centres (such as the stroke competitive funding (pharmaceutical companies, center). foundations etc). The annual budget for basic research in the NSI is Following planning which ended in 2008, the NSI around CHF 340,000, excluding the CTU's costs. was officially set up and opened on 1 July 2009. It offers patients a cutting-edge approach to neu- Main areas of research of the NSI rological diseases and their treatment, and to patients' safety considering diagnosis, treatment and 2.1 Neurology Service rehabilation from the early stages of the disease Multiple Sclerosis (MS) up to discharge. Epidemiology National epidemiological registry (SMSC) – collec-

38 Scientific Report 2012 tion of personal, clinical and radiology data and la- TY720D2406 (PASS), EMR200136-532 (SO- bor/liquor parameters in MS patients: C. Gobbi, C. LAR), 205MS301 (DECIDE), WA21092 (OP- Zecca, M. Adami, U. Candrian, E. Pravatà, F. Keller. ERA I), WA25046 (ORATORIO), PERSIST.

Diagnostics Sleep and epileptology EOC.NSI.12.02: C. Gobbi, C. Zecca, E. Pravatà. Re- • Autonomic function and cardio-vascular risk in search on possible objective radiological correla- patients with restless legs syndrome - the Au- tions of fatigue in patients suffering from MS. to-REST study. M. Manconi, S. Fulda, C. Cereda, C. Bassetti, A. Salvadè, F. Baracchi, A. Auric- Therapy chio, C. Carelli. • EOC.NSI.11.01: C Gobbi, C Zecca. The study tests the clinical and radiological effectiveness • Animal models of restless legs syndrome and of an immunomodulator following therapy with periodic movements of the lower limbs: the natalizumab. role of an antidopaminergic drug. M. Manconi, S. Fulda, A. Salvadè, in collaboration with S. Cle- • EOC.NC.10.04: C. Gobbi, C. Zecca. Examination mens, Greenville, USA. of the effectiveness and safety of an oral taper after bolus steroids in MS. • Animal models of restless legs syndrome and periodic movements of the lower limbs: the • CORE: C Gobbi, C Zecca. The study tests the tol- role of mirtazapine. M. Manconi, S. Fulda, A. lerance and acceptability of immunomodulators. Salvadè, in collaboration with M. Esteves, San Paulo, Brasil. • Participation in the following multicenter studies: AC-058B202-MS, CBAF312A2201E1 • Analysis of the correlation between periodic (BOLD), CFTY720D2306 (INFORMS), CF- movements of the lower limbs and respiratory

2. Neurocenter of Southern Switzerland (NSI) 39 sleeping disorders. M. Manconi, S. Fulda, in col- • Effects of benzodiazepine abuse in insomniacs laboration with R. Ferri, Troina, Italy, and J. Win- on the structure of sleep and their cognitive kelmann, Boston, USA. functions. M. Manconi, M. Maestri.

• Treatment of augmentation in patients with • High-density EEG in normal and pathological restless legs syndrome after prolonged re- (parasomnias) sleep. M. Manconi, I. Pisarenco, lease dopamine agonists. M. Manconi, M. in collaboration with F. Faraci, Manno, Switzer- Maestri, S. Fulda. land (SUPSI).

• Evaluation of the polysomnographic and breath- Parkinson's disease ing variables following an ischemic stroke (SAS- • The role of sleep homeostasis in the develop- CARE study). C. Bassetti. ment of dyskinesia brought on by L-Dopa in patients suffering from advanced stage Parkin- • Fatigue, sleepiness and psychiatric symptoms son's disease. S. Galati, C. Möller, C. Städler. in multiple sclerosis. M. Caporro, M. Manconi, C. Gobbi, S. Fulda, C. Zecca, A. Pratesi. • The role of sleep homeostasis in the development of dyskinesia brought on by levodopa: • EEG patterns and functional correlations in tran- electrophysiological and molecular analysis in sitory global amnesia. P. Agazzi, I. Pisarenco, C. the animal model of Parkinson's disease. S. Ga- Prosperetti, M. Manconi. lati, C. Möller, M. Pace, C. Städler.

• Disperception in sleep and psychological vari- • Electrophysiological effects of acute blocking ables of personality in primary insomnia. M. of the nigrostriatal pathways on cortex striate Manconi, F. Drovandi, in collaboration with P. interplay. C. Prosperetti, C. Möller, S. Galati, in Schulz, Lugano, Switzerland (USI). collaboration with A. Stefani, Rome, Italy.

40 Scientific Report 2012 • Time course of the development of the patho- • Rehabilitation combined with bihemispheric logical beta band in the animal models for Par- transcranial direct current stimulation in pa- kinson's and its significance in the course of the tients with subacute stroke in order to recover development of dyskinesia. Electrophysiological movement in the upper limbs - Study "Re.Com. study of the animal model of Parkinson's dis- Bi.Ne (Rehabilitation Combined with Bihemi- ease. S. Galati, C. Möller. spheric Neuromodulation) post-stroke study". C. Cereda, G. Bianco, C. Möller, in collaboration • Prevalence of movement disorders in the popu- with F. Conti, Brissago, D. Zutter, Zihlschlacht lation of Ticino – biobank. C. Städler, S. Galati, and R. Müri, Berne, Switzerland. C. Möller. • Prospective registry of strokes affecting the Stroke insula. C. Cereda, in collaboration with F. Le- • Prospective EOC Stroke Unit registry (RADIAL). mieux, Montreal, Canada. C. Cereda, C. Städler, L. Biancon Montaperto, J. Andreotti. • Participation in the following multicenter studies: SWISS (NCT00811538), SYSS; 15-city • Multicenter study of sleep apnea syndrome in study. acute SAS stroke and in the post-stroke phase analysing the impact of CPAP therapy in sec- 2.2 Neurosurgery Service ondary cerebral and cardiovascular preven- During 2012 no relevant research was carried tion. C. Cereda, M. Pons, A. Azzola, M. Manconi, out. The new Head of the Department of Neuro- L. Petrini, C. Städler, A. Gallino; in collaboration surgery, Prof. M. Reinert, began working at the NSI with C. Bassetti, Berna, L. Nobili, Milano, Italy, P. in January 2013. Young, Münster, Germany and P. Lavie, Haifa, Israel.

2. Neurocenter of Southern Switzerland (NSI) 41 2.3 Neuroradiology Service Peer reviewed publications in 2012 (selection) • fMRI and fatigue in patients with MS. A. Cian- • Zecca C, Cereda C, Wetzel S, Tschuor S, Stae- foni, E. Pravatà, in collaboration with C. Gobbi, dler C, Santini F, Nadarajah N, Bassetti C, Neurology Division. Gobbi C. "Diffusion-weighted imaging in acute demyelinating myelopathy". Neuroradiology • Other research protocols on MS. A. Cianfoni, E. 2012; 54:573-8. Pravatà, in collaboration with Dr C. Gobbi, Neu- rology Division. • Zecca C, Yawalkar N, Gobbi C. "Improvement of interferon-beta related skin reactions after • The role of tumour ablation and percutaneous diluent halving: first experience of five patients". cementoplasty in neoplasms of the spinal cord Pat Pref Adher 2012;6:565-7. (a retrospective study). A. Cianfoni. • Manconi M, Ferri R, Zucconi M, Bassetti CL, 2.4 Pain Management Center Fulda S, Aricò D, et al. "Dissociation of periodic • Facilitating the rapport with the patient: five leg movements from arousals in restless legs questions to understand his point of view. P. syndrome". Ann Neurol 2012; (6) 71:834-44. Maino, C. Möller, M. Raimondi, C. Gobbi, in collaboration with C. Zanini and S. Rubinelli, Nottwil. • Ferri R, Manconi M, Plazzi G, Bruni O, Cosen- tino FI, Ferini-Strambi L, et al. "Leg movements • Pain for the doctor and the patient, how to com- during wakefulness in restless legs syndrome: municate and how to understand it P. Maino, time structure and relationships with peri- in collaboration with C. Zanini and S. Rubinelli, odic leg movements during sleep". Sleep Med Nottwil. 2012; 13: 529-35.

• Accidental injection into the soft tissue of medi- • Cereda CW, Petrini L, Azzola A, Ciccone A, cines for filling intrathecal pumps: increased Fischer U, Gallino A, et al. "Sleep disordered risk without an x-ray. P. Maino, C. Möller. breathing in acute ischemic stroke and transient ischemic attack: effects on short- and • Stimulation of the dorsal root gangli in the long-term outcome and efficacy of treatment treatment of refractory neuropathic pains in with continuous positive airways pressure - ra- parts of the body that are difficult to cover. P. tionale and design of the SAS CARE study". Int Maino, C. Möller. J Stroke 2012; 7: 597-603.

2.5 Neurosciences Conference communications in 2012 Scientific activities, with particular reference to • Zecca C, Meier DS, Tschuor S, Nadarajah N, basic research, are listed under their respective Cotto F, Sintzel M, et al. ECTRIMS. Poster: "Na- clinical service. The CTU-EOC, which has a unit in talizumab de-escalation to interferon beta 1b the NSI, is presented in a separate section. in multiple sclerosis: a randomized, controlled, pilot trial." Lyon, October 2012. Main funding obtained in 2012 SNSF, ABREOC, UCB, "Fondazione per lo studio • Zecca C, Yawalkar N, Gobbi C. Riunione della delle malattie neurodegenerative", "Fondazione Società Svizzera di Neurologia. Oral presenta- Svizzera di Cardiologia", private funds and pharma- tion: "Diluent halving: a new strategy to optimize ceutical companies. interferon beta-1b-related skin reactions?" Lu- gano, May 2012.

42 Scientific Report 2012 • Galati S, Möller JC, Ferrazzoli D. Riunione della Società Svizzera di Neurologia. Poster: "Patho- logical synchronization of the rat basal ganglia following the functional blockade of the nigro- striatal pathway." Lugano, May 2012.

• Cereda C, Tamisier R, Andreotti J, Bassetti C. Annual Meeting of the American Society of Neurology. Oral presentation: "Endothelial Dysfunction and Arterial Stiffness in Ischemic Stroke: the role of Sleep Disordered Breath- ing". New Orleans, April 2012.

• Massari F, Rumboldt Z, Bonaldi G, Vandergrift AW, Cianfoni A. Annual Meeting of the Ameri- can Society of Neuroradiology. Poster: "Image- guided cervical spine procedures". New York, April 2012.

Awards 2012 • M. Manconi MD received the "SGKN" Preis (prize of the Swiss Society of Clinical Neuro- physiology) for the best oral presentation at the Swiss neurological Society Congress (Lugano 2012) on the topic "Dissociation of periodic leg movements from arousals in restless legs syndrome".

• M. Maestri MD in October 2012 received the "Franco Ferrillo" prize from the Italian Associa- tion of Sleep Medicine for the best oral presentation entitled "Efficacy prolonged release pramipexole in the management of augmentation in restless legs syndrome".

• S. Galati MD in May 2012 received the Déjé- rine-Dubois prize from the Swiss Neurology Society for "Pathological synchronization of the rat basal ganglia following the functional blockade of the nigro-striatal pathway".

2. Neurocenter of Southern Switzerland (NSI) 43

3 EOC Multisite Departments and Services 3. EOC Multisite Departments and Services

The multisite Departments and Services are struc- its functioning are based on the fundamental prin- tures which are transversal to all institutes and are ciples of shared clinical governance (accountabil- an organizational mode of clinical management. ity, participation, transparency and management). The Departments are, as a rule, the functional and The Department is organized using a multisite ap- organizational integration of operational units that proach, providing a gateway to general surgical are homogeneous, similar, or complementary to services for each region, and can advise and direct and mutually dependent on one another, sharing patients who need to undergo highly complex sur- the same goals – goals which could not otherwise gery to the appropriate reference centres. be achieved. They are, however, clinically autono- mous, with their own separate professional re- The EOC Department of Surgery guarantees high- sponsibility. quality localized surgical assistance, either planned The Departments are made up of services, divi- or in emergency situations, making use of the spe- sions and units of competency, grouped according cific specialized competencies of the Department, to nosology, function and size. The needs for clini- and it aims to be the best solution to harmonize and cal governance are also taken into account in the rationalize the facilities for surgery in the Canton. organization of the Departments. Main areas of research 3.1 EOC Department of Surgery The following studies are currently underway: Prof. Raffaele Rosso MD • Two techniques for the treatment of sacro- Head of EOC Department of Surgery and Head coccygeal cysts: a randomized and controlled Surgeon of the Regional Hospital of Lugano study (Regional Hospital of Lugano)

The Department has a functional type of organiza- • Feasibility of a program for abdominal aortic tional structure, and is managed and coordinated aneurysm ultrasound screening in the popula- by the Department Board. The rules adopted for tion served by the Regional Hospital of Lugano

46 Scientific Report 2012 (Regional Hospital of Lugano) Peer reviewed publications in 2012 (selection) • Van den Berg JC, Pedrotti M, Canevascini R, • Isolation and characterization of cancer stem Chimchila Chevili S, Giovannacci L, Rosso R. cells from colorectal carcinoma (Regional Hos- "Endovascular treatment of in-stent restenosis pital of Lugano and Regional Hospital of Bellin- using excimer laser angioplasty and drug eluting zona and Valli). This study was carried out in balloons". J cardiovasc surg 2012; 53: 215-22. collaboration with the University of Basel it is a retrospective study on HAL/RAR (ultrasound- • Christoforidis D, Clerc D, Demartines N. "Tran- guided haemorrhoid artery ligatation and recto- srectal specimen extraction after laparoscopic anal repair) in the treatment of haemorroids left colectomy: a case-matched study". Colorec- (Regional Hospital of Mendrisio) tal Diseases. Epub 2012 Oct 3. doi: 10.1111/ codi.12006, in press 2013. • Retrospective study on the conservative treatment of proximal humeral fractures (Regional • Lübbeke A, Garavaglia G, Rothman KJ, Bonvin Hospital of Mendrisio) A, Roussos C, Miozzari H, Hoffmeyer P. "Statins may reduce femoral osteolysis in patients with • SAKK Study 40/04 on the type of reconstruc- total Hip arthroplasty". J Orthop Res. 2012 tion following low anterior resection of the Nov 8. doi: 10.1002/jor.22262. rectum with total mesorectal excision in the treatment of low rectal carcinoma (Regional • Bianchi V, Spitale A, Mazzucchelli L, Bordoni A Hospital of Mendrisio) and the QC Working Group. Quality Indicators of Clinical Cancer Care (QC) in the territory of Main funding obtained in 2012 Canton Ticino: a population-based study. Bulle- ABREOC, University of Basel, SIAK. tin Suisse du Cancer 2012; 3: 205-208.

3. EOC Multisite Departments and Services 47 Thoracic Surgery Unit – • Role of major surgical treatment in elderly pa- Regional Hospital of Bellinzona and Valli tients André Dutly MD PD It is believed that a careful assessment of el- Head Surgeon derly patients in the decisional phase, performance status, general clinical conditions, the The Thoracic Surgery Unit is situated in the Bellin- possibility of carrying out an operation for ther- zona branch of the Regional Hospital of Bellinzona apeutic purposes and the wishes of the patient and Valli. are determining factors in the decisional work- up and that age alone cannot be considered an The Unit guarantees complete, immediate and excluding factor. high-quality all-round care for patients suffering To this end, a multicenter scientific collabora- from lung cancer, chest wall tumours, mediastinal tion is currently underway with the thoracic disorders, secondary chest neoplasms, as well as surgery unit of the University Hospital of Zürich non-neoplastic lung diseases, such as pneumotho- (Prof. Weder) aimed at the surgical and on- rax, pleurisy and empyema deposits. cological assessment of outcome in patients over-80 undergoing thoracic surgery. The high standard of treatment is guaranteed not only by the use of mini-invasive surgical techniques Conference communications in 2012 (VATS –Video Assisted Thoracic Surgery) and • Giuliani M, Matarrelli E, Carboni G, Karoubi G, state-of-the-art equipment (digital detection of air Dutly AE. Joint Annual Meeting of the Swiss loss following lung surgery; microsutures, robotic Society of Pneumology, Swiss Society of Pedi- thoracic surgery), but also by the multidisciplinary atric Pneumology, Swiss Society for Thoracic approach used in thoracic surgery when manag- Surgery, Swiss Underwater and Hyperbaric ing oncology patients. Medical Society. Crans-Montana, 25-27 April 2012. "Feasibility study of ePTFE suture in Main areas of research sleeve lobectomy". • André Dutly MD PD coordinated a "Systematic Published in: Internationa Journal of Thoracic international multicenter review" focused on Medicine – Respiration 2012; 84: 49. understanding the current role of personalized therapies in non-small-cell lung cancers. This • Matarrelli E, Giuliani M, Dutly AE. on behalf of important attention to the onco-genome applied pneumoclub Ticino. Joint Annual Meeting of to lung cancer has enabled collaboration be- the Swiss Society of Pneumology, Swiss Soci- tween the thoracic surgery unit of the EOC with ety of Pediatric Pneumology, Swiss Society for the University of Milan, the Università Cattolica Thoracic Surgery, Swiss Underwater and Hy- del Sacro Cuore of Rome, the "Centro Onco- perbaric Medical Society. Crans-Montana, 25- logico Fiorentino (Florence Cancer Centre)" and 27 April 2012. "Suitability of Thoracoscopic various Italian Scientific Institutes for Research wedge resection for day surgery". Hospitalization and Health Care (IRCCS). Published in: International Journal of Thoracic Medicine – Respiration 2012; 84: 50. • Review of pulmonary adenocarcinoma classification • Cafarotti S, Giuliani M, Matarelli E, Karoubi G, Carboni G, Dutly AE. • New surgical and peri-operative management Congresso Nazionale Italiano della FONICAP - techniques of patients undergoing pulmonary Forza operativa nazionale contro il cancro del resection polmone. Poster: "E’ fattibile la resezione cunei-

48 Scientific Report 2012 forme toracoscopica ambulatoriale?". Verona, Main areas of research November 2012. • Sonographic follow-up of patients with cubital tunnel syndrome (CTS) undergong open neurol- • Cafarotti S, Matarelli E, Giuliani M, Karoubi ysis in situ or endoscopic: a prospective study G, Carboni G, Dutly AE. Congresso Nazionale Sonographic examination is a useful technique Italiano della FONICAP - Forza operativa nazion- in the assessment of the follow-up of patients ale contro il cancro del polmone. undergoing surgical treatment for cubital tun- Poster: "Studio di fattibilità nell’utilizzo della nel syndrome (CTS). sutura ePTFE nella sleeve lobectomy". Verona, There is, moreover, a direct correlation be- November 2012. tween the values of the cross section area (CSA) of the ulnar nerve determined by sono- Hand Surgery Unit graphic examination and the clinical pre- and Daniele De Spirito MD, post-operative state in patients undergoing ul- Regional Hospital of Lugano nar nerve decompression at the elbow. The aim Cesare Fusetti MD, of the study is to compare the clinical results of Regional Hospital of Bellinzona and Valli open release and endoscopically assisted cubi- Stefano Lucchina MD, tal tunnel release who encounter decompres- Regional Hospital of Locarno sion of the ulnar nerve at the elbow using the Alain Thebaud MD, differences found by sonographic examination Regional Hospital of Mendrisio of the cross section area (CSA) of the ulnar nerve, seeking an association between the clini- The Hand Surgery Unit, together with hospital and cal results and the CSA. health service partners, provides diagnosis, treatment and rehabilitation services for upper limb dis- • Prospective study comparing the treatment of eases and injuries. fractures of the fifth metacarpal neck by reduction and casting or mobilization and soft wrap/ Its activities include the treatment of arthrosis and buddy-taping (in collaboration with HUG Geneva rheumatic diseases, lesions of tendons or nerves, – Naval Hospital of San Diego and Mayo Clinic, tendinitis and nerve inflammation, fractures of the Rochester). hand and the upper limb, accidents at work, sports injuries, musician and artist pathologies, occupa- • Study of the correlation between pain in the tional diseases, functional overload syndromes shoulder and hand in patients with neuropathy and aesthetic microsurgery. As regards the hand, of the median nerve in the wrist in particular, the Unit deals with reconstruction after amputation or complex lesions, reconstructive Peer reviewed publications in 2012 (selection) microsurgery, paralysis of the peripheral nerves, • Lucchina S, Fusetti C. "Revision surgery for microsurgery of the skin and blood vessels, trigger failed carpal tunnel release". Plast Reconstr finger, Dupuytren disease, carpal tunnel syndrome, Surg 2012; 130 (6): 898-899. reconstruction of congenital malformations, fun- tional surgery for patients affected by congenital/ • Lucchina S, Fusetti C, Nistor A. "Arterial grafts acquired spasticities or cerebral paralyses, and are also available locally for hand reconstruc- surgical treatment of the paediatric hand. tion". J Hand Surg Am 2012; 37(7) : 1510-1511.

• Ferrero A, Garavaglia G, Gehri R, Maenza F, Fu- setti C. "Analysis of the inter- and intraobserver

3. EOC Multisite Departments and Services 49 agreement in radiographic evaluation of wrist rect patients to the appropriate reference centres. fractures using the multimedia messaging ser- The EOC Department of Internal Medicine was set vice (MMS)". Hand 2011; 6(4): 384-389. up to ensure high-quality localized internal medicine assistance, either planned or in emergency Conference communications in 2012 situations, making full use of its specific specialized • Brunetti S, Fusetti C. Congrès SFCM-GEM. competencies, as the best way of harmonizing and "L'information médicale sur internet: patients rationalizing the facilities for this sector in the Canton. et tunnel carpien". Paris, December 2012. Cardiology Service – Regional Hospital of Lugano • Lucchina S, Fusetti C. Jahreskongress SGH- Giorgio Moschovitis MD SSCM 46. "Are health insurances and bureau- Head of Service cracy pulling back surgeons from patient care? A fight against time". Thun, November 2012. The Cardiology Service of the Regional Hospital of Lugano assists inpatients or patients at the Emer- • Brunetti S, Fusetti C. 2012 Combined Meeting gency Department. It also provides diagnoses and of the ASSH and AHSS. "Inter- and intraobserv- advice for outpatients referred to the Service by er agreement in wrist fracture classification both internal and external doctors. using MMS. A prospective study". Koloa Kanai Hawai USA, 2012. Main areas of research: • ACTELION study - ACT-128800 Relapsing- • Brunetti S, Fusetti C. 13th European congress remitting Multiple Sclerosis, Protocol AC- of Trauma & Emergency Surgery. "MMS and 058B202: Multicenter, randomized, dou- wrist fracture classification. Analysis of inter- ble-blind, parallel-group extension to study and intraobserver agreement". Basel, 12-15th AC-058B201 to investigate the long-term safe- May 2012. ty, tolerability, and efficacy of 10, 20, and 40 md/day ACT-128800, an oral S1P1 receptor • Lucchina S. ISSHPORT congress. "Bony mallet agonist, in patients with relapsing-remetting options in atheletes". Miami (USA), 7th Febru- multiple sclerosis (in collaboration with C. Gobbi ary 2012. of the NSI):

3.2 EOC Department of Internal Medicine • SAS-CARE study - Sleep disordered breathing Prof. Augusto Gallino MD in TIA/ischemic Stroke: effects on short- and Head of EOC Department of Internal Medicine and long-term outcome and CPAP treatment Effica- Head Doctor of Internal Medicine of Regional Hos- cy: an open, observational, clinical, multicenter pital of Bellinzona and Valli trial with a randomized arm Clinical Phase IV. (in collaboration with C. Cereda of the NSI and The EOC Department of Internal Medicine is a func- M. Pons, Internal Medicine Head Doctor of Re- tional type of organizational structure, and is man- gional Hospital of Lugano). aged and coordinated by the Department Board. The rules adopted for its functioning are based on • INPUT study - CTEPH after PE. Multicenter ob- the fundamental principles of shared clinical gov- servational screening survey for the detection of ernance (accountability, participation, transpar- chronic thromboembolic pulmonary hyperten- ency and management) and it is organized using sion (CTEPH) following pulmonary embolism (in a multisite approach, offering a gateway to general collaboration with A. Azzola from the Pneumol- internal medicine services, and can advise and di- ogy Service of the Regional Hospital of Lugano

50 Scientific Report 2012 and the Swiss Society of Pulmonary Hyperten- • Menafoglio A, Di Valentino M, Limoni C, Siragu- sion). sa P, Moschovitis G, Gallino A. American Heart Association meeting (AHA), Los Angeles, 3-7 • Impact of cardiovascular screening with ECG November, 2012. Abstract: "Comparison of in young athletes aged 14-35, in collaboration European Society of Cardiology and Circulation with A. Gallino and A. Menafoglio of the Cardio- criteria for interpretation of the electrocardio- vascular Research Centre of the Regional Hos- gram in young athletes". Published in: Circula- pital of Bellinzona and Valli tion 2012; 126: A9479.

Collaborations are also underway with the follow- • Di Valentino M, Siragusa P, Moschovitis G, ing Swiss Hospitals: Gallino A, Menafoglio A. American Heart As- • BEAT-AF: Basel Atrial Fibrillation Registry, with sociation meeting (AHA), Los Angeles, 3-7 David Conen of the University Hospital of Basel, November, 2012. Abstract: "Malignant" early in collaboration with the Cardiology Service of repolarisation is relatively frequent in young the Regional Hospital of Bellinzona and Valli (M. athletes". Published in: Circulation 2012; 126: Di Valentino) A9478.

• Swiss Heart: Swiss Registry in Acute Heart Fail- Infectious Diseases Service – Regional Hospital ure with Paul Mohacsi of the Berne University of Lugano Hospital Prof. Enos Bernasconi MD Deputy-Head of Internal Medicine Peer reviewed publications in 2012 Pfister O, Evéquoz D, Mach F, Moschovitis G, Samii The Infectious Diseases Service (SMI) is a special- K, Waeber G. "Should anemia and Iron deficiency ized day clinic that deals with patients with infec- be treated in patients with chronic heart failure?" tious diseases. The Service works in close collabo- Cardiovascular Medicine 2012;15(4):109-115. ration with local GPs.

Conference communications in 2012 The SMI is one of the seven reference centres • Di Valentino M, Siragusa P, Maggi M, Romano for the Swiss HIV Cohort Study (SHCS), one of the GA, Pezzoli R, Moschovitis G, Gallino A, Mena- world’s largest epidemiological and clinical studies foglio A. European Society Cardiology meeting in the HIV field with approximately 15,000 partici- (ESC), Munich, 25-29 August, 2012. Abstract: pants. "Electrocardiograms in young athletes: char- The intense scientific activity is reflected in the large acteristics and prevalence of abnormalities". number of publications found at www.shcs.ch. Published in: Eur Heart J 2012; 33(suppl1): P1755. Main areas of research 1. MRSA in the community and virulence of the • Di Valentino M, Siragusa P, Maggi M, Romano Candid sp (in collaboration with the EOC Micro- GA, Pezzoli R, Moschovitis G, Gallino A, Mena- biology Service) foglio A. European Society Cardiology meeting (ESC), Munich, 25-29 August, 2012. Abstract: 2. Th 17 cell migration and differentiation in HIV "Early repolarisation in young athletes: electro- infection (in collaboration with the IRB) (MD- cardiographic characteristics and prevalence THIV) of risky phenotype". Published in: Eur Heart J Lead investigators: E. Bernasconi, R. Speck, M. 2012; 33(suppl1): P1759. Uguccioni.

3. EOC Multisite Departments and Services 51 Thirty years after the discovery of human im- analysis of HIV-related B-cell lymphomas from munodeficiency virus (HIV) type 1, the mecha- the Swiss HIV Cohort Study nisms that regulate the pathogeneses of AIDS Lead investigators: F. Bertoni, K. Darling, M. and the progression of the disease are still not Battegay, B. Hasse, A. Calmy, C. Staehelin, P. completely clear. A progressive immunodefi- Vernazza, F. Schöni-Affolter, S. Dirnhofer, E. ciency characterizes HIV infection. In the cur- Zucca, E. Bernasconi. rent paradigm, the extended activation of the Despite the introduction of Highly Active Anti- immune system is considered one of the great- Retroviral Therapy (HAART), Non-Hodgkin’s est causes of loss of T CD4+ cells and altera- Lymphomas (NHL) are still a major complications to the immune response that lead to the tion of HIV infection, occurring more frequently progression of the disease. than in immunocompetent subjects and caus- The loss of T CD4+CCR5+ cells in Gut Asso- ing morbidity and mortality. Diffuse Large B-cell ciated Lymphoid Tissue (GALT) has been very Lymphomas (DLBCL) are the most common well documented in both the natural host and type of NHL associated with HIV infection and pathogenesis models of Simian Immunodefi- are clinically and biologically very aggressive. ciency Virus (SIV) infection. The outcome of lymphoma HIV-DLBCL is even Moreover, a reduction in the frequency of Th17 worse than the form developed in immuno- cells in the mucosa of SIV infected macaques competent subjects (IC-DLBCL). Moreover, has been described. This is a recently discov- the gene alterations that are the basis of the ered subgroup of T effector cells and is involved pathogenesis of the HIV-DLBCL cannot be in the immune response to extracellular bac- completely superimposed on those observed teria. in immunocompetent patients. The standard The migration capacity of this subpopulazion of therapy for IC-DLBCL is a polychemotherapy T cells has not been studied up to now in either combined with the monoclonal antibody Rituxi- human beings or macaques. mab, but there are still open issues in the man- Chemokines are important mediators of the agement of HIV-DLBCL, above all regarding the traffic and function of leucocytes and the de- necessity of HAART and Rituximab. regulation of their expression could contribute to the pathogenesis of the infection HIV-1/SIV. The main aims of the study are to: Recently, chemokines that induce synergy and • monitor current treatment of HIV-DLBCL with- can deeply modulate cellular traffic have been in the "Swiss HIV Cohort Study (SHCS)"; described. • compare outcomes of HIV-DLBCL with the IC- The question is, therefore, whether a decrease DLBCL population; in the Th17 cells in the GALT is because of • collect data on the availability of histological their reduced formation/differentiation or the material for future studies. reduced traffic in the GALT. The secondary aims are to: The aim of this project is to study the mecha- • compare outcomes of HIV-DLBCL chemother- nisms that mediate the traffic and differentia- apy with or without the addition of Rituximab; tion of the Th7 cells during HIV infection in or- • compare HIV-DLBCL outcomes based on the der to better understand the pathogenesis of type of anti-retro viral used in conjunction; AIDS. • compare the incidence of metastasis in the central nervous system of HIV-DLBCL with the 3. Non-Hodgkin’s lymphomas and HIV (in collabo- IC-DLBCL population. ration with the IOSI). More precisely: A survey of treatment modalities and outcome From a methodological point of view, the study in-

52 Scientific Report 2012 volves the collection of the basic data and HIV-NHL Csajka C, Bucher HC, Günthard HF, Rickenbach outcomes within the SHCS from 01.01.2004 to M, Nicca D, Hirschel B, Bernasconi E, Wandel- 31.12.2011; the analysis of the clinical outcomes er G, Battegay M, Marzolini C; Swiss HIV Cohort of HIV-DLBCL will then be compared with non-se- Stuy. "Determinants of sustained viral suppres- lected cases of IC-DLBCL. sion in HIV-infected patients with self-reported This will be a one-year observational study of two poor adherence to antiretroviral therapy". PloS groups, more specifically: group 1 – approximate- One 2012; 7(1): e29186. ly 100 patients (both male and female) with HIV and DLBCL (SHCS participants); group 2 – ap- • Bucher HC, Richter W, Glass TR, Magenta L, proximately 140 immunocompetent patients with Cavassini M, Vernazza P, Hirschel B, Weber DLBCL (IOSI cohort). R, Furrer H, Battegay M, Bernasconi E. "Small dense lipoproteins, apolipoprotein B and risk Main funding obtained in 2012 of coronary events in HIV-infected patients on ABREOC, SHCS (through SNSF) and Infectious Dis- antiretroviral therapy: the Swiss HIV Cohort ease Research Fund. Study". J Acquir Immune Defic Syndr 2012; 60(2): 135-42. Peer reviewed publications in 2012 (selection) • Young J, Schäfer J, Fux C.A, Furrer H, Bernas- Nephrology and Haemodialysis Service – coni E, Vernazza P, Calmy A, Cavassini M, We- Regional Hospital of Lugano ber R, Battegay M, Bucher HC, the Swiss HIV Carlo Schönholzer MD Cohort Study. "Renal function in patients with Head Doctor HIV starting therapy with tenofovir and either efavirenz, lopinavir or atazanavir". AIDS 2012; The Nephrology and Haemodialysis Service offers 26: 567-575. specialist assistance for patients suffering from renal disease, providing consultancy, tests re- • Pillai SK, Abdel-Mohsen M, Guatelli J, Skasko M, quired for further diagnostic investigation and both Monto A, Fujimoto K, Yukl S, Green WC, Kovari pharmacological and instrumental treatments for H, Rauch A, Fellay J, Battegay M, Hirschel B, renal diseases and their complications. Witteck A, Bernasconi E, Ledergerber B, Gün- thard HF, Wong JK and the Swiss HIV Cohort Main areas of research Study. "Role of retroviral restricion factors in Prospective assessment of vascular ageing the inferon-α-mediated suppression of HIV-1 in through analysis of the wrist pulse wave in a co- vitro". Proc Natl Acad Sci USA 2012; 109(8): hort of chronic haemodialysis patients 3035-40. This is a 3-year study in collaboration with the EOC's co-ordinated Nephrology and Dialysis Service. • Scherrer AU, Ledergerber B, von Wyll V, Böni J, Yerly S, Klimkait T, Cellerai C, Furrer H, Calmy Gastroenterology Service – Regional Hospital A, Cavassini M, Elzi L, Vernazza PL, Bernasconi of Lugano E, Günthard HF; Swiss HIV Cohort Study. "Mi- Vera Kessler Brondolo MD nor protease inhibitor mutations at baseline do Head of Service not increase the risk for a virological failure in HIV-1 subtype B infected patients". PloS One Gastroenterology is the specialization in internal 2012; 7(6): e37983. medicine that studies the functions and pathologies of the thoracic and abdominal organs involved • Glass TR, Rotger M, Telenti A, Decosterd L, in digestive processes (fore, mid and hind gut) and the

3. EOC Multisite Departments and Services 53 pancreas. It also provides, through endoscopic proce- tion obtained from hr-MRI (the remodelling of dures, diagnosis and treatment of these pathologies. the artery) in collaboration with the group led by Prof. Yuan of Seattle, and that obtained from Main areas of research a specific assessment using Duplex-Ultrasound ALIGN study (Gray-scales) in collaboration with Prof. Froio, This is an international cross-sectional epidemio- Bocconi University, could enable a better un- logical study of the perception of patients affected derstanding of the "in vivo" characteristics that by chronic inflammatory disease in relation to sys- render the plaque more vulnerable and/or temic therapies and their compliance. prone to progression.

The senior researcher for Switzerland is P. Michet- • Vulnerability of carotid plaque: role of informa- ti, while V. Kessler Brondolo is the senior research- tion and intraplaque neoangiogenesis er for the Regional Hospital of Lugano. Lead investigator: A. Gallino. The pathophysiological elements that lead to Main funding obtained in 2012 acute thrombotic occlusion responsible for Abbvie Company. cerebrovascular or coronary events are still in- completely explained. Inflammatory factors in- Cardiovascular Research Centre – Regional side or adjacent to the plaque, as well as haem- Hospital of Bellinzona and Valli orrhaging inside the atherosclerotic plaque, Prof. Augusto Gallino MD can constitute important triggering elements. Head of EOC Department of Internal Medicine and In order to study this phenomenon "in vivo" spe- Head Doctor of Internal Medecine of Regional Hos- cial sophisticated magnetic resonance tech- pital of Bellinzona and Valli niques, created by Prof. M. Stuber of CVBM of CHUV of Lausanne, will be used to establish Main areas of research the degree of vascularization of the x plaque/s. • "In vivo" assessment of the evolution of the At the same time, lesions at the carotid level atherosclerosis plaque using high-resolution will be investigated using a special technology Magnetic Resonance (hr-MRI) and Duplex- associated with Duplex carotid examinations Ultrasound: prospective comparative study at employing a contrast medium (Contrast en- the level of the femoral and carotid arteries hanced Ultrasound) in collaboration with Dr Lead investigator: A. Gallino. Staub of Basel. There will be a parallel study on Understanding the progression of atheroscle- the role of certain structures inside the plaque rosis is mainly based on autoptical or invasive frequently associated with inflammatory phe- studies. This recently completed study (Eu- nomena, which are also potentially responsible ropean Heart Journal 2012; Eur; 33: 230- for more serious cardio- or cerebrovascular 7), financed by the National Research Fund events. (NCT00918541) and the Swiss Cardiology Foundation, which began in 2008, has made it • Orphan cardiac diseases: Cardiac X and Takot- possible, thanks to a non-invasive assessment subo syndrome with hr-MRI, to determine distinct degrees of Lead investigator: A. Porretta. progression of atherosclerosis at the level of Cardiac syndrome X (angina pectoris and two territories despite the absence of intra- myocardial ischaemia) and Takotsubo syn- individual variables. The sub-studies resulting drome (transitory acute dyskinesia) constitute from this initial research, currently the object two rare signs of coronaropathy (chronic and of a comparative assessment of the informa- acute respectively) occurring predominantly

54 Scientific Report 2012 in women with normal epicardial coronary ar- cardiovascular diseases in a population of adult teries. The pathophysiological mechanisms athletes and their ECG characteristics. remain speculative. For some years now data have been collected by a network of cardiolo- • Incidence of acute coronary syndrome in Can- gists in Ticino on chronic manifestations, which ton Ticino following the banning of smoking in have been included anonymously with the public places. No Smoke Pub Study consent of the Ethics Committee in the Italian Lead investigator: M. Di Valentino. Registry on cardiac syndrome X (Prof. G. Am- The aim of the study was to assess the impact brosio – the Italian Registry is also expected of the banning by law of smoking in all public to be incorporated with the British Registry on places in Canton Ticino (from 13.04.2007) on cardiac Syndrome X: Prof. J.C. Kaski). In order the incidence of hospitalization for secondary to assess two of the major physiopathological acute coronary syndrome (SCA). It was an ob- mechanisms two series of 15 patients from servational retrospective study. The incidence Ticino, one with cardiac syndrome X and the of hospitalization for SCA was analyzed from other with Takotsubo syndrome, were studied 13.04.2004 to 12.04.2010 in both Can- prospectively (with the external expertise of Dr ton Ticino and the City Canton of Basel (April I. Sudano PD of the University of Zurich) by test- 2005-April 2010), when the smoking ban was ing the degree of endothelial dysfunction (En- not yet effective in this Canton. All the data doPAT) and the dysfunction of the involuntary were collected from the admission records of nervous system (BRS) against a control group EOC public hospitals, the Ticino Cardiocenter of healthy volunteers. The expected results and the University Hospital of Basel. The re- should add to our understanding of the role sults show that in Canton Ticino after the ap- of the independent nervous system and the plication of the provision, the STEMI diagnosis endothelial dysfunction, and their interdepend- had a statistically significant reduction, by ap- ence, if any. proximately 20% within three years since the ban entered into force. On the other hand, a • Impact of cardiovascular screening among minimal reduction that was not statistically senior sports people aged 35-65 significant was observed in the City Canton of Lead investigator: A. Menafoglio. Basel during the trial period. Sports reduces morbidity and cardiovascular mortality. However, in subjects affected • Triggers of acute infarct of the myocardium by cardiopathy, sports can be dangerous and two months before the event. Study of cardiac occasionally lead to cardiac arrest. In adults prevention. TAMI Study the main cause of cardiac arrest is coronary Lead investigator: M. Di Valentino. disease. The European Society of Cardiology Many cases of myocardium infarction are recently issued recommendations for cardio- caused by an occlusion of a coronary branch, vascular screening of adults actively participat- often preceded by a period of instability of the ing in sport. There are no studies analyzing the atherosclerotic plaque. The endothelial dys- impact of these recommendations. The main function (cells that cover the inner wall of blood aim of the present study is to estimate the sus- vessels) plays a particular role immediately tainability of this policy applied on a wide scale, before, during and after the acute myocardial in particular in terms of total costs (including event. Rehabilitation is a non-pharmacological screening and the additional examinations that approach aimed at improving the endothelial then become necessary). A secondary aim is function. The aim of this study is to analyze, to determine the prevalence of undiscovered through questionnaires completed by patients

3. EOC Multisite Departments and Services 55 with infarction who will carry out a cardiac re- tients with coronary artery disease): inclusion habilitation cycle, what the possible "triggers" and follow-up. were that preceded the event. Moreover, the study proposes to assess the endothelial func- • IMPROVE-IT study (Multicenter, double blind, tion at the beginning and end of the cardiac randomized study to etablish the clinical ben- rehabilitation cycle. The aim is to include 100 efit and safety of Vytorin (Ezetimbie/Simvas- patients in the study group and another 100 tatin) vs Simvastatin monotherapy in high risk in the comparative group. Currently, about 80 subjects presenting acute coronary syndrome patients have been recruited for the question- (Improved Reduction of Outcomes: Vytorin Ef- naire group and about 25 patients for the en- ficacy International Trial): follow-up. dothelial function group. • RELY-ABLE study (long-term multi-center exten- • Basel Atrial Fibrillation Registry (BEAT-AF) sion of dabigatran treatement in patients with Lead investigator: M. Di Valentino. atrial fibrillation who completed the RE-LY trial This study, directed by Prof. Dr David Conen, and a randomized cluster trial to assess the ef- is being carried out in collaboration with the fect of a knowledge translation intervention on University Hospital of Basel. Atrial fibrillation patient outcomes): follow-up. is the most frequent arrhythmy present in the general population and the evolution of the dis- • TRILOGY study (A Comparision of Prasugrel ease is not completely clear. The study of the and Clopidogrel in Acute Coronary Syndrome – evolution of this arrhythmy requires a simple ACS – Subjects with Unstable Angina/Non-St- examination and the filling in of a specific ques- Elevation Myocardial Infarction – UA/NSTEMI tionnaire. The aim is to build up a registry of all – Who are medically Managed): follow-up. patients with documented atrial fibrillation and also to prospectively establish a follow-up for all • TAMARIS study (A randomized double-blind patients in the registry. This is an epidemiologi- placebo controlled parallel group study of the cal prospective multicenter study. In Canton Ti- efficacy and safety of 4 administrations of cino there are 50-100 probable participants, XRP0038/NV1FGF 4mg at 2-week intervals with ca. 50 patients currently included in this on amputation or any death in critical limb is- registry. chemia patients with skin lesions): follow-up.

Moreover, the Cardiovascular Research Centre is Main funding obtained in 2012 also participating in the following international mul- ABREOC, SNSF, Swiss Cardiology Foundation, ticenter pharmacological studies: Medtronic Switzerland and Biotronik Switzerland. • HOKUSAI study (a randomized, double-blind, double-dummy, parallel-group, multi-center, Peer reviewed publications in 2012 (selection) multi-national phase III study for the assess- • Bianda N, Di Valentino M, Périat D, Segatto ment of the efficacy and safety of (LMW) hepa- JM, Oberson M, Moccetti M, Sudano I, Santini rin/edoxaban versus (LMW) heparin/warfarin P, Limoni C, Froio A, Stuber M, Corti R, Gallino in subjects with symptomatic deep-vein throm- A, Wyttenbach R. "Progression of human ca- bosis and/or pulmonary embolism): inclusion rotid and femoral atherosclerosis: a prospec- and follow-up. tive follow-up study by magnetic resonance vessel wall imaging". EHJ 2012; 33: 230-7. • SIGNIFY study (Study assessing the morbi-mortality benefits of the If inhibitor ivabradine in pa- • Gallino A, Stuber M, Crea F, Falk E, Corti R,

56 Scientific Report 2012 Lekakis J, Schwitter J, Camici P, Gaemperli foglio A. EuroPRevent. Abstract: "Infero-lateral O, Di Valentino M, Prior J, Garcia-Garcia HM, early repolarisation in young athletes: preva- Vlachopoulos Ch, Cosentino F, Windecker St., lence and electrocardiographic phenotypes". Pedrazzini G, Conti R, Mach F, De Caterina R, Dublin, May 2012. Libby P. ""In vivo" Imaging of Atherosclerosis". Atherosclerosis 2012; 224: 25-36. • Porretta AP, Alerci M, Di Valentino M, Wytten- bach R, von Segesser L, Gallino A. AHA. Oral • Gallino A. "The utility of Emerging Biomarkers communication: "Excellent in corporation of en- and Imaging for Assessment of Cardiovascular dovascular aneruysm repair after telementor- Risk". Courrent Vascular Pharmacology 2012; ing program in a secondary care center". Los 10: 712-4. Angeles, November 2012.

• Gallino A, Alerci M. "Commentary: reducing • Menafoglio A, Porretta AP, Di Valentino M, errors in the interventional suite: a structured Gallino A. SGK. Poster: "The response of the mental rehearsal is a step in the right direc- QT interval and the T-wave morphology to sud- tion." J Endovasc Ther 2012;19(3):390-1. den tachicardia provoked by standing in young athletes". Lausanne, June 2012. • Cereda CW, Petrini L, Azzola A, Ciccone A, Fischer U, Gallino A, et al. "Sleep-disordered • Porretta AP, Di Valentino M, Segatto JM, Wyt- breathing in acute ischemic stroke and tran- tenbach R, Bianda N, Klimusina J, Corti R, Froio sient ischemic attack: effects on short- and A, Oberson M, Gallino A. ESC. Poster: "Plaque long-term outcome and efficacy of treatment burden and vulnerability: a prospective study with continuous positive airways pressure -- ra- using both ultrasonography and high-resolution tionale and design of the SAS CARE study". Int magnetic resonance". Munich, August 2012. J Stroke. 2012; 7: 597-603. • Porretta AP. American Heart Association • Guessous I, Dudler V, Glatz N, Theler JM, Zoller meeting. Poster: "EVAR: single center long O, Paccaud F, Burnier M, Bochud M, Conen D, term follow-up". Los Angeles, November 2012. Hayoz D, Péchère-Bertschi A, Erne P, Binet I, Greminger P, Muggli F, Gabutti L, Gallino A, • Menafoglio A, Di Valentino M, Gallino A. Amer- Meier P, Suter PM. Swiss Survey on Salt Group ican Heart Association meeting. Abstract: "The "Vitamin D levels and associated factors: a response of the QT interval and the T-wave population-based study in Switzerland." Swiss morphology to sudden tachycardia provoked by Med Wkly. 2012; 26: 142:0. doi: 10.4414/ standing in young athletes". Los Angeles, No- smw.2012.13719. vember 2012.

Conference communications in 2012 • Menafoglio A, Di Valentino M, Limoni C, Sira- • Porretta AP, Di Valentino M, Menafoglio A, gusa P, Moschovitis G, Gallino A. American Guggiari U, Györik S, Gallino A, Quadri F. SGIM Heart Asociation meeting. Abstract: "Compari- Basel. Poster: "Platypnea-orthodeoxia syn- son of "European Society of Cardiology" and drome associated to a patient foramen ovale: a "Circulation" criteria for interpretation of the rare coincidence". Basel, May 2012. electrocardiogram in young athletes". Los An- geles, November 2012. • Di Valentino M, Siragusa P, Maggi M, Romano GA, Pezzoli R, Moschovitis G, Gallino A, Mena- • Di Valentino M, Siragusa P, Moschovitis G,

3. EOC Multisite Departments and Services 57 Gallino A, Menafoglio A. American Geart As- about to receive dialysis at the Haemodialysis and sociation meeting. Abstract: ""Malignant early Nephrology Service’s day centers or private dialy- repolarisation is relatively frequent in young sis centers in Ticino. athletes". Los Angeles, November 2012. The aims of the study are to: quantify the changes in the overall level of mobility and the postural and • Menafoglio A, Di Valentino M, Siragusa P, walking strategies that accompany entry into dialy- Maggi M, Romano GA, Pezzoli R, et al. Euro- sis, highlight factors linked to the fragility of the pa- pean Society Cardiology meeting. Abstract: tient’s and/or dialysis likely to condition the degree "Costs of cardiovascular screening with ECG in of mobility and independence in everyday life, the young athletes in Switzerland". Munich, August balance and walking control of the patients, as well 2012. as affecting the danger of a fall. • Menafoglio A, Di Valentino M, Siragusa P, Moschovitis G, Gallino A. European Society Main funding obtained in 2012 Cardiology meeting. Abstract: "Prevalence of ABREOC. Brugada ECG-pattern recorded with V1 and V2 in the third intercostal space in young athletes". Peer reviewed publications in 2012 (selection) Munich, August 2012. • Espeli V, Zucca Z, Ghielmini M, Giannini O, Salatino A, Martucci F, Richetti A. "Weekly and • Di Valentino M, Siragusa P, Maggi M, Romano 3-weekly cisplatin concurrent with intensity- GA, Pezzoli R, Moschovitis G, Gallino A, Mena- modulated radiotherapy in locally advanced foglio A. European Society Cardiology meeting. head and neck squamous cell cancer". Oral On- Abstract: "Electrocardiograms in young ath- col 2012; 48(3): 266-71. letes: characteristics and prevalence of abnormalities.". Munich, August 2012. • Peruzzo M, Giannini O, Bianchetti MG. "Mea- sles in a mother and her newborn baby". Arch Internal Medicine Service – Regional Hospital Dis Child 2012; 97: 660. of Mendrisio Brenno Balestra MD • Pereira-Mestre R, Giannini O, Manzocchi V, Head Doctor Bianchetti MG. "Masked hypertension delaying diagnosis in Gordon's syndrome". Journal of Hy- The Internal Medicine Service of the Regional Hos- pertension 2012, 30: 2240–2243. pital of Mendrisio is one of the many Services that make up EOC’s multisite Department of Internal Nefrology and Haemodialysis Service – Medicine. Regional Hospital of Locarno Prof. Luca Gabutti MD Main areas of research Head Doctor of Internal Medicine Service, Nefrol- Influence of hemodialysis on physical activity and ogy and Haemodialysis Service of Regional Hospital motory skills in patients with stage V chronic renal of Locarno and Coordinator of the EOC's Nephrol- insufficiency (K/DOQI) ogy and Haemodialysis Service Lead investigators: O. Giannini, C. Cereghetti, P. Quadri. The Nephrology and Haemodialysis Service of the This is a prospective multicenter observational Regional Hospital of Locarno is the Coordination study carried out among an outpatient population Center for the functional type of organizational of at least 30-50 patients with chronic renal insuf- structure that groups the nephrology services of ficiency (CKD 5, in line with K/DOQI) who were the EOC’s four regional hospitals and is aimed at

58 Scientific Report 2012 ensuring that medical and nursing care is of the • Temperature of the dialysate and haemody- highest quality, and also that these exact complex namics: a randomized study pathologies are recorded online. Lead investigator: L. Gabutti In a randomized controlled cross-over, the Main areas of research haemodynamic consequences of the change • An estimation of renal function using Cystatin in temperature of the dialysate were analyzed. C in a population study (from the data of the Swiss Salt Study) • Lock on indwelling catheters and permeability: Lead investigator: L. Gabutti a prospective study The determination of Cystatin C serum on Lead investigator: L. Gabutti blood samples during the Swiss Salt Study is The study aims to prospectively assess the ef- underway. The results will allow a comparison fect on the permeability of indwelling catheters for the Swiss population of the estimated re- for haemodialysis and the effect of using differ- nal function, obtained using creatinine, 24-hour ent filling solutions. urine collection and Cystatin C. • Hypokalaemia in the internal medicine servic- • Swiss Salt Study: secondary analyses of the es: retrospective assessment and acceptance data. project Member of the working group: L. Gabutti Lead investigator: L. Gabutti Numerous secondary analyses of the data of This study will analyze the incidence and risk the "Swiss Salt Study" are currently underway. factors of Hypokalemia in ECO hospital inpatients. There will also be an interventional • Vascular aging in hemodialysis patients: a pro- phase to deal more effectively with cases. spective study Lead investigator: L. Gabutti • Magnesium in the dialysate and haemodynamics In a cohort study involving 4 EOC dialysis units, Lead investigator: L. Gabutti the pulse wave velocity and the main risk fac- The study aims to analyze the haemodynamic tors for cardio-vascular diseases were moni- consequences of changes in the concentration tored prospectively for 2 years. of magnesium in the dialysate.

• Membranes for hemodialysis and hemodynam- Main funding obtained in 2012 ic impact Fondazione Balli, Fondazione Gianella. Lead investigator: L. Gabutti In a cross-over, the haemodynamic conse- Peer reviewed publications in 2012 (selection) quences of the use of 4 different hemodialysis • Gabutti L, Montagna C, Mombelli G. "Early sur- membranes were analysed. gery for infective endocarditis". N Engl J Med 2012; 367: 1366-7 (letter). • Citrate pre-and post-filter: a randomized controlled trial in a population in chronic hemodi- • Guessous I, Dudler V, Glatz N, Theler JM, Zoller alysis O, Paccaud F, et al. "Vitamin D levels and asso- Lead investigator: L. Gabutti ciated factors: a population-based study in Swit- In a randomized controlled cross-over, the zerland". Swiss Med Wkly 2012; 142: w13719. consequences on the quality of dialysis following the use of citric acid in the dialysate were • Frank M, Guarino-Gubler S, Burnier M, Maillard examined. M, Keller F, Gabutti L. "Estimation of glomeru-

3. EOC Multisite Departments and Services 59 lar filtration rate in hospitalised patients: are pation, transparency and management) and it is we overestimating renal function?" Swiss Med organized using a multisite approach. Here, too, Wkly 2012; 142: w13708. the creation of the EOC Department of Intensive Care Medicine was aimed at providing the most • Burnier M, Bock A, Halabi G, Gaser UE, Pe- suitable response to the need to harmonize and chère Bertschi A, et al. "Usefulness of telemet- rationalize the services offered in this sector in our ric blood pressure monitoring in hypertensive Canton. patients with chronic kidney diseases". J Neph- rol Therapeut 2012; 2: 5. Intensive Care Medicine Service – Regional Hospital of Bellinzona and Valli Conference communications in 2012 Main areas of research • Schieppati A, Daina E, Gamba S, Noris M, Ga- • Clinical consequences of physical versus phar- butti L, Remuzzi G, et al. Rare Diseases and Or- macological restraint in critically ill patients: an phan Drug Registries - International Workshop. observational study Poster: "Italian registry of MPGN: contribution Lead investigators: A. Perren, E. Iapichino, D. to advancement in the pathogenesis of the dis- Corbella, V. Di Bernardo, I. Sperandio, C. Som- ease and patient care". Rome, October 2012. macal, F. Barazzoni, R. Malacrida.

• Chappuis A, Glatz N, Suter P, Conen D, Erne P, Analgosedative therapy is used in intensive Binet I, et al. Annual Meeting of the Swiss So- care medicine mainly to increase patient com- ciety of Nephrology. Poster: "Sex differences in fort, and to carry out invasive procedures or dietary patterns associated with salt intake at for mechanical ventilation. However, this also the population level". Zurich, December 2012. lengthens the time patients spend in hospital with increased mortality and morbidity, both • Gabutti L, Meier P, Schwarzkopf AK, Zaruba J, physical and psychological. The reduction in Ambühl P. Annual Meeting of the Swiss Soci- sedative therapy increases the risk of patients ety of Nephrology. Poster: "Comparison of Hb not in a perfectly lucid state of accidentally events (decreases >1g/dl) in a hemodialysis harming themselves, as, for example, during patient population - Final analysis of the Swiss states of psychomotor agitation, a pathology MOTION Survey". Zurich, December 2012. frequently seen in such units. In both situations – for the protection of both the patient 3.3 EOC Department of Intensive Care Medicine and health-care staff – pharmacological and/ Andreas Perren MD PD or physical restraint may be necessary. Head of the EOC Department of Intensive Care The aim of this study is to describe whether Medicine and Head Doctor in the Regional Hospi- physical/pharmacological restraint can pre- tal of Bellinzona and Valli vent adverse events, whatever the clinical setting in which it is employed. The EOC Department of Intensive Care Medicine All the data have been collected and the first comprises the relevant services in the Hospitals draft has been written. The final statistical anal- of Bellinzona, Lugano, Mendrisio and Locarno. The yses are currently being carried out before the Department has a functional type of organizational article is sent to a "peer reviewed" journal. structure, and is managed and coordinated by the Department Board. The rules adopted for its func- • Survey of scoring practices and accuracy in as- tioning are based on the fundamental principles of sessing SAPS II and NEMS in Swiss ICUs shared clinical governance (accountability, partici- Lead investigators: A. Perren, M. Previsdomini,

60 Scientific Report 2012 M. Kaufmann, P. Massarotto, I. Perren, P. Mer- • Moretti D, Heidegger CP, Eckert P, Malacrida lani, H.U. Rothen H. R, Pascual M, Perren A, Revelly JP. The Latin Organ Donation Programme: an effective Re- The calculation of the SAPS II (index of the gional initiative to increase organ donation in severity of disease for a patient) and NEMS Switzerland. Organs Tissues & Cells 2012; 15: scores (index of the nursing workload) are im- 47-54. portant in calculating the payment to be made to hospitals by the SwissDRG. However, recent Conference communications in 2012 studies carried out in Ticino show that there • Perren A, Corbella D, Iapichino E, Di Bernardo are problems doing this. Above all in seriously V, Leonardi A, Di Nicolantonio R, Buschbeck ill patients these scores are often underesti- C, Boegli L, Pagnamenta A, Malacrida R. Oral mated, which may lead to inadequate payment communication: "Relation between physical / being received for the services provided. pharmacological restraint in the ICU and ad- The aim of this study is to analyze the situa- verse events". Basel, November 2012. tion at a national level, involving all the intensive care units in Switzerland. • Perren A, Corbella D, Iapichino E, Di Bernardo The survey has been completed and the data V, Leonardi A, Di Nicolantonio R, Buschbeck C, obtained are currently being analyzed. Two Boegli L, Pagnamenta A, Malacrida R. Poster: original articles will be published on the findings "Relation between physical / pharmacological of the study. restraint in the ICU - clinical settings". Basel, November 2012. Main funding obtained in 2012 ABREOC, Società Svizzera Medicina Intensiva • Perren A, Previsdomini M, Perren I, Cerutti (SSMI) B, Massarrotto P, Kaufmann M, Merlani P, Rothen HU. Poster: "SwissScoring - Survey of Peer reviewed publications in 2012 (selection) SAPS II assessing practices". Basel, November • Perren A, Previsdomini M, Perren I, Merlani 2012. P. "Critical care nurses inadequately assess SAPS II scores of very ill patients in real life". • Perren A, Previsdomini M, Perren I, Cerutti Crit Care Res Pract 2012; 2012: 919106. B, Massarrotto P, Kaufmann M, Merlani P, Rothen HU. Poster: "Swiss Scoring - Survey of • Previsdomini M, Gini M, Cerutti B, Dolina M, NEMS assessing practices". Basel, November Perren A. "Predictors of positive blood cultures 2012. in critically ill patients: a retrospective evaluation". Croat Med J 2012; 53(1): 30-9. Prizes awarded in 2012 Best Poster: annual Conference of Intensive Care • Perren A, Previsdomini M, Perren I, Merlani P. Medicine, Basel, November 2012 (article forth- "High accuracy of the Nine Equivalents of Nursing coming). Manpower Use Score assessed by critical care nurses". Swiss Med Wkly 2012; 142: w13555. Intensive Care Medicine Service – Regional Hospital of Mendrisio • Perren A, Previsdomini M, Bendjelid K. "Com- Alberto Pagnamenta MD ment on Serum Potassium Levels and Mortali- Head of Service ty in Acute Myocardial Infarction". JAMA 2012; 307(15): 1578.

3. EOC Multisite Departments and Services 61 Main areas of research also offers greater potential for a rational develop- Impact of a communications strategy on family ment. The Department is the result of an innova- members’ satisfaction in intensive care medicine tive project, which has also aroused interest out- Lead investigator: A. Pagnamenta side Canton Ticino, and it can be considered one of the major public institutions of medical analysis Main funding obtained in 2012 in Switzerland. ABREOC. Main areas of research Peer reviewed publications in 2012 • Thyroid disease diagnostics • Pagnamenta A, Rabito G, Arosio A, Perren A, In collaboration with the Nuclear Medicine Di- Malacrida R, Barazzoni F, Domenighetti G. "Ad- vision, EOLAB has committed to carry out re- verse events reporting in adult intensive care search in this sector, analyzing the reference unit and the impact of a multifaceted interven- values of certain biological markers associated tion on drug-related adverse events". Ann Inten- with thyroid disease and developing new ana- sive Care 2002; 2(1): 47. lytical methods.

Conference communications in 2012 • New point-of-care (POCT) equipment for blood • Perren A, Corbella D, Iapichino E, Di Bernardo gas analysis V, Leonardi A, Di Nicolantonio R, Buschbeck EOLAB is actively involved in assessing this C, Boegli L, Pagnamenta A, Malacrida R. Oral equipment, which could be of use in hospital communication: "Relation between physical / emergency services. This collaboration is the pharmacological restraint in the ICU and ad- result of the work being carried out together verse events". Basel, November 2012. with the Regional Hospital of Lugano and the Green Cross of Lugano. • Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, Buschbeck C, The following study, in particular, has been car- Boegli L, Pagnamenta A, Malacrida R. Poster: ried out: "Relation between physical / pharmacological Assessment of the introduction of POCT equip- restraint in the ICU - clinical settings". Basel, ment for blood gas analysis in hospital emer- November 2012. gency departments and pre-hospital emergency care 3.4 EOC Department of Laboratory Medicine Lead investigator: M. Imperiali. Dr Franco Keller FAMH The introduction of POCT (point-of-care testing) Head of Department for blood gas analysis in emergency services could improve the care offered to critically-ill The EOC Department of Laboratory Medicine patients by making it easier for hospital emer- (EOLAB) was set up to meet the needs of modern gency departments to deal with these patients. medicine as regards laboratory services, and also Moreover, the use of POCT for blood gas analy- because of the need to contain costs and make a sis could be used in departments that require more rational use of resources, including increas- results immediately (emergency departments, ingly sophisticated and expensive equipment. intensive care units, etc), without having to Although EOLAB is present in several EOC hospital send a sample to the laboratory. sites, it is centralized from a technical, scientific New technologies have made it possible to de- and administrative point of view, giving the Depart- velop POCT that are extremely easy to use and ment its unified image. This form of organization do not require the support of laboratory staff.

62 Scientific Report 2012 However, so far very little is known about their 50(5): 895-900. technical performance. The main aim of this research project is to • Giovanella L, Imperiali M, Ferrari A, Palumbo A, compare the POCT equipment currently avail- Furlani L, Graziani MS, Castello R. "Serum thy- able on the market for blood gas analysis with roglobulin reference values according to NACB the "gold standard": laboratory equipment for criteria in healthy subjects with normal thyroid blood gas analysis. ultrasound". Clin Chem Lab Med. 2012; 50(5): This comparison will show which is the best 891-3. tool from a technical point of view, taking into consideration its possible use by the emergen- Conference communications in 2012 cy services. • Imperiali M, Giovanella L, Ferrari A, Palumbo A, Lippa L, Peretti A, Graziani MS, Ceriani L, • New method to measure thyroglobulin Verburb FA, Castello R. Poster: Swiss medLab Lead investigator: F. Keller. "Redefining calcitonin reference values in dif- This is a multicenter study aimed at assessing ferent immunoassays by integrating thyroid the analytical and clinical characteristics of thy- ultrasonography to select the reference popu- roglobulin using a method designed by Roche lation", Bern, June 2012. Company. During the study EOLAB will carry out experiments following the CLSI criteria to • Gaffuri T, Castelli C., Keller F, Della Bruna R, prove the effectiveness of the Roche method Imperiali M. Poster: Swiss medLab. " Evalua- so that it can obtain "FDA approval" for market- tion of two Point-of-care (POC) instruments for ing the product. the blood gas analysis", Bern, June 2012.

Main funding obtained in 2012 3.5 Breast Cancer Centre of Southern ABREOC, Roche. Switzerland (CSSI) Olivia Pagani MD Peer reviewed publications in 2012 (selection) Clinical Director • Giovanella L, Verburg FA, Imperiali M, Vala- brega S, Trimboli P, Ceriani L. "Comparison of The Breast Cancer Centre of Southern Switzer- serum calcitonin and procalcitonin in detecting land (CSSI) is a dedicated structure for breast medullary thyroid carcinoma among patients problems, whose task is the early detection of with thyroid nodules". Clin Chem Lab Med. 2012 breast cancer and its treatment using a multi- Dec 25: 1-5. doi: 10.1515/cclm-2012-0610. disciplinary approach. The Centre offers patients the great advantage of providing all the necessary • Giovanella L, Imperiali M, Verburg FA, Ceriani care under one roof. This is made possible thanks L. "Evaluation of the BRAHMS Kryptor® Thy- to the close collaboration between the members roglobulin Minirecovery Test in patients with of a team of specialists operating together in the differentiated thyroid carcinoma". Clin Chem field of women’s breast health and the availability Lab Med. 2012 Aug 19. of modern diagnostic equipment.

• Giovanella L, Imperiali M, Ferrari A, Palumbo The Breast Cancer Centre of Southern Switzerland A, Lippa L, Peretti A et al. "Thyroid volume in- was the first centre to be certified by the European fluences serum calcitonin levels in a thyroid- Society of Breast Cancer Specialists EUSOMA as healthy population: results of a 3-assay, 519 a Breast Cancer Care Unit. subjects study". Clin Chem Lab Med. 2012; This is an important recognition, which allows the

3. EOC Multisite Departments and Services 63 Centrer to take full advantage of all the medical Ganz PA, Gelmon K, Goldhirsch A, Harbeck N, and scientific knowledge made available in Europe Houssami N, Hudis C, Kaufman B, Leadbeater in the fight against breast cancer. It is, above all, a M, Mayer M, Rodger A, Rugo H, Sacchini V, guarantee for patients, as they can be sure that Sledge G, Van't Veer L, Viale G, Krop I, Winer E. the Centre operates following well-defined method- "1st International consensus guidelines for ologies using recognized specialists. advanced breast cancer (ABC 1)". The Breast The Centre is also about to obtain certification 2012; 21: 242-252. from the Swiss Society of Breast Cancer Special- ists and the Swiss Cancer League. • Cardoso F, Loibl S, Pagani O, Graziottin A, Panizza P, Martincich L, Gentilini O, Peccatori Main areas of research F, Fourquet A, Delaloge S, Marotti L, Penault- Involvement in clinical studies Llorca F, Kotti- Kitromilidou A, Rodger A and • Radiotherapy Harbeck N. "The European Society of Breast Studies are currently underway in women with Cancer Specialists recommendations for the intraductal neoplasia (coordinated by the Inter- management of young women with breast can- national Breast Cancer Study Group - IBCSG) cer". Eur J Cancer. 2012; 48: 3355–3377. and women with the disease at an early stage (an Italian multicenter study). • Pagani O, Azim HA Jr. "Pregnancy after breast cancer: myths and facts". Breast Care 2012; • Medical oncology 7: 210–214. Four clinical studies are also underway in women with advanced-stage breast cancer, • Christinat A, Pagani O. "Fertility after breast coordinated by the IBCSG (International Breast cancer". Maturitas 2012; 73(3): 191-6. Cancer Study Group), the SAKK (Swiss Group for Clinical Cancer Research) and Novartis, a • Costa A. "Surgery has become more and more clinical study in women with early-stage breast conservative". Breast 2012; 21(2): 111. cancer together with Roche (SAFE-HER study), and an observational study on the medical and • Cardoso F, Harbeck N, Fallowfield L, et al. psychosocial aspects in young patients coordi- ESMO Guidelines Working Group. "Locally re- nated by the IBCSG. current or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treat- • Feasibility study for the development of a diag- ment and follow-up." Ann Oncol. 2012; 23 (Sup- nostic tool based on microwaves for the early pl 7): vi11-9. detection and monitoring of breast cancer together with the SUPSI • Valli MC, Association of Radiotherapy and On- cology of the Mediterranean arEa (AROME). Main funding obtained in 2012 "Controversies in loco-regional treatment: post- Roche, SAKK and other competitive and non-com- mastectomy radiation for pT2-pT3N0 breast petitive external funding. cancer arguments in favour". Crit Rev Oncol Hematol 2012; 84 Suppl 1: e70-4. Peer reviewed publications in 2012 (selection) • Cardoso F, Costa A, Norton L, Cameron D, • Martin V, Botta F, Zanellato E, Molinari F, Crippa Cufer T, Fallowfield L, Francis P, Gligorov J, Kyri- S, Mazzucchelli L, Frattini M. "Molecular char- akides S, Lin N, Pagani O, Senkus E, Thomssen acterization of EGFR and EGFR-downstream C, Aapro M, Bergh J, Di Leo A, El Saghir N, pathways in triple negative breast cancers with

64 Scientific Report 2012 basal like features". Histol Histopathol. 2012; of a specific CMU to deal with less urgent cas- 27(6): 785-92. es had a positive effect.

• Martin V, Camponovo A, Ghisletta M, Bon- • Cardiovascular physiology (CHUV) giovanni M, Mazzucchelli L. "Internal Quality The aim of the study is to assess the interac- Assurance Program for ERBB2 (HER2) Test- tions between the neurovegetative nervous ing Improves the Selection of Breast Cancer system and the endothelial synthesis of nitro- Patients for Treatment with Trastuzumab". gen monoxide (NOT endothelial) in the patho- Patholog Res Int. 2012; 2012:261857. genesis of arterial hypertension and resistance to insulin. 3.6 Emergency Services – Emergency Medicine Mattia Lepori MD PD Peer reviewed publications in 2012 Coordinator Trueb L, Lepori M, Duplain H, Scherrer U, Sartori C. "Nitric oxide mediates the blood pressure The EOC’s Emergency Services provide 24/7 response to mental stress in humans". Swiss assistance for every type of medical urgency, ir- Med Wkly. 2012; 142: 13627. Doi: 10.4414/ respective of the type or seriousness of the pa- smw.2012.13627. thology or the patient’s background or financial situation. The Emergency Services, which are co- Conference communications 2012 ordinated by the EOC’s Emergency Board, work in Lepori M, Trobia M. Patients who "leave without close collaboration with the pre-hospital emergen- being seen" the Emergency Department: the role cy services – the Canton’s emergency phone num- of a fastrack way (Notfallpraxis). Swiss Medical Fo- ber service "Centrale 144" run by Ticino Soccorso, rum 2012; 42(suppl 59): 47S. REGA (the emergency air service) and all the other services providing emergency assistance. 3.7 Radiology Services Massive developments have been made during the Emergency Service – Emergency Medicine at last 50 years in the field of radiology as regards San Giovanni Hospital its use in diagnosis and treatment, and now has a Mattia Lepori MD PD fundamental role in the diagnosis and treatment of Head of Service virtually every human pathology.

Main areas of research Radiology Service – Regional Hospital of Lugano • Quality management Filippo Del Grande MD The Regional Hospital of Bellinzona recently Head Doctor carried out a study entitled "Leaving the Emer- gency Department too soon: the role of recep- In 2011 and 2012 (13 months) Filippo Del tion nurses, triage and a fast track approach Grande MD was a research fellow at the Johns (Notfallpraxis)". Hopkins Hospital in Baltimore, USA, in the MSK The aim of the study is to assess the efficacy radiology department (musculoskeletal radiology), of introducing a triage nurse (IT) and an emer- where he was mainly engaged in research involv- gency medical clinic (CMU) to deal specifically ing 3 Tesla osteoarticular MRI. with less urgent cases. An analysis of the data reveals that IT did not Main areas of research help to prevent people from leaving the Emer- Several clinical research projects are currently gency Department too soon, while the opening underway in the field of imaging in sport, rheuma-

3. EOC Multisite Departments and Services 65 tology and oncology together with Dr Carrino, Dr Certificate of Merit selected for publication in Fayad, Dr Chhabra and Dr Stine, Johns Hopkins Radiographics. Hospital, Baltimore, USA. Here they are in brief: • Del Grande F, Carrino JA, Chaabra A. Spec- • 3 Tesla MRI in imaging in sport and rheumatology trum of Elbow Injuries in Baseball Pitchers: 3 Tesla MRI imaging. RSNA, Chicago 2012. • MR imaging of bone tumours • Del Grande F, Chhabra A, Chalian M, eng J, • Role of chemical shift sequences in the detec- Carrino JA. Diagnostic Performance and Inter tion of injuries to the narrow using 3 Tesla MRI observer Reliability of Pelvic MR Neurography for Femoral Neuropathy. RSNA, Chicago 2012. Peer reviewed publications in 2012 (selection) • Chhabra A, Thawait GK, Soldatos T, Thakkar • Del Grande F, Carrino JA.3 Tesla MRI imag- RS, Del Grande F, Chalian M, ing of the elbow in asymptomatic professional Carrino JA. "High-Resolution 3T MR Neurog- baseball pitchers. RSNA, Chicago 2012. raphy of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging". AJNR Am J Awards Neuroradiol 2012 Dec 6. The article by Del Grande F, Santini F, Herzka D, Carrino JA. Fat suppression techniques on 3 Te- • Thakkar RS, Del Grande F, Thawait GK, An- sla MRI in musculoskeletal system. RSNA 2012, dreisek G, Carrino JA, Chhabra A. "Spectrum Chicago, was awarded a Certificate of Merit and of high-resolution MRI findings in diabetic neu- was selected for publication in the journal Radio- ropathy". AJR Am J Roentgenol 2012; 199(2): graphics. 407-12. Service of Interventional Radiology – Regional • Del Grande F, Maus TP, Carrino JA. "Imaging Hospital of Lugano the intervertebral disk: age-related changes, Josua C. Van Den Berg MD herniations, and radicular pain". Radiol Clin Head of Service North Am. 2012; 50(4): 629-49. Interventional Radiology includes all the invasive or • Chhabra A, Soldatos T, Thawait GK, Del Grande mini-invasive diagnostic or treatment procedures F, Thakkar RS, Means KR Jr, Carrino JA. "Cur- that make use of radiological methods for their rent perspectives on the advantages of 3-T MR guidance and control, such as fluoroscopy, com- imaging of the wrist". Radiographics. 2012; puterized tomography and diagnostic medical Ul- 32(3): 879-96. trasound.

Conference communications in 2012 Most of the interventional activities include vascu- • Del Grande F, Tatizawa-Shiga N , Chalian M, lar interventional radiology (including, for example, Fayad LM. Is contrast-enhanced MRI required carotid arterial stenting and the positioning of en- to evaluate the extent of a bone tumour? SSR, doprotesis for abdominal aortic aneurism). Miami 2012. Main areas of research • Del Grande F, Santini F, Herzka D, Carrino JA. • Treating in-stent restenosis, PHOTOPAC rand- Fat suppression techniques on 3 Tesla MRI in omized study musculoskeletal system. RSNA, Chicago 2012.

66 Scientific Report 2012 • AFS treatment with balloons releasing LEVANT PAD intervention". TSVIR 14th Annual meeting, Kanchanaburi 2012. • Treatment of critical ischaemia with stem cells • Van den Berg JC. "Advanced imaging tech- Main funding obtained in 2012 niques for navigation during endovascular pro- University of Bad-Krozingen (Germany), Lutonix cedures: current status and future perspec- (BARD) and co-financing with Cardiocentro Ticino. tives". iCON, Scottsdale 2012.

Peer reviewed publications in 2012 (selection) • Van den Berg JC. "Fusion imaging: further re- • Van den Berg JC, Waser JS, Trelle S, Diehm ducing contrast and radiation exposure to the N, Baumgartner I. "Lesion characteristics of patient (a system to import existing CT and MR patients with chronic critical limb ischemia images to the angiosuite)"; "Treatment of AV that determine choice of treatment modality". fistula in the lower leg after Fogarty embolec- J Cardiovasc Surg (Turin). 2012; 53(1): 45-52. tomy using covered stent"; "Treatment of iatrogenic false aneurysm of aberrant right hepatic • Van den Berg JC, Pedrotti M, Canevascini R, artery after cholecystectomy"; "Fenestration Chimchila Chevili S, Giovannacci L, Rosso R. of common iliac artery and entire abdominal "Endovascular treatment of in-stent restenosis aorta in patient with a type A dissection"; "Tips using excimer laser angioplasty and drug elut- and tricks for safe renal artery stenting using ing balloons". J Cardiovasc Surg (Turin). 2012; the V12 RX"; "Bare metal stents vs. covered 53(2): 215-222. V12 stents for renal artery stenosis"; "Is acute deep venous thrombosis in the lower limb best • Van den Berg JC. "Type II endoleaks: still the managed by: Trellis?". 34th International Sym- crux of EVAR?". J Endovasc Ther. 2012; 19(2): posium Charing Cross, London 2012. 209-212. • Van den Berg JC. "PHOTOPAC Trial for In-Stent Chapters of books in 2012 Restenosis". 13th NCVH, New Orleans 2012. • Van den Berg JC. Tips and tricks for successful EVAR In: J-P. P. M de Vries, editor. Latest • Van den Berg JC. "Does debulking before DEB insights into abdominal aortic aneurysms and make sense?". CIRSE, Lisbon 2012. endovascular repair. Turin, Edizioni Minerva Medica, 2012: 59-72. • Van den Berg JC. "Endovascular conversion of open surgical failures and complications: tips • Van den Berg JC. Acute deep venous thrombo- and tricks; Bringing atherectomy to the next sis in the lower limb is best managed by: Trellis level: what is its future; Laser debulking and In: R.M. Greenhalgh, editor. Vascular and endo- DEB for in-stent restenosis". 39th VEITH sym- vascular consensus update. London, BIBA Pub- posium, New York 2012. lishing, 2012: 653-658. Radiology Service – Regional Hospital of Bellin- Conference communications zona and Valli • Van den Berg JC. "Coated balloons: how does it Prof. Rolf Wyttenbach MD work, what are the results?". CACVS, Paris 2012. Head Doctor

• Van den Berg JC. "Interventional room of the Main areas of research future; closure devices and access routes in • Multi-parametric evaluation of liver perfusion

3. EOC Multisite Departments and Services 67 by MR-Dwl under fasting and postprandial con- Conference communications in 2012 ditions in healthy volunteers: correlation with • Médioni N, Puligheddu C, Santini P, Vock P, quantitative phase-contrast portal venous flow Szucs-Farkas Z, Wyttenbach R. Seconda Gior- measurements nata della Ricerca Clinica della Svizzera Italiana. Lead investigators: R Wyttenbach and F Regini, Abstract: "Reperti extracardiaci in risonanza S Colagrande, University Hospital Careggi, Flo- magnetica cardiaca". Bellinzona, March 2012. rence. The aim of this study is to assess in vivo the cor- • Cartolari R. LII Congresso Nazionale SNO. Oral relation between the variation in portal venous communication: "Sessione spinale: Diagnostica flow measurements under fasting and post- per immagini – Quale e perché". Rome, May prandial conditions, and the following measur- 2012. able parameters in DWI: apparent diffusion coefficient (ADC), slow diffusion coefficient (D), • Puligheddu C. Le Pneumopatie Interstiziali fast diffusion coefficient (D*) and perfusion Diffuse (P.I.D.). Oral communication: "Pattern fraction (PF). nodulare: presentazione radiologica". Gubbio, May 2012. • Differences in plaque phenotypes in the carotid and femoral arteries: an in vivo study using MRI • Wyttenbach R. Annual meeting West Mid- plaque imaging lands Association of Radiologists. Oral commu- Lead investigators: R. Wyttenbach together nication: "Cardiac MRI 2012: Indications and with A. Helck, T. Saam, University of Grosshad- clinical applications". Birmingham, May 2012. ern in Munich (D) and C. Yuan, University of Se- attle (USA). • Santini P. Journée Française de Radiologie The aim of the study is to carry out an intra- (JFR). Oral communication: "Imagerie de diffu- individual assessment of the differences in the sion (DWI) mammaire". Paris, October 2012. composition and morphology of atherosclerotic plaques in different vascular areas using • Wyttenbach R. Annual meeting European So- high-resolution Magnetic Resonance. ciety of Cardiac Radiology (ESCR). Oral communication: "Coronary arteries and perfusion Main funding obtained in 2012 territories". Barcelona, October 2012. ABREOC and "Fondazione Svizzera di Cardiologia". 3.8 EOC Geriatric Service Peer reviewed publications 2012 (selection) Pierluigi Quadri MD • Bianda N, Di Valentino M, Périat D, Segatto JM, Coordinator of the EOC Geriatric Service Oberson M, Moccetti M, et al. "Progression of human carotid and femoral atherosclerosis: a Geriatrics is a medical discipline studying the dis- prospective follow-up study by magnetic reso- eases that occur in the elderly and their disabling nance vessel wall imaging". Eur Heart J. 2012; consequences, with the main aim of delaying func- 33(2): 230-7. tional and mental decline, while maintaining self- sufficiency and the best possible quality of life. • Wyttenbach R, Médioni N, Santini P, Vock P, From a modern viewpoint, where prevention is the Szucs-Farkas Z. "Extracardiac findings detect- cornerstone of health protection, geriatrics has ed by cardiac magnetic resonance imaging". much in common with the fields of sociology and Eur Radiol. 2012; 22(6): 1295-302. social psychology. In a world in which the average age of the popu-

68 Scientific Report 2012 lation and life expectancy is increasing, the treat- otherapy in elderly patients who have a fear ment of pathologies relating to the natural process of falling (with or without previous falls without of aging is of extreme importance to the economic serious consequences). and social policies of a country. Geriatrics is, therefore, generally concerned with • The influence of haemodyalisis on physical ac- the treatment and prevention of disability and tivity and motor skills of patients with chronic frailty in the elderly, placing particular emphasis on renal impairment stage 5 (K/DOQI) typical geriatric syndromes, such as memory dis- Lead investigators: Olivier Giannini, Damiano orders, ambulatory instability and falling, depres- Zemp, Claudio Cereghetti, Mauro Tettamanti, sion, malnutrition, etc. Pierluigi Quadri. The EOC Geriatrics Service, present in the Re- The aim of this study is to assess the changes gional Hospitals of Lugano, Bellinzona and Valli, in the degree of autonomy and overall mobility Mendrisio and Locarno, offers a multidisciplinary that accompany the entry into dialysis and high- approach with specialist day clinics and wards to light any risk factors associated with altered assess and intervene at an early stage, or prevent strategies of postural control and walking, frail- these geriatric problems. ty in patients and/or dialysis treatment, which The Service also operates in a network together are likely to influence the degree of mobility and with other local dedicated geriatric structures. autonomy in everyday life, control of balance and gait, as well as affecting the risk of falling. Sottocenerino Geriatric Service, Regional Hos- pital of Lugano and Mendrisio • A longitudinal and observational registry of pa- Pierluigi Quadri MD tients with memory disorders (Canton Ticino Head of Service Study) in the Sottocenerino Geriatriacs Service day clinics Main areas of research This is a database of patients with balance The following studies are currently underway, the disorders and gait abnormalities and/or with first two of which are in collaboration with the a history of falls assessed anamestically, func- Mario Negri Pharmacological Research Institute tionally and using quantitative instruments. in Milan, Department of Neurosciences, geriatric neuropsychiatry: Main funding obtained in 2012 • The feasibility of physiotherapy associated with ABREOC, Geriatric Research Fund of the Regional the cognitive approach (Imagery) for elderly pa- Hospital of Mendrisio. tients with a fear of falling: observational pilot study Peer reviewed publications in 2012 (selection) Lead investigators: Fabiano Meroni, Pierluigi • Polito L, Kehoe P G, Davin A, Benussi L, Ghidoni Quadri, Rita Pezzati, Carola Celeste, Lorena R, Binetti G, Quadri P, Lucca U, Tettamanti M Curia, Francesca Gallina, Simona Chiari, Silvia et al. "The SIRT2 polymorphism rs 10410544 Ambrogio, Elena Biglia, Fulvio Bianchi, Damiano and risk of Alzheimer’s disease in two Cauca- Zemp, Mauro Tettamanti, Sara Avesani, Nicola sian case-control cohorts". Alzheimer’s & De- Schiavone. mentia, 2012; 1-8. The aim of the study is to break the vicious circle brought on by the fear of falling and to im- • Merlo A, Zemp D, Zanda E, Rocchi S, Meroni prove mobility (and consequently the functional F, Tettamanti M, Recchia A, Lucca U, Quadri capacity of elderly patients), considering cog- P. "Postural stability and history of falls in cognitive interventions (imagery) alongside physi- nitively able older adults: The Canton Ticino

3. EOC Multisite Departments and Services 69 study". Gait & Posture 2012; 36(4): 662-666. breast cancer through the repeated measurement of values of permittivity and electrical Conference communications in 2012 conductivity of individual samples taken in the • Quadri P, Zemp D, Zanda E, Rocchi S, Meroni operating theatre during normal surgery. F, Tettamanti M, Recchia A, Lucca U, Merlo A. Stabilità posturale ed antecedenti di caduta in Conference communications in 2012 soggetti anziani senza demenza. Seconda Gior- • Gyr Th. International Breast Ultrasound School nata della Ricerca Clinica della Svizzera Italiana, (IBUS) Meeting. Oral communication: "Margin Bellinzona, 23rd March 2012. assessment with MarginProbe". Zurich, Swit- zerland, January 2012. • Mora O, Marelli L, Quadri P, Tettamanti M, C. Pedrazzini C, Ghielmini M. 37th ESMO Con- • Gyr Th. Basiskurs endoskopische Chirurgie gress, Vienna, 28 September – 2 October AGE. Oral communication: "Adnexeingriffe, 2012. Abstract: "Abbreviated comprenhensive wann laparoskopie, wann laparotomie?". Da- geriatric assessment (CGA) in elderly cancer vos, March 2012. patients: preliminary results of an observational pilot study". Published in: Annals of On- • Gyr Th. International advanced course in lapa- cology 2012; 23 (suppl. 9): ix447-ix461. doi: roscopic gynecologic surgery on embalmed 10.1093/annonc/mds410. cadavers. Oral communication: "Indications for pelvic and/or paraaortal lymphadenectomy 3.9 Services of Gynaecology and Obstetrics and their pitfalls". Fribourg, October 2012. The Services of Gynaecology and Obstetrics are a reference point for women's health and guaran- • Gyr Th. SwissEndos. Oral communication: "lap- tees a service for women during pregnancy and aroskopische Hysterektomie: der schwierige childbirth. It also deals with urogenital dysfunctions Uterus". Fribourg, November 2013. and breast pathologies. The Breast Cancer Centre of Southern Switzerland (CSSI), which is present in • Polli C, Lauria F, Gyr Th, Rosso R, Jermini F. the Regional Hospitals of Bellinzona and Valli and Congresso annuale Società Svizzera di Gineco- Lugano, was specifically set up in 2004 to deal logia ed Ostetricia – 2012 Poster: "Endometri- with breast pathologies. ose pelvienne et prise en charge chirurgicale multidisciplinaire. L’expérience de L’Hôpital Gynaecology and Obstetrics Service – Regional Civico Lugano". Interlaken, June 2012. Hospital of Lugano Thomas Gyr MD • Gyr Th, Polli C, Taddei E, Jermini F. Congres- Head Doctor so annuale Società Svizzera di Ginecologia ed Ostetricia – 2012 Video presentation: "Lapa- Main areas of research roskopische Naht einer Ureterläsion". Interlak- • A feasibility study for the construction of a diag- en, June 2012. nostic tool based on microwaves for the early diagnosis and monitoring of breast cancer. • Polli C, Gyr Th, Hagmann PD. 18. Praktischer Analysis of the dielectric properties of breast Kurs in Gynäkologisher Endoscopie - Arbe- tissue itsgemeinschaft für Gynäkologishe Endoscopie Lead investigators: Gyr Th, Maffongelli M. (SGGG) – 2012 Course/Oral communication: The aim of this feasibility study is to assess the "Technisches Vorgehen bei der Laparoskopie potential of microwave tomography applied to von Adnextumoren". Davos, March 2012.

70 Scientific Report 2012 Gynaecology and Obstetrics Service – Projects currently underway: Regional Hospital of Mendrisio a. phosphorus metabolism; Giorgio Caccia MD b. interaction between dyselectrolytemia and Head Doctor ECG.

Main areas of research • Treatment of secondary arterial hypertension Collaboration with the NSI in the field of neuro-uro- at a developmental age (in collaboration with logical disorders, in specialist and therapeutic di- the University Pediatric Clinics of Milan and the agnostics (video urodynamic balance), particularly University Pediatric Clinic of Berne). with PTNS. Lead investigator: MG. Bianchetti. Projects currently underway: palatability of an- Conference communications 2012 tihypertensives. Digesu A, Puccini P, Hendricken C,Bhide A, Khul- lar V, Tubaro A, Caccia G, Zecca C, Gobbi C. IUGA • Systematic reviews of rare clinical conditions in 37th annual meeting in Brisbane 2012. Abstract: childhood (in collaboration with the University Motor and/or sensory response during PTNS – Pediatric Clinics of Berne and Basel). do they predict treatement outcome? Published in: Lead investigator: MG. Bianchetti. Int Urogynecol J. 2012; 23 (Suppl 2): S84. Projects currently underway a. transient benign hyperphosphatemia; 3.10 Paediatrics Services b. dermatitis vernalis aurium; Pediatrics is a branch of medicine that deals with c. dyselectrolytemia in cystic fibrosis. the physical and mental development of children, and the diagnosis and treatment of childhood dis- • Symptomatic management of fever in Switzer- eases. land (Swiss national survey coordinated by the hospitals of Bellinzona, Locarno and Mendrisio). Neonatology is the branch of pediatrics that deals Lead investigator: MG. Bianchetti. with newborn children during their first month of life. Cooperation between pediatrics and obstet- • Psychomotor development of children with se- rics helps prevent malformations of the fetus and vere encephalopathy – longitudinal study treat diseases from birth. Lead investigator: GP. Ramelli.

Integrated Paediatric Services in Bellinzona, • The diagnostic impact of new genetic tests in Locarno and Mendrisio mentally retarded children Prof. Mario G. Bianchetti MD Lead investigator: GP. Ramelli. Head Doctor and in charge of the Integrated Pae- diatric Services of the Regional Hospitals of Bell- • The correlation between functional MRI, EEG inzona and Valli, Locarno and Mendrisio together and cognitive development of children with ro- with Gian Paolo Ramelli MD PD. landic epilepsy (in collaboration with the Univer- sity Pediatric Clinic of Basel) Main areas of research Lead investigator: GP. Ramelli. • Management of hereditary hypokalemic tubulopathies (in collaboration with the University • Epidemiology of myalgia cruris in children Pediatric Clinic of Milan and the Merate-Lecco Lead investigator: MG. Bianchetti. Hospital). Lead investigator: MG. Bianchetti. The main research topics include the introduc-

3. EOC Multisite Departments and Services 71 tion and use of antihypertensive drugs for adults • Simonetti GD, Mohaupt MG, Bianchetti MG. in children, the problem of the oral palatability of "Monogenic forms of hypertension". Eur J Pedi- medicines for their correct administration, the as- atr 171(10): 1433-1439, 2012. sessment of rare tubulopathies with hypokalemia and the validation of blood pressure measurement Paediatric Haematology and Oncology Service – in children. Regional Hospital of Bellinzona and Valli Important collaboration is also underway with the Pierluigi Brazzola MD University Pediatric Clinic of Milan and the Lecco- Head of Service Merate paediatric clinic to collect data on hypopo- tassemic tubulopathies in the field of biomolecular Main areas of research research. The cardiovascular research is coordi- 1. International multicenter studies for phase III nated together with the University of Berne’s Pae- clinical studies in the field of paediatric onco- diatric Nephrology Unit. logy, and more specifically: • Study on acute lymphoblastic leukaemias Main funding obtained in 2012 AIEOP-BFM 2009 ABREOC, Funding from the University of Milan, the This is a multicenter international clinical Universities of Basel and Berne and Private funds. study using polychemotherapy for the treatment of acute lymphoblastic leukemias in Peer reviewed publications in 2012 (selection) young children and adolescents. Using an • Bullo M, Tschumi S, Bucher BS, Bianchetti optimal stratification in three risk groups MG, Simonetti GD. "Pregnancy outcome follow- the aim is to optimize therapy, while mini- ing exposure to angiotensin-converting enzyme mizing acute and late occurring side-effects. inhibitors or angiotensin receptor antagonists: Currently the treatment of young children a systematic review". Hypertension 60: 444- and adolescents with low-grade brain tu- 450, 2012. mours occurs in a non-standardized way with a variety of study protocols. The ration- • Caiata-Zufferey M, Zanini CA, Schulz PJ, Syrén alization and standardization of treatment ML, Bianchetti MG, Bettinelli A. "Living with should lead to better diagnostics, the identi- Gitelman disease: an insight into patients' daily fication of acute and long-term side effects experiences". Nephrol Dial Transplant 27(8): and consequently a better long-term prog- 3196-3201, 2012. nosis.

• Lava SAG, Simonetti GD, Ramelli GP, Tschumi • Study on Hodgkin’s lymphomas EuroNet- S, Bianchetti MG. "Symptomatic manage- PHL-C1 ment of fever among Swiss board-certified Based on experience gained since 1978 pediatricians: the results of a cross-sectional with the GPOH-HD study group, the first Web-based survey". Clin Ther 34(1): 250-256, and second line treatment for pediatric 2012. Hodgkin's lymphoma needs to be improved to reduce overtreatment and reduce long- • Salmina C, Taddeo I, Falesi M, Weber P, Bian- term side effects. chetti MG, Ramelli GP. "Paroxysmal tonic up- FDG-PET is routinely used in many centres. gaze in normal children: a case series and a The results of FDG-PET are now formally review of the literature". Eur J Paediatr Neurol integrated for staging and evaluating the 16(6): 683-687, 2012. response to treatment. Radiotherapy is not used in any of the treat-

72 Scientific Report 2012 ment groups after chemotherapy in pa- tissue tumours. This study proposes stand- tients with an adequate response (CR or PR ard treatment following the guidelines of with negative PET) after two cycles of OEPA. the CWS study group (CWS guidance) or of In the intermediate and advanced stages the European study group for pediatric soft (TG-2 and TG-3) COPDAC chemotherapy tissue sarcomas. (Procarbazine is replaced by dacarbazine to reduce the risk of infertility) is randomized • Study on brain tumour HIT 2000 with respect to standard COPP treatment. The main aims of the study are to: The treatment of relapses is standardized a. improve survival compared to previous for the three groups according to the time studies by intensifying chemotherapy of relapse and initial group treatment. and/or radiotherapy compared to pro- The main objectives of the study are as fol- tocols HIT-91 and HIT-SKK 92, using a lows: risk-adapted treatment with the treat- a. event-free survival at 5 years (EFS) in ment assigned to groups of patients patients with good response after two defined according to risk by means of OEPA cycles treated without radiothera- a centralized assessment (neuropa- py coinciding with an EFS target of 90% thology, neuroradiology and liquor); and in all treatment groups; through a quality control of surgery, b. dacarbazine can safely replace procar- chemotherapy and radiotherapy. bazine in the treatment groups (TG) 2 b. reduce and limit long-term side effects and 3 without worsening the EFS rand- and improve the quality of life by elimi- omization COPDAC vs COPP; nating or reducing craniospinal radio- c. description of the result in relapses therapy in younger patients diagnosed according to a standardized approach with medulloblastoma; by hyperfraction- based on risk. ating conventional craniospinal radiotherapy or reducing the dose of radia- • Study on high-risk sarcomas CWS-2007- tion therapy in patients over the age of HR four with medulloblastoma or PNET; by Soft tissue sarcomas can arise in practi- eliminating craniospinal adjuvant radio- cally any part of the body, with the risk that therapy in patients with ependymoma. at the time of diagnosis the disease is already present and has metastasized. The • Kraniopharyngeom 2007 study metastases may be so small that they can- This is a prospective international multi- not be detected even with the most modern center clinical study to assess the results radiological techniques (micrometastases). of using radiotherapy in craniofaringiomas If the tumour and metastases can be com- that have not been completely removed, de- pletely eliminated, or reduced to a minimum pending on when it was used. through a combination of surgery, intensive chemotherapy and possibly radiotherapy, • SIOP-LGG 2004 study then patients with soft tissue sarcomas This is an international multicenter clinical with an unfavorable constellation have a study using surgical approaches, radiothe- good chance of recovering despite the risk rapy and known drugs in the field of pedi- of a relapse. The current study is based on atric oncology. The study is aimed at young the SoTiSaR study, a registry of all patients children and adolescents with brain tu- with newly diagnosed sarcomas and soft mours such as low-grade gliomas.

3. EOC Multisite Departments and Services 73 • SIOP 2001/GPOH study hamartomas, are a very heterogeneous, This is a multicenter clinical study using in- rare category of tumours with an annual ternational surgical approaches, radiother- incidence in Europe of around 2-4 cases apy and known drugs in the field of pediatric per 100,000 inhabitants. Within a single oncology. The study is aimed at young chil- institution or regional network the number dren and adolescents with renal tumours. of recruited patients is, therefore, too small The study is based on previous European to enable the study of the molecular char- studies. acteristics, diagnostics and treatment. Only with a comprehensive non-selective collec- • SIOPEL 6 study tion of all patients can there be a thorough This international multicenter clinical study understanding of the epidemiology and bi- uses chemotherapy combined with surgery ology of this group of tumours, which can for the treatment of standard-risk hepato- then lead to a quicker and easier identifica- blastomas in young children and adoles- tion of new forms of treatment and prog- cents. By randomizing as regards the use of nostic parameters. The CWS is a leading sodium Thiosulphate it is hoped to reduce world study group in research in the field the risk of damage to the patients' hearing. of pediatric soft tissue tumours, and since 1981 has held consecutive clinical trials. 2. International registries for different oncological The SoTiSaR concept is based on the use of pathologies, more specifically: the experience acquired over many years. • NHL – BFM Registry 2012 The main purpose of the project is to obtain The aim of this registry is to ensure the op- a prospective collection of epidemiological, timal treatment of young children and ado- diagnostics and treatment data for young lescents with NHL even at a stage where children, adolescents and young adults <21 there are no clinical studies. All young years with soft tissue tumours, and create children and adolescents from Germany, a database for clinical and basic epidemio- Austria, Czech Republic and Switzerland di- logical research. agnosed with NHL are registered. The registry is not used to introduce new therapies, Paediatric Surgery Service – Regional Hospital but those therapies currently considered of Bellinzona and Valli the most effective and based on the experi- Mario Mendoza Sagaon MD ence of previous studies and literature are Head Doctor suggested. The registry also functions as a means of checking quality by providing sec- The Pediatric Surgery Service cares for children ond opinions from key institutions and an up to 16 years of age who require surgery or are assessment of case files by the NHL-BFM suffering from diseases that frequently require study centre. The study centre can also use surgery. It is a full service, including all the main its experience to enable doctors to receive surgical specializations, in particular mini-invasive, individual advice as regards second opin- orthopedic surgery. ions. Main areas of research • SoTiSar Registry Distal Tibia Fractures - Treatment with Métaizeau Soft tissue tumours, which include sarco- Nails mas, gastrointestinal stromal tumours, Lead investigator: De Rosa V. very aggressive juvenile fibromatosis and

74 Scientific Report 2012 The aim of this study is to assess this treatment in a part of the anatomy for which it is not usually recommended.

Conference communications 2012 Longhino V, De Rosa V, Regazzoni P, Candrian C. 99e Congrès annuel de la Société Suisse de Chi- rurgie. Pediatric navicular fractures, to operate? 20th-22nd June 2012.

3. EOC Multisite Departments and Services 75

4 Swiss Clinical Trial Organization 4. Swiss Clinical Trial Organization

The Swiss Clinical Trial Organization (Organiz- 4.1 EOC Clinical Trial Unit (CTU-EOC) zazione svizzera di ricerca clinica - SCTO) is the General introduction central platform for cooperation in patient-orient- In February 2012, the EOC Board of Directors ed clinical research in Switzerland. Its main objec- approved the setting up of the CTU-EOC to offer tive is to make Swiss clinical research more com- qualified support to researchers, both within and petitive as regards innovation and quality. outside the EOC, carrying out clinical trials and The SCTO intends to achieve this through: support them in all activities related to clinical re- • promoting a culture of study and high quality at search. The CTU-EOC provides services to carry a national level; out observational and interventional studies. • supporting the creation of a national network; The CTU-EOC is in line with the other CTUs in Swit- • promoting the integration of national clinical re- zerland and collaborates with the Clinical Trial search in international networks; Center of the University Hospital of Zürich. • building bridges between academia, industry and the public authorities. Functional Units The CTU-EOC is a two-centre structure led by a The SCTO generally promotes favorable conditions Steering Committee. One centre is located in the in the field of clinical research, as well as coordi- IOSI (CTU-IOSI), San Giovanni Hospital, Bellinzona natng multicenter studies and acting as an inter- (Director: Prof. Sessa); the other is based in the mediary between different studies. NSI (CTU-NIS), Regional Hospital of Lugano (Direc- The SCTO is a joint initiative of the SNSF and the tor Prof. Möller). In specific cases, the CTU-EOC Swiss Academy of Medical Sciences (ASSM). requests the opinion of the Scientific Committee.

The Members of the Steering Committee of the CTU-EOC are as follows: • Fabrizio Barazzoni MD, MPH, Head Officer of

78 Scientific Report 2012 the EOC Medical Area, Chairman; • Alberto Pagnamenta MD, Head of the Intensive • Prof. Claudio Bassetti MD, Head of the Neuro- Care Medicine Service, Regional Hospital of logical Clinic, Inselspital, Berne; Mendrisio; • Dino Cauzza, CFO of the EOC; • Prof. Cristiana Sessa MD, Director of the CTU- • Prof. Franco Cavalli MD, Scientific Director of EOC at the IOSI, Bellinzona; the IOSI, Bellinzona; • Dario Valcarenghi MSc, IOSI Nursing Area, Bell- • Prof. Carsten Möller MD, Director of the CTU- inzona. EOC at the NSI, Lugano; • Prof. Cristiana Sessa MD, Director of the CTU- Collaborators EOC at the IOSI, Bellinzona; In 2012 Mrs Tatiana Terrot was hired as Project • Yvonne Willems Cavalli RM MSc., Head of the Manager, Mrs Jane Frangi as Clinical Studies Co- EOC’s Nursing Sector; ordinator, Mr Yves Franzosi as Monitor and Dr Lili- • Prof. Gregor Zünd, Director of Research and ane Petrini as Medical Writer. It was also decided Training, University Hospital of Zurich. to use external experts for the biostatistics service and to manage the quality system. The Members of the Scientific Committee of the CTU-EOC are as follows: Activities • Dimitri Christoforidis MD, Head of General Sur- The CTU-EOC began offering its services to users gery Section, Regional Hospital of Lugano; on 1st October 2012. • Prof. Augusto Gallino MD, Head of the EOC’s In- ternal Medicine Department, Regional Hospital Before that the CTU was set up within the EOC, in of Bellinzona and Valli; particular by carrying out the following activities: • Prof. Carsten Möller MD, Director of the CTU- • description of the structure and finalizing of the EOC at the Neurocenter of Southern Switzer- organization chart; land, Lugano; • description of the functions;

4. Swiss Clinical Trial Organization 79 • drafting of the budget and price list; Coordination of clinical studies • organizing of the collaboration with the EOC ad- In 2012 various clinical studies, which were al- ministration; ready underway in the NSI were coordinated and • hiring of staff; followed (Dr Agazzi, Dr Cereda, Dr Gobbi and Prof. • setting up of the steering and scientific com- Möller). mittees; • presentation of the CTU-EOC on the EOC’s in- Monitoring tra- and internet platform: Four contracts were concluded. • discussions regarding external collaborators and the management of the quality system; Medical Writing • purchasing of Secutrial software. The Medical Writer revised one manuscript and provided advice on the drafting of a protocol for a Projects clinical study. The Project Manager is responsible for all requests for the supply of services. Other activities Offers were prepared for various requests for Internal documentation monitoring and coordinating clinical studies, for The year 2012 was dedicated to the development a statistical evaluation using the "Secutrial" soft- and creation of part of the internal documenta- ware. tion concerning the directives, main procedures Three projects were concluded in the field of statis- (Standard Operation Procedures – SOP), instruc- tical analysis, medical writing and the preparation tions and modules. The Central Service of EOC of documentation to be submitted to the Canton’s Quality was hired to handle the documentation and Ethics Committee. also provide consultancy in this area.

80 Scientific Report 2012 Training The two Directors, the Project Manager and the The contents of a course in Good Clinical Prac- other staff of the CTU-EOC had a number of meet- tice, module 1, were drawn up and submitted to ings with the Head Office and Administrative Ser- Swissmedic for approval (obtained on 4th January vices to discuss and resolve individual problems. 2013), and the first course will begin on 2nd May 2013. Intra/internet website The CTU-EOC is present on the EOC’s intra- and in- Clinical Research Day ternet, where the aims of the unit and the services The CTU-EOC appeared at the second Clinical Re- it offers are described. search Day held at San Giovanni Hospital, Bellin- zona, on 23rd March 2012. Communications The beginning of the CTU-EOC’s operations was Meetings announced in a press release on 29th October The two Directors and the staff met every month 2012, which was given coverage by the Canton’s to discuss matters and resolve any problems con- main media. cerning the CTU-EOC, while the Steering Commit- tee met on 2nd August 2012.

4. Swiss Clinical Trial Organization 81

5 Scientific Research Advisory Board (ABREOC) 5. Scientific Research Advisory Board (ABREOC)

The Scientific Research Advisory Board (ABREOC) ABREOC has the following specific tasks: was set up in October 2007 as an advisory body a. propose general guidelines for the research to and to coordinate the research in EOC hospitals. be carried out in the hospitals, taking into ac- ABREOC is aimed at improving knowledge in the count local interests, competencies, initiatives medical and nursing fields by: and activities; • favouring research within the EOC; b. identify the sectors or new areas in which to • promoting collaboration with both national and promote or continue research; international research institutions; c. create the necessary general conditions to fos- • encouraging the creation of research centres ter research; in specific sectors; d. provide an assessment of the scientific value of • creating the right conditions for the greatest research projects for which funding is request- possible integration between research and its ed, paying special attention to how the project clinical applications; fits in with the EOC’s vision and mission; • encouraging interdisciplinary research. e. inform, in line with the available budget, the awarding of funding for research projects not ABREOC operates in accordance with the current covered by external funding; legislation, taking into account the recommenda- f. assess, when consulted by the EOC head office tions of the Swiss Academy of Medical Sciences or local management, the scientific value of and the Canton’s Ethics Committee. The medical studies or scientific research not funded by the staff may submit research projects requiring fund- EOC and their consistency with the EOC’s vision ing to ABREOC to be carried out in EOC hospitals. and mission; g. regularly collect from the Canton’s Ethics Com- mittee all necessary information regarding the research authorized by and carried out within the EOC.

84 Scientific Report 2012 The Members of ABREOC are as follows: Between 2008 and 2012, 62 of the 101 clinical • Fabrizio Barazzoni MD, MPH, Head Officer of and translational studies submitted to the Scien- the EOC Medical Area, Chairman; tific Research Advisory Board were funded by the • Prof. Franco Cavalli MD, Scientific Director of Scientific Fund (including some studies that were the IOSI; resubmitted and received financing at the start of • Prof. Augusto Gallino MD, Head of the EOC’s 2013). Internal Medicine Department; • Piergiorgio Mombelli MD, Medical Officer in In- The projects that received funding are listed in the ternal Medicine of Regional Hospital of Locarno; table attached to the "Report" (Appendices 1, 2, 3, • Alberto Pagnamenta MD, Head of Intensive 4 and 5) with the state of progress indicated for Care Medicine Service of Regional Hospital of each project: either concluded (with a publication Mendrisio; or final report) or still underway. • Paola Di Giulio, nurse member of the professional skills teaching staff (SUPSI) at the De- The funds allocated by ABREOC since 2008, when partment of Health (DSAN); the first funding was awarded, are shown below: • Prof. Raffaele Rosso MD, Head of the EOC’s Surgery Department; ABREOC notices of competition 2008 – 2012 • Maria Luisa Aimi Hohl, specialist nurse from No. projects submitted 101 the Pneumology Division of Regional Hospital of No. projects approved 62 Bellinzona and Valli; No. projects rejected 39 • Manuela Sarti MD, ABREOC Secretary, EOC Total sum requested by CHF 8,060,045 Medical Area. researchers Sum awarded CHF 2,781,147

5. Scientific Research Advisory Board (ABREOC) 85

6 Panel of Experts on Professional Confidentiality in Medical Research and General Authorisation granted to the EOC 6. Panel of Experts on Professional Confidentiality in Medical Research and General Authorisation granted to the EOC

The Panel of Experts on Professional Confidential- the information relates; and ity in Medical Research was set up in 1993 when c. the interests of research outweigh the in- article 321bis of the Swiss Criminal Code (CPS) terest of preserving confidentiality. was issued. 4. The Panel makes authorisation subject to the Premise conditions in compliance with data protection Article 321bis of the CPS states the following: requirements. The Panel publishes its authori- 1. Any person who unlawfully discloses a profes- sation decision. sional secret that has come to his knowledge in the course of his research activities in the 5. If the interests of the person to whom the in- fields of medicine or health care is liable to a formation relates and that are worthy of pro- penalty in accordance with Article 321. tection are not endangered and if personal data are anonymized from the beginning of the 2. Professional secrets may be disclosed for the research, the Panel may grant a general au- purpose of research in the fields of medicine thorisation or may relax procedures by other or health care provided a Panel of experts so means. authorizes it and the person to whom the information relates, having had his rights explained 6. The Panel is not bound by any directives. to him, does not expressly prohibit it. 7. The Federal Council appoints the president and 3. The Panel grants authorisation provided: the members of the Panel and issues regulations a. the research cannot be carried out with an- concerning its organization and procedures. onymized data; b. it is impossible or unreasonably difficult to obtain the consent of the person to whom

88 Scientific Report 2012 The relevant Federal Order of enforcement pro- As a result of this Authorisation, non-anonymized vides for two types of authorisation: data can be accessed without being in breach of a. a special authorisation that covers only the professional confidentiality. This is possible only specific research project for which the applica- within EOC structures as the EOC is the holder of tion is made (article 2); the Authorisation. b. a general authorisation that the Panel of experts may grant to private or teaching hospi- Following the granting of the Authorisation, "Regu- tals. General authorisations allow personnel lations on access to patients’ data by staff of the conducting internal research as well as PhD Ente Ospedaliero Cantonale conducting research students to access personal data, provided studies" were drawn up. This is compulsory in or- that the legitimate interests of the concerned der to start clinical studies that cannot be carried persons are not compromized and that data out with the patient’s informed consent. are made anonymous from the beginning of Moreover, before a research project begins, eve- the research (article 3). ry researcher involved in the project must sign a "Declaration concerning the obligation to respect The Panel thus grants authorisation for research confidentiality in medical research". studies, hospitals and medical registries within the scope of clinical research. As data protection is A detailed description of the studies carried out in the main concern, it is necessary to decide which 2012 following the General Authorisation can be patients’ data may be used and sent. found in Appendix 6.

An important decision for research projects at the EOC. On 7th May 2012 we proudly welcomed the news that, after complex and demanding preparatory work, the Berne Panel of Experts on Professional Confidentiality in Medical Research granted us general authorisation to disclose professional secrets for research studies carried out at EOC institutes (www.admin.ch/ch/i/ff/2012/6191.pdf).

Fabrizio Barazzoni, MD, MPH, Head of the Medical Area of the Head Office, is in charge of EOC Gen- eral Authorisation (No. 035.0003-43).

This Authorisation grants medical staff permission to access, under specific and binding conditions, non-anonymized patients’ personal data to carry out research in the fields of medicine or health care.

6. Panel of Experts on Professional Confidentiality in Medical Research and General Authorisation granted to the EOC 89

7 Publications in 2012 7. Publications in 2012

The scientific activity carried out within the EOC The Table below shows the number of peer-re- Services in 2012 resulted in 385 scientific pub- viewed articles published in 2012 for each Hos- lications or communications. pital:

Hospital sites Number of More in detail there were: publications • 194 original articles published in peer reviewed in 2012 journals; The Regional Hospital of Lugano 26 • 17 books or chapters in books; The Regional Hospital of Bellinzona • 15 original articles published in non peer re- and Valli 29 viewed journals; The Regional Hospital of Mendrisio 3 • 159 communications at national and interna- The Regional Hospital of Locarno 6 tional conferences. Oncology Institute of Southern Switzerland (IOSI) 77 Neurocenter of Southern Switzerland (NSI) 53 Total publications 194

92 Scientific Report 2012 Publications in peer-reviewed journals Babbio F, Pistore C, Curti L, Castiglioni I, Kunderfranco P, Brino L, Oudet P, Seiler R, Albino D, Longoni N, Curti L, Mello-Grand M, Thalman GN, Roggero E, Sarti M, Pinton S, Mello- Pinton S, Civenni G, Thalmann G, D'Ambrosio Grand M, Chiorino G, Catapano CV, Carbone GM, G, Sarti M, Sessa F, Chiorino G, Catapano CV, Bonapace IM. Carbone GM. The SRA protein UHRF1 promotes epigenetic ESE3/EHF controls epithelial cell differentiation crosstalks and is involved in prostate cancer and its loss leads to prostate tumours with progression. mesenchymal and stem-like features. Oncogene. 2012 Nov;31(46):4878-87. Cancer Res. 2012 Jun;72(11):2889-900. doi: 10.1038/onc.2011.641. doi: 10.1158/0008-5472.CAN-12-0212. IF 6.373 IF 7.856 Oncology Oncology Beitinger PA, Fulda S, Dalal MA, Wehrle R, Alvarez-Fischer D, Grundmann M, Lu L, Samans Keckeis M, Wetter TC, Han F, Pollmächer T, B, Fritsch B, Möller JC, Schäfer MK, Hartmann A, Schuld A. Oertel WH, Bandmann O. Glucose tolerance in patients with narcolepsy. Prolonged generalized dystonia after chronic Sleep. 2012 Feb;35(2):231-6. cerebellar application of kainic acid. doi: 10.5665/sleep.1628. Brain Res. 2012 Jun;1464:82-8. IF 5.1 doi: 10.1016/j.brainres.2012.05.007. Neurology IF 2.7 Neurology

7. Publications in 2012 93 Bellei M, Chiattone CS, Luminari S, Pesce EA, Impact Of HLA-DPB1 Haplotypes On Outcome Of Cabrera ME, de Souza CA, Gabús R, Zoppegno L, 10/10 Matched Unrelated Hematopoietic Stem Zoppegno L, Milone J, Pavlovsky A, Connors JM, Cell Donor Transplants Depends On MHC-Linked Foss FM, Horwitz SM, Liang R, Montoto S, Pileri Microsatellite Polymorphisms. SA, Polliack A, Vose JM, Zinzani PL, Zucca E, Biol Blood Marrow Transplant. Federico M. 2012 Apr;18(4):608-616. IF 3.873 T-Cell Lymphomas In South America And Europe. Haematology Rev Bras Hematol Hemoter. 2012 ;34(1):42-7. doi: 10.5581/1516-8484.20120013. IF 4.941 Bettinelli A, Longoni L, Tammaro F, Faré PB, Oncology Garzoni L, Bianchetti MG. Renal salt-wasting syndrome in children with Berger MD, Gerber B, Arn K, Senn O, Schanz U, intracranial disorders. Stussi G. Pediatr Nephrol. 2012 May;27:733-739. Significant reduction of red blood cell transfusion doi: 10.1007/s00467-011-2093-5. IF 2.518 requirements by changing from a double-unit Paediatrics to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell Bianco G, Feurra M, Fadiga L, Rossi A, Rossi S. transplantation. Bi-hemispheric effects on corticospinal excitability Haematologica. 2012 Jan;97(1):116-22. induced by repeated sessions of imagery versus doi: 10.3324/haematol.2011.047035. IF 6.424 observation of actions. Haematology Restor Neurol Neurosci. 2012;30(6):481-9. doi: 10.3233/RNN-2012-120241. IF 3.3 Bettens F, Passweg J, Schanz U, Chalandon Neurology Y, Heim D, Güngör T, Stüssi G, Nicoloso G, Baldomero H, Gratwohl A, Tiercy JM. Bianco G, Vuolo G, Ulivelli M, Bartalini S, Chieca R,

94 Scientific Report 2012 Rossi A, Rossi S. IF 3.325 A clinically silent, but severe, duodenal Oncology complication of duodopa infusion. J Neurol Neurosurg Psychiatry. Bonaldi G, Bertolini G, Marrocu A, Cianfoni A. 2012 Jun;83(6):668-70. Posterior vertebral arch cement augmentation doi: 10.1136/jnnp-2011-301984. IF 4.8 (spinoplasty) to prevent fracture of spinous Neurology processes after interspinous spacer implant. AJNR Am J Neuroradiol. Bianda N, Di Valentino M, Périat D, Segatto JM, 2012 Mar;33(3):522-8. Oberson M, Moccetti M, Sudano I, Santini P, doi: 10.3174/ajnr.A2792. IF 2.928 Limoni C, Froio A, Stuber M, Corti R, Gallino A, Neuroradiology Wyttenbach R. Progression of human carotid and femoral Bonaldi G, Cianfoni A. atherosclerosis: a prospective forrow-up study by Percutaneous treatment of lumbar compression magnetic resonance vessel wall imaging. fracture with canal stenosis and neurogenic Eur Heart J. 2012 Jan;33(2):230-237. intermittent claudication: combining kyphoplasty doi: 10.1093/eurheartj/ehr332. IF 10.478 and interspinous spacer. Radiology/Cardiology J Vasc Interv Radiol. 2012 Nov;23(11):1437-41. doi: 10.1016/j.jvir.2012.06.023. IF 2.1 Boi M, Stathis A, Zucca E, Inghirami G, Bertoni F. Neuroradiology Genetic Alterations In Systemic Nodal And Extranodal Non-Cutaneous Lymphomas Derived Bonanni E, Di Coscio E, Maestri M, Carnicelli L, From Mature T- And Natural Killer-Cells. Tsekou H, Economou NT, Paparrigopoulos T, Cancer Sci. 2012 Aug;103(8):1397-404. Bonakis A, Papageorgiou SG, Vassilopoulos D, doi: 10.1111/j.1349-7006.2012.02321.x. Soldatos CR, Murri L, Ktonas PY.

7. Publications in 2012 95 Differences in EEG delta frequency characteristics Study. and patterns in slow-wave sleep between J Acquir Immune Defic Syndr. dementia patients and controls: a pilot study. 2012 Jun 1;60(2):135-42. J Clin Neurophysiol. 2012 2012 Feb;29(1):50-4. doi: 10.1097/QAI.0b013e31824476e1. doi: 10.1097/WNP.0b013e318246b56d. IF 4.425 IF 1.5 Infectious Diseases Neurology Bulian P, Rossi D, Forconi F, Del Poeta G, Bertoni Bonanni E, Maestri M, Fabbrini M, Cirignotta F, F, Zucca E, Montillo M, Pozzato G, D'Arena G, Ferini-Strambi L, Gigli GL, Parrino L, Murri L. Efremov DG, Marasca R, Lauria F, Gaidano G, Sleep education in Italy. Gattei V, Laurenti L. Sleep Med. 2012 Apr;13(4):450. doi: 10.1016/ IGHV Gene Mutational Status And 17p Deletion j.sleep.2011.12.002. IF 3.4 Are Independent Molecular Predictors In A Neurology Comprehensive Clinical-Biological Prognostic Model For Overall Survival Prediction In Chronic Bongiovanni M, Mazzucchelli L, Martin V, Crippa Lymphocytic Leukemia. S, Bolli M, Suriano S, Giovanella L. J Transl Med. 2012 Jan;10:18. Images In Endocrine Pathology: A Starry-Sky In doi: 10.1186/1479-5876-10-18. IF 3.474 The Thyroid. Oncology Endocr Pathol. 2012 Mar;23(1):79-81. doi: 10.1007/s12022-011-9191-6. IF 1.358 Bullo M, Tschumi S, Bucher BS, Bianchetti MG, Nuclear Medicine Simonetti GD. Pregnancy outcome following exposure to Bongiovanni M, Suriano S, Bolli M, Cattaneo F, angiotensin-converting enzyme inhibitors or Fasolini F, Giovanella L. angiotensin receptor antagonists: a systematic Ectopic Substernal Thyroid Tissue: A Challenging review. Differential Diagnosis. Hypertension. 2012 Aug;60:444-450. J Clin Endocrinol Metab. 2012 Mar;97(3):719- doi: 10.1161/ 20. doi: 10.1210/jc.2011-2543. IF 5.967 HYPERTENSIONAHA.112.196352. IF 6.207 Nuclear Medicine Paediatrics

Boulter DJ, Luigetti M, Rumboldt Z, Chalela JA, Burnier M, Bock A, Halabi G, Gasser UE, Pechère Cianfoni A. Bertschi A, Ambühl P, Forster C, Gabutti L, Multimodal CT imaging of a posterior fossa Giovannini M, Hess B, Höfliger N, Meier P, stroke. Mohaupt M, Pfammatter R, Schönholzer C, Neurol Sci. 2012 Feb;33(1):215-6. Schwarz A, Steiger J, Wagner G and Würzner G doi: 10.1007/s10072-011-0652-y. IF 1.22 Usefulness of telemetric blood pressure Neuroradiology monitoring in hypertensive patients with chronic kidney diseases. Bucher HC, Richter W, Glass TR, Magenta L, J Nephrol Therapeut. 2012 May;2: 122 Cavassini M, Vernazza P, Hirschel B, Weber R, doi: 10.4172/2161-0959.1000122. Furrer H, Battegay M, Bernasconi E. IF 1.654 Small dense lipoproteins, apolipoprotein B and Nephrology risk of coronary events in HIV-infected patients on antiretroviral therapy: The Swiss HIV Cohort Caiata-Zufferey M, Zanini CA, Schulz PJ, Syrén

96 Scientific Report 2012 ML, Bianchetti MG, Bettinelli A. ESMO Clinical Practice Guidelines for diagnosis, Living with Gitelman disease: an insight into treatment and follow-up. patients' daily experiences. Ann Oncol. 2012; 23 (Suppl 7): vi11-9. Nephrol Dial Transplant. 2012 Aug;27:3196- IF 6.425 3201. doi: 10.1093/ndt/gfs017. IF 3.396 Oncology Paediatrics Cardoso F, Loibl S, Pagani O, et al. Canafoglia L, Gennaro E, Capovilla G, Gobbi G, The European Society of Breast Cancer Boni A, Beccaria F, Viri M, Michelucci R, Agazzi Specialists recommendations for the P, Assereto S, Coviello DA, Di Stefano M, Rossi management of young women with breast Sebastiano D, Franceschetti S, Zara F. cancer. Electroclinical presentation and genotype- Eur J Cancer 2012 Dec; 48: 3355–77. IF 5.536 phenotype relationships in patients with Oncology Unverricht-Lundborg disease carrying compound heterozygous CSTB point and indel mutations. Carota A, Düron N, Cereda C, Bassetti CL. Epilepsia. 2012 Dec; 53(12):2120-7. Vertical pendular nystagmus and hypertrophic doi: 10.1111/j.1528-1167.2012.03718.x. IF 4.0 inferior olivary nuclei degeneration: an "odd Neurology couple". J Neurol. 2012 Feb;259(2):372-4. doi: Capone F, Pravatà E, Novello M, Moncelsi S, 10.1007/s00415-011-6170-2. IF 3.853 Pirronti T, Meglio M, Servidei S. Neurology A rare case of life-threatening giant plexiform schwannoma. Cereda CW, Carrera E. Spine J. 2012 Jan;12(1):83. Posterior cerebral artery territory infarctions. doi: 10.1016/j.spinee.2011.12.001. IF 3.3 Front Neurol Neurosci. 2012; 30: 128-31. Neuroradiology doi: 10.1159/000333610. Neurology Caporro M, Haneef Z, Yeh HJ, Lenartowicz A, Buttinelli C, Parvizi J, Stern JM. Cereda CW, Petrini L, Azzola A, Ciccone A, Functional MRI of sleep spindles and K-complexes. Fischer U, Gallino A, Györik S, Gugger M, Mattis J, Clin Neurophysiol. 2012 Feb;123(2):303-9. Lavie L, Limoni C, Nobili L, Manconi M, Ott S, Pons doi: 10.1016/j.clinph.2011.06.018. IF 3.8 M, Bassetti CL. Neurology Sleep-disordered breathing in acute ischemic stroke and transient ischemic attack: effects Cardoso F, Costa A, Norton L, Cameron D, Cufer on short- and long-term outcome and efficacy T, Fallowfield L, Francis P, Gligorov J, Kyriakides S, of treatment with continuous positive airways Lin N, Pagani O, et al. pressure--rationale and design of the SAS CARE 1st International consensus guidelines for study. advanced breast cancer (ABC 1). Int J Stroke. 2012 Oct;7(7):597-603. Breast 2012 Jun; 21: 242-252. IF 2.491 doi: 10.1111/j.1747-4949.2012.00836.x. Oncology IF 2.382 Neurology Cardoso F, Harbeck N, Fallowfield L, Kyriakides S, Senkus E; ESMO Guidelines Working Group. Ceriani L, Suriano S, Ruberto T, Zucca E, Locally recurrent or metastatic breast cancer: Giovanella L.

7. Publications in 2012 97 18fdg uptake changes in liver and mediastinum study. during chemotherapy in patients with diffuse large Colorectal Diseases. 2012 Oct 3. b-cell lymphoma. doi: 10.1111/codi.12006. IF 2.385 Clin Nucl Med. 2012 Oct;37(10):949-52. Surgery doi: 10.1097/RLU.0b013e318263831d. IF 3.674 Cianfoni A, Distefano D, Chin SH, Varma AK, Nuclear Medicine Rumboldt Z, Bonaldi G. Percutaneous cement augmentation of a lytic Chhabra A, Soldatos T, Thawait GK, Del Grande F, lesion of C1 via posterolateral approach under CT Thakkar RS, Means KR Jr, Carrino JA. guidance. Current perspectives on the advantages of 3-T Spine J. 2012 Jun;12(6):500-6. MR imaging of the wrist. doi: 10.1016/j.spinee.2012.05.012. IF 3.3 Radiographics 2012 May-Jun; 32(3): 879-96. Neuroradiology IF 2.854 Radiology Clifford GM, Lise M, Franceschi S, Egger M, Bouchardy C, Korol D, Levi F, Ess S, Jundt G, Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Wandeler G, Fehr J, Schmid P, Battegay M, Del Grande F, Chalian M, Carrino JA. Bernasconi E, Cavassini M, Calmy A, Keiser O, High-Resolution 3T MR Neurography of the Schöni-Affolter F and the Swiss HIV Cohort Study. Brachial Plexus and Its Branches, with Emphasis Lung cancer in the Swiss HIV Cohort Study: role on 3D Imaging. of smoking, immunodeficiency and pulmonary AJNR Am J Neuroradiol 2012 Dec 6 infection. IF 2.928 Br J Cancer. 2012 Jan;106(3):447-52. Radiology doi: 10.1038/bjc.2011.558. IF 5.042 Infectious Diseases Christensen J, El-Gebali S, Natoli M, Sengstag T, Delorenzi M, Bentz S, Bouzourene H, Rumbo M, Colombo N, Carinelli S, Colombo A, Marini C, Rollo Felsani A, Siissalo S, Hirvonen J, Vila MR, Saletti P, D, Sessa C. Aguet M, Anderle P. Cervical cancer: ESMO Clinical Practice Guidelines Defining new criteria for selection of cell- for diagnosis, treatment and follow-up. based intestinal models using publicly available Ann Oncol. 2012 Oct;23(7):vii27-vii32. IF 6.425 databases. Oncology BMC Genomics. 2012 Jun;13:274. doi: 10.1186/1471-2164-13-274. IF 4.073 Colombo N, Peiretti M, Garbi A, Carinelli S, Marini Oncology C, Sessa C. Non-epithelial ovarian cancer: ESMO Clinical Christinat A, Pagani O. Practice Guidelines for diagnosis, treatment and Fertility after breast cancer. follow-up. Maturitas 2012 Nov; 73(3): 191-6. Ann Oncol. 2012 Oct;23(7):vii20-vii26. IF 6.425 IF 2.767 Oncology Oncology Conconi A, Ponzio C, Lobetti-Bodoni C, Motta M, Christoforidis D, Clerc D, Demartines N. Rancoita PM, Stathis A, Moccia AA, Mazzucchelli Transrectal specimen extraction after L, Bertoni F, Ghielmini M, Cavalli F, Zucca E. laparoscopic left colectomy: a case-matched Incidence, Risk Factors And Outcome Of

98 Scientific Report 2012 Histological Transformation In Follicular Radiol Clin North Am. 2012 Jul; 50(4): 629-49. Lymphoma. IF 2.59 Br J Haematol. 2012 Apr;157(2):188-96. Radiology doi: 10.1111/j.1365-2141.2012.09054.x. IF 4.941 De Simone M, Muccio CF, Pagnotta SM, Esposito Oncology G, Cianfoni A. Comparison between CT and MR in perfusion Costa A. imaging assessment of high-grade gliomas. Surgery has become more and more Radiol Med. Epub 2012 Mar. conservative. doi: 10.1007/s11547-012-0801-5. IF 1.4 Breast 2012 Apr; 21(2): 111. IF 2.491 Neuroradiology Oncology Dienstmann R, De Dosso S, Felip E, Tabernero J. Crippa S, Saletti P, Barizzi J, Mazzucchelli L. Drug development to overcome resistance to The clinical management in familial adenomatous EGFR inhibitors in lung and colorectal cancer. polyposis deserves continuous monitoring for Mol Oncol 2012 Feb;6(1):15-26. thyroid carcinoma. doi: 10.1016/j.molonc.2011.11.009. BMJ Case Rep. 2012 Nov. doi: 10.1136/bcr- IF 0.658 2012-007046. IF 4.328 Oncology Oncology Di Lazzaro V, Profice P, Dileone M, Della Marca Curlo M, Popovic J, Pignatti R, Sacco L. G, Colosimo C, Pravatà E, Pavone A, Pennisi M, Palinopsia in a patient with a left pericalcarine Maviglia R, Pilato F. cavernous haemangioma. Delayed hypothermia in malignant ischaemic Swiss Arch Neurol Psychiatry. 2012;163(7): 2. stroke. Neurology Neurol Sci. 2012 Jun;33(3):661-4. doi: 10.1007/s10072-011-0824-9. IF 1.3 Czerny M, Eggebrecht H, Sodeck G, Verzini F, Neuroradiology Cao P, Maritati G, Riambau V, Beyersdorf F, Rylski B, Funovics M, Loewe C, Schmidli J, Tozzi Di Lazzaro V, Profice P, Pilato F, Capone F, Ranieri P, Weigang E, Kuratani T, Livi U, Esposito G, F, Florio L, Colosimo C, Pravatà E, Pasqualetti P, Trimarchi S, Van Den Berg JC, Fu W, Chiesa Dileone M. R, Melissano G, Bertoglio L, Lonn L, Schuster I, The Level of Cortical Afferent Inhibition in Acute Grimm M. Stroke Correlates With Long-Term Functional Mechanisms of Symptomatic Spinal Cord Ischemia Recovery in Humans. After TEVAR: Insights From the European Registry Stroke. 2012 Jan;43(1):250-2. of Endovascular Aortic Repair Complications doi: 10.1161/STROKEAHA.111.631085. (EuREC). IF 5.7 J Endovasc Ther. 2012 Feb;19(1):37-43. Neuroradiology doi: 10.1583/11-3578.1. IF 2.856 Interventional Radiology Dratva J, Keidel D, Gaspoz JM, Liu S, Künzli N, Phuleria H, Pons M, Foraster M, Zemp E, Gerbase Del Grande F, Maus TP, Carrino JA. M, Schindler C. Imaging the intervertebral disk: age-related Transportation Noise and Blood Pressure in a changes, herniations, and radicular pain. Population-Based Sample of Adults.

7. Publications in 2012 99 Environ Health Perspect. 2012 Jan;120(1):50-5. Cavassini M, Hoffmann M, Bernasconi E, doi: 10.1289/ehp.1103448. IF 6.09 Schrenzel J, Bodmer T, Böttger E, Helbling P, Internal Medicine Egger M for the Swiss HIV Cohort and Molecular Epidemiology of TB Study Groups. Economou NT, Manconi M, Ghika J, Raimondi M, Tuberculosis in HIV-negative and HIV-infected Bassetti CL. patients in a low-incidence country: clinical Development of Parkinson and Alzheimer characteristics and treatment outcomes. diseases in two cases of narcolepsy-cataplexy. PloS One. 2012;7(3):e34186. Eur Neurol. 2012;67(1):48-50. doi: 10.1371/journal.pone.0034186. IF 4.092 doi: 10.1159/000334733. IF 1.811 Infective Diseases Neurology Fernandez P, Solenthaler M, Spertini O, Quarroz Espeli V, Zucca E, Ghielmini M, Giannini O, Salatino S, Rovo A, Lovey PY, Leoncini L, Ruault-Jungblut S, A, Martucci F, Richetti A. D'Asaro M, Schaad O, Docquier M, Descombes P, Weekly And 3-Weekly Cisplatin Concurrent With Matthes T; Swiss Cytometry Society. Intensity-Modulated Radiotherapy In Locally Using digital RNA counting and flow cytometry to Advanced Head And Neck Squamous Cell Cancer. compare mRNA with protein expression in acute Oral Oncol. 2012 Mar;48(3):266-71. leukemias. doi: 10.1016/j.oraloncology.2011.10.005. Plos One. 2012;7(11):e49010. IF 2.857 doi: 10.1371/journal.pone.0049010. IF 4.092 Oncology Haematology

Fasolo A, Sessa C, Gianni L, Broggini M. Ferreri AJ, Govi S, Pasini E, Mappa S, Bertoni F, Seminars in clinical pharmacology: an introduction Zaja F, Montalbán C, Stelitano C, Cabrera ME, to MET inhibitors for the medical oncologist. Giordano Resti A, Politi LS, Doglioni C, Cavalli F, Ann Oncol. 2012 Jan;24(1):14-20. Zucca E, Ponzoni M, Dolcetti R. doi: 10.1093/annonc/mds520. Chlamydophila Psittaci Eradication With IF 6.425 Doxycycline As First-Line Targeted Therapy For Oncology Ocular Adnexae Lymphoma: Final Results Of An International Phase II Trial. Fasolo A, Sessa C. J Clin Oncol. 2012 Aug;30(24):2988-94. Targeting mTOR pathways in human doi: 10.1200/JCO.2011.41.4466. malignancies. IF 18.372 Curr Phar, Des. 2012;18:2766-77. Oncology IF 3.87 Oncology Ferri R, Fulda S, Cosentino FII, Pizza F, Plazzi G. A preliminary quantitative analysis of REM sleep Fehr T, Stussi G. chin EMG in Parkinson´s disease with or without ABO-incompatible kidney transplantation. REM sleep behaviour disorder. Curr Opin Organ Transplant. 2012 Sleep Med. 2012 Jun:13(6):707-13. Ago;17(4):376-85. doi: 10.1097/ doi: 10.1016/j.sleep.2012.01.003 MOT.0b013e328355f013. IF 2.967 IF 3.4 Haematology Neurology

Fenner L, Gagneux S, Janssens JP, Fehr J, Ferri R, Manconi M, Plazzi G, Bruni O, Cosentino

100 Scientific Report 2012 FI, Ferini-Strambi L, Zucconi M. G, Böhm S, Driessen C, De Braud F, Marsoni S, Leg movements during wakefulness in restless Cereda R, Sala F, D’Incalci M, Sessa C. legs syndrome: time structure and relationships A first in human phase I study of the proteasome with periodic leg movements during sleep. inhibitor CEP-18770 in patients with advanced Sleep Med. 2012 May; ;13(5):529-35. solid tumours and multiple myeloma. doi: 10.1016/j.sleep.2011.08.007. IF 3.4 Eur J Cancer Epub. 2012 Oct. IF 5.536 Neurology Oncology

Fischer J, Dogas Z, Bassetti CL, Berg S, Grote L, Gallino A, Alerci M. Jennum P, Levy P, Mihaicuta S, Nobili L, Riemann Commentary: reducing errors in the D, Puertas Cuesta FJ, Raschke F, Skene DJ, interventional suite: a structured mental Stanley N, Pevernagie D. rehearsal is a step in the right direction Standard procedures for adults in accredited J. Endovasc Ther. 2012; Jun; 19(3); 390-1. sleep medicine centres in Europe. doi: 10.1583/11-3785R.1. J Sleep Res. 2012 Aug;21(4):357-68. IF 2.856 doi: 10.1111/j.1365-2869.2011.00987.x. Interventional Radiology IF 3.361 Neurology Gerber B, Guggenberger R, Fasler D, Nair G, Manz MG, Stussi G, Schanz U. Frank M, Guarino-Gubler S, Burnier M, Maillard M, Reversible skeletal disease and high fluoride Keller F, Gabutti L. serum levels in hematologic patients receiving Estimation of glomerular filtration rate in voriconazole. hospitalised patients: are we overestimating renal Blood. 2012 Sep;120(12):2390-4. function? IF 9.898 Swiss Med Wkly. 2012 Dec 19;142:w13708. Haematology doi: 10.4414/smw.2012.13708. IF 1.895 Nephrology Gerber B, Stussi G, Rosemann T, Senn O. The health care setting rather than medical Gabutti L, Montagna C, Mombelli G. speciality impacts on physicians adherence to Early surgery for infective endocarditis. guideline-conform anticoagulation in outpatients N Engl J Med. 2012 Oct;367(14):1366; with non-valvular atrial fibrillation: a cross author reply 1366-7. doi: 10.1056/ sectional survey. NEJMc1209897#SA2. IF 53.298 BMC Cardiovasc Disord. 2012 Feb 29;12:12. Internal Medicine doi: 10.1186/1471-2261-12-12. IF 1.517 Haematology Gallerani E, Von Moos R, Bartosek A, Sessa C. A phase I study of the oral platinum agent Gerull S, Stern M, Ben Aissa A, Manz MG, Schanz satraplatin in combination with oral vinorelbine in U, Stussi G, Chalandon Y, Passweg J, Mohty B. patients with advanced solid malignancies. Allo-SCT for multiple myeloma in the era of novel Onkologie. 2012;36(1-2):40-5. agents: a retrospective study on behalf of Swiss doi: 10.1159/000346671. IF 0.868 Blood SCT. Oncology Bone marrow transplant. 2012 Sep. IF 3.746 Haematology Gallerani E, Zucchetti M, Brunelli D, Marangon E, Noberasco C, Hess D, Delmonte A, Martinelli Ghielmini M, Vitolo U, Kimby E, Montoto S,

7. Publications in 2012 101 Walewski J, Pfreundschuh M, Federico M, Hoskin Clin Chem Lab Med. 2012 Aug. pii: /j/cclm. P, McNamara C, Caligaris-Cappio F, Stilgenbauer ahead-of-print/cclm-2012-0378/cclm-2012- S, Marcus R, Trneny M, Dreger P, Montserrat E, 0378.xml. doi: 10.1515/cclm-2012-0378. Dreyling M. IF 2.15 On behalf of the Panel Members of the 1st ESMO Laboratory Medicine–Nuclear Medicine Consensus Conference on Malignant Lymphoma. ESMO Guidelines consensus conference on Giovanella L, Ceriani L, De Palma D, Suriano S, malignant lymphoma 2011 part 1: diffuse large Castellani M, Verburg FA. B-cell lymphoma (DLBCL), follicular lymphoma (FL) Relationship Between Serum Thyroglobulin And and chronic lymphocytic leukemia (CLL). (18)Fdg-Pet/Ct In (131) I-Negative Differentiated Ann Oncol. 2012 Nov. IF 6.425 Thyroid Carcinomas. Oncology Head Neck. 2012 May;34(5):626-31. doi: 10.1002/hed.21791. IF 3.135 Gillessen S, Gnad-Vogt U, Gallerani E, Beck J, Nuclear Medicine Sessa C, Omlin A, Mattiacci MR, LIedert B, Kramer D, Laurent J, Speiser DE, Stupp R. Giovanella L, Toffalori E, Tozzoli R, Caputo M, A phase I dose-escalation study of the Ceriani L, Verburg FA. immunocytokine EMD 521873 (Selectikine) in Multiplexed immunoassay of thyroglobulin patients with advanced solid tumours. autoantibodies in patients with differentiated Eur J Cancer Epub. 2012 Aug. IF 5.536 thyroid carcinoma. Oncology Head Neck. 2012 Oct;34(10):1369-71. doi: 10.1002/hed.21933. IF 3.135 Giovanella L, Imperiali M, Ferrari A, Palumbo A, Nuclear Medicine Furlani L, Graziani MS, Castello R. Serum thyroglobulin reference values according Giovanella L, Treglia G, Verburg FA, Salvatori M, to NACB criteria in healthy subjects with normal Ceriani L. thyroid ultrasound. Serum cytokeratin 19 fragments: a Clin Chem Lab Med. 2012 Jan;50(5):891-3. dedifferentiation marker in advanced thyroid doi: 10.1515/cclm.2011.756. IF 2.15 cancer. Laboratory Medicine–Nuclear Medicine Eur J Endocrinol. 2012 Dec;167(6):793-7. doi: 10.1530/EJE-12-0660. IF 3.423 Giovanella L, Imperiali M, Ferrari A, Palumbo Nuclear Medicine A, Lippa L, Peretti A, Graziani MS, Castello R, Verburg FA. Giovanella L, Verburg FA, Imperiali M, Valabrega Thyroid volume influences serum calcitonin S, Trimboli P, Ceriani L. levels in a thyroid-healthy population: results of a Comparison of serum calcitonin and procalcitonin 3-assay, 519 subjects study. in detecting medullary thyroid carcinoma among Clin Chem Lab Med. 2012 Apr 4;50(5):895-900. patients with thyroid nodules. doi: 10.1515/cclm-2011-0920. IF 2.15 Clin Chem Lab Med. 2012 Dec 25:1-5. Laboratory Medicine–Nuclear Medicine doi: 10.1515/cclm-2012-0610. IF 2.15 Laboratory Medicine–Nuclear Medicine Giovanella L, Imperiali M, Verburg FA, Ceriani L. Evaluation of the BRAHMS Kryptor® Giovanella L. Thyroglobulin Minirecovery Test in patients with Positron emission tomography/computed differentiated thyroid carcinoma. tomography in patients terated for differentiated

102 Scientific Report 2012 thyroid carcinomas. Swiss Med Wkly. 2012 Nov 26;142:0. Exp Rev Endocrinol Metab. 2012;7:35-43 doi: 10.4414/smw.2012.13719. IF 1.895 Nuclear Medicine Internal Medicine

Giovanella L. Helbling D, Bodoky G, Gautschi O, Sun H, Bosman Serum procalcitonin and calcitonin normal values F, Gloor B, Burkhard R, Winterhalder R, Madlung before and after calcium gluconate infusion. A, Rauch D, Saletti P, Widmer L, Borner M, Exp Clin Endocrinol Metab. 2012 Baertschi D, Yan P, Benhattar J, Leibundgut EO, Mar;120(3):169-70. doi: 10.1055/s-0031- Bougel S, Koeberle D. 1301290. Neoadjuvant chemoradiotherapy with or Nuclear Medicine without panitumumab in patients with wild-type KRAS, locally advanced rectal cancer (LARC): Glass TR, Rotger M, Telenti A, Decosterd L, a randomized, multicenter, phase II trial SAKK Csajka C, Bucher HC, Günthard HF, Rickenbach 41/07. M, Nicca D, Hirschel B, Bernasconi E, Wandeler Ann Oncol. 2012 Nov. G, Battegay M, Marzolini C; Swiss HIV Cohort doi: 10.1093/annonc/mds519. IF 6.425 Study. Oncology Determinants of sustained viral suppression in HIV-infected patients with self-reported poor Hennings JM, Schaaf L, Fulda S. adherence to antiretroviral therapy. Glucose metabolism and antidepressant medication. PloS One. 2012;7(1):e29186. Curr Pharm Design. 2012; 18: 5900-19. IF 3.9 doi: 10.1371/journal.pone.0029186. IF 4.092 Neurology Infectious Diseases Huber M, Ledergerber B, Sauter R, Young J, Fehr Gori S, Lucchesi C, Maluccio MR, Morelli N, J, Cusini A, Battegay M, Calmy A, Orasch C, Nicca Maestri M, Bonanni E, Murri L. D, Bernasconi E, Jaccard R, Held L, Weber R. Inter-critical and critical excessive daily sleepiness Outcome of smoking cessation counselling of HIV- in episodic migraine patients. positive persons by HIV care physicians. Neurol Sci. 2012 Oct;33(5):1133-6. HIV Med. 2012 Aug;13(7):387-97. doi: 10.1007/s10072-011-0924-6. IF 1.3 doi: 10.1111/j.1468-1293.2011.00984.x. Neurology IF 3.006 Infectious Diseases Gori S, Lucchesi C, Morelli N, Maestri M, Bonanni E, Murri L. Joerger M, Ferreri AJ, Krähenbühl S, Schellens Sleep-related migraine occurrence increases with JH, Cerny T, Zucca E, Huitema AD. aging. Dosing Algorithm To Target A Predefined AUC In Acta Neurol Belg. 2012 Jun;112(2):183-7. Patients With Primary Central Nervous System doi: 10.1007/s13760-012-0049-6. IF 0.5 Lymphoma Receiving High-Dose Methotrexate. Neurology Br J Clin Pharmacol. 2012 Feb;73(2):240-7. doi: 10.1111/j.1365-2125.2011.04084.x. Guessous I, Dudler V, Glatz N, Theler JM, Zoller O, IF 2.958 Paccaud F, Burnier M, Bochud M; Swiss Survey Oncology on Salt Group. Vitamin D levels and associated factors: a Kallweit U, Hidalgo H, Engel A, Baumann CR, population-based study in Switzerland. Bassetti CL, Dahmen N.

7. Publications in 2012 103 Post H1N1 vaccination narcolepsy-cataplexy with IF 4.941 decreased CSF beta-amyloid. Oncology Sleep Med. 2012 Mar;13(3):323. doi: 10.1016/j.sleep.2011.10.023. IF 3.43 Lava SAG, Simonetti GD, Ramelli GP, Tschumi S, Neurology Bianchetti MG. Symptomatic management of fever among Swiss Klimusina J, Di Valentino M, Menafoglio A, board-certified pediatricians: the results of a Pedrazzini G, Faletra F, von Segesser L, Gallino A. cross-sectional Web-based survey. Unexplained aneurysm involving both ventricles. Clin Ther. 2012 Jan; 34; 250-256. doi: Cardiovascular Medicine. 2012; 15(12); 368- 10.1016/j.clinthera.2011.12.002. IF 2.321 370. IF 0.582 Paediatrics Cardiology Lee JM, Ramos EM, Lee JH, Gillis T, Mysore Klimusina J, Menafoglio A. JS, Hayden MR, Warby SC, Morrison P, Nance A dangerous "notch" M, Ross CA, Margolis RL, Squitieri F, Orobello Cardiovascular Medicine. 2012; 15(6); 208-210. S, di Donato S, Gomez-Tortosa E, Ayuso C, IF 0.582 Suchowersky O, Trent RJ, McCusker E, Novelletto Cardiology A, Frontali M, Jones R, Ashizawa T, Frank S, Saint-Hilaire MH, Hersch SM, Rosas HD, Lucente Klimusina J, Menafoglio A. D, Harrison MB, Zanko A, Abramson RK, Marder A dangerous "spike". Cause or coincidence? K, Sequeiros J, Paulsen JS, Predict-HD study of Cardiovascular Medicine. 2012; 15(11); 331- the Huntington Study Group, Landwehrmeyer GB, 332. IF 0.582 REGISTRY study of the European Huntington`s Cardiology Disease Network, Myers RH, HD-MAPS study group, MacDonald ME, Gusella JF, COHORT study Kwee I, Capello D, Rinaldi A, Rancoita PM, Bhagat of the HSG. G, Greiner TC, Spina M, Gloghini A, Chan WC, CAG repeat expansion in Huntington disease Paulli M, Zucca E, Tirelli U, Carbone A, Gaidano G, determines age at onset in a fully dominant Bertoni F. fashion. Genomic Aberrations Affecting The Outcome Of Neurology. 2012 Aug; 28;79(9):952; author reply Immunodeficiency-Related Diffuse Large B-Cell 952-3. Lymphoma. doi: 10.1212/WNL.0b013e3182697986. IF 8.3 Leuk Lymphoma. 2012 Jan;53(1):71-6. Neurology doi: 10.3109/10428194.2011.607729. IF 2.58 Lemieux F, Lanthier S, Chevrier MC, Gioia L, Oncology Rouleau I, Cereda C*, Nguyen DK* *last co- authorship. Kwee I, Rinaldi A, Rancoita P, Rossi D, Capello D, Insular Ischemic Stroke: Clinical Presentation and Forconi F, Giuliani N, Piva R, Inghirami G, Gaidano Outcome. G, Zucca E, Bertoni F. Cerebrovascular Dis. 2012 Jan;2(1):80-7. Integrated DNA Copy Number And Methylation doi: 10.1159/000343177. IF 2.7 Profiling Of Lymphoid Neoplasms Using A Single Neurology Array. Br J Haematol. 2012 Feb;156(3):354-357. Li ZM, Rinaldi A, Cavalli A, Mensah AA, Ponzoni M, doi: 10.1111/j.1365-2141.2011.08946.x. Gascoyne RD, Bhagat G, Zucca E, Bertoni F.

104 Scientific Report 2012 MYD88 Somatic Mutations In MALT Lymphomas. 899e; author reply 899e. Br J Haematol. 2012 Sep;158(5):662-4. doi: 10.1097/PRS.0b013e31826d9e42. doi: 10.1111/j.1365-2141.2012.09176.x. IF 3.382 IF 4.941 Hand Surgery Oncology Luigetti M, Bartalena T, Pravatà E, Cianfoni A. Longoni N, Kunderfranco P, Pellini S, Albino D, Spontaneous Bilateral Internal Carotid Artery Mello-Grand M, Pinton S, D’Ambrosio G, Sarti M, Dissection Presenting With Right Hemifacial Pain. Sessa F, Chiorino G, Catapano CV and Carbone Headache. 2012 Jul. GM doi: 10.1111/j.1526-4610.2012.02225.x. Aberrant expression of the neuronal-specific IF 2.5 protein DCDC2 promotes malignant phenotypes Neuroradiology and is associated with prostate cancer progression. Luigetti M, Goldsberry GT, Cianfoni A. Oncogene. 2012 Jun;25. Brain MRI in global hypoxia-ischemia: a map of doi:10.1038/onc.2012.245. IF 6.373 selective vulnerability. Oncology Acta Neurol Belg. 2012; 112 (1): 105-7. IF 0.5 Neuroradiology Lübbeke A, Garavaglia G, Rothman KJ, Bonvin A, Roussos C, Miozzari H, Hoffmeyer P. Luigetti M, Sabatelli M, Montano N, Cianfoni A, Statins may reduce femoral osteolysis in patients Fernandez E, Lo Monaco M. with total Hip arthroplasty. Teaching neuroimages: Peroneal intraneural J Orthop Res. 2012 Nov 8. ganglion cyst: a rare cause of drop foot in a child. doi: 10.1002/jor.22262. IF 2.811 Neurology. 2012 Feb 14;78(7):e46-7. Orthopaedics doi: 10.1212/WNL.0b013e318246d6e9. IF 8.3 Lucchesi C, Bonanni E, Maestri M, Siciliano G, Neuroradiology Murri L, Gori S. Evidence of increased restless legs syndrome Manconi M, Ferri R, Zucconi M, Bassetti CL, Fulda occurrence in chronic and highly disabling S, Aricó D, Ferini-Strambi L. migraine. Dissociation of periodic leg movements from Funct Neurol. 2012 Apr-Jun;27(2):91-4. IF 1.5 arousals in restless legs syndrome. Neurology Ann Neurol. 2012 Jun;71(6):834-44. doi: 10.1002/ana.23565. IF 11.1 Lucchina S, Fusetti C, Nistor A. Neurology Arterial grafts are also available locally for hand reconstruction. Manconi M, Ulfberg J, Berger K, Ghorayeb I, J Hand Surg Am. 2012 Jul;37(7):1510; author Wesström J, Fulda S, Allen RP, Pollmächer T. reply 1510-1. doi: 10.1016/j.jhsa.2012.04.031. When gender matters: Restless legs syndrome. IF 1.354 Report of the "RLS and woman" workshop Hand Surgery endorsed by the European RLS Study Group. Sleep Med Rev. 2012 Aug;16(4):297-307. Lucchina S, Fusetti C. doi: 10.1016/j.smrv.2011.08.006. IF 6.931 Revision surgery for failed carpal tunnel release. Neurology Plast Reconstr Surg. 2012 Dec;130(6):898e-

7. Publications in 2012 105 Mancuso M, Bonanni E, LoGerfo A, Orsucci Lymphomas. D, Maestri M, Chico L, DiCoscio E, Fabbrini M, Br J Haematol. 2012 May;157(3):382-4. Siciliano G, Murri L. doi: 10.1111/j.1365-2141.2011.08980.x. Oxidative stress biomarkers in patients with IF 4.941 untreated obstructive sleep apnea syndrome. Oncology Sleep Med. 2012 Jun;13(6):632-6. doi: 10.1016/j.sleep.2011.10.030. IF 3.4 Menzler K, Belke M, Unger MM, Ohletz T, Keil B, Neurology Heverhagen JT, Rosenow F, Mayer G, Oertel WH, Möller JC, Knake S. Mariotti P, Nociti V, Stefanini MC, Cianfoni A, DTI reveals hypothalamic and brainstem white Veltri S, Ferrantini G, Batocchi AP. matter lesions in patients with idiopathic Chronic migraine-like headache caused by a narcolepsy. demyelinating lesion in the brain stem. Sleep Med. 2012 Jun;13(6):736-42. Pain Med. 2012 Apr;13(4):610-2. doi: 10.1016/j.sleep.2012.02.013. IF 3.4 doi: 10.1111/j.1526-4637.2012.01344.x. Neurology IF 2.4 Neuroradiology Merlo A, Zemp D, Zanda E, Rocchi S, Meroni F, Tettamanti M, Recchia A, Lucca U, Quadri P. Martinez A, Ponzoni M, Agostinelli C, Hebeda Postural stability and history of falls in cognitively KM, Matutes E, Peccatori J, Campidelli C, Espinet able older adults: The Canton Ticino study B, Perea G, Acevedo A, Mehrjardi AZ, Martinez- Gait & Posture. 2012 Sep;36(4):662-6. Bernal M, Gelemur M, Zucca E, Pileri S, Campo doi: 10.1016/j.gaitpost.2012.06.016. E, López-Guillermo A, Rozman M; International IF 2.123 Extranodal Lymphoma Study Group. Geriatrics Primary Bone Marrow Lymphoma: An Uncommon Extranodal Presentation Of Aggressive Non- Miranda C, Nucifora M, Molinari F, Conca E, Hodgkin’s Lymphomas. Anania MC, Bordoni A, Saletti P, Mazzucchelli Am J Surg Pathol. 2012 Feb;36(2):296-304. L, Pilotti S, Pierotti MA, Tamborini E, Greco A, doi: 10.1097/PAS.0b013e31823ea106. Frattini M. IF 4.352 KRAS and BRAF mutations predict primary Oncology resistance to imatinib in gastrointestinal stromal tumours. Menafoglio A, Di Valentino M, Segatto J.M, Clin cancer res. 2012 Mar;18(6):1769-76. Siragusa P, Pezzoli R, Maggi M, Romano GA, doi: 10.1158/1078-0432.CCR-11-2230. Moschovitis G, Gallino A. IF 7.742 Cardiovascular screening in young athletes. Oncology Controversies and feasibility. Cardiovascular Medicine 2013;16(1):11–19. Colombo N, Peiretti M, Garbi A, Carinelli S, Marini IF 1.51 C, Sessa C. On behalf of the ESMO Guidelines Cardiology Working Group. Non-epithelial ovarian cancer: ESMO Clinical Mensah AA, Rinaldi A, Ponzoni M, Canzonieri V, Practice Guidelines for diagnosis, treatment and Uccella S, Rossi D, Bhagat G, Gaidano G, Zucca E, follow-up†. Bertoni F. Ann Oncol. 2012; 23(7). IF 6.425 Absence Of NOTCH1 Gene Mutations In MALT Oncology

106 Scientific Report 2012 Neuenschwander H, Gamondi C. Haematology 20 Years Of Experiences From Ticino, Southern Switzerland. Pagani O, Azim HA Jr. Ther Umsch. 2012 Feb;69(2):1:6. Pregnancy after breast cancer: myths and facts. doi: 10.1024/0040-5930/a000264. Breast Care 2012 Jun; 7: 210–4. IF 0.446 IF 0.273 Oncology Palliative Care Pagnamenta A, Rabito G, Arosio A, Perren A, Nicolosi Guidicelli S, Lopez-Guillermo A, Falcone Malacrida R, Barazzoni F, Domenighetti G. U, Conconi A, Christinat A, Rodriguez-Abreu D, Adverse events reporting in adult intensive Grisanti S, Lobetti-Bodoni C, Piffaretti JC, Johnson care units and the impact of a multifaceted PW, Mombelli G, Cerny A, Montserrat E, Cavalli F, intervention on drug-related adverse events. Zucca E.. Ann Intensive Care. 2012;2:10. Hepatitis C Virus And GBV-C Virus Prevalence Intensive Care Medicine Among Patients With B-Cell Lymphoma In Different European Regions: A Case-Control Study Peirano P, Algarin C, Chamorro R, Manconi M, Of The International Extranodal Lymphoma Study Lozoff B, Ferri R. Group. Iron deficiency anemia in infancy exerts longterm Hematol Oncol. 2012 Sep;30(3):137-42. effects on the tibialis anterior motor activity doi: 10.1002/hon.1015. IF 2.475 during sleep in childhood. Oncology Sleep Med. 2012 Sep; 13: 1006-12. doi: 10.1016/j.sleep.2012.05.011. IF 3.4 Nowak M, Möller C, Tackenberg B. Neurology European Huntington’s Disease Network Neurologist-in-training. Pereira-Mestre R, Giannini O, Manzocchi V, Swiss Arch Neurol Psychiatry. 2012;163: 41-2 Bianchetti MG. Neurology Masked hypertension delaying diagnosis in Gordon’s syndrome. Ossenkoppele GJ, Stussi G, Maertens J, van J Hypertens. 2012 Nov;30:2240. Montfort K, Biemond BJ, Breems D, Ferrant A, doi: 10.1097/HJH.0b013e3283580069. Graux C, de Greef GE, Halkes CJ, Hoogendoorn IF 4.021 M, Hollestein RM, Jongen-Lavrencic M, Levin Paediatrics MD, van de Loosdrecht AA, van Marwijk Kooij M, van Norden Y, Pabst T, Schouten HC, Vellenga E, Perren A, Previsdomini M, Bendjelid K. Verhoef GE, de Weerdt O, Wijermans P, Passweg Serum Potassium Levels and Mortality in Acute JR, Löwenberg B. Myocardial Infarction. Addition of bevacizumab to chemotherapy JAMA. 2012 Jan; 307(2):157-64. doi: in acute myeloid leukemia at older age: a 10.1001/jama.2011.1967. IF 30.026 randomized phase 2 trial of the Dutch-Belgian Intensive Care Medicine Cooperative Trial Group for Hemato-Oncology (HOVON) and the Swiss Group for Clinical Cancer Perren A, Previsdomini M, Perren I, Merlani P. Research (SAKK). Critical care nurses inadequately assess SAPS II Blood. 2012 Dec;120(24):4706-11. scores of very ill patients in real life. doi: 10.1182/blood-2012-04-420596. Crit Care Res Pract. 2012 Apr;919106. IF 9.898 doi: 10.1155/2012/919106. IF 1.671

7. Publications in 2012 107 Intensive Care Medicine Should anemia and Iron deficiency be treated in patients with chronic heart failure? Perren A, Previsdomini M, Perren I, Merlani P. Cardiovascular Medicine. 2012;15(4):109-115. High accuracy of the Nine Equivalents of Nursing IF 1.51 Manpower Use Score assessed by critical care Cardiology nurses. Swiss Med Wkly. 2012 Apr;142:w13555. Philip I, Leblanc I, Berroëta C, Mouren S, Chterev doi: 10.4414/smw.2012.13555. IF 1.895 V, Clerici N, Bourel P. Intensive Care Medicine Prise en charge de la fibrillation atriale lors de la période périopératoire. Peruzzo M, Giannini O, Bianchetti MG. Le Praticien en Anesthésie Réanimation. 2012 Measles in a mother and her newborn baby. Nov;16(5):285-295. Arch Dis Child. 2012 Jul;97(7):660. doi:10.1016/j.pratan.2012.04.008. doi: 10.1136/archdischild-2011-301561. Anaesthesiology-Intensive Care Medicine IF 2.881 Paediatrics Pignatti R. Il marcatore somatico è meglio dei neuroni Pesce GA, Klingbiel D, Ribi K, Zouhair A, von Moos specchio? R, Schlaeppi M, Caspar CB, Fischer N, Anchisi S, Riv Ital Ipnosi Clin Sper. 2012;32: 22-5. Peters S, Cathomas R, Bernhard J, Kotrubczik Neurology NM, D'Addario G, Pilop C, Weber DC, Bodis S, Pless M, Mayer M, Stupp R. Pillai SK, Abdel-Mohsen M, Guatelli J, Skasko M, Outcome, quality of life and cognitive function Monto A, Fujimoto K, Yukl S, Green WC, Kovari H, of patients with brain metastases from non- Rauch A, Fellay J, Battegay M, Hirschel B, Witteck small cell lung cancer treated with whole A, Bernasconi E, Ledergerber B, Günthard HF, brain radiotherapy combined with gefitinib or Wong JK and the Swiss HIV Cohort Study. temozolomide. A randomised phase II trial of the Role of retroviral restricion factors in the inferon- Swiss Group for Clinical Cancer Research (SAKK α-mediated suppression of HIV-1 in vistro. 70/03). Proc Natl Acad Sci USA. 2012 Feb Eur J Cancer 2012; 48(3): 377-84. 21;109(8):3035-40. doi: 10.1073/ doi: 10.1016/j.ejca.2011.10.016. Epub 2011 pnas.1111573109. IF 9.681 Nov 15. IF 5.536 Infectious Diseases Radiation Oncology Polito L, Kehoe PG, Davin A, Benussi L, Ghidoni R, Petrausch U, Frauenfelder T, Mueller NJ, Arn K, Binetti G, Quadri P, Lucca U, Tettamanti M, Clerici Stussi G, Schanz U. F, Bagnoli S, Galimberti D, Nacmias B, Sorbi S, Optimised radiological diagnosis of hepatic fungal Guaita A, Scarpini E, Mariani C, Forloni G, Albani D. infection during the treatment of leukemia. The SIRT2 polymorphism rs 10410544 and risk Mycoses. 2012 Sep;55(5):447-53. of Alzheimer's disease in two Caucasian case- doi: 10.1111/j.1439-0507.2012.02172.x. control cohorts. IF 2.247 Alzheimers Dement. 2012 May. [Epub ahead of Haematology print] IF 6.373 Pfister O, Evéquoz D, Mach F, Moschovitis G, Geriatrics Samii K, Waeber G.

108 Scientific Report 2012 Potocnik P, Puig L, Candrian C. Landwehrmeyer GB. Periprosthetic fractures of the proximal femur - Discrepancies in reporting the CAG repeat Vancouver A type fracture. lengths for Huntington’s disease. European Orthopaedics and Traumatology. Epub Eur J Hum Genet. 2012 Jan;20(1):20-6. 2012 Dec. doi: 10.1007/s12570-012-0148-0 doi: 10.1038/ejhg.2011.136. IF 4.4 IF 0.097 Neurology Orthopaedics Regan MM, Leyland-Jones B, Bouzyk M, Pagani O, Previsdomini M, Gini M, Cerutti B, Dolina M, et al. Perren A. CYP2D6 Genotype and Tamoxifen Response Predictors of positive blood cultures in critically ill in Postmenopausal Women with Endocrine- patients: a retrospective evaluation. Responsive Breast Cancer: The Breast Croat Med J. 2012 Feb;53:30-39 IF 1.7960 International Group 1-98 Trial. Intensive Care Medicine J Natl Cancer Inst. 2012 Mar; 104(6): 441-51 IF 13.757 Provenzano C, Ricciardi R, Scuderi F, Maiuri MT, Oncology Maestri M, La Carpia F, Sferrazza A, Marino M, Leone L, Lucchi M, Mussi A, Zollino M, Evoli A, Reni M, Balzano G, Aprile G, Cereda S, Passoni Bartoccioni E. P, Zerbi A, Tronconi MC, Milandri C, Saletti P, PTPN22 and myasthenia gravis: replication in an Rognone A, Fugazza C, Magli A, Di Muzio N, Di Italian population and meta-analysis of literature Carlo V, Villa E. data. Adjuvant PEFG (cisplatin, epirubicin, 5-fluorouracil, Neuromusc Disord. 2012 Feb;22(2):131-8. gemcitabine) or gemcitabine followed by doi: 10.1016/j.nmd.2011.09.003. IF 2.8 chemoradiation in pancreatic cancer: a Neurology randomized phase II trial. Ann Surg Oncol. 2012 Jul;19(7):2256-63. Putaala J, Yesilot N, Waje-Andreasson U, doi: 10.1245/s10434-011-2205-2. IF 4.166 Vassilopoulou S, Odier C, Hofgart G, Engelter S, Oncology Burow A, Mihalka L, Kloss M, Ferrari J, Lemmens R, Coban O, Haapaniemi E, Maaijwee NAAM, Renner C, Zinzani PL, Gressin R, Klingbiel D, Rutten-Jacobs LCA, Bersano A, Cereda C, Baron Dietrich PY, Hitz F, Bargetzi M, Mingrone W, P, Borellini L, Valcarenghi C, Grau AJ, Palm F, Martinelli G, Trojan A, Bouabdallah K, Lohri A, Urbanek C, Tuncay R, Durukan A, van Dijk EJ, de Gyan E, Biaggi C, Cogliatti S, Bertoni F, Ghielmini Leeuw FE, Thijs V, Greisenegger S, Vemmos K, M, Brauchli P, Ketterer N. Swiss SAKK and Lichy C, Bereczki D, Csiba L, Michel P, Spengos K, French GOELAMS group from European Mantle Naess H, Bahar SZ, Tatlisumak T. Cell Lymphoma Network. Comparison of risk factors and etiology of A multicenter phase II trial (SAKK 36/06) of first-ever ischemic stroke in the young between single-agent everolimus (RAD001) in patients geographic regions in Europe: the 15-cities young with relapsed or refractory mantle cell lymphoma. stroke study. Haematologica. 2012 Jul;97(7):1085-91. Stroke. 2012 Oct;43(10):2624-30. IF 5.7 doi: 10.3324/haematol.2011.053173. IF 4.941 Neurology Oncology

Quarrell OW, Handley O, O’Donovan K, Dumoulin Ribi K, Aldridge J, Phillips KA, Thompson A, Harvey K, Ramos-Arroyo M, Biunno I, Bauer P, Kline M, V, Thürlimann B, Cardoso F, Pagani O, et al.

7. Publications in 2012 109 Subjective cognitive complaints one year after Eur J Paediatr Neurol. 2012 Nov;16:683-687. ceasing adjuvant endocrine treatment for early- IF 2.123 stage breast cancer. Paediatrics Br J Cancer 2012 May; 106(10): 1618-25. IF 5.042 Salvadè I, Domenighetti G, Maggiorini M, Rothen Oncology HU, Jolliet PH. Perception of non-invasive ventilation in adult Ribrag V, Caballero D, Fermé C, Zucca E, Arranz Swiss intensive Care Units. R, Briones J, Gisselbrecht C, Salles G, Gianni AM, Swiss Med Wkly. 2012 Apr;142:w13551. Gomez H, Kahatt C, Corrado C, Szyldergemajn S, doi: 10.4414/smw.2012.13551. IF 1.895 Extremera S, de Miguel B, Cullell-Young M, Cavalli F. Intensive Care Medicine Multicenter Phase II Study Of Plitidepsin In Patients With Relapsed/Refractory Non- Salvaterra E, Giorda R, Bassi MT, Borgatti R, Hodgkin's Lymphoma Knudsen LE, Martinuzzi A, Nobile M, Pozzoli U, Haematologica. 2013 Mar;98(3):357-63. Ramelli GP, Reni GL, Rivolta D, Stazi MA, Strazzer doi: 10.3324/haematol.2012.069757. S, Thijs C, Toccaceli V, Trabacca A, Turconi AC, IF 6.424 Zanini S, Zucca C, Bresolin N, Lenzi L, on behalf of Oncology the Pediatric Biobank ELSI Working Group. Pediatric biobanking: a pilot qualitative survey of Rocchi A, Mazzoni M, Bertolozzi G, Milani G, practices, rules, and researcher opinions in ten Napolitano L, Colli A, Rizzuti T, Bianchetti MG, European countries. Plebani A, Laicini E, Fossali E. Biopreservation and Biobank. 2012 Feb;10(1);29- Atypical onset and course in a child with fulminant 36. IF 1.294 myocarditis. Paediatrics Minerva Pediatr. 2012 Aug;64(4):447-450. Paediatrics Saporito A, Sturini E, Petri GJ, Borgeat A, Aguirre J. Case report: unusual complication during Rosell R, Wannesson L. outpatient continuous regional popliteal analgesia. A genetic snapshot of small cell lung cancer. Can J Anesth. 2012 Oct;59(10):958-62. Cancer Discov. 2012 Sep;2(9):769-71. IF 2.346 doi: 10.1158/2159-8290.CD-12-0346. Anaesthesiology Oncology Scherrer AU, Ledergerber B, von Wyll V, Böni J, Rossi A, Rossi T, Bertini M, Caccia G. Yerly S, Klimkait T, Cellerai C, Furrer H, Calmy A, The use of Lactobacillus rhamnosus in therapy of Cavassini M, Elzi L, Vernazza PL, Bernasconi E, bacterial vaginosi. Evaluation of clinical efficacy in Günthard HF; Swiss HIV Cohort Study. a population of 40 women treated for 24 months. Minor protease inhibitor mutations at baseline do Arch Gnecol Obstet. 2010;281(6):1065-9. not increase the risk for a virological failure in HIV- IF 1.277 1 subtype B infected patients. Gynaecology PloS One. 2012;7(6):e37983. doi: 10.1371/journal.pone.0037983. IF 4.092 Salmina C, Taddeo I, Falesi M, Weber P, Infective Diseases Bianchetti MG, Ramelli GP. Paroxysmal tonic upgaze in normal children: a Schmidhauser T, Azzola A. case series and a review of the literature. Images in clinical medicine. Lichtenberg figures.

110 Scientific Report 2012 N Engl J Med. 2011 Dec 29;365(26):e49. the Swiss HIV Cohort Study. IF 53.298 Longer term clinical and virological outcome of Pneumology Sub-Saharan African participants on antiretroviral treatment in the Swiss HIV Cohort Study. Schumacher A, Jacomella V, Stüssi G, Amann- J Acquir Immune Defic Syndr. 2012 Vesti B, Corti N, Marc Husmann A. Jan;59(1):79-85. doi: 10.1097/ Castleman's disease and arterial thrombosis: QAI.0b013e318236be70. IF 4.425 result of excessively elevated interleukin-6 plasma Infectious Diseases level? Vasa. 2012 Mar;41(2):145-8. Stamelou M, Dohmann H, Brebbermann J, Boura doi: 10.1024/0301-1526/a000178. IF 1.308 E, Oertel WH, Höglinger G, Möller JC, Mylius V. Haematology Clinical pain and experimental pain sensitivity in progressive supranuclear palsy. Sidler JA, Filges I, Boesch N, Ramelli GP, Parkinsonism Rel Disord. 2012 Jun;18(5):606-8. Röthlisberger B, Huber AR, Tercanli S, Bronz L, doi: 10.1016/j.parkreldis.2011.11.010. IF 3.8 Miny P, Heinimann K. Neurology TRPS1 codon 952 constitutes a mutational hot spot in trichorhinophalangeal syndrome type I and Stathis, Ghielmini M. could be associated with intellectual disability. New Agents For The Treatment Of Lymphoma. Clin Dysmorphol. 2012 Apr;21:87-90. IF 0.543 Ann Oncol. 2012 Sep;23(10):92-8. IF 6.425 Paediatrics Oncology

Simonetti GD, Bucher BS, Tschumi S, Lava SAG, Stussi G, Tsakiris DA. Bianchetti MG. Late effects on haemostasis after haematopoietic Arterial hypertension and proteinuria in pediatric stem cell transplantation. chronic kidney disease. Haemostasiologie. 2012;32(1):63-6. Minerva Pediatr. 2012 Apr;64:171-182. doi: 10.5482/ha-1184. IF 1.19 Paediatrics Haematology

Simonetti GD, Mohaupt MG, Bianchetti MG. Subramanian S, Srinivas C, Ramalingam K, Monogenic forms of hypertension. Babaiah M, Swamy ST, Arun G, Kathirvel M, Ashok Eur J Pediatr. 2012; 171; 1433-1439. IF 1.879 S, Clivio A, Fogliata A, Nicolini G, Rao KS, Reddy Paediatrics TP, Amit J, Vanetti E, Cozzi L. Volumetric Modulated Arc-Based Stacchiotti S, Longhi A, Ferraresi V, Grignani G, Hypofractionated Stereotactic Radiotherapy Comandone A, Stupp R, Bertuzzi A, Tamborini For The Treatment Of Selected Intracranial E, Pilotti S, Messina A, Spreafico C, Gronchi A, Arteriovenous Malformations: Dosimetric Report Amore P, Vinaccia V, Casali PG. And Early Clinical Experience. Phase II study of imatinib in advanced chordoma. Int J Radiat Oncol Biol Phys. 2012; Mar 1; 82(3); J Clin Oncol. 2012 Mar;30(9):914-20. 1278-1284. IF 4.503 doi: 10.1200/JCO.2011.35.3656. IF 18.372 Radiation Oncology Oncology Synofzik M, Ronchi D, Keskin I, Basak AN, Wilhelm Staehelin C, Keiser O, Calmy A, Weber R, Elzi L, C, Gobbi C, Birve A, Biskup S, Zecca C, Fernández- Cavassini M, Schmid P, Bernasconi E, Furrer H; Santiago R, Kaugesaar T, Schöls L, Marklund SL,

7. Publications in 2012 111 Andersen PM. DD, Crescenzi A, Valabrega S, Giovanella L. Mutant superoxide dismutase-1 indistinguishable Medullary thyroid nodules by measurement of from wild type causes ALS. calcitonin (ct) in aspiration needle washout in Hum Mol Genet. 2012 Aug 15;21(16):3568-74. patients with multinodular goiter and moderately doi: 10.1093/hmg/dds188. IF 7.6 elevated serum ct. Neurology Exp Clin Endocrinol Metab. 2012 Apr;120(4):234- 7. doi: 10.1055/s-0031-1291344. Thakkar RS, Del Grande F, Thawait GK, Andreisek Nuclear Medicine G, Carrino JA, Chhabra A. Spectrum of high-resolution MRI findings in Trueb L, Lepori M, Duplain H, Scherrer U, Sartori C. diabetic neuropathy. Nitric oxide mediates the blood pressure AJR Am J Roentgenol 2012 Aug; 199(2): 407- response to mental stress in humans. 12. IF 2.775 Swiss Med Wkly. 2012 Jul;142:13627. Radiology doi: 10.4414/smw.2012.13627. IF 1.895 Emergency Medicine Thieblemont C, Davi F, Noguera ME, Brière J, Bertoni F, Zucca E, Traverse-Glehen A, Felman P, Tubaro A, Puccini F, De Nunzio C, Digesu GA, Berger F, Salles G, Coiffier B. Elneil S, Gobbi C, Khullar V. Splenic Marginal Zone Lymphoma: Current The treatment of lower urinary tract symptoms Knowledge And Future Directions. in patients with multiple sclerosis: a systematic Oncology (Williston Park). 2012 Feb;26(2):194- review. 202. Curr Urol Rep. 2012 Oct;13(5):335-42. Oncology doi: 10.1007/s11934-012-0266-9. Neurology Thierfelder C, Weber R, Elzi L, Furrer H, Cavassini M. Calmy A, Bernasconi E, Gutmann C, Van Den Berg J, Waser S, Trelle S, Diehm N, Ledergerber B, Swiss HIV Cohort Study Group. Baumgartner I. Partecipation, characteristics and retention Lesion characteristics of patients with chronic rates of HIV-positive immigrants in the Swiss HIV critical limb ischemia that determine choice of Cohort Study. treatment modality. HIV Med. 2012 Feb;13(2):118-26. J Cardiovasc Surg. 2012 Feb;53(1):45-52. doi: 10.1111/j.1468-1293.2011.00949.x. IF 1.559 IF 3.006 Interventional Radiology Infectious Diseases Van Den Berg JC, Pedrotti M, Canevascini R, Treglia G, Rufini V, Salvatori M, Giordano A, Chimchila Chevili S, Giovannacci L, Rosso R. Giovanella L. Endovascular treatment of in-stent restenosis Pet imaging in recurrent medullary thyroid using excimer laser angioplasty and drug eluting carcinoma. balloons. Int J Mol Imaging . 2012 Dic;53(12):1863-71. J Cardiovasc surg. 2012 Apr;53(2):215-22. doi: 10.2967/jnumed.112.105940. IF 1.559 IF 1.573 Interventional Radiology Nuclear Medicine Van Den Berg JC. Trimboli P, Nigri G, Romanelli F, Cicciarella Modica Type II endoleaks: still the crux of EVAR?

112 Scientific Report 2012 Journal of Endovascular Therapy. doi: 10.1093/cid/cir728. IF 9.154 2012Apr;19(2):209-12. Infectious Diseases doi: 10.1583/11-3653C.1. IF 2.856 Interventional Radiology Wyttenbach R, Médioni N, Santini P, Vock P, Szucs-Farkas Z. Verburg FA, Grelle I, Giovanella L, Reiners C. Extracardiac findings detected by cardiac Evaluation of the brahms kryptor thyroglobulin magnetic resonance imaging. "mini-recovery" test in thyroid healthy subjects. Eur Radiol. 2012 Jun;22(6);1295-302. Horm Metab Res. 2012 Jun;44(7):555-7. doi: 10.1007/s00330-011-2369-y. IF 3.222 doi: 10.1055/s-0032-1314804. IF 2.188 Radiology Nuclear Medicine Young J, Schäfer J, Fux C.A, Furrer H, Bernasconi Vinai P, Ferri R, Ferini-Strambi L, Cardetti S, Anelli E, Vernazza P, Calmy A, Cavassini M, Weber R, M, Vallauri P, Ferrato N, Zucconi M, Carpegna G, Battegay M, Bucher HC, the Swiss HIV Cohort Manconi M. Study. Defining the borders between Sleep-Related Renal function in patients with HIV starting Eating Disorder and Night Eating Syndrome. therapy with tenofovir and either efavirenz, Sleep Med. 2012 Jun;13(6):686-90. lopinavir or atazanavir. doi: 10.1016/j.sleep.2011.11.017. IF 3.4 AIDS. 2012 Mar;26(5):567-75. Neurology doi: 10.1097/QAD.0b013e32834f337c. IF 6.245 Wahrmann M, Schiemann M, Marinova L, Infectious Diseases Körmöczi GF, Derfler K, Fehr T, Stussi G, Böhmig GA. Zaman K, Thürlimann B, Huober J, Anti-A/B antibody depletion by semiselective Schönenberger A, Pagani O, Lüthi J, Simcock M, versus ABO blood group-specific Giobbie-Hurder A, Berthod G, Genton C, Brauchli immunoadsorption. P, Aebi S, Swiss Group For Clinical Cancer Nephrol Dial Transplant. 2012 May;27(5):2122- Research (SAKK). 9. doi: 10.1093/ndt/gfr610. IF 3.396 Bone Mineral Density In Breast Cancer Patients Haematology Treated With Adjuvant Letrozole, Tamoxifen, Or Sequences Of Letrozole And Tamoxifen In The BIG Weibel M, Ossola N. 1-98 Study (SAKK 21/07). To start eating again could be dangerous. Ann Oncol. 2012 Jun;23(6):1474-81. Praxis. 2012 Jan;101(1):55-8. doi: 10.1093/annonc/mdr448. IF 6.452 doi: 10.1024/1661-8157/a000810 Oncology Internal Medicine Zappa F, Droege C, Betticher D, von Moos Wyl V, Yerly S, Böni J, Shah C, Cellerai C, Klimkait R, Bubendorf L, Ochsenbein A, Gautschi O, T, Battegay M, Bernasconi E, Cavassini M, OppligerLeibundgut E, Froesch P, Stahel R, Furrer H, Hirschel B, Vernazza P, Ledergerber B, Hess T, Rauch D, Schmid P, Mayer M, Crowe Günthard HF; and the Swiss HIV Cohort Study. S, Brauchli P, Ribi K, Pless M. Swiss Group for Incidence of HIV-1 drug resistance among Clinical Cancer Research (SAKK). antiretroviral treatment-naïve individuals starting Bevacizumab and erlotinib (BE) first-line therapy modern therapy combinations. in advanced non-squamous non-small-cell lung Clin Infect Dis.2012 Jan;54(1):131-40. cancer (NSCLC) (stage IIIB/IV) followed by

7. Publications in 2012 113 platinum-based chemotherapy (CT) at disease Paediatrics progression: a multicenter phase II trial (SAKK 19/05). Publications in non-peer-reviewed journals Lung Cancer. 2012 Dec;78(3):239-44. doi: 10.1016/j.lungcan.2012.08.017. Balestra B. IF 3.434 Gamba Gonfia: l'occhio clinico e quello Oncology strumentale. Tribuna Medica Ticinese, Sezione scientifica, Zavalko I, Bassetti CL, Cianfoni A, Carugati J, Il caso clinico in 1000 parole. 2012. Fulda S, Manconi M. Internal Medicine Hypersomnia due to bilateral thalamic lesions: unexpected response to modafinil. Bianchi M, Columpsi P, Davitti V, Prandi R, Eur J Neurol. 2012 Nov;19(11):e125-6. Trupiano I, Pedrazzoli-Hutz C, Tosi-Casado S, doi: 10.1111/j.1468-1331.2012.03835.x. IF 3.7 Zanon M, Pedrazzani C, Valcarenghi D. Neurology I cateteri venosi centrali ad impianto periferico: un'opportunità per lo sviluppo delle cure Zecca C, Cereda C, Wetzel S, Tschuor S, Staedler infermieristiche. C, Santini F, Nadarajah N, Bassetti CL, Gobbi C. Onkologiepflege Soins en oncologie. 2012;3:23-24. Diffusion-weighted imaging in acute demyelinating Nursing Medicine myelopathy. Neuroradiology. 2012 Jun;54(6):573-8. Bianchi M, Valcarenghi D. doi: 10.1007/s00234-011-0907-6. IF 2.8 Establishing a PICC (Peripherally Inserted Central Neurology Catheters) Team at the Oncology Institute of Southern Switzerland - an opportunity for Zecca C, Cereda C, Wetzel S, Tschuor S, Staedler patients, nurses and health service. C, Santini F, Nadarajah N, Bassetti CL, Gobbi C. Schweizer Krebsbulletin. 2012;3:226-228. Diffusion-weighted imaging in acute demyelinating Nursing Medicine myelopathy. Neuroradiology. 2012 Jun;54(6):573-8. Bianchi V, Spitale A, Mazzucchelli L, Bordoni A and doi: 10.1007/s00234-011-0907-6. IF 2.824 the QC Working Group. Neurology Quality Indicators of Clinical Cancer Care (QC) in the territory of Canton Ticino: a population-based Zecca C, Yawalkar N, Gobbi C. study. Improvement of interferon-beta related skin Bulletin Suisse du Cancer. 2012; 205 – 208. reactions after diluent halving: first experience of Nursing Medicine five patients. Pat Pref Adher. 2012;6:565-7. Carzo A, Manelli A, Oliveira M, Schiavone N, doi: 10.2147/PPA.S33727. IF 1.1 Prigione G, Cipolli A, et al. Neurology Analisi dell'equilibrio con pedana di forza dopo trattamento propriocettivo della colonna Zgraggen L, Faré PB, Lava SAG, Simonetti GD, vertebrale. Fossali EF, Amoruso C, Bianchetti MG. La Riabilitazione, Rivista di Medicina Fisica e Palatability of crushed ß-blockers, converting Riabilitazione, Organo Ufficiale dell'unione Europea enzyme inhibitors and thiazides di Medicina Manuale: UEMMA, 2012. J Clin Pharm Ther. 2012 Oct;37:544-546. IF 1.57 Rehabilitation

114 Scientific Report 2012 Fratila C, Moschovitis G Schönholzer C, Violetti E, Pianca S, Van Den Berg Aktuelles aus der Kardiologie: herzinsuffizienz. JC. Neuigekeiten zur Herzinsuffizienz. Angioplastica e posizionamento di uno stent VSAO Journal ASMAC No.6, December 2012. possono tuttora essere la migliore terapia di una Cardiology stenosi aterosclerotica dell'arteria renale. Tribuna Medica Ticinese. 2012;77(2):63-65. Froesch P, Peters S, Gautschi O. Nephrology Multimodale und individualisierteTherapie. Thorax- Onkologie. Zecca C, Gobbi C. Schweiz Medizin Forum. 2012 May. Studi comparativi randomizzati tra le terapie di Oncology primo livello della sclerosi multipla. Tribuna Medica Ticinese. 2012;4:437. Giannini O, Balestra B, Selmoni G. Neurology Die Kultur der Organisationsverbesserung in einer Abteilung für Innere Medizin. Zecca C, Gobbi C. Schweiz Aerztezeitung. 2012;93:36-40. Trattamento analgesico dell’emicrania. Managing Tribuna Medica Ticinese. 2012;4:431. Neurology Lepori M, Tobia M. Patients who "leave without being seen" the Medical conference abstracts Emergency Department: the role of a fastrack way (Notfallpraxis). Arigoni M. Annual Congress of the Dutch Society Notfallpraxis (Swiss Medical Forum). 2012; of Traumatology. November 1-2, 2012. 42(59):47s. Trauma Care in Switzerland. Emergency Medicine Surgery

Melchiorre-Mayer P., Moschovitis G. Azinwi NC, Fanti P, Martucci F, Pittoni P, Richetti Cuore e batticuore e…poetica dell’extrasistole. A, Valli MC, Pesce G. Farmacie, SpazioSalute, attualità e benessere. XVI SASRO Annual Meeting 2012 La rivista delle 24 farmacie Spazio Salute. Accuracy evaluation in IGRT/RAPIDARC for brain March 2012 metastases (BM). Cardiology Radiation Oncology

Regusci L, Ossola N, Castelnuovo M, Fasolini F. Bedard P, Tabernero J, Kurzrock R, Britten Constipation? Non tuberculose rénale. C, Stathis A, Perez-Garcia JM, Zubel A, Le Schweiz Med Forum. 2012;12(16):338-339. NT, Carter K, Bellew KM, Gallarati C, Niazi F, Internal Medicine Demanse D, De Buck S, Sessa C. ASCO Annual Meeting. Chicago, Illinois, June 1-5, 2012. Saporito A, Sturini E, Petri GJ, Borgeat A, Aguirre J. A phase lb, open-label, multi-center, dose- Outpatient continuous Regional l l l analgesia escalation study of the oral pan-PI3K inhibitor after orthopaedic foot surgery: economical BKM120 in combination with the oral MEK1/2 considerations. inhibitor GSK1120212 in patients (pts) with Schweiz Med Forum. 2012; 12(59) selected advanced solid tumours. Anaesthesiology Journal of Clinical Oncology, 2012 ASCO Annual Meeting Proceedings (Post-Meeting Edition).

7. Publications in 2012 115 Vol 30, No 15_suppl (May 20 Supplement), Annual Meeting of the American Society of Spine 2012: 3003 Radiology. Miami, February 2012. Oncology Percutaneous treatment of vertebral compression fracture and lumbar stenosis. Bender-Rizzuti N, Ghisletta-Facchin N. Neuroradiology Congress de l'ASI 2012 - "L'univers des soins infermiers". Interlaken, May 9-11, 2012. Britten CD, Wainberg ZA, Tabernero J, Maqueda L'infermière coordinatrice en rèadaptation MA, Leong S, Sessa C, Millham R, Gallo J, Siu L, oncologique. Brana I. Nursing Medicine The 24th EORTIC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics. 6th Bianchi M, Broggini L, Pedrazzoli-Hutz C, Tosi- November 2012. Casado S, Valcarenghi D. A three-arm phase I dose-escalation study of the 1) 2a Giornata Ricerca Clinica della Svizzera safety, pharmacokinetics, and pharmacodynamics Italiana, abstract No. 46, Bellinzona , 23rd of the dual PI3K/mTOR inhibitors PF-04691502 March 2012; (oral) and PF-05212384 (IV) in combination with 2) 2° Congresso Infermieristico EOC - "Infermieri the MEK inhibitor PD-0325901 or irinotecan in EOC: co-protagonisti nel sistema sanitario che patients with advanced cancer. cambia". Lugano, 9th May 2012. Oncology L'inserimento di un programma di arte-terapia per pazienti ricoverati allo IOSI: uno studio pilota. Brunetti S, Fusetti C. Nursing Medicine 13th European congress of Trauma & Emergency Surgery. Basel, May 12-15, 2012. Bianchi M, Valcarenghi D. MMS and wrist fracture classification. Analysis of 7a Conferenza Nazionale GIMBE. Bologna inter and intraobserver agreement. (abstract No. 23), 17th February 2012. Hand Surgery La costituzione di una rete di referenti per la ricerca infermieristica e l’evidence-based practise Brunetti S, Fusetti C. all'Oncology Institute of Southern Switzerland (the Combined Meeting of the ASSH and AHSS. Koloa IOSI). Kanai, Hawaii, March 22-25, 2012. Nursing Medicine Inter-and intraobserver agreement in wrist fracture classification using MMS. A prospective Bianchi M; Pedrazzani C, Valcarenghi D. study. 1) 2a Giornata Ricerca Clinica della Svizzera Hand Surgery Italiana, abstract No. 18, Bellinzona, 23rd March 2012; Brunetti S, Fusetti C. 2) 2° Congresso Infermieristico EOC - "Infermieri Congrès SFCM-GEM. Paris, December 2012. EOC: co-protagonisti nel sistema sanitario che L'information médicale sur internet: patients et cambia". Lugano, 9th May 2012. tunnel carpien. Le esigenze e le proposte degli infermieri Hand Surgery dell'Oncology Institute of Southern Switzerland rispetto all’EBP: presentazione di alcuni risultati. Cafarotti S, Giuliani M, Matarelli E, Karoubi G, Nursing Medicine Carboni G, Dutly AE. Congresso Nazionale Italiano della FONICAP - Bonaldi G, Cianfoni A. Forza operativa nazionale contro il cancro del

116 Scientific Report 2012 polmone. Verona, November 2012. Roma, May 2012. È fattibile la resezione cuneiforme toracoscopica Sessione spinale: Diagnostica per immagini – ambulatoriale? Quale e perché. Surgery Radiology

Cafarotti S, Matarelli E, Giuliani M, Karoubi G, Cereda C, Tamisier R, Andreotti J, Bassetti C. Carboni G, Dutly AE. Congresso Nazionale Italiano Annual Meeting of the American Accademy of della FONICAP - Forza operativa nazionale contro Neurology. New Orleans, April 2012. il cancro del polmone. Verona, November 2012. Endothelial Dysfunction and Arterial Stiffness in Verona, November 2012. Ischemic Stroke: the role of Sleep Disordered Studio di fattibilità nell’utilizzo della sutura ePTFE Breathing. nella sleeve lobectomy. Neurology Surgery Ceriani L, Zucca E, Zinzani PL, Ferreri AJM, Vitolo Candrian C. U, Stelitano C, et al. 99e Congrès annuel de la Société Suisse de ASH. Atlanta, December 8-11, 2012. Chirurgie. June 20-22, 2012. Role of positron emission tomography (PET/ Moderazione: Pharmacological blocking of CT) in primary mediastinal large B cell lymphoma osteoclastic biocorrosion of surgical stainless (PMLBCL): preliminary results of an international steel in vitro Infection / Immunity. phase II trial (IELSG-26 study) conducted on behalf Surgery of the International Extranodal Lymphoma Study Group (IELSG), the Fondazione Italiana Linfomi Canevascini L, Radiation Oncology Unit, Palliative (FIL) and the UK NCRI Lymphoma Group. Care Unit, Pedrazzoli C, Bianchi M. Nuclear Medicine/Oncology 2° Congresso Infermieristico EOC - "Infermieri EOC: cooprotagonisti nel sistema sanitario che Chappuis A, Glatz N, Suter P, Conen D, Erne P, cambia". Lugano, 9 May 2012. Binet I, et al. Annual Meeting of the Swiss Society L'autodeterminazione nella cura: la creazione di of Nephrology. una visione condivisa attraverso la conoscenza Zurich, December 2012. delle direttive anticipate. Sex differences in dietary patterns associated Nursing Medicine with salt intake at the population level. Internal Medicine Carbone GM, Longoni N, Mello-Grand G, Sarti M, Pinton S, Dellavalle C, Chiorino G, Catapano CV. Christoforidis D, Rosso R. An American Association for Cancer Research 99e Congrès annuel de la Société Suisse de (AACR) Special Conference - Advances in prostate Chirurgie. June 20-22, 2012. cancer research. Orlando (FL, USA), February 6-9, Séance de vidéos Invitation I. Single incision 2012. sigmoidectomy from the right iliac fossa. The ETS transcription factor ESE1 promotes Surgery activation of the NFKB pathway in prostate tumours. Christoforidis D. Oncology 13th International Colorectal Forum. Verbier, January 29-31, 2012. Cartolari R. Moderazione: Organizer and Chairman II Congresso Nazionale SNO. of the video session "Rectal prolapse and

7. Publications in 2012 117 intususception". Moderazione: Visite de l’exposition de posters. Surgery Chirurgie viscérale. Surgery Christoforidis D. 13th International Colorectal Forum. Verbier, Ja- Christoforidis D. nuary 29-31, 2012. 99e Congrès annuel de la Société Suisse de (Bio) LIFT technique: indications, tips and tricks. Chirurgie. June 20-22, 2012. Surgery Moderazione: Chirurgie viscérale - Communications libres. Colo-Proctology. Christoforidis D. Surgery 7th annual meeting of the European Society of Coloproctology (ESCP). Wien, September 27-28, Christoforidis D. 2012. Simposio primaverile di Chirurgia. The Regional Novel approaches for the treatment of anal Hospital of Lugano, 21st May 2012. fistulas. L’incontinenza fecale. Surgery Surgery

Christoforidis D. Christoforidis D. 7th annual meeting of the European Society of The DreiländertagungfürminiinvasiveChirugie. Coloproctology (ESCP). Wien, September 27-28, 2012 September 27-28. 2012. Is laparoscopy the new standard for colon cancer Ileocecal Crohn’s disease. resection? Surgery Surgery

Christoforidis D. Cianfoni A, Weininger M, Mills JC, Rumboldt Z, 7th Mendrisio Medical Meeting. 10th May 2012. Bonaldi G, Huda W. Moderazione: Chairman for the session European Congress of Radiology. Wien, March "Chirurgia". 2012. Surgery Accuracy of CT-guidance for Lumbar Facet Blocks. Christoforidis D. Neuroradiology 7° Simposio Ticinese di Nutrizione Clinica, The Regional Hospital of Lugano, 16th October 2012. Colla M, Del Torso M, Pesenti C, Walther Veri S. Progetto ERAS - The Regional Hospital of Lugano. 2° Congresso Infermieristico EOC - "Infermieri Surgery EOC: co-protagonisti nel sistema sanitario che cambia". Lugano, 9th May 2012. Christoforidis D. La consulenza infermieristica in Cure Palliative: 9° Symposium César Roux. CHUV, Lausanne, cosa possiamo fare per voi? 23rd November 2012. Nursing Medicine –Palliative Care Quoi de neuf en chirurgie des stomies. Surgery Cristaudi A, Matthey-Gié ML, Demartines N, Christoforidis D. Christoforidis D. 99e Congrès annuel de la Société Suisse de 99e Congrès annuel de la Société Suisse de Chirurgie. 2012 June 20-22. Chirurgie. June 20-22, 2012. Is it really worth the effort to renounce to 5mm

118 Scientific Report 2012 trocars? selected for publication in Radiographics. Surgery Radiology

De Spirito D. Del Grande F, Tatizawa-Shiga N , Chalian M, Fayad SGH-/SGHR-Kongress. November 8-9, 2012. LM. SSR. Miami, 2012. Muscle-in-vein tubulization for a 3.5 cm nerve Is contrast-enhanced MRI required to evaluate reconstruction in the palm. A case report. the extent of a bone tumour? Surgery Radiology

Del Conte G, Bahleda R, Moreno V, Damian S, Dessi K, Engelberger S, Rosso R, Van Den Berg Perotti A, Lassau N, Farace F, Ong M, Stimpson JC, Giovannacci L. SJ, Tunariu N, Micallef S, Demers B, Oprea C, 13° Congrès de l’union des sociétés suisse des Capri G, Soria JC, Sessa C, Molife R. ASCO Annual maladies vasculaires. November 21-23, 2012. Meeting. Chicago, Illinois, June 1-5, 2012. Endoleak type II after open abdominal aortic A phase I study of ombrabulin (O) combined with aneurysm repair. bevacizumab (B) in patients with advanced solid Surgery tumours (NCT01193595). Journal of Clinical Oncology, 2012 ASCO Annual Dessi K, Engelberger S, Van Den Berg JC, Rosso Meeting Proceedings (Post-Meeting Edition). Vol R, Giovannacci L. 30, Nr. 15_suppl (May 20 Supplement), 2012: 99e Congrès annuel de la Société Suisse de 3080 Chirurgie. June 20-22, 2012. Oncology Endoleak type II after open abdominal aortic aneurysm repair. Del Grande F, Carrino JA, Chaabra A. RSNA. Surgery Chicago, 2012 Spectrum of Elbow Injuries in Baseball Pitchers: 3 Di Valentino M, Siragusa P, Maggi M, Romano GA, Tesla MRI imaging. Pezzoli R, Moschovitis G, Gallino A, Menafoglio A. Radiology European Congress of Preventive Cardiology EuroPRevent. Dublin, May 3-5, 2012. Del Grande F, Carrino JA. RSNA. Chicago, 2012. Infero-lateral early repolarisation in young 3 Tesla MRI imaging of the elbow in athletes: prevalence and electrocardiographic asymptomatic professional baseball pitchers. phenotypes. Radiology European Journal of Preventive Cardiology. 2012;19(Supplement1):S49. Del Grande F, Chhabra A, Chalian M, eng J, Cardiology Carrino JA. RSNA. Chicago, 2012. Diagnostic Performance and Interobserver Di Valentino M, Siragusa P, Maggi M, Romano GA, Reliability of Pelvic MR Neurography for Femoral Pezzoli R, Moschovitis G, et al. Neuropathy. SGK annual conference. Lausanne, June 13-15, Radiology 2012. Prevalence and characteristics of early Del Grande F, Santini F, Herzka D, Carrino JA. repolarisation in young female athletes. RSNA. Chicago, 2012. Cardiovascular Medicine. Fat suppression techniques on 3 Tesla MRI in 2012;15(5):Suppl21:39S. musculoskeletal system. Certificate of Merit Cardiology

7. Publications in 2012 119 Di Valentino M, Siragusa P, Maggi M, Romano GA, Droeser R.D, Hirt C, Eppenberger-Castori S, Pezzoli R, Moschovitis G, Gallino A, Menafoglio A. Zlobec I, Viehl C.T, Zuber M. European Society Cardiology meeting. Munich, International Falk Symposium. February 10-11, August 25-29, 2012. 2012. Early repolarisation in young athletes: High myeloperoxidase positive cell density in electrocardiographic characteristics and colorectal cancer is an independent favorable prevalence of "risky" phenotype. prognostic factor - Carcinogenesis, prevention Eur Heart J. 2012;33(suppl1):P1759. and treatment of colorectal cancer - State of the Cardiology art 2012. Surgery Di Valentino M, Siragusa P, Maggi M, Romano GA, Pezzoli R, Moschovitis G, Gallino A, Menafoglio A. Gabutti L, Meier P, Schwarzkopf AK, Zaruba J, European Society Cardiology meeting. Munich, Ambühl P. Annual Meeting of the Swiss Society of August 25-29, 2012. Nephrology. Electrocardiograms in young athletes: Zurich, December 2012. characteristics and prevalence of abnormalities. Comparison of Hb events (decreases >1g/dl) in a Eur Heart J. 2012; 33(suppl1):1755. hemodialysis patient population - Final analysis of Cardiology the Swiss MOTION Survey. Internal Medicine Di Valentino M, Siragusa P, Maggi M, Romano GA, Pezzoli R, Moschovitis G, Gallino A, Menafoglio A. Gaffuri T, Castelli C., Keller F, Della Bruna R, SGK annual conference. Lausanne, June 13-15, Imperiali M. 2012. Swiss medLab. Bern, June 2012. Electrocardiograms in young athletes: Evaluation of two Point-of-care (POC) for the blood characteristics and prevalence of abnormalities. gas analysis. Cardiovascular Medicine Laboratory Medicine 2012;15(5)(Suppl21):37S. Cardiology Galati S, Möller JC, Ferrazzoli D. 187° Riunione della Società Svizzera di Di Valentino M, Siragusa P, Moschovitis G, Gallino Neurologia. Lugano, May 2012. A, Menafoglio A. Pathological synchronization of the rat basal American Heart Association meeting. Los ganglia following the functional blockade of the Angeles, November 2012. nigro-striatal pathway. "Malignant" early repolarisation is relatively Neurology frequent in young athletes. Circulation. 2012;126:A9478. Gamondi C. Cardiology The 19th Annual International Palliative Care Conference on Teaching and Learning in Palliative Digesu A,Puccini P, Hendricken C,Bhide A, Khullar Care: Lessons for the Future. Dublin, March V, Tubaro A, Caccia G, Zecca C, Gobbi C. IUGA 2012. 37th annual meeting in Brisbane 2012. Developing competencies for specialists Motor and/or sensory response during PTNS-do in palliative care in Switzerland: a national they predict treatement outcome? consensus. Int Urogynecol J. 2012;23(Suppl 2):S84 Palliative Care Gynaecology

120 Scientific Report 2012 Giovannacci L. of Pneumology, Swiss Society of Pediatric 13° Congrès de l’union des sociétés suisse des Pneumology, Swiss Society for Thoracic Surgery, maladies vasculaires. November 21-23, 2012. Swiss Underwater and Hyperbaric Medical What the surgeon wants to know. Séance Society. Crans-Montana, April 25-27, 2012. 4 SSCVIR - Imagerie moderne non-invasive Feasibility study of ePTFE suture in sleeve des patients avec des maladies artérielles lobectomy. périphériques occlusives. Respiration: International Journal of Thoracic Surgery Medicine. 2012 May;83(5):469-470. Thoracic Surgery Giovannacci L. 99e Congrès annuel de la Société Suisse de Govi S, Pasini E, Mappa S, Bertoni F, Zaja F, Chirurgie. June 20-22, 2012. Montalbán C, et al. on behalf of the International Moderazione: Chirurgie vasculaire - Extranodal Lymphoma Study Group (IELSG). Communications libres. Divers II. 17th Annual Congress European Haematology Surgery Association (EHA). Amsterdam June 14-17, 2012. Giovannacci L. Chlamydophila psittaci eradication with Assemblée annuelle commune 2012 «Femme et doxycycline is an active first-line targeted therapy cœur». Lausanne, June 13-15, 2012. for ocular adnexae lymphoma: final results Moderazione: Presentazione su chirurgia of an international phase II prospective study nell’arteriopatia periferica obliterante. (IELSG-27). Surgery Oncology

Giovannacci L. Gyr Th, Polli C, Taddei E, Jermini F. Simposio Associazione Svizzera per la cura delle SGGG annual conference. Interlaken, 2012. ferite SAfW. 19th April 2012. Laparoskopische Naht einer Ureterläsion. Ulcus cruris visto dal chirurgo vascolare. Gynaecology Surgery Imperiali M, Giovanella L, Ferrari A, Palumbo A, Giovannacci L. Lippa L, Peretti A, Graziani MS, Ceriani L, Verburb Simposio primaverile di Chirurgia.The Regional FA, Castello R.. Hospital of Lugano, 31st May 2012. Swiss medLab. Bern, June 2012. Cura invasiva dell’arteriopatia periferica Redefining calcitonin reference values in obliterante. different immunoassays by integrating thyroid Surgery ultrasonography to select the reference population. Giovannacci L. Laboratory Medicine–Nuclear Medicine Simposio primaverile di Chirurgia. The Regional Hospital of Lugano, 31st May 2012. Jermini F. Progetto di Screening dell’AAA. II° Workshop di Andrologia della Società Urologica Surgery Insubrica. 24th November 2012. Il trattamento del varicocele: quali orientamenti Giuliani M, Matarrelli Em, Carboni GC, Karoubi GK, per l'andrologo oggi. Dutly AE. Urology Joint Annual Meeting of the Swiss Society

7. Publications in 2012 121 Kraus R, Candrian C, Rosso R, M. Arigoni M. Neuroradiology, New York, April 2012; 13th European Congress of Trauma & 2) Annual Meeting of the Society of Emergency Surgery. Basel, May 12-15, 2012. Neurointerventional Surgery, San Diego, July Fixation of syndesmosis rupture: why wait after 2012; surgery for a 3-D position control? 3) Annual Meeting of the Radiological Society of Surgery North America, Chicago, November 2012. Image-guided cervical spine procedures. Longhino V, De Rosa V, Regazzoni P, Candrian C. Neuroradiology 99e Congrès annuel de la Société Suisse de Chirurgie. June 20-22, 2012. Matarrelli E.M, Giuliani M, Dutly A.E on behalf of Pediatric navicular fractures, to operate? pneumoclub Ticino. Surgery Joint Annual Meeting of the Swiss Society of Pneumology, Swiss Society of Pediatric Lucchina S, Fusetti C. Pneumology, Swiss Society for Thoracic Surgery, Jahreskongress SGH-SSCM. Thun, November Swiss Underwater and Hyperbaric Medical 2012. Society. Crans-Montana, April 25-27, 2012. Are health insurances and bureaucracy pulling Suitability of Thoracoscopic wedge resection for back surgeons from patient care? A fight against day surgery?: P50 time. Respiration: International Journal of Thoracic Hand surgery Medicine. 2012 May;83(5);470. Thoracic Surgery Lucchina S. ISSHPORT congress. Miami, 7th February 2012. Médioni N, Puligheddu C, Santini P, Vock P, Szucs- Bony mallet options in atheletes. Farkas Z, Wyttenbach R. 2a Giornata Ricerca Hand surgery Clinica della Svizzera Italiana. Bellinzona, 23 March 2012. Martucci F, Pittoni P, Valli M, Pesce G, Azinwi NC, Reperti extracardiaci in risonanza magnetica Fanti P, Richetti A. cardiaca. XVI SASRO Annual Meeting 2012. Radiology Image Guided radiotherapy for set-up margin in lung cancer. Menafoglio A, Di Valentino M, Gallino A. Radiation Oncology American Heart Association meeting. Los Angeles, November 2012. Massari F, Rumboldt Z, Bonaldi G, Tsai N, Cianfoni A. The response of the QT interval and the T-wave 1) Annual Meeting of the American Society of morphology to sudden tachycardia provoked by Neuroradiology, New York, April 2012; standing in young athletes. 2) Annual Meeting of the Society of Circulation. 2012;126:A9481. Neurointerventional Surgery, San Diego,July Cardiology 2012. Image-guided sympathetic blocks. Menafoglio A, Di Valentino M, Limoni C, Siragusa Neuroradiology P, Moschovitis G, Gallino A. American Heart Association meeting. Los Massari F, Rumboldt Z, Bonaldi G, Vandergrift Angeles, November 2012. AW, Cianfoni A. Comparison of "European Society of Cardiology" 1) Annual Meeting of the American Society of and "Circulation" criteria for interpretation of the

122 Scientific Report 2012 electrocardiogram in young athletes. Menafoglio A, Di Valentino M, Siragusa P, Maggi Circulation. 2012;126:A9479. M, Romano GA, Pezzoli R, et al. Cardiology European Society Cardiology meeting. Munich, August 25-29, 2012. Menafoglio A, Di Valentino M, Sartori F, Cardiovascular screening with ECG in young Moschovitis G, Gallino A. European Congress of athletes is feasible at low cost. Intermediate Preventive Cardiology EuroPRevent. Dublin, May results of a prospective study. 3-5, 2012. Eur Heart J 2012;33(Suppl1):3978. Brugada ECG- pattern type 2 and 3 recorded Cardiology with V1 and V2 in the third intercostal space is relatively common in young athletes. Moccetti S, Pedrazzini A. European Journal of Preventive Cardiology. Annual conference MTE. 28th June 2012. 2012;19(Supplement1):S62. State of the Art: the Elderly Patients with ACS. Cardiology Cardiology

Menafoglio A, Di Valentino M, Siragusa P, Molife R, Mateo J, McGoldrick T, Krebs M, Drew Moschovitis G, Gallino A. Y, Banerjee SN, Nicum S, Ranson M, J. Rustin European Society Cardiology meeting. Munich, GJS., Sessa C, Plummer R, Leunen K, Friedlander August 25-29, 2012. M, Swaisland H, Burke W, McCormack P, Prevalence of Brugada ECG-pattern recorded with Pemberton K, Tchakov I, Kaye SB, Gourley C. V1 and V2 in the third intercostals space in young ASCO Annual Meeting. Chicago, Illinois, June 1-5, athletes. 2012. Eur Heart J. 2012;33(suppl1):3981. Safety and efficacy results from two randomized Cardiology expansions of a phase I study of a tablet formulation of the PARP inhibitor, olaparib, Menafoglio A, Di Valentino M, Siragusa P, Maggi in ovarian and breast cancer patients with M, Romano GA, Pezzoli R, Moschovitis G, Gallino A. BRCA1/2 mutations. European Society Cardiology meeting. Munich, Journal of Clinical Oncology, 2012 ASCO Annual August 25-29, 2012. Meeting Proceedings (Post-Meeting Edition). Costs of cardiovascular screening with ECG in Vol 30, No 15_suppl (May. 20 Supplement), young athletes in Switzerland. 2012: 3048 Eur Heart J 2012;33(Suppl1):3978. Oncology Cardiology Mora O, Marelli L, Pedrazzani C, Quadri P, Menafoglio A, Di Valentino M, Siragusa P, Maggi Tettamanti M, Bianchi M, Ghielmini M. M, Romano GA, Pezzoli R, Moschovitis G, Gallino 2a Giornata Ricerca Clinica della Svizzera Italiana, A. European Congress of Preventive Cardiology abstract No. 44, Bellinzona, 23rd March 2012. EuroPRevent. Dublin, May 3-5, 2012. Valutazione geriatrica multidisciplinare rapida Cardiovascular screening with ECG in young (VGMr) nel paziente oncologico anziano: risultati athletes is feasible at low cost. Intermediate preliminari di uno studio pilota preliminare. results of a prospective study. Oncology-Nursing Medicine European Journal of Preventive Cardiology. 2012 May 19:135. Mora O, Marelli L, Quadri P, Tettamanti M, Cardiology Pedrazzini C, Ghielmini M. Abbreviated comprenhensive geriatric

7. Publications in 2012 123 assessment (CGA) in elderly cancer patients: Prevention strategies against cancer. preliminary results of an observational pilot study. Oncology ESMO 2012. 28th September-2nd October 2012. Pedrazzani C, Manganiello-Danesi L, Anelli S. Annals of Oncology 2012;23. 2° Congresso Infermieristico EOC - "Infermieri Geriatrics -Oncology EOC: co-protagonisti nel sistema sanitario che cambia". Lugano, 9th May 2012. Moschovitis G, Menafoglio A, Pons M. Congresso Rilevamento delle problematiche delle donne annuale Medicina interna, SGIM. Basel, 25th May con tumore al seno dopo la fine dei trattamenti, 2012 . per l'impostazione di un programma di follow-up Impact of ECG monitoring (telemetry) in the infermieristico presso il Southern Italian Breast decision-making process of patients admitted for Cancer Centre. cardiovascular reasons to an internal medicine Nursing Medicine ward. Eur Heart J. 2012 May 25;33(1):1755. Pedrazzani C, Valcarenghi D, Bianchi M. Cardiology 8a EONS Spring Convention. Abstract Book, No. 91, Geneva, April 26-27, 2012. Pagani O. Breast Cancer in Young Women Comprehensive Geriatric Assessment (CGA) in Conference. Dublin, November 8-10, 2012. the elder cancer patient: implications in nursing Endocrine therapy for early breast cancer: decision-making process. standards and controversies. Nursing Medicine Oncology Pedrazzani C, Valcarenghi D, Bianchi M. Pagani O. Program for Oncology Leaders in 8th EONS Spring Convention, April 26-27, 2012. Europe. Milan, September 7-9, 2012. 91 Comprehensive Geriatric Assessment (CGA) How to set-up and run a multidisciplinary tumour In The Elder Cancer Patient: Implications In board. Nursing Decision-Making Process. Oncology European Journal of Oncology Nursing. 2012 Apr;16(S1);S32. Pagani O. 17th SIS World Congress on Breast Nursing Medicine Diseases. Salvador, Bahia, October 10-13, 2012. Managing breast patients in the era of molecular Perren A, Corbella D, Iapichino E, Di Bernardo medicine: adjuvant adjustment based on genetic V, Leonardi A, Di Nicolantonio R, Buschbeck C, signatures. Boegli L, Pagnamenta A, Malacrida R. ". Basel, Oncology November 2012. Relation between physical/pharmacological Pagani O. 8th European Breast Cancer restraint in the ICU and adverse events. Conference (EBCC-8). March 21-23, 2012. Intensive Care Medicine Advanced BC Clinics: more questions than answers. Perren A, Corbella D, Iapichino E, Di Bernardo Oncology V, Leonardi A, Di Nicolantonio R, Buschbeck C, Boegli L, Pagnamenta A, Malacrida R. Basel, Pagani O. Summer School in Public Health Policy, November 2012. Economics and Management. Lugano, August Relation between physical/pharmacological 20-25, 2012. restraint in the ICU - clinical settings.

124 Scientific Report 2012 Intensive Care Medicine Preoperative Planning for Hemiarthroplasty for Femoral Neck Fractures – is it necessary? Perren A, Previsdomini M, Perren I, Cerutti B, Surgery Massarrotto P, Kaufmann M, Merlani P, Rothen HU. Basel, November 2012. Posabella A, Valente P, Rosso R, Arigoni M. SwissScoring - Survey of SAPS II assessing 99e Congrès annuel de la Société Suisse de practices. Chirurgie. June 20-22, 2012. Intensive Care Medicine Diagnostic value of radiologic examination in appendicitis: a retrospective study. Perren A, Previsdomini M, Perren I, Cerutti B, Surgery Massarrotto P, Kaufmann M, Merlani P, Rothen HU. Pujade-Lauraine EB, Vergote I, Allard A, Rey Basel, November 2012. A, Sessa C, Birrer MJ. ASCO Annual Meeting. Swiss Scoring - Survey of NEMS assessing Chicago, Illinois, June 1-5, 2012. practices. OPSALIN: A phase II placebo-controlled Intensive Care Medicine randomized study of ombrabulin in patients with platinum-sensitive recurrent ovarian cancer Pesce GA. treated with carboplatin (Cb) and paclitaxel (P). 2a Giornata della Ricerca Clinica della Svizzera Journal of Clinical Oncology, 2012 ASCO Annual Italiana. Bellinzona, 23rd March 2012. Meeting Proceedings (Post-Meeting Edition). Radioterapia ipofrazionata a modulazione di Vol 30, No 15_suppl (May 20 Supplement), intensità volumetrica del letto tumorale, dopo 2012: TPS5112 resezione di metastasi cerebrali da tumori solidi. Oncology Radiation Oncology Puligheddu C. Polli C, Lauria F, Gyr Th, Rosso R, Jermini F. III corso: Le Pneumopatie Interstiziali Diffuse L’expérience de L’Hôpital Civico Lugano SGGG (P.I.D.). Gubbio, May 3-5, 2012. annual conference. Interlaken, 2012. Pattern nodulare: presentazione radiologica. Endometriose pelvienne et prise en charge Radiology chirurgicale multidisciplinaire. Gynaecology Quadri P, Zemp D, Zanda E, Rocchi S, Meroni F, Tettamanti M, Recchia A, Lucca U, Merlo A. Polli C, Gyr Th. Hagmann P.D. 2a Giornata della Ricerca Clinica della Svizzera 18th Praktischer Kurs in Gynäkologisher Italiana, Bellinzona, 23rd March 2012. Endoscopie - Arbeitsgemeinschaft für Stabilità posturale ed antecedenti di caduta in Gynäkologishe Endoscopie (SGGG) 2012. Davos, soggetti anziani senza demenza. March 2012. Geriatrics Technisches Vorgehen bei der Laparoskopie von Adnextumoren. Richetti A. Congresso Senoforum di Lugano Gynaecology 2012. Radioterapia la rivoluzione di tempi, dosi e Posabella A, Biraima A, Hotz T, Gross T, Arigoni T. modalità. Combined 33rd SICOT & 17th PAOA Orthopaedic Radiation Oncology World Conference. 25th November-1st December 2012. Roggero E, Sarti M, Pesce G, Stoffel F, Lladò A,

7. Publications in 2012 125 Barbazza R, Stanta G, Cavalli F, Catapano CV, 29th International Gastrointestinal Surgery Carbone GM, Alimonti A. Workshop. Davos, 25th February-2nd March 2a Giornata Ricerca Clinica della Svizzera Italiana, 2012. abstract No.56, Bellinzona, 23rd March 2012. Open abdomen - therapeutic options for closure Espressione degli onco-soppressori PTEN e P53 of laparostomy. in pazienti con carcinoma della prostata. Surgery Oncology Rosso R. Roggero E, Sarti M, Pinton S, Mello-Grand M, 29th International Gastrointestinal Surgery Chiorino G, George N. Thalman GN, Bonapace IM, Workshop. Davos, 25th February-2nd March Carlo V. Catapano CV, Carbone GM. 2012. 2a Giornata Ricerca Clinica della Svizzera Italiana, Moderazione: Interactive session I - Acute abstract No. 57, Bellinzona, 23rd March 2012. situations in abdominal surgery: Clinical scenarios I. Nuovi biomarcatori nel carcinoma prostatico: Surgery ruolo del fattore epigenetico UHRF1 nel definire il rischio di progressione della malattia. Rosso R. Oncology 29th International Gastrointestinal Surgery Workshop. Davos, 25th February-2nd March Roggero E, Sarti M, Pinton S, Thalmann G, 2012. Catapano CV, Bonapace IM, Carbone GM. Moderazione: Session IV. ASCO Annual Meeting; abstract No. 98014. Surgery Chicago, Illinois, June 1-5, 2012. Correlation of UHRF1 expression in primary Rosso R. prostate cancer patients with adverse prognosis. 2a Giornata Ricerca Clinica della Svizzera Italiana. Oncology Bellinzona, 23rd March 2012. Moderazione: Ricerca clinica nel EOC Department Rosso R. Seminare zur Chirurgischen of Surgery. Facharztvorbereitung. 2012 April 19-20. Surgery Tractus gastrointestinal II - Pathologie des voies biliaires. Rosso R. Surgery Seminar organized by FCTSA. January 13-14, 2012. Rosso R. Il politraumatizzato tra hub e spoke: quali 13th European Congress of Trauma & competenze. Registro Trauma Ticino: strumento Emercency Surgery. Basel, May 12-15, 2012. per sviluppare la qualità della presa a carico. Moderazione: Video session - Visceral Trauma. Surgery Surgery Rosso R. Rosso R. Union Européenne des Médecins spécialistes. 13th European Congress of Trauma & September 21-22, 2012. Emercency Surgery. Basel, May 12-15, 2012. High specialized medicine in Switzerland UEMS Moderazione: Visceral Trauma II. Section of Surgery, Meeting. Surgery Surgery

Rosso R. Sacco L, Calabrese P, Marta S, Chitò E, Greco A,

126 Scientific Report 2012 Tiraboschi P, Defanti CA. cambia". Lugano, 9th May 2012. 187° Riunione della Società Svizzera di La sorveglianza del dolore allo the IOSI: a che Neurologia, Lugano, May 2012. punto siamo? Unawareness of deficits in Alzheimer's disease Nursing Medicine patients. Neurology Valente P, Maffei M, Miazza B, Rosso R, Christoforidis D. Santini P. Journée Française de Radiologie (JFR). 99e Congrès annuel de la Société Suisse de Paris, October 2012. Chirurgie. June 20-22, 2012. Imagerie de diffusion (DWI) mammaire. Management of persistent post-operative Radiology bleeding from double-stapled colorectal anastomosis. Saporito A. 31st Annual European Society of Surgery Regional Anaesthesia (ESRA) Congress 2012. Bordeaux, September 5-8, 2012. Valli M. Congresso Senoforum di Lugano 2012. Outpatient continuous Regional l l l analgesia 18FDG PET-CT nella pianificazione e nel after ambulatory orthopaedic surgery: a cost- trattamento radioterapico. effectiveness analysis. Radiation Oncology RAPM. 2012; 37(7):184. Anaesthesiology Valli M, Fanti P, Leva S, Rottoli G, Martucci F, Pittoni P, Azinwi NC, Pesce G, Richetti A. Sarti M, Pinton S, Limoni C, Carbone GM, Pagani XVI SASRO Annual Meeting 2012. Respiratory O, Cavalli F, Catapano CV. gating RT in breast cancer: light and shade. 2a Giornata Ricerca Clinica della Svizzera Italiana, Radiation Oncology abstract No. 40. Bellinzona, 23rd March 2012. Alterata espressione di Survivina e Testin in Valli M, Martucci F, Azinwi NC, Pesce G, Canziani sottotipi di Breast cancer. L, Richetti A. Oncology VIII European Breast Cancer Conference 2012. 3D-conformal Partial Breast Irradiation (3D-CRT Schieppati A, Daina E, Gamba S, Noris M, Gabutti PBI): how to optimize its reproducibility. L, Remuzzi G, et al. Radiation Oncology Rare Diseases and Orphan Drug Registries - International Workshop. Valli M, Pittoni P, Fanti P, Pesce G, Azinwi C, Rome, October 2012. Martucci F, Ceriani L, Richetti A. XII Congresso Italian registry of MPGN: contribution to Nazionale Associazione Italiana Radioterapia advancement in the pathogenesis of the disease Oncologica 2012. and patient care. La 18FDG-PET/CT può modificare la strategia Internal Medicine terapeutica nel trattamento delle neoplasie mammarie localmente avanzate o ad alto rischio? Valcarenghi D, Bianchi M, Di Giulio P, Pedrazzani C. Radiation Oncology 1) 2a Giornata Ricerca Clinica della Svizzera Italiana, abstract No. 16. Bellinzona, 23rd Van Den Berg JC. March 2012; 2) 39th VEITH symposium. New York, 15 November 2) 2° Congresso Infermieristico EOC - "Infermieri 2012. EOC: co-protagonisti nel sistema sanitario che Bringing atherectomy to the next level: what is its

7. Publications in 2012 127 future. Van Den Berg JC. Radiology 34th International Symposium Charing Cross. London, 16th April 2012. Van Den Berg JC. Fenestration of common iliac artery and 39th VEITH symposium. New York, 18 November entire abdominal aorta in patient with a type A 2012. dissection. Endovascular conversion of open surgical failures Radiology and complications: tips and tricks. Radiology Van Den Berg JC. 34th International Symposium Charing Cross. Van Den Berg JC. London, 16th April 2012. 13° Congrès de l’union des sociétés suisse des Tips and tricks for safe renal artery stenting using maladies vasculaires. November 21-23, 2012. the V12 RX. Interventional Round Table SSA, SSCV, SSCVIR. Radiology Surgery Van Den Berg JC. Van Den Berg JC. 34th International Symposium Charing Cross. 13th NCVH , New Orleans, 7th July 2012. London, 16th April 2012. PHOTOPAC Trial for In-Stent Restenosis. Bare metal stents vs. covered V12 stents for Radiology renal artery stenosis. Radiology Van Den Berg JC. 34th International Symposium Charing Cross. Van Den Berg JC. London, 16th April 2012. 34th International Symposium Charing Cross. Fusion imaging: Further reducing contrast and London, 16th April 2012. radiation exposure to the patient (a system Is acute deep venous thrombosis in the lower limb to import existing CT and MR images to the best managed by: Trellis? angiosuite). Radiology Radiology Van Den Berg JC. Van Den Berg JC. 39th VEITH symposium. New York, 15th 34th International Symposium Charing Cross. November 2012. London, 16th April 2012. Laser debulking and DEB for in-stent restenosis. Treatment of AV fistula in the lower leg after Radiology Fogarty embolectomy using covered stent. Radiology Van Den Berg JC. CACVS. Paris, 21st January 2012. Van Den Berg JC. Coated balloons: how does it work, what are the 34th International Symposium Charing Cross. results? London, 16th April 2012. Radiology Treatment of iatrogenic false aneurysm of aberrant right hepatic artery after Van Den Berg JC. cholecystectomy. CIRSE. Lisbon, 18th September 2012. Radiology Does debulking before DEB make sense? Radiology

128 Scientific Report 2012 Van Den Berg JC. 2° Congresso Infermieristico EOC. Infermieri EOC: EVC 2012. Maastricht, 11th March 2012. co-protagonisti nel sistema sanitario che cambia. Advanced imaging techniques for navigation Lugano, 9th May 2012 during endovascular procedures: current status Cure infermieristiche in movimento, quale futuro? and future perspectives. Nursing Medicine Radiology Willems Cavalli Y. Van Den Berg JC. SVPL-Kongress. Transformation in der Führung. iCON2012. Scottsdale, 13th February 2012. October 2012. Advanced imaging techniques for navigation Von Transformation in der Führung zur during endovascular procedures: current status Transformation der Pflegepraxis: von Inspiration zu and future perspectives. Ergebnissen. Radiology Nursing Medicine

Van Den Berg JC. Wyttenbach R. LINC. Leipzig, 25th January 2012. Annual meeting European Society of Cardiac Imaging protocol after EVAR: what can be left Radiology (ESCR). out? Barcelona, October 2012. Radiology Coronary arteries and perfusion territories. Radiology Van Den Berg JC. LINC. Leipzig, 26th January 2012. Wyttenbach R. Study update: bringing laser atherectomy to the Annual meeting West Midlands Association of next level. Radiologists. Birmingham, May 2012. Radiology Cardiac MRI 2012: Indications and clinical applications. Van Den Berg JC. Radiology LINC. Leipzig, 26th January 2012. Recorded case presentation. Zanon M, F Foletti, M Bianchi. Radiology 2° Congresso Infermieristico EOC - "Infermieri EOC: co-protagonisti nel sistema sanitario che Van Den Berg JC. cambia". Lugano, 9th May 2012. TSVIR, 14th Annual meeting. Kanchanaburi, 9th Progetto di implementazione del Primary Nursing February 2012. presso l'ambulatorio the IOSI di Bellinzona. Interventional room of the future. Nursing Medicine Radiology Publications in books Van Den Berg JC. TSVIR, 14th Annual meeting. Kanchanaburi, 9th Bonanni E, Maestri M, Di Coscio E, Murri L. February 2012. Excessive Daytime Sleepiness in Neurological Closure devices and access routes in PAD Disorders. intervention. Sleep disorders in neurology. Silvestri L. (ed.). Radiology Nova Science Publishers, Inc. New York. 2012;59-70. Willems Cavalli Y. Neurology

7. Publications in 2012 129 Braczkowska M, Aguirre J, Del Moral Olmo A, de Nova Science Publishers, Inc. New York. Andrés J, Borgeat A, Saporito A. 2012;223-235. Continuous popliteal analgesia after foot surgery Neurology at home: cost-effectiveness and safety. Book of act ESRA Spain. 2012. Martignoni G, Grignoli N, Di Bernardo V, Anaesthesiology Malacrida M, Bernegger G, Barazzoni F, Malacrida R. Cereda CW, Bassetti CL. A question of style; Critical Review of Oncology/ Syndrome des Apnée obstructives du Sommeil Haematology. (SAOS) et accident vasculaire cérébral aigu (AVC). Medical Humanities. 2012;84:101-104. Les troubles du sommeil. Billiards M, Devaulliers Oncology Y (eds.). Masson, Paris. 2012;297-309. Neurology Möller JC, Oertel WH. Therapie des fortgeschrittenen Parkinson- Cereda CW, Lavie L, Bassetti CL. Syndroms. Sleep-disordered breathing (SDB) and stroke. Jost W (ed.). Uni-Med Verlag, Bremen. 2012;68-73. Sleep disorders in neurology. Silvestri L (ed.). Nova Neurology Science Publishers, Inc. New York. 2012;301- 324. Ponzoni M, Glass J. Zucca E. Neurology Intravascular Lymphoma Of The CNS. Chapter 14 In Batchelor T, Deangelis L.M. (Eds). Cereda CW, Manconi M, Bassetti CL. Lymphoma And Leukemia Of The Nervous Sleep and wake disturbances in stroke. System. Second Edition. Stroke syndromes, 3rd edition. Caplan LR, van Gijn J Springer Science+Business Media. 2012;978-14. (eds.). Cambridge University Press. 2012;166-78. Oncology Neurology Rubinelli S. & Malacrida R. (eds.) Depboylu C, Möller JC, Oertel WH. What they are, why they matter in oncology; Rare degenerative syndromes associated with Critical Reviews of Oncology/Haematology. parkinsonism. Medical Humanities. 2012;84. Movement Disorders, 3rd edition. Watts RL, Oncology Standaert D, Obeso JA (eds). McGraw-Hill, New York. 2012;481-97. Schulz H, Fulda S. Neurology Geschlechtsunterschiede im Schlaf [Sex differences in sleep]. Galati S, Di Giovanni G. Deutsche Gesellschaft für Schlafmedizin und Intracerebral human microdialysis in Parkinson's Schlafforschung. Schulz H, Geisler P, Rodenbeck disease. A (eds.). Kompendium Schlafmedizin. Ecomed- Neuromethods. 2012;209-23. Verlag, Heidelberg. 2012;XVI-2.1. Neurology Neurology

Manconi M, Pisarenco I. Sessa C, Gianni L, Garassino M, Van Halteren H. Sleep disorders in multiple sclerosis and in ESMO Handbook of Clinical Pharmacology of Anti- amyothrophic lateral sclerosis. Cancer Agents. Sleep disorders in neurology. Silvestri L (ed.). Oncology

130 Scientific Report 2012 Van Den Berg JC. Acute deep venous thrombosis in the lower limb is best managed by: Trellis In: R.M. Greenhalgh, editor. Vascular and endovascular consensus update. London, BIBA Publishing. 2012;653-658. IF 0.891 Radiology

Van Den Berg JC. Drug eluting balloon: how does it work, what are the results? In: J-P. Becquemin, editor. Controversies and updates in vascular surgery. 2012;415-420. IF 0.864 Radiology

Van Den Berg JC. Tips and tricks for successful EVAR. In: J-P. P. M de Vries, editor. Latest insights into abdominal aortic aneurysms and endovascular repair. Editions Minerva Medica. 2012:59-72. Radiology

7. Publications in 2012 131

8 Appendices 8. Appendices

Appendix 1 - Research projects funded by ABREOC in 2008

Principal Investigator Other researchers Institute Study title Status report (December 2012) Andreas Perren Roberto Malacrida / Elena Iapichino/ Regional Hospital Physical vs. drug restraint in the intubated patient: clinical con- in progress Davide Corbella / Fabrizio Barazzoni / of Bellinzona and Valli - sequences Valentina di Bernardo / Ines Sperandino / Intensive Care Medicine Cristina Sommacal Gianfranco John Petri Fabio Garofalo / Robin Chanda / M. Lazzaro / Luca Regional Hospital Diabetes in orthopedics: perioperative management of the dia- in progress Deabate / F. Strano /Paola Genini / Ivana Roguljic of Bellinzona and Valli - betic patient - a continuous intravenous infusion of rapid insulin Orthopaedics (IEC) versus corrections with subcutaneous insulin (standard regimen) Piercarlo Saletti Sara De Dosso / Milo Frattini / Luca Mazzucchelli / IOSI - Oncology Analysis of molecular markers ERCC-1, TS, p53 and PTEN in closed (presented final report) Emanuele Zucca patients affected by gastric or esophagogastric junction adenocarcinoma, who are radically operated and have undergone a preventive chemotherapy Olivia Pagani Monica Taborelli / Gabriella Bianchi-Micheli / IOSI - Oncology Analysis of the quality of information in genetic counseling for in progress Manuela Sarti 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 par- athyroid hormone-related peptide in hyperthyroid patients" Luca Giovanella / Luca Mazzucchelli / Luca Ceriani / Sergio Suriano IOSI - Nuclear Prognostic significance of 18fdg-PET/CT in progress Emanuele Zucca Medicine/Oncology Mario Bianchetti P.J. Schulz / M. Caiata Zufferey Regional Hospital Living with a chronic and genetic disease: the Gitelman syn- closed and published in Nephrol Dial Trans- of Bellinzona and Valli - drome plant, 27(8): 3196-3201, 2012: "Living with Paediatrics Gitelman disease: an insight into patients' daily experiences" Michele Ghielmini Jürg Stamm / Alden Moccia / Alessandra Fusconi IOSI - Oncology Fertility preservation through cryopreservation of ovarian tissue in progress

134 Scientific Report 2012 Appendix 1 - Research projects funded by ABREOC in 2008

8. Appendices 135 Appendix 2 - Research projects funded by ABREOC in 2009

Principal Investigator other researchers Institute Title Status report (December 2012) Olivia Pagani Aron Goldhirsch / Franco Cavalli / Laura Richetti IOSI - Oncology CARMA database: collection of retrospective and prospective in progress clinical data in breast cancer patients to assess the impact on outcome of prognostic and predictive factors identified at the diagnosis Luca Giovanella Franco Keller / Sergio Suriano IOSI - Nuclear Medicine Procalcitonin and medullary thyroid carcinoma in progress Gian Paolo Ramelli Alessandra Ferrarini Regional Hospital Database creation of pediatric patients with mental retardation in progress of Bellinzona and Valli - assisted by neuropaediatrics Service of San Giovanni Hospital Paediatrics of Bellinzona Martin Bolli Riccardo Vandoni / Luca Mazzucchelli / Regional Hospital Expression and prognostic role of molecular, biological and clini- closed (presented final report) Milo Frattini of Bellinzona and Valli - cal markers in hepatocarcinoma Surgery Carlo Cereda Claudio Bassetti / Claudio Staedler / NSI Health impact of a structure of continuous neurological treat- in progress Laura Zampieri / Antonio Carota ment (stroke unit) within the Neurocenter (EOC) of Southern Switzerland- observational community-based study of acute cerebrovascular diseases in Ticino Pierluigi Quadri Fabiano Meroni /Rita Pezzati / Damiano Zemp / Regional Hospital Fear of falling in the elderly: physiotherapy intervention and cog- in progress Lorena Curia/ Carola Celeste / Silvia Ambrogio / of Mendrisio - Geriatrics nitive approach (imagery) Simona Chiari / Francesca Gallina / Nicola Schiavone / Gianluca Guffanti Claudia Gamondi M. Caiata Zufferey / Joyce Pellandini IOSI - Oncology Assisted Suicide: attitudes and experiences of bereaved families in progress (Palliative Care Unit) and beloved ones. An exploratory study Emanuele Zucca Francesco Bertoni / Marco Zaffalon / IOSI - Oncology Development of new algorithms for the identification of prognos- in progress Cassio Polpo de Campos tic models in patients with lymphomas by optimizing the management of missing data Marcello Di Valentino Augusto Gallino / Stefano Muzzarelli Regional Hospital No Smoke Pub Study in progress (the preliminary results were of Bellinzona and Valli - presented as scientific communications at in- Cardiology ternational conferences and the manuscript for publication in a scientific journal is being edited) Michele Ghielmini Oreste Mora / Lucia Marelli / Carla Pedrazzani / IOSI - Oncology Feasibility and acceptability of a quick multidimensional assess- in progress Monica Bianchi / Mauro Tettamanti / Pierluigi Quadri ment for the elderly cancer patient: an observational pilot study

136 Scientific Report 2012 Appendix 2 - Research projects funded by ABREOC in 2009

8. Appendices 137 Appendix 3 - Research projects funded by ABREOC in 2010

Principal Investigator Other researchers Institute Study title Status report (December 2012) Rolf Wyttenbach Zsolt Szücs-Farkas / Nathalie Médioni Regional Hospital Extracardiac Findings on Cardiac Magnetic Resonance Imaging closed and published in Eur Radiol, of Bellinzona and Valli - Studies 22(6):1295-302, 2012:"Extracardiac Radiology 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 in progress Luca Giovanella Luca Ceriani / Sergio Suriano / Riccardo Ricci IOSI - Nuclear Medicine Differential diagnosis of thyroid nodules with non-diagnostic cy- in progress tology by 18FDG-PET/CT Luca Giovannacci Raffaele Rosso / Filippo Del Grande / Regional Hospital Feasibility of a abdominal aortic aneurysm ultrasound screen- in progress Reto Canevascini / Stephane Schlunke / of Lugano - Vascular Surgery ing program in the population served by Regional Hospital of Josua van den Berg / Hans Stricker Lugano Gian Paolo Ramelli Tamara Gonzalez / Nadia Zanda / Emanuelle Regional Hospital of Database creation of pediatric patients with autism spectrum closed (presented final report) Rossini Bellinzona and Valli - disorder assisted by neuropaediatrics Service of San Giovanni Paediatrics Hospital of Bellinzona Michele Ghielmini Andrea Bordoni / Luca Mazzucchelli / IOSI - Oncology Indicators of Quality of Cancer Care in Southern Switzerland in progress Alessandra Spitale Augusto Gallino Marcello Di Valentino / Julija Klimusina / Regional Hospital Cardiac X Syndrome: role of endothelial function: a substudy of in progress Regional Group of Ticino cardiologists of Bellinzona and Valli - the swiss-italian cohort of the italian Registry on X Syndrome Cardiology Andrea Menafoglio Marcello Di Valentino / Reto Pezzoli / Regional Hospital Impact of cardiovascular screening with ECG in young (12-35 closed (the preliminary results were present- Julija Klimusina / Augusto Gallino of Bellinzona and Valli - years) competitive athletes ed at "Congresso europeo di cardiologia pre- Cardiology ventiva, EuroPRevent 2012" May 3-5, 2012, Dublin Dario Valcarenghi Paola Di Giulio / Monica Bianchi / Carla Pedrazzani / IOSI - Nursing Service Pain monitoring at IOSI: where are we? closed (presented final report) Sonia Tosi Casado / Christa Pedrazzoli Hutz Claudio Gobbi Chiara Zecca / Ursula Candrian / Marta Garcia NSI A prospective, randomized, double-blind, placebo-controlled, in progress Calle / Mara Gola / Costanzo Limoni / parallel-group, phase IV study of oral prednisone taper vs. pla- Liliane Petrini cebo 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 response to in progress preoperative radio-chemotherapy in patients with locally advanced rectal carcinoma Roberto Malacrida Valentina Di Bernardo / Nicola Grignoni / Chantal Regional Hospital of Lugano - Intimacy in the intensive care unit of the Canton Ticino in progress Marazia / Andreas Perren / Michael Llamas / Intensive Care Alberto Pagnamenta / Ines Sperandio / Rosanna Medicine Di Nocolantonio / Attilio Sicilia / Barbara Schulte Alberto Pagnamenta Moreno Doninelli / Michael Llamas / Andreas Regional Hospital of Mendrisio - Impact of a communication strategy on the relatives satisfac- in progress Perren / Roberto Malacrida / Kurt Schmidlin / Intensive Care tion in intensive care medicine Hans Ulrich Rothen Medicine Manuela Sarti Sandra Pinton / Pina Carbone / Carlo Catapano / IOSI - Oncology Expression analysis of putative stem cell markers in human main progress Enrico Roggero / Franco Cavalli lignant prostate tumour and prognostic implications Dario Valcarenghi Monica Bianchi / Claudia Gamondi Palmesino / IOSI - Nursing Service / Introduction of art therapy program for cancer patients admit- closed (presented final report) Sonia Tosi Casado / Christa Pedrazzoli Hutz / Oncology ted to the IOSI: a pilot study Carla Pedrazzani Enrico Roggero Barbara Marongiu / Mariarosa Pascale / IOSI - Oncology Pilot study comparing genomic and metabolomic profiling of pain progress Andrea Alimonti / Flavio Stoffel / Franco Cavalli tients with prostate cancer at diagnosis and during disease progression to find specific intra-individual genetic and metabolic alterations

138 Scientific Report 2012 Appendix 3 - Research projects funded by ABREOC in 2010

8. Appendices 139 Appendix 4 - Research projects funded by ABREOC in 2011

Principal Investigator other researchers Institute Study title Status report (December 2012) Luca Giovanella Massimo Bongiovanni / Sergio Suriano IOSI Nuclear Medicine Thyroid nodules with indeterminate cytology: diagnostic role of in progress elastography and immunocytochemical markers Claudia Gamondi Chantal Corti Polti / Murielle Pott IOSI - Oncology Parteciper à un suicide assisté: étude exploratoire sur in progress (Palliative Care Unit) 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 Epidemiology of dying in Southern Switzerland: circumstances in progress (Palliative Care Unit) of death. Dimitri Christoforidis Mike Schmalzbauer / Alberto Posabella / Regional Hospital Two surgical techniques for the treatment of sacro-coccygeal in progress Raffaele Rosso of Lugano - Surgery cysts: a randomized and controlled study Florian Bihl Antonio Lanzavecchia Regional Hospital Evaluation of the cellular immune response against the hepa- in progress of Bellinzona and Valli - titis B virus in various stages of infection: characterization of Gastroenterology responses of T and B lymphocytes and analysis of new viral epitopes Christina Caporale Claudio Bassetti / Fabio Conti / Claudio Petrillo / NSI Rehabilitation combined with bihemispheric transcranial direct in progress René Müri / Thomas Nyffeler / Antonino Uncini / current stimulation in subacute ischemic stroke to increase up- Daniel Zutter per limb motor recovery Piercarlo Saletti Milo Frattini / Luca Mazzucchelli / Sara De Dosso IOSI - Oncology Treatment with Herceptin in gastric carcinomas: best selection in progress of patients through molecular markers analysis Franco Keller Mauro Imperiali / Roberto Della Bruna/ EOLAB Department Evaluation of the introduction of POCT devices for blood gas closed (presented at "congresso svizzero di Luca Martinolli analysis in the hospital and pre-hospital emergency medicina di laboratorio (Swiss medLab)") Marco Pons Andrea Azzola / Alessia Riglietti / Claudio Bassetti / Regional Hospital The central apneas during the TIA / ischemic stroke: clinical, in progress Mauro Manconi / Carlo Cereda / Liliane Petrini / of Lugano - Internal Medicine prognostic and physiopathological elements Guido Ferretti / Massimo Pagani / Fabio Esposito / Costanzo Limoni Rolf Wyttenbach Stefano Colagrande / Francesco Regini / Regional Hospital Multi-parametric evaluation of liver perfusion by MR-Dwl under in progress Elisa Ardemagni of Bellinzona and Valli - fasting and postprandial conditions in healthly volunteers: corre- Radiology lation with quantitative phase-contrast portal venous flow measurements Salvatore Galati Carsten Möller / Claudio Städler/ NSI Role of sleep homeostasis in the development of dyskinesias in- in progress Chiara Prosperetti / Mauro Manconi / duced by L-dopa in patients with advanced stage of Parkinson's Simone Sarasso / Marcello Massimini disease Gianfranco Pesce Azinwi Ngwa Che / Antonella Richetti / IOSI - Radio-Oncology Hypofractionated cerebral irradiation protocol or radiosurgery in progress Jolanda De Jong (IGRT or stereotaxic mode) of the resection cavity in patients undergoing surgical removal of single cerebral metastasis from solid tumours

140 Scientific Report 2012 Appendix 4 - Research projects funded by ABREOC in 2011

8. Appendices 141 Appendix 5 - Research projects funded by ABREOC in 2012

Principal Investigator Other researchers Institute Study title Expected study duration Andrea Menafoglio Marcello Di Valentino Regional Preparticipation Screen- 24 months Patrick Siragusa Hospital of ing Gian-Antonio Romano Bellinzona and Assessment of Car- Reto Pezzoli and Valli - diovascular diseases in Giorgio Moschovitis Cardiology Masters Athletes (PSA- Masters Study) Leonardo Sacco Leonardo Sacco NSI The alteration of A-BETA 12 months Guido Ongaro 42, TAU and PHOSPHO- Fabiano Meroni TAU in the cerebrospinal Riccardo Pignatti fluid of patients with mild Claudio Staedler cognitive impairment Franco Keller (CDR 0.5) are an indirect sign of amyloid accumula- tion and neuronal damage. Are semantic memory, ecological memory and dual task tests con- sistent with the neurodegenerative process? Enos Bernasconi Francesco Bertoni Regional A survey of treatment 12 months Emanuele Zucca Hospital modalities and outcome Stephan Dirnhofer of Lugano - analysis of HIV-related B- Infectious cell lymphomas from the diseases Swiss HIV Cohort Study Dario Valcarenghi Monica Bianchi IOSI - Nursing Patient education to oral 18 months Carla Pedrazzani Service cancer therapy Agostino Chiriatti Massimiliano Zanon Luciano Wannesson Milo Frattini IOSI - Gene expression analysis 12 months Luca Mazzucchelli Oncology of ROR1 in lung carcino- Francesca Molinari mas: a new marker in view of new target-specific therapies Manuela Sarti Gianluca Civenni IOSI - Isolation and characteri- 24 months Flavio Stoffel Oncology zation of epithelial stem Carlo Catapano cells from human pros- Giuseppina Carbone tate biopsies Cristiana Sessa Sara De Dosso IOSI - Phase I study evaluating 18 months Anastasios Stathis Oncology indomethacin in combination with platinum-based chemotherapy

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

No. Study title Principal Other researchers Collaborators Expected Approval Investigator that have study by Ethics (PI) access duration Committee to non- of Canton anonymized Ticino data (besides the PI) 1/AG12 Epidemiol- Claudia Paola Di Giulio, Alessandra 18 approved ogy of dying Gamondi Ilaria Bernardi Arosio, months (29th in Southern Zucca, Balice Colette, November, Switzerland: Michele Egloff Viviana 2012) circumstances Freudiger, Ref. EC of death Peter Moeller, 2553 Dario Valcarenghi 2/AG12 Clinical and Olivia Silvia Longhi Butti, Silvia Longhi 15 approved biological char- Pagani Cinzia Cafaro Butti, months (20th acterization of Greco Cinzia Cafaro December, male breast Greco 2012) cancer: an Ref. EC international 2643 retrospective EORTC, BIG and NABCG intergroup study 3/AG12 Pilot study Enrico Barbara Marongiu, GianCarla 24 approved comparing Roggero Mariarosa Pascale, Busi, months (14th genomic and Andrea Alimonti, Flavio Stoffel, December, metabolomic Flavio Stoffel, Barbara 2012) profiling of Franco Cavalli Marongiu, Ref. EC patients with Stefano Crippa 2639 prostate cancer at diagnosis and during disease progression to find specific intra-individual genetic and metabolic alterations

8. Appendices 143 Impressum

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