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Scientific Report Index Scientific Report 2012 2012 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 im- portant 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 ac- cess, 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 con- gress 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.
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