Delemont

Researchers are investigating the effectiveness, feasibility, and safety of combining bicycle exercise with an intensive lifestyle intervention for three months in adults recently diagnosed with untreated type 2 diabetes. This study aims to promote lifestyle changes early after diagnosis to control blood sugar levels without the use of medication. The trial focuses on patients who often show symptoms like excessive urination and thirst at diagnosis, providing a unique chance to demonstrate the benefits of exercise and diet changes. Participants will be randomly assigned to either standard care or an intensified lifestyle intervention that begins with a 30-minute bicycle exercise at 60% of their maximum heart rate, followed by a physical activity program. This program includes 3 to 5 aerobic sessions lasting 15-40 minutes each and 2 resistance training sessions weekly. Motivational coaching by phone and nutritional counseling are also part of the lifestyle intervention. Patients will be monitored and receive follow-up visits at multiple intervals over a year. Throughout the study, patients will have their blood glucose levels, heart rate, blood pressure, and other clinical parameters regularly assessed. They will be trained to measure blood glucose at home and send results for monitoring. Physical activity will be tracked using mobile phones and activity trackers. Outcome measures include achieving metabolic control at three months without anti-diabetic medication, defined by specific HbA1c targets based on initial levels. Safety and adherence will be closely observed during follow-up visits at 2, 7, 30, 60, 90 days, 6 months, and 1 year.

Breast, colorectal, ovarian, and endometrial cancers account for about 30% of new cancer cases in Switzerland, affecting over 12,000 people each year. Many of these patients may carry genetic mutations linked to Hereditary Breast and Ovarian Cancer (HBOC) or Lynch Syndrome (LS). Genetic testing can help prevent cancer deaths by identifying those at risk early and providing management options like surveillance, prevention, or surgery. However, many mutation carriers and their families do not use genetic services due to poor care coordination or lack of communication within families. This research is studying a family-based approach called CASCADE genetic screening. It involves enrolling mutation carriers, their blood relatives who test negative, and untested relatives into a cohort. The goal is to understand cancer status, surveillance habits, care coordination needs, communication patterns, and quality of life among these groups. The study also explores how patient-provider communication affects family communication and tests the acceptability of interventions focused on family-based communication and decision support. Participants will complete surveys about their cancer and mutation status, surveillance practices, psychosocial needs, and communication experiences. Researchers will assess willingness to serve as advocates for genetic services and to participate in related studies. The study monitors outcomes over 12 months to establish the CASCADE cohort. Eligibility includes adults living in Switzerland who carry mutations linked to HBOC or LS and have living blood relatives. The study emphasizes understanding and improving the use of genetic testing and care among families at risk.

This research investigates the best approach for treating low-risk patients with isolated subsegmental pulmonary embolism (SSPE), a condition where small blood clots block tiny arteries in the lungs. The study aims to clarify whether SSPE truly requires anticoagulant treatment or if careful monitoring without medication is a safe option. Currently, many patients receive anticoagulants, which can increase bleeding risk, but some evidence suggests that avoiding these drugs might be safe in selected patients without other complications. Participants are randomly assigned to receive either the anticoagulant drug rivaroxaban or a placebo, allowing comparison between clinical surveillance without anticoagulation and standard anticoagulation treatment. This phase 4, multicenter trial evaluates outcomes over a 90-day period following randomization. During the study, researchers monitor participants for recurrent venous thromboembolism and assess safety outcomes related to bleeding. Participants provide informed consent and are followed closely to observe any clots returning or adverse events. The total follow-up is at least 90 days to determine the efficacy and safety of withholding anticoagulation in this specific patient group.

Chronic leg and foot ulcers are wounds that do not heal properly over several weeks, often due to blood flow problems caused by conditions like chronic venous insufficiency or peripheral artery disease. These ulcers share biological challenges such as reduced oxygen and nutrient supply, leading to impaired cell functions, persistent inflammation, and infections that prevent healing. Standard treatments include compression therapy, physical activity, and surgical procedures to improve blood flow and support wound repair. This trial evaluates a combined treatment called Concurrent Optical and Magnetic Stimulation (COMS) alongside standard care, compared to standard care alone, in patients with venous leg ulcers or venous leg ulcers with peripheral artery disease. COMS therapy uses magnetic stimulation and light therapy to activate cellular processes that promote healing, such as increased energy production, cell growth, blood vessel dilation, and reduced inflammation. Patients in the intervention group receive COMS treatment 2-3 times weekly for at least 8 weeks, with a minimum of 16 sessions, during their usual wound care procedures. Participants will be followed for a total of 24 weeks. During this time, researchers will monitor wound healing progress, including the percent reduction in wound area at 24 weeks. Assessments include wound evaluations, quality of life measures, pain levels, and device usability. The study is conducted across multiple centers in several European countries, with treatments and follow-up occurring in outpatient or home care settings. Safety and effectiveness data will be analyzed to understand the impact of COMS therapy on chronic vascular ulcers.

Researchers are investigating whether adding linezolid to standard antibiotic treatment improves outcomes for patients with Staphylococcus aureus bloodstream infections, a serious infection that causes high mortality and complications despite existing treatments. This trial focuses on targeting bacterial virulence factors that help the infection persist and cause harm. Previous studies suggest that linezolid may reduce these harmful factors, but no randomized controlled trials have tested this approach for this infection until now. Participants will receive either linezolid 600 mg tablets twice a day for 5 days or placebo tablets on the same schedule, in addition to their usual antibiotic treatment. This placebo-controlled trial compares the combination of linezolid plus standard care against standard care alone. The main treatment period lasts 5 days with either the active drug or placebo. Throughout the study, researchers will monitor participants from the day of randomization up to 90 days to evaluate outcomes using a measure called Desirability of Outcome Ranking (DOOR). Patients will be assessed for survival, complications, and overall clinical improvement. The trial includes hospitalized adults diagnosed with S. aureus bloodstream infections and involves consent procedures and close follow-up to ensure safety and collect data on treatment effects.

Gastroentero-pancreatic neuroendocrine tumors (GEP-NETs) are rare tumors that arise from the neuroendocrine system in the gastrointestinal tract and pancreas. This registry study aims to better understand these tumors by collecting detailed clinical information from patients diagnosed with GEP-NETs in Switzerland. Since limited knowledge exists about the biology and treatment of these tumors, the study focuses on gathering data to improve understanding and management strategies. Patients with a confirmed diagnosis of neuroendocrine tumors from any location who agree to participate will have their information entered prospectively into a secure, anonymized database. Data collection involves visits from study nurses to healthcare centers, where patient files are reviewed and information is recorded. There are no specific treatments assigned by this registry; instead, it tracks various treatment approaches used in Switzerland. Participants contribute data that includes tumor types, treatments received, and outcomes such as mortality and hospitalization rates. The study reviews and evaluates this information regularly to identify patterns and assess patient outcomes over time. The main outcome measured is tumor-related mortality every five years, helping to monitor long-term effects. This registry allows for improved knowledge sharing across hospitals and practitioners in Switzerland to enhance care for patients with neuroendocrine tumors.

The main aims of the study will be: 1. To obtain epidemiological data on individuals asking for PrEP in Switzerland. We are particularly interested in: * Determining the extent of PrEP use in Switzerland; * Assessing and monitoring the occurrence of sexually transmitted infections (STIs) in this particular population. 2. To assess sexual health and sexual well-being in individuals asking for PrEP using a questionnaire specifically designed for the SwissPrEPared program.