Delemont

Researchers are evaluating the effectiveness, feasibility, and safety of a bicycle exercise followed by an intensive lifestyle intervention over three months in patients recently diagnosed with and not yet treated for type 2 diabetes. The study focuses on early lifestyle changes as a first-line treatment to control metabolic problems without medication. This approach seeks to show the benefits of exercise and diet changes, especially in patients with symptoms like increased urination and thirst, who often receive immediate drug treatment instead. Participants are randomly assigned to either standard care or an intervention group that performs a 30-minute bicycle exercise at 60% of their maximum heart rate, followed by a lifestyle program including 3 to 5 aerobic sessions and 2 resistance trainings per week, plus weekly motivational coaching calls. The study involves a symbolic removal of the emergency room bed to encourage exercise immediately after diagnosis. Follow-up visits occur at 2, 7, 30, 60, and 90 days, as well as at 6 months and one year. During the study, participants will monitor blood glucose at home, sending fasting glucose readings to the research team for ongoing metabolic monitoring. Clinical measurements like heart rate, blood pressure, blood gases, and HbA1c will be taken at multiple time points. Activity levels will be tracked by mobile phone and an activity tracker. The main outcome is metabolic control without medication after 3 months, with additional evaluations of physical activity, safety, and quality of life over time.

Researchers are studying hereditary breast and ovarian cancer HBOC and Lynch syndrome LS, which together account for about 30% of new cancer cases in Switzerland. The study focuses on genetic testing for these hereditary cancers to identify mutation carriers and improve prevention through early detection and management. Despite available genetic services, many mutation carriers and their family members do not use these services due to care coordination and communication challenges. The study uses a family-based cohort approach called CASCADE genetic screening, involving mutation carriers, their blood relatives who test negative, and untested relatives. It aims to survey index patients with HBOC or LS and their family members to understand their cancer status, genetic testing use, care coordination needs, communication patterns, and quality of life. The study will also explore the acceptability of a family-based communication and decision support intervention. Participants will be involved in surveys assessing their cancer and genetic mutation status, surveillance practices, psychosocial needs, communication with providers and family, and willingness to engage in genetic services. The primary outcome is establishing the CASCADE cohort within 12 months, with secondary outcomes including cancer surveillance practices. The study is observational and ongoing, with participants living in Switzerland and able to communicate in German, French, Italian, or English.

Researchers are investigating the best approach to treat low-risk patients with isolated subsegmental pulmonary embolism SSPE, a type of blood clot in small lung arteries. The study aims to determine whether monitoring patients without anticoagulation is as safe and effective as giving anticoagulant medication. This is important because many patients currently receive anticoagulants that carry a risk of bleeding, but it is unclear if all patients with isolated SSPE need this treatment. Patients in the trial are randomly assigned to one of two groups. One group receives the anticoagulant drug rivaroxaban, starting with 15 mg twice daily for 21 days, then 20 mg once daily for a total of 90 days. The other group receives a placebo matching the same schedule. The trial compares clinical surveillance without anticoagulation to anticoagulation treatment to assess safety and effectiveness. Participants will be followed for 90 days after randomization to monitor for recurrent venous thromboembolism, significant bleeding events, and overall survival. Researchers will track these outcomes through clinical assessments and safety monitoring. This study is designed to evaluate if careful monitoring alone is a safe alternative to anticoagulation in selected patients with isolated SSPE, potentially reducing bleeding risks from treatment.

Chronic leg and foot ulcers are wounds that do not heal properly over 4 to 8 weeks despite standard care, often due to vascular problems like chronic venous insufficiency and peripheral artery disease. These conditions reduce blood flow, limiting oxygen and nutrients needed for healing, and cause ongoing inflammation and infection. This trial evaluates a new combined optical and magnetic stimulation COMS therapy alongside standard care to improve healing, pain, quality of life, and economic outcomes for patients with venous leg ulcers, including those with arterial complications. Participants will be randomly assigned to receive either standard care alone or standard care plus COMS therapy. Standard care includes wound cleaning, dressing changes, debridement, analgesics as needed, and compression therapy according to guidelines. The COMS treatment is applied 2 to 3 times per week for at least 8 weeks using a specialized device during standard care procedures. If patients receive care at home, trained caregivers will perform these treatments. During the 24-week study, participants will have regular assessments to monitor wound healing, pain, quality of life, and ulcer recurrence. Researchers will measure the percent reduction in wound area as the primary outcome after 24 weeks, along with complete wound closure and time to healing. Safety and device usability will also be evaluated. The study is single-blinded with data assessors unaware of group assignments and includes multiple clinical sites across several countries.

Staphylococcus aureus bloodstream infections are serious and deadly, with high mortality and complications despite available antibiotics. Researchers are evaluating whether adding linezolid, an antibiotic known to inhibit bacterial toxins, to standard treatment can improve outcomes in these infections. This randomized controlled trial aims to test if targeting bacterial virulence factors with linezolid benefits patients with S. aureus bacteraemia. Participants receive either linezolid 600 mg tablets twice daily for 5 days or matching placebo tablets, both alongside standard antibiotic treatment. This is a placebo-controlled, randomized trial designed to assess the additional effect of linezolid when combined with usual care. The treatment period is five days, followed by observation until day 90 to evaluate outcomes. During the study, participants are monitored from the day of randomization through day 90 for clinical outcomes using a Desirability of Outcome Ranking DOOR measure. Researchers collect data on mortality, function, microbiological results, hospital stay, antibiotic use, and safety events, including adverse reactions and laboratory assessments. The study involves detailed follow-up visits and assessments focusing on both efficacy and safety over a three-month period.

Gastroentero-pancreatic neuroendocrine tumours GEP-NETs are rare cancers arising from the neuroendocrine cells in the gastrointestinal tract and pancreas. These tumours share common clinical features but their cell biology and mechanisms are not well understood, limiting targeted treatments. The SwissNET registry is designed to collect detailed information to better understand GEP-NETs and improve management strategies in Switzerland. This study collects data prospectively from patients diagnosed with neuroendocrine tumours confirmed by tissue analysis, regardless of the tumours original location. Data entry is anonymized and gathered from hospitals and general practitioners across Switzerland. A study nurse visits contributing centers to review patient files, and a review board addresses conflicting information. The registry monitors treatment approaches including surgery, medical therapy, and peptide-receptor radionuclide therapy. Participants provide informed consent for their data to be included. Researchers regularly evaluate patient outcomes such as tumour-related mortality and hospitalisation rates every five years. The registry also tracks the incidence of GEP-NETs in Switzerland and the effects of different treatments over time. This ongoing data collection aims to improve understanding and guide future care for patients with neuroendocrine tumours.

Researchers are conducting the SwissPrEPared Study to observe and follow individuals in Switzerland who request pre-exposure prophylaxis PrEP prescriptions. The study aims to gather long-term data on PrEP use, including how common it is, the types of PrEP regimens used, and the occurrence of sexually transmitted infections STIs among this population. It also seeks to assess sexual health and well-being using a specialized questionnaire designed for this program. Participants include individuals aged 16 and older who request PrEP at participating centers and are HIV negative. The study involves ongoing recruitment and observation over a period of 3 years within the SwissPrEPared program. There are no interventional treatments instead, researchers collect data on participants PrEP usage patterns, drug supply methods, adherence, and side effects. Participants will be monitored through questionnaires and medical assessments to track the prevalence and incidence of HIV and other STIs such as syphilis, hepatitis B and C, gonorrhoea, chlamydia, and mycoplasma genitalium. Researchers will also evaluate adherence to PrEP and the program itself over a 10-year period. The study includes regular data collection on these outcomes to better understand the sexual health of individuals using PrEP in Switzerland.