[Endocrine therapy resistance in metastatic breast cancer: mechanisms and clinical implications]. / Résistance à l'endocrinothérapie dans le cancer du sein: mécanismes et implications cliniques.

Endocrine therapy remains a mainstay in the treatment of hormone-sensitive metastatic breast cancer. Nevertheless, acquired resistance to endocrine therapy is an important clinical problem. Understanding the mechanisms of resistance is fundamental in order to develop new therapeutic strategies such as mTOR inhibition through everolimus. Its efficacy in association with endocrine therapy has been shown in two randomized trials. However, the addition of everolimus to endocrine therapy is accompanied by a significant increase in potentially severe side effects. Identifying and adequately addressing these side effects is crucial to decrease toxicity of these new therapies.

["Warm-up!" Prevention of skiing accidents. A preventive campaign by the Swiss Accident Insurance Organization]. / "Warm-up!" Verhütung von Skiunfällen. Eine Präventionskampagne der SUVA.

In 1991, 762,800 leisure time accidents were recorded in Switzerland. 33% of the accidents occurred in the course of a sporting activity with the majority happening while playing football. Skiing accidents came second. Although the recession reduced the number of accidents, skiing accidents were on the increase. The number of all other leisure time accidents including football accidents (the largest group) declined, as did occupational accidents. In terms of medicine, insurance and the economy, the significance of more than 54,000 skiing accidents each year is enormous. SUVA, the Swiss National Accident Insurance Organization is launching a comprehensive campaign to prevent skiing accidents. Among the many methods of prevention possible, such as physical preparation prior to the skiing season, safe equipment, correct skiing technique, consideration for other slope users and adaptation to the snow conditions, etc., this campaign focuses on the avoidance of a cold start. The campaign, which is planned to last several years and will cover the whole of Switzerland, aims to propagate the warm up before setting off downhill. The concept and development of this large-scale, professionally-run SUVA preventive campaign are described.

SWAT team approach to ventricular assistance.

In 1986, the Cardiovascular Research Institute in Sion, Switzerland, created a flying bridge-to-cardiac transplantation team. This team, consisting of two physicians, a physicist, a biomedical engineer, and two intensive care nurses, has participated in 23 bridges to cardiac transplantation in 11 cardiovascular surgery centers in Europe. The cardiac function of all patients was 100% supported by paracorporeal pneumatic biventricular Pierce-Donachy devices. Twenty of the 23 patients have had transplantation, and 11 are alive and well. The bridge-to-cardiac transplantation team, which travels with a transportable driver and the ventricle sets, supervises the bridged patients 24 hours a day until cardiac transplantation is performed.

Instant shift from continuous flow assistance to paracorporeal diaphragm type pulsatile assistance.

Experiments were conducted implementing a special technique for shifting instantaneously from continuous flow to pulsatile flow assistance by using the assistant heart and obtaining the following results: Within only a few minutes, the shift could easily be made from one type of flow assistance to another on calves with normal hearts. In the 10 calves in which ventricular failure was produced, this instantaneous shift from continuous to pulsatile flow assistance brought about remarkable improvements in their hemodynamics. At the occurrence ventricular fibrillation in 6 of the calves, the return to sinus rhythm was possible with aid of this shift mechanism.