Type 1 diabetes (T1D) is the most common metabolic disorder in children. It progresses through three distinct stages, which are now utilized for preclinical diagnosis. Advances in genetics and screening techniques are enhancing the prediction, prevention, and treatment of the disease. The identification of different T1D subtypes has deepened our understanding of the disease's underlying mechanisms, reflecting genetic, clinical, and immunological diversity. Key genetic variations, including high-risk HLA haplotypes such as DR3 and DR4-DQ8, alongside non-HLA variants. Many of these genetic risk regions are also linked to other autoimmune diseases. Early diagnosis enables secondary prevention strategies, notably with teplizumab, the first approved drug for delaying T1D onset, already in use for stage 2 patients in the USA.
Migrant and allophone people often face linguistic, cultural and structural barriers, with limited access to healthcare. To address this issue, the Therapeutic Patient Education Unit has created at the University Hospitals of Geneva a new therapeutic programme specifically for these people living with obesity. It includes educational workshops tailored to their language skills, health literacy and migratory background. An interdisciplinary team, with the support of interpreters, works together to provide inclusive and personalized care, promoting persons' autonomy. The aim of this innovative scheme is to reduce health inequalities, improve access to care and enhance persons' ability to manage their illness in an environment that respects their cultural diversity.
Peritoneal carcinomatosis is a major therapeutic challenge in gynecological and gastrointestinal malignancies, associated with poor quality of life and short survival. Little is known about the tumor microenvironment (TME) of peritoneal carcinomatosis resistant to chemotherapy. Using multiplexed immunohistochemistry (FoxP3, CD163, CD8, CD68, FAP and Cytokeratin) and sensitive T cell receptor (TCR) repertoire analysis, we investigated spatial and longitudinal changes of the TME of 54 biopsies collected from 18 patients with peritoneal carcinomatosis (six ovarian cancer, nine gastric cancer and three pancreatic cancer) treated in the Nab-PIPAC phase IB trial (repeated cisplatin and nab-paclitaxel by pressurized intraperitoneal aerosol chemotherapy [PIPAC]). Overall, tumors were cold with low T cell infiltration. There was high intra- and inter-patient heterogeneity of TCR repertoire and immune cell distribution, with different tumor patterns and TME compositions depending on the primary cancer. Ovarian and gastric cancers were enriched in CD163+ tumor-associated macrophages while pancreatic cancer was enriched in FAP+ cancer-associated fibroblasts and FoxP3+ regulatory T cells. TCR clonality was higher in ovarian cancer, as compared to oesogastric cancer, likely reflecting expansion of tumor reactive T cells. Focusing on ovarian cancer, hyperexpanded T cells were more abundant in the tumor core as compared to matched stroma. Our spatial and longitudinal study brings new insights into the TME of peritoneal carcinomatosis, with implications for the future design of precision medicine in this disease. Laura Grassi, Raphael Genolet, Valentine Du Bois, Manuela Undurraga, Thibaud Koessler, Jean-Christophe Tille, Antonella Diciola, Mariagrazia Di Marco, Noémie Lang, Nicolas Mach, remi Peanne, Eileen Zhao, Nawel Zouggari, Julie Terzic, Catherine Raimond, Patrick Petignat, Christian Toso, Stefan Monig, Martin Hübner, Frederic Ris, Alexandre Harari, Intidhar Labidi-Galy. Spatial and longitudinal characterization of tumor microenvironment of peritoneal carcinomatosis: Nab-PIPAC phase IB trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6541.
Osteoporosis is a chronic disease requiring lifelong treatment, both non-pharmacological and pharmacological. If life expectancy is long enough, drug treatment must be sequential and adapted to the risk of fracture and to comorbidities. With other treatments than bisphosphonates, sequences are mandatory. When denosumab is stopped, bisphosphonates reduce the rebound effect and limit the risk of vertebral fractures. Osteoanabolic treatments are used for 12 (romosozumab) to 24 months (teriparatide). Their anti-fracture benefits can be maintained with subsequent antiresorptive treatment (bisphosphonates, denosumab), which is an integral part of the management of patients pre-treated with an osteoanabolic agent. Regular monitoring is necessary to assess whether drug treatment should be interrupted, continued, or extended. The aim is to preserve bone health into old age and prevent fractures.
Heart failure affects 2 % of adults and remains a major challenge due to its high morbidity and mortality. Despite optimal treatment, repeated hospitalizations are a burden for patients and healthcare systems. Silently increasing filling pressures lead to pulmonary congestion and cardiac decompensation. Detecting these elevations before symptoms occur is critical. The CardioMEMS validated system, implanted in the pulmonary artery, now provides real-time hemodynamic monitoring. Linked to telemedicine, it allows early optimization of diuretics in order to prevent decompensation and hospitalization, thereby improving the management of heart failure.
