Immunity against vaccine-preventable diseases among pregnant employees in Germany. A situation analysis before the introduction of the Measles Protection Act.

Background: Immunization against vaccine-preventable diseases prior to pregnancy is an important measure of primary prevention both for the mother and the unborn child. We analyzed immunity rates against measles, mumps, rubella, varicella, and pertussis in pregnant employees in Germany prior to significant changes in legal conditions in 2020, to provide a basis of comparison for future research.

Methods: We analyzed occupational-medical routine data in three collectives of pregnant women with an occupational risk of infection in the years 2018 and 2019: 1: hospital staff with regular access to an in-house company physician (n = 148); 2: employees in childcare with regular access to external occupational-health services (n = 139); 3: teachers with no regular access to occupational healthcare (n = 285).

Safety analysis of new medications in clinical trials: a simulation study to assess the differences between cause-specific and subdistribution frameworks in the presence of competing events.

Safety is an essential part of the evaluation of new medications and competing risks that occur in most clinical trials are a well identified challenge in the analysis of adverse events. Two statistical frameworks exist to consider competing risks: the cause-specific and the subdistribution framework. To date, the application of the cause-specific framework is the standard practice in safety analyses.

Washout appearance of hepatocellular carcinomas using standardized contrast-enhanced ultrasound (CEUS) including an extended late phase observation - Real-world data from the prospective multicentre DEGUM study.

Background: Non-invasive diagnosis of hepatocellular carcinoma (HCC) in contrast-enhanced ultrasound (CEUS) is based on the combination of arterial phase hyperenhancement (APHE) and subsequent late (>60 seconds) and mild contrast washout (WO). Whereas APHE is seen in the majority of HCC, wash-out pattern may vary in onset and intensity. In some HCC lesions, even no washout is seen at all.

[Use of high-flow oxygen treatment in the emergency medical service: what are the dangers for users from the perspective of occupational and fire protection?].

Introduction: The administration of high concentrations of oxygen may harm patients or paramedics by increasing the probability of fire. The presented work investigated the effect of oxygen applied via high flow in different concentrations and flow rates on environmental oxygen concentrations in the patient compartment of an ambulance.

Results: Environmental oxygen concentrations increased rapidly over time and oxygen is stored in blankets and clothes over a long period.

Bowel wall thickening and hyperemia assessed by high-frequency ultrasound indicate histological inflammation in Crohn's ileitis.

Purpose: We evaluated ileal bowel wall thickness and semiquantitative vascularization by ultrasound in correlation with the presence or absence of histopathological inflammation in patients with Crohn's disease (CD).

Methods: We conducted a retrospective analysis of 221 ultrasound examinations of the terminal ileum or neoterminal ileum in CD patients with biopsies of the ileum during colonoscopies within 8 weeks of the ultrasound. Ultrasound data were obtained from an inflammatory bowel disease ultrasound register from 2011 to 2017.

The Positive Rate of Pulmonary Embolism by CT Pulmonary Angiography Is High in an Emergency Department, Even in Low-Risk or Young Patients.

Objective: The clinical presentation of pulmonary embolism (PE) can be various and misleading. We analyzed patients with suspicion of PE and subsequently performed computed tomography pulmonary angiography (CTPA) in an emergency department of Internal Medicine, focusing on patient groups in which PE might be underestimated in the emergency setting, such as young patients and patients with low clinical probability.

Material And Methods: In 2016 and 2017, all patients receiving a CTPA for investigation of PE were retrospectively evaluated for clinical parameters (age, symptoms, and vital parameters) and D-dimers.

Clinical Characteristics of Influenza in Season 2017/2018 in a German Emergency Department: A Retrospective Analysis.

Introduction: Influenza infection is a viral disease with significant morbidity and mortality during the cold months. Clinical presentation typically includes cough, fever, and pain. Influenza disease is hardly diagnosed only on the basis of clinical symptoms due to similar clinical presentation of other diseases such as a typical cold or other flu-like diseases.

Acoustic Radiation Force Impulse (ARFI) Elastography in Autoimmune and Cholestatic Liver Diseases.

Introduction: Acoustic Radiation Force Impulse (ARFI) elastography evaluates hepatic fibrosis non-invasively and has been mainly validated in viral hepatitis. Data on rare liver diseases such as autoimmune hepatitis (AIH), overlap syndrome, primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC) are sparse.

Material And Methods: 85 patients (including 31 AIH, 26 PBC, 16 PSC and 3 PSC-and 9 PBC-AIH-overlap syndromes) were retrospectively analysed pointing at ARFI elastography of the liver and the correlation with histologic Ishak fibrosis score (F0-6).

Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis.

Background: Acoustic radiation force impulse (ARFI) elastography is a non-invasive, ultrasound-based approach of evaluation of tissue elasticity. It has not yet been systematically applied to the bowel wall.

Purpose: To perform ARFI elastography of the bowel wall in healthy volunteers and patients with ulcerative colitis (UC).

Indirect comparison of vedolizumab and adalimumab for biologic-naive patients with ulcerative colitis.

Aim: Indirect comparison of efficacy and safety of vedolizumab with adalimumab in biologic-naïve patients with moderate to severe ulcerative colitis (UC).

Methods: Vedolizumab is a gut-selective medication for moderate to severe UC. Since no comparative trials are available for direct comparison of vedolizumab vs adalimumab in UC, a systematic review of literature databases was conducted to identify randomized, placebo-controlled trials of the two drugs in patients with moderate to severe UC after failure of conventional treatment.

Investigations on the Staudinger explosion and its prevention.

About 100 years ago, Hermann Staudinger discovered a series of "strange explosions" involving alkali metals and halocarbons, which were not only very violent, but they were also initiated by mechanical shocks. Later these explosions were referred to as "Staudinger explosions". However, most of the resulting investigations by Staudinger were lost during World War II.

The importance of pancreatic inflammation in endosonographic diagnostics of solid pancreatic masses.

Aims: Endosonography (EUS) is one of the main diagnostic tools for the differential diagnosis of pancreatic masses. The aim of our study was to describe the value of this technique in the work-up of solid pancreatic lesions, considering the influence of the morphological evidence of pancreatic inflammation in the diagnostic process.

Material And Methods: Retrospective analysis of prospectively collected data in our tertiary University center.

Improvement of clinical management and outcome in hepatocellular carcinoma nowadays compared with historical cohorts.

Objectives: Therapeutic approaches in the treatment of hepatocellular carcinoma (HCC) depend on tumour stage, liver function and patient comorbidities. The aim of this study was to investigate the influence of tumour stage and therapeutic approach on overall survival in HCC.

Materials And Methods: Two hundred and fourteen patients with HCC diagnosed between December 2012 and May 2017 were assessed retrospectively for tumour stage [Barcelona Clinic Liver Cancer (BCLC)], liver function (Child-Pugh score), therapeutic approach and outcome (mean survival time).

Interobserver Agreement for Contrast-Enhanced Ultrasound (CEUS)-Based Standardized Algorithms for the Diagnosis of Hepatocellular Carcinoma in High-Risk Patients.

Objectives:  This pilot study aimed at assessing interobserver agreement with two contrast-enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.

Methods:  Focal liver lesions in 55 high-risk patients were assessed independently by three blinded observers with two standardized CEUS algorithms: ESCULAP (Erlanger Synopsis of Contrast-Enhanced Ultrasound for Liver Lesion Assessment in Patients at risk) and ACR-CEUS-LI-RADSv.2016 (American College of Radiology CEUS-Liver Imaging Reporting and Data System).

Differentiation of malignant liver tumors by software-based perfusion quantification with dynamic contrast-enhanced ultrasound (DCEUS).

Unlabelled: BACKGROUNDEnhancement patterns on contrast-enhanced ultrasound (CEUS) help to distinguish different liver tumors.

Objective: Assessing the diagnostic value of dynamic contrast-enhanced ultrasound (DCEUS) for the discrimination of different malignant liver lesions.

Methods: 148 malignant focal liver lesions were assessed prospectively with DCEUS (hepatocellular carcinoma = HCC; cholangiocellular carcinoma = CCC; pancreatic adenocarcinoma = PCA; breast cancer = BC; colorectal cancer = CRC; melanoma = MM).

Interobserver and intermodality agreement of standardized algorithms for non-invasive diagnosis of hepatocellular carcinoma in high-risk patients: CEUS-LI-RADS versus MRI-LI-RADS.

Objectives: We compared the interobserver agreement for the recently introduced contrast-enhanced ultrasound (CEUS)-based algorithm CEUS-LI-RADS (Liver Imaging Reporting and Data System) versus the well-established magnetic resonance imaging (MRI)-LI-RADS for non-invasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.

Methods: Focal liver lesions in 50 high-risk patients (mean age 66.2 ± 11.

Acoustic radiation force impulse (ARFI) elastography of the bowel wall as a possible marker of inflammatory activity in patients with Crohn's disease.

Aim: To evaluate acoustic radiation force impulse (ARFI) shear-wave velocities of the bowel wall in patients with Crohn's disease (CD).

Material And Methods: ARFI shear-wave elastography was analysed within the wall of the stomach, terminal ileum, and sigmoid, and correlated with ultrasound signs of activity in CD patients both retrospectively and in a prospective cohort.

Results: A total of 77 retrospective and 21 prospective CD patients were included.

Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study.

Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab.

EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version).

We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography, focused on the assessment of diffuse liver disease. The first part (long version) of these Guidelines and Recommendations deals with the basic principles of elastography and provides an update of how the technology has changed. The practical advantages and disadvantages associated with each of the techniques are described, and guidance is provided regarding optimization of scanning technique, image display, image interpretation, reporting of data and some of the known image artefacts.

EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Short Version).

We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed.

Two-dimensional shear-wave elastography: a new method comparable to acoustic radiation force impulse imaging?

Objectives: Two-dimensional shear-wave elastography (2D-SWE) is an ultrasound-based technique for the noninvasive assessment of tissue stiffness. In contrast to the well-established point-shear-wave elastography (pSWE) method acoustic radiation force impulse imaging, there is little evidence on the performance and usefulness of 2D-SWE in the assessment of liver stiffness. Thus, the aim of our study was to compare 2D-SWE versus pSWE.

Acoustic radiation force impulse elastography: comparison and combination with other noninvasive tests for the diagnosis of compensated liver cirrhosis.

Background And Aims: The aim of this study was to compare acoustic radiation force impulse (ARFI) elastography with other noninvasive tests and to develop a new score for the assessment of liver fibrosis/cirrhosis.

Materials And Methods: B-mode ultrasound (including high-frequency liver surface evaluation), routine blood tests, ARFI quantification, and mini-laparoscopic liver evaluation were obtained in compensated patients scheduled for mini-laparoscopic biopsy. Our new cirrhosis score (CS) for the assessment of liver cirrhosis, based on a linear combination of ARFI, platelet (PLT), liver surface, and prothrombin index (PI), was calculated by linear discriminant analysis.

Acoustic radiation force impulse shear wave elastography (ARFI) of acute and chronic pancreatitis and pancreatic tumor.

Introduction: Acoustic Radiation Force Impulse (ARFI) elastography evaluates tissue stiffness non-invasively and has rarely been applied to pancreas examinations so far. In a prospective and retrospective analysis, ARFI shear wave velocities of healthy parenchyma, pancreatic lipomatosis, acute and chronic pancreatitis, adenocarcinoma and neuroendocrine tumor (NET) of the pancreas were evaluated and compared.

Material And Methods: In 95 patients ARFI elastography of the pancreatic head, and also of the tail for a specific group, was analysed retrospectively.