Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.

Objectives: To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.

Methods: A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables.

Iliosacral screw osteosynthesis - state of the art.

Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. While conventional fluoroscopy remains the primary method for intraoperative guidance, precise preoperative planning using multiplanar reconstructions and three-dimensional volume rendering is crucial for ensuring accurate placement of iliosacral or transsacral screws.

Exploring Dietary- and Disease-Related Influences on Flatulence and Fecal Odor Perception in Inflammatory Bowel Disease.

: Inflammatory bowel disease (IBD) affects gastrointestinal function and may alter fecal and flatulence odor (intestinal odor) due to changes in inflammation, the gut microbiome, and metabolism. Investigating the relationship between dietary habits and intestinal odor in IBD is critical given the relationship between diet, gut health, and microbiome diversity. : We performed a cohort analysis of a monocentric, cross-sectional study at a tertiary referral center and compared the perception of fecal and flatulence odor in 233 IBD patients (n = 117 women) with that of 96 healthy controls (HCs) (n = 67 women).

The US4ABL Strategy: A Systematic Ultrasound-Guided Approach for Left Atrial and Ventricular Ablation Procedures.

: The safety and efficacy of electrophysiological (EP) procedures using ultrasound (US) guidance are being increasingly studied. We investigated if a systematic workflow with ultrasound guidance (the US4ABL), comprising four steps (transesophageal echocardiography (TEE) for left atrial thrombus exclusion, US of the groin vessels to guide femoral access, TEE-aided transseptal puncture, and transthoracic echocardiography (TTE) for exclusion of pericardial tamponade after the procedure), reduces the number of complications and fluoroscopy duration and dose. : A total of 212 consecutive patients underwent left-sided ablations using the US4ABL workflow and were compared to a group of 299 patients who underwent the same type of ablations using post-procedural TTE to exclude tamponade (standard group: venous and/or arterial access by palpation and fluoroscopy, and pressure guided transseptal puncture).

Altered thrombin generation with prothrombin complex concentrate is not detected by viscoelastic testing: an in vitro study.

Background: Bleeding guidelines currently recommend use of viscoelastic testing (VET) to direct haemostatic resuscitation in severe haemorrhage. However, VET-derived parameters of clot initiation, such as clotting time (CT) and activated clotting time (ACT), might not adequately reflect a clinically relevant interaction of procoagulant and anticoagulant activity, as revealed by thrombin generation assays. The aim of this study was to evaluate the ability of CT and ACT to indicate thrombin generation activity.

Practical recommendations for therapy and monitoring of mogamulizumab patients in Germany.

Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of the heterogeneous group of cutaneous T-cell lymphomas (CTCL). With the expansion of the biologic treatment landscape, new treatment options have become available in recent years, most notably the C-C chemokine receptor 4 (CCR4)-directed monoclonal antibody mogamulizumab. Based on the phase III pivotal trial, mogamulizumab is recommended by the German S2k guidelines for the second-line treatment of stage IB and above SS and MF, after at least one prior systemic therapy.

Contrasting genetic burden for bipolar disorder: Early onset versus late onset in an older adult bipolar disorder sample.

Older Adults with Bipolar Disorder (OABD) represent a heterogeneous group, including those with early and late onset of the disorder. Recent evidence shows both groups have distinct clinical, cognitive, and medical features, tied to different neurobiological profiles. This study explored the link between polygenic risk scores (PRS) for bipolar disorder (PRS-BD), schizophrenia (PRS-SCZ), and major depressive disorder (PRS-MDD) with age of onset in OABD.

Type 2 diabetes and chronic kidney disease as long-term predictors of cardiovascular events in patients with coronary artery disease.

Background: Both chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) confer a high risk of cardiovascular disease and mortality. These entities frequently coincide. The separate and joint impact of CKD and T2DM on the risk of major cardiovascular events (MACE) and survival is unclear.

Is mesh pore size associated with the outcome in laparo-endoscopic inguinal hernia repair? - a registry-based multivariable analysis.

Introduction: In inguinal hernia repair, mesh weight and pore size are used to describe the mesh characteristics. One meta-analysis of laparo-endoscopic inguinal hernia repairs identified 12 prospective randomized controlled trials (RCTs) with 2,909 patients who had all been treated with lightweight (≤ 50 g/m²) or heavyweight (> 70 g/m²) meshes. None of the 12 RCTs gave details of the pore size.

Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study.

Objectives: The study aimed to estimate the incidence of flap dehiscence and/or necrosis (FD/N) following standard rotational flap (SRF) surgery for cranial vault osteomyelitis without intracranial involvement (CVO) and to identify factors associated with these complications.

Methods: A retrospective study was conducted using chart reviews of patients who underwent SRF to cover CVO defects over a 10-year period. Twenty-one predictor variables were analysed, categorised into demographic, health status, anatomic, and surgical factors.

Three decades of glucose-lowering therapy in patients at high cardiovascular risk - A real-world analysis.

Aim: Over recent years, therapy options and strategies for type 2 diabetes mellitus (T2DM) have developed substantially. This study investigated glucose-lowering treatment in patients with high cardiovascular risk over three decades.

Materials And Methods: A total of 2158 patients undergoing elective coronary angiography at a tertiary care hospital in Europe were included in three sequential observational studies (OS): OS1 (1999-2000; n = 672), OS2 (2005-2008; n = 1005) and OS3 (2022-2023; n = 481).

Characteristics of Patients With Asymptomatic Atrial Fibrillation and Ischemic Stroke-Insights From the GLORIA-AF Registry (Phase 2).

Background: Asymptomatic nonvalvular atrial fibrillation is often suspected in patients with cryptogenic stroke which constitute 20%-30% of ischemic strokes. Detection of atrial fibrillation (AF) and treatment with anticoagulation can reduce the risk of stroke. We sought to investigate the prevalence of asymptomatic atrial fibrillation (aAF) in patients with a history of stroke or an acute stroke on admission.

Abbreviated or Standard Antiplatelet Therapy After PCI in Diabetic Patients at High Bleeding Risk.

Background: Abbreviated antiplatelet therapy (APT) reduces bleeding without increasing ischemic events in largely unselected high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI). Diabetes mellitus (DM) is associated with higher ischemic risk, and its impact on the safety and effectiveness of abbreviated APT in HBR PCI patients remains unknown.

Objectives: This study sought to investigate the comparative effectiveness of abbreviated (1 month) vs standard (≥3 months) APT in HBR patients with and without DM after biodegradable polymer sirolimus-eluting coronary stent implantation.

Assessment of hemodynamic parameters by PiCCO and PAC in patients treated with the Impella CP.

In 28 patients supported by an Impella pump (Impella CP, Abiomed Inc., Danvers, MA), hemodynamic measurements by PiCCO (PULSION Medical Systems SE, Feldkirchen, Germany) and pulmonary artery catheter (PAC or Swan-Ganz Catheter; Edwards Lifescience, Unterschleissheim, Germany) were compared. There was a significant positive correlation of cardiac output (CO;  = 0.