The Diagnostic Accuracy of an Electrocardiogram in Pulmonary Hypertension and the Role of "R V1, V2 + S I, aVL - S V1".

: Pulmonary hypertension (PH) can cause characteristic electrocardiographic (ECG) changes due to right ventricular hypertrophy and/or strain. The aims of the present study were to explore the diagnostic accuracy of ECG parameters for the diagnosis of PH, applying the recently adjusted mean pulmonary artery pressure (mPAP) threshold of >20 mmHg, and to determine the role of "R V1, V2 + S I, aVL - S V1". : Between July 2012 and November 2023, 100 patients without PH, with pulmonary arterial hypertension, or with chronic thromboembolic pulmonary hypertension were retrospectively enrolled.

Metabolites in the Dance: Deciphering Gut-Microbiota-Mediated Metabolic Reprogramming of the Breast Tumor Microenvironment.

Breast cancer (BC), a major cause of death among women worldwide, has traditionally been linked to genetic and environmental factors. However, emerging research highlights the gut microbiome's significant role in shaping BC development, progression, and treatment outcomes. This review explores the intricate relationship between the gut microbiota and the breast tumor microenvironment, emphasizing how these microbes influence immune responses, inflammation, and metabolic pathways.

The impact of white matter lesions and subclinical cerebral ischemia on postoperative cognitive training outcomes after heart valve surgery: A randomized clinical trial.

Background: White matter lesions and subclinical cerebral ischemia (SCI) are described as risk factors for postoperative cognitive decline (POCD) following cardiac surgery. This report aims to investigate the effect of brain lesions on postoperative cognitive training outcomes.

Methods: In a randomized, treatment-as-usual controlled trial, elderly patients scheduled for elective heart valve surgery participated.

Digital Transformation of Rheumatology Care in Germany: Cross-Sectional National Survey.

Background: In recent years, health care has undergone a rapid and unprecedented digital transformation. In many fields of specialty care, such as rheumatology, this shift is driven by the growing number of patients and limited resources, leading to increased use of digital health technologies (DHTs) to maintain high-quality clinical care. Previous studies examined user acceptance of individual DHTs in rheumatology, such as telemedicine, video consultations, and mHealth.

Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor management.

Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor (CoGNET), previously called ampullary gangliocytic paragangliomas (GP) are a rare entity, with only few reported cases in the literature. This is a multicentric retrospective cohort of patients treated with endoscopy or surgery for ampullary CoGNET. A literature review of ampullary CoGNET was also performed.

Patient Support in Obstructive Sleep Apnoea by a Large Language Model - ChatGPT 4o on Answering Frequently Asked Questions on First Line Positive Airway Pressure and Second Line Hypoglossal Nerve Stimulation Therapy: A Pilot Study.

Purpose: Obstructive sleep apnoea (OSA) is a common disease that benefits from early treatment and patient support in order to prevent secondary illnesses. This study assesses the capability of the large language model (LLM) ChatGPT-4o to offer patient support regarding first line positive airway pressure (PAP) and second line hypoglossal nerve stimulation (HGNS) therapy.

Methods: Seventeen questions, each regarding PAP and HGNS therapy, were posed to ChatGPT-4o.

Mixed-methods process evaluation of a proactive approach to healthcare in Parkinson's disease-ParkProReakt: a protocol of a hybrid efficacy-implementation study.

Introduction: People with Parkinson's disease (PwPD) experience a wide range of motor and non-motor symptoms that have a significant impact on their health and quality of life. Effective care management for PwPD involves monitoring symptoms at home, involving specialised multidisciplinary care providers and enhancing self-management skills. This study protocol describes the process evaluation within a randomised clinical trial to assess the implementation and its impact on patient health outcomes of ParkProReakt-a proactive, multidisciplinary, digitally supported care model for community-dwelling PwPD.

Differentiating Benign from Malignant Causes of Splenomegaly: Is Acoustic Radiation Force Impulse Elastography Helpful?

Purpose: To evaluate the ability of acoustic radiation force impulse (ARFI) elastography in differentiating benign from malignant etiologies of splenomegaly based on differences in splenic stiffness.

Materials And Methods: Between September 2020 and November 2022, we evaluated 40 patients with splenomegaly-defined by a splenic long axis greater than 13 cm and/or a short axis greater than 6 cm, without visible focal or infiltrative mass lesions-using abdominal ultrasound at our university hospital. Each patient also underwent a standardized ARFI elastographic assessment of the enlarged spleen, with data collected prospectively.

Minimally Invasive Mitral Valve Repair with Intercostal Cryoablation: A Case Report.

 Minimally invasive lateral thoracotomies may cause severe postoperative pain and discomfort. We describe an intraoperative intercostal cryo-neuronal pain block as one possibility for postoperative pain relief.  A 63-year-old male patient underwent minimally invasive mitral valve repair.

Impact of absolute values and changes in meteorological and air quality conditions on community-acquired pneumonia in Germany.

Community-acquired pneumonia (CAP) is a major global health concern as it is a leading cause of morbidity, mortality and economic burden to the health care systems. In Germany, more than 15,000 people die every year from CAP. Climate change is altering weather patterns, and it may influence the probability and severity of CAP.

Adult-onset status epilepticus in patients with COQ8A coenzyme Q10 deficiency: A case series.

This case series describes the clinical features, diagnostic challenges, treatment approaches, and outcomes of three adult patients with COQ8A-related CoQ10 deficiency presenting with focal status epilepticus, who were effectively treated at the Department of Neurology, Philipps University Marburg, Marburg, Germany. The patients, all from consanguineous families with the first two being siblings, presented with a late onset of the disease, characterized by progressive cerebellar ataxia and epilepsy, with clinical deterioration and focal status epilepticus occurring in adulthood. The first patient exhibited myoclonic status, while the second and third patients presented with bilateral tonic-clonic seizures followed by focal status epilepticus manifesting with cortical blindness.

Quantification of Different Types of Waste and Batteries Associated With the Widespread Usage of Continuous Glucose Monitoring Systems.

Background: People with diabetes benefit from continuous glucose monitoring (CGM) systems. A downside of these valuable aids for diabetes management is the generation of a tremendous amount of waste. This study aimed to quantify this CGM-related waste.

Endosonography in head and neck imaging and surgery.

This CME article explores the evolving role of endosonography in otorhinolaryngology and head and neck surgery. Endosonography offers significant potential to improve imaging inside the upper respiratory tract, particularly with advancements in probe technology and imaging resolution. The article will describe the sonoanatomy of the oral cavity, pharynx, and larynx and the selection of probes and scanning techniques used for the various anatomical sites.

Comparison of fludarabine/melphalan (FM140) with fludarabine/melphalan/BCNU (FBM110) in patients with relapsed/refractory AML undergoing allogeneic hematopoietic cell transplantation - a registry study on behalf of the EBMT Acute Leukemia Working Party.

The treatment of relapsed/refractory acute myeloid leukemia (AML) is associated with a dismal prognosis. The allogeneic hematopoietic cell transplantation (allo-HCT) is frequently performed as salvage therapy. Reduced intensity conditioning protocols have been developed with the aim of reducing the leukemia burden without increasing their toxicity.

Visual detection of pulselessness by carotid artery sonography - A prospective observational study among medical students.

Aim: This cross-sectional study aimed to determine whether medical students with little to no ultrasound experience could correctly distinguish between 'pulsation present' and 'no pulsation present' after a short introductory video on the subject using ultrasound videos of the common carotid artery (CCA).

Methods: Ultrasound videos (B-mode, M-mode, and Color Doppler) of pulsatile (systolic blood pressure 70-80 mmHg) and non-pulsatile (cardiopulmonary bypass surgery, clamped aorta) CCA were created. These were demonstrated to the medical students for a period of ten seconds - corresponding to the duration of the manual pulse palpation during cardiopulmonary resuscitation (CPR).

Central vs. Brachial Blood Pressure and Pulse Pressure Amplification for Mortality Risk Prediction in Patients Undergoing Coronary Angiography.

Background: Arterial hypertension is a significant risk factor for cardiovascular (CV) morbidity and mortality. Although central blood pressure (BP) evaluation is considered the gold standard, the reliability of non-invasive measurements remains unclear. Therefore, we compared the predictive value of invasively measured central BP with non-invasively measured brachial BP and analyzed pulse pressure (PP) amplification (delta-PP; difference between central and peripheral PP) as an independent predictor of mortality.

Effectiveness of fissure sealants in 8- to 10-year-olds with and without molar-incisor hypomineralization (MIH) - results from a cross-sectional epidemiological study.

Objective: This cross-sectional study aimed to investigate the use, quality, and caries-preventive effects of fissure sealants (FSs) in 8- to 10-year-olds with and without molar-incisor hypomineralization (MIH).

Materials And Methods: A total of 5,418 children (2,692 males, 2,726 females) were examined via standard instruments (dental mirrors, CPI probes, adequate lighting, mobile examination tables, and air syringes) and methods for the recording of caries (DMFT index, WHO method) and FSs. The classification of MIH followed the recommendations of the European Academy of Pediatric Dentistry (EAPD).

Genes, Gene Loci, and Their Impacts on the Immune System in the Development of Multiple Sclerosis: A Systematic Review.

Multiple sclerosis (MS) is a condition that is characterized by damage to the central nervous system (CNS) that causes patients to experience cognitive and physical difficulties. Although the disease has a complex etiology that involves genetic and environmental factors, little is known about the role of genes and gene loci in its development. Aims: This study aimed to investigate the effects of genes and gene loci on the immune system during the development of MS.

Differentiation of Tumors of the Upper Respiratory Tract Using Optical Metabolic Imaging.

Objectives: With over 184,000 new cases and more than 99,000 deaths per year, malignancies of the larynx are a global health problem. Currently, a dedicated screening method enabling a direct onsite diagnosis is missing. This can lead to delayed diagnosis and worse outcomes of the patients.

Synchrotron-Based Phase-Contrast Micro-CT Combined With Histology to Decipher Differences Between Hereditary and Sporadic Pediatric Pulmonary Veno-Occlusive Disease.

Pulmonary veno-occlusive disease (PVOD) is a lethal variant of pulmonary hypertension. The degree of pulmonary arterial involvement varies. Here, we compare two PVOD patients who were transplanted at 8 years of age, whereof one is a homozygous mutation carrier.

Riociguat in pulmonary arterial hypertension: Application of the 4-strata COMPERA 2.0 risk assessment tool in the PATENT studies.

Background: Risk stratification is an essential part of evaluating disease severity in patients with pulmonary arterial hypertension (PAH). This study applied the 4-strata COMPERA 2.0 risk model to the Phase 3 PATENT-1/2 studies of riociguat.

Do we need standardized postoperative radiographs after locking plate fixation of distal radius fractures - A retrospective analysis of 664 patients.

Introduction: After surgical treatment of fractures of the distal radius, radiographs in 2 planes are routinely performed postoperatively as a standard procedure to verify anatomic reduction and implant positioning. However, the postoperative radiological examinations rarely has a consequence. Therefore, the purpose of this study was to evaluate the frequency of treatment plan changes based on standardized postoperative radiographs.

Isatuximab, Lenalidomide, Bortezomib, and Dexamethasone Induction Therapy for Transplant-Eligible Newly Diagnosed Multiple Myeloma: Final Part 1 Analysis of the GMMG-HD7 Trial.

Previously, addition of isatuximab (Isa) to standard-of-care lenalidomide-bortezomib-dexamethasone (RVd) in transplant-eligible patients with newly diagnosed multiple myeloma in the GMMG-HD7 trial (ClinicalTrials.gov identifier: NCT03617731) resulted in a significant increase of minimal residual disease negativity (MRD-) rates after induction therapy. A total of 662 patients were randomly assigned to receive induction therapy with Isa-RVd (n = 331) or RVd (n = 329), followed by single or tandem autologous stem-cell transplant and second random assignment to maintenance with lenalidomide alone or Isa-lenalidomide.