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The influence of blood transfusion indexed to patient blood volume on 5-year mortality after coronary artery bypass grafting : an EuroSCORE II adjusted spline regression analysis
No full textBackground:While timely blood transfusion is critical for restoring oxygen-carrying capacity after coronary artery bypass grafting (CABG), allogeneic blood product transfusions are independently associated with increased long-term mortality, necessitating a risk-stratified approach to balance oxygen delivery against immunological complications and infection risks.Methods: We retrospectively analyzed 3376 patients undergoing isolated CABG between 2005 and 2023 at a single tertiary center. Patients who died during their perioperative hospital stay within 30 days were excluded. Transfusion burden was assessed both as the absolute number of blood product units (packed red blood cells, platelet transfusion, fresh frozen plasma) and as a percentage of calculated patient blood volume. The primary outcome was all-cause mortality at 5 years. Flexible Cox regression with penalized smoothing splines, adjusted for EuroSCORE II, was used to model dose–response relationships.Results: From our cohort of 3376 patients, a total of 137 patients (4.05%) received >10 units of packed red blood cells (PRBC) perioperatively. These patients were older (median 71 vs. 68 years, p Conclusions: Indexing transfusion burden to the percentage of patient blood volume replaced provides a more accurate and clinically actionable predictor of 5-year mortality after CABG than absolute unit counts. Our findings support a shift toward individualized, volume-based transfusion strategies to optimize patient outcomes and resource stewardship in a time of limited availability of blood products
Deep learning for pediatric chest x-ray diagnosis : repurposing a commercial tool developed for adults
No full textThe number of commercially available artificial intelligence (AI) tools to support radiological workflows is constantly increasing, yet dedicated solutions for children are largely unavailable. Here, we repurposed an AI-tool developed for chest radiograph interpretation in adults (Lunit INSIGHT CXR) and investigated its diagnostic performance in a real-world pediatric clinical dataset. 958 consecutive frontal chest radiographs of children aged 2−14 years were included and analyzed with the commercially available AI-tool. The reference standard was determined in a dedicated reading session by a board-certified radiologist. The original reports validated by specialized pediatric radiologists, were considered as second readings. All discordant findings were reanalyzed in consensus. The diagnostic performance of the AI-tool was validated using standard measures of accuracy. For this, the continuous AI output (ranging from 0−100) was binarized using vendor recommended thresholds recommended for adults and optimized thresholds identified for children. Relevant findings were defined as consolidation, atelectasis, nodule, cardiomegaly, mediastinal widening due to mass, pleural effusion and pneumothorax. 200 radiographs [20.9%] demonstrated at least one relevant pathology. Using the adult threshold, the AI-tool showed a high performance for all relevant findings with an AUC 0.94 (95% CI: 0.92–0.95) and. In stratified analysis by age (2−7 vs. 7–14-years-old) a significantly higher performance (p < 0.001) was found for older children with an AUC of 0.96 (95% CI: 0.94–0.98) with a sensitivity and specificity of 87.5% and 82.3% respectively, which further increased using optimized thresholds for children. Repurposing existing AI-tools developed for adult application to pediatric patients could support clinical workflows until dedicated solutions become available
Surveillance of tick-borne encephalitis virus - comparison of vaccination- and infection-induced seroprevalences in Lower Bavaria, Germany
No full textTick-borne encephalitis virus (TBEV) is an emerging flavivirus in Europe and Asia, causing severe neurological disease in humans. Recent advances in serological diagnostics, in particular the detection of antibodies against the nonstructural protein 1 (NS1), enable epidemiological research by differentiation of vaccine- and infection-induced antibodies. This assay facilitates precise studies on TBEV seroprevalence. Our study investigates the TBEV seroprevalence in the district of Passau and the surrounding high-risk areas in Lower Bavaria, Germany. A total of 1339 serum samples from voluntary blood donors were examined using a combination of IgG ELISA, NS1-antibody ELISA, and micro-neutralization test (NT). The results showed a TBEV-specific IgG antibody prevalence of 84.8% (1135/1339). Of these, 3.6% (41/1135) were NS1-antibody positive samples, which indicates infection-related antibodies. The vaccination coverage rate was estimated at 81.2% (1094/1339), which is in line with the results from neighboring Austria but exceeds previous vaccination estimates for Bavaria. The study showed a discrepancy between the officially reported incidences (3.7 new cases/100 000 inhabitants annually) and the actual infection rate based on NS1-antibody seroprevalence (180.6 infections/100 000 inhabitants annually). The manifestation index was calculated at 2.1%, confirming that the majority of TBE infections are subclinical or asymptomatic. The results emphasize the usefulness of NS1-antibody-based diagnostics in the accurate assessment of TBEV prevalence and highlight the need for improved surveillance in endemic areas
Efficient in vivo targeting of the myocardial scar using Moloney murine leukaemia virus complexed with nanoparticles
No full textStevens-Johnson-Syndrom/toxisch epidermale Nekrolyse - Diagnostik und Therapie aus ophthalmologischer Sicht
No full textImpact of Freiburg's urban heat island on atmospheric humidity: a comparative analysis of urban-rural and intra-urban variations across diurnal and seasonal scales using R and QGIS
No full textData-driven consideration of genetic disorders for global genomic newborn screening programs
No full textDer Einfluss von Allgemeinzustand, Vigilanz, Mobilität und die Entwicklung sensomotorischer Defizite auf Mortalität und Outcome bei operativer und konservativer Therapie der Spondylodiszitis im Vergleich
No full textZytokin-Antwort im Rahmen der vaskulären Permeabilitätssstörung bei Patientinnen und Patienten nach Herz- und Gefäßchirurgie
No full textOncological outcomes after robotic salvage radical prostatectomy in patients primarily treated with focal versus radiation therapy: a junior ERUS/YAU collaborative study
No full textBackgroundTo evaluate surgical and cancer-control outcome differences in robotic salvage radical prostatectomy (s-RARP) patients after primary prostate cancer treatment with radiation (RT) versus focal therapy (FT).MethodsThe Junior ERUS/Young Academic Urologist Working Group Robotics in Urology conducted a multicentric project to investigate biochemical recurrence-free (BCR), metastases-free (MFS) and overall survival outcomes in s-RARP patients primarily treated with RT versus FT.ResultsOverall, 439 s-RARP patients qualified for analyses, of which 54% initially received RT with a median time interval between primary cancer treatment and s-RARP of 48 months. Patients with RT more frequently exhibited unfavorable oncological characteristics before s-RARP (PSA, ISUP score), as well as pathological ISUP score (all ≤ 0.01), relative to FT patients. No differences in postoperative complications were observed (p > 0.9). In BCR-free analyses, no significant differences between RT and FT were observed (hazard ratio [HR]: 1.30, p = 0.2). In MFS and OS analyses, patients with RT harbored a higher risk of metastases (HR: 10.1, p ConclusionsImportant differences in tumor characteristics between RT versus FT s-RARP patients exist. These baseline differences translate into unfavorable short-term MFS- and OS outcomes for RT s-RARP patients