259594 research outputs found
Sort by
Zur Hochwasserwahrnehmung im Murgtal - eine Analyse der aktuellen Hochwasserrisikowahrnehmung von Anwohner:innen in Gaggenau
No full textDrug reaction with eosinophilia and systemic symptoms (DRESS) induced by meropenem in a patient receiving avelumab and subsequent flare-up
No full text
Assessment of the reporting and incidence of prostate cancer unconventional histologies in tertiary referral institutions: an under-reported but exploding phenomenon?
No full textProstate cancer (PCa) with unconventional histologies (UHs) is not infrequent and may be associated with different prognosis compared with conventional PCa depending on the type, subtype, or pattern considered. A recent World Health Organization update recommends UHs to be reported on biopsy and final pathology. Our study aimed to assess the incidence and reporting attitudes of PCa UHs at tertiary referral institutions. Overall, 22 and 11 centers provided data on internal pathological guidelines and/or UH incidence, respectively. A comprehensive list of UHs was reported by pathologists only in <50% of the centers. Of note, ductal, intraductal, cribriform, and sarcomatoid UHs were consistently reported in ≥85% of the centers. The incidence of UHs was 373 on 15 605 biopsies (2.4%) and 737 on 14 945 (4.9%) final pathology specimens. However, UH incidence at final pathology increased from 0.7% in 2010 to 19% in 2023, while it remained stable on biopsy (1.5% in 2010 and 2.1% in 2023). The most frequent UH was cribriform (64%), followed by ductal (10%) and intraductal (9%) PCa. In conclusion, UHs are not infrequent and their recognition is increasing. However, pathological reporting is not well standardized, and prostate biopsies likely underestimate UHs
Development of Powerly, unguided mobile app intervention preventing postpartum depression and anxiety & study protocol of randomized clinical trial
No full textBackgroundUp to 30 % of pregnant individuals experience high levels of stress. At the same time, 15–20 % of new mothers develop postpartum depression, and 25–35 % experience postpartum anxiety. Mobile applications have the potential to provide an accessible, scalable solution to these mental health challenges. However, previous evidence indicates that none of the commercially available apps for perinatal depression and anxiety have been rigorously evaluated through randomized clinical trials (RCTs), and the quality of these apps remains moderate. In response to this gap, we aim to develop and empirically evaluate Powerly, a mobile app intervention designed to prevent postpartum depression and anxiety.MethodsWe will conduct a two-arm RCT with 140 healthy pregnant participants to assess the impact of Powerly use compared to care as usual (CAU). Powerly is based on cognitive behavioral therapy techniques and developed in consultation with stakeholders, including healthcare professionals and pregnant individuals. It will offer personalized psychological support tailored to users' needs for four weeks. Self-reported mental health assessments will be collected at baseline, after four weeks of app use, and six weeks postpartum.DiscussionWe anticipate that participants using Powerly will demonstrate significant improvements in mental health outcomes, including reduced rates of postpartum depression, compared to the CAU group. Additionally, we expect positive changes in emotion regulation, resilience, and mother and child outcomes, such as enhanced maternal bonding and a more positive birth experience. If proved effective, Powerly can offer a scalable, publicly accessible solution for pregnant individuals in need
Antioxidant therapy in inborn metabolic diseases
No full textOxidative stress contributes to the pathophysiology of several inherited metabolic diseases (IMDs). The quality and extent of clinical evidence for the use of antioxidant therapies in IMDs have yet to be ascertained. Despite frequent clinical use, robust evidence from large-scale trials is limited. The strongest support comes from studies on idebenone in Leber's hereditary optic neuropathy, showing improvements in visual outcomes. For other antioxidants and conditions, evidence is mixed or constrained by small sample sizes and short trial durations. Coenzyme Q10 in mitochondrial diseases, vitamin E in lipid disorders, and N-acetylcysteine in various IMDs have shown some promise, but evidence is heterogeneous. Challenges include optimizing dosing, dissecting oxidative stress mechanisms across disorders, and overcoming pharmacokinetic limitations. High-grade evidence exists for the clinical efficacy of N-acetyl-L-leucine for both Niemann Pick type C disease and other lysosomal storage diseases, though its potential antioxidant effect is indirect. This review highlights the need for larger trials with standardized, clinically relevant outcomes. Future research should explore oxidative stress mechanisms, targeted therapies, and combination approaches. While antioxidants hold potential, evidence remains limited, warranting cautious use and further investigation to define their role in these rare but cumulatively impactful disorders
The effectiveness of a physician-led web portal on back pain: a cluster randomized controlled trial
No full text
The clinical and molecular landscape of diffuse hemispheric glioma, H3 G34-mutant
No full textBackgroundDiffuse hemispheric glioma, histone 3 (H3) G34-mutant, has been newly defined in the 2021 World Health Organization (WHO) classification of central nervous system tumors. Here we sought to define the prognostic roles of clinical, neuroimaging, pathological, and molecular features of these tumors.MethodsWe retrospectively assembled a cohort of 114 patients (median age 22 years) with diffuse hemispheric glioma, H3 G34-mutant, central nervous system WHO grade 4, and profiled the imaging, histological, and molecular landscape of their tumors.ResultsCompared with glioblastoma, H3 G34-mutant diffuse hemispheric gliomas exhibited less avid contrast enhancement, necrosis, and edema on MRI. Comprehensive analyses of mutational and DNA copy number profiles revealed recurrent mutations in TP53 and ATRX, homozygous deletions of CDKN2A/B, and amplifications of PDGFRA, EGFR, CCND2, and MYCN. MGMT promoter methylation was detected in 79 tumors (75%); 11 tumors (13%) showed DNA copy number profiles suggestive of circumscribed deletions on 10q26.3 involving the MGMT locus. Median survival was 21.5 months. Female sex, gross total resection, and MGMT promoter methylation were positive prognostic factors on univariate analysis. Among radiological, pathological, and molecular features, the absence of pial invasion and the presence of microvascular proliferation and CDK6 amplification were positive prognostic factors on univariate analyses.ConclusionsThis study refines the clinical and molecular landscape of H3 G34-mutant diffuse hemispheric gliomas. Dedicated trials for this novel tumor type are urgently needed