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Secondary sclerosing cholangitis in patients suffering cardiogenic shock
No full textAbstract Aims Cardiogenic shock (CS) patients suffer from severe organ hypoperfusion, yet the incidence of secondary sclerosing cholangitis in critically ill patients (SSC‐CIP) in CS is poorly described. Given the limited evidence and severity of this syndrome, we aimed to further investigate SSC‐CIP in the context of CS. Methods and results 24 251 total CS patients admitted between 1 January 2010 and 31 December 2023 were retrospectively screened for the diagnosis of SSC‐CIP across nine German tertiary care centers. Following identification of confirmed SSC‐CIP diagnosis, baseline characteristics, laboratory values, SSC‐CIP‐specific imaging, diagnostics, and outcomes were obtained for analysis. 35 CS patients with a diagnosis of SSC‐CIP were identified, representing a prevalence of 0.14% [95% confidence interval (CI) 0.10, 0.19]. Patients were predominantly male (77.1%) with a median age of 58 years (interquartile range [IQR] 52.5, 68.0). Acute myocardial infarction (42.9%) was the most common aetiology of CS, followed by cardiac arrhythmias (20.0%). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 77.1% of cases after a median of 33 days following CS onset [IQR 24, 65], showing typical biliary casts (60.0%), intraductal filling defects (28.6%), and bile duct obliteration (20.0%). Cast removal and stent placement was performed in nearly half of ERCP procedures (45.7%). Magnetic resonance cholangiopancreatography (MRCP) was performed in 22.9% of cases and showed intraductal dilation (11.4%), lumen narrowing (17.1%), or strictures (14.3%). Median intensive care unit and hospital length of stay was 43 days [IQR 33, 66] and 58 days [IQR 33, 88], respectively. In‐hospital mortality was 57.1%. One‐year (65.7%) and 3‐year (71.4%) mortality remained high. Two patients underwent liver transplantation after a median of 113 days [IQR 105, 122] and were alive at 3‐year follow‐up. Conclusions In this multicentre retrospective analysis in a high‐risk CS cohort, SSC‐CIP was a rare yet serious complication of intensive care unit stay with high in‐hospital mortality. Treatment options are limited, and liver transplantation remains the only viable long‐term treatment option
Strategic selection of polliniser trees can improve fruit quality of lychee, a crop that exhibits mixed-mating
No full texthttp://dx.doi.org/10.13039/501100000981 Horticulture Innovation Australia LtdOpen-Access-Publikationsfonds 202
How do young-old and old-old adults benefit from cognitive-behavioral therapy compared to working-age adults? A large multicenter naturalistic study
No full textDarboux type theorems in multisymplectic geometry
No full textWe give a survey of Darboux type theorems in multisymplectic geometry. These
theorems establish when a closed differential form of a certain type admits a
constant-coefficient expression in some local coordinate system. Beyond the
classical cases of symplectic and volume forms, 0-deformability (i.e. constancy
of linear type) is typically not automatic and has to be imposed, leading to
distinct theorems 'per linear type'
Commentary: Is Trichoderma ear rot on maize really a new dangerous plant disease?
No full textOpen-Access-Publikationsfonds 202
Microtubules as a versatile reference standard for expansion microscopy
No full textOpen-Access-Publikationsfonds 202
Ergebnisse einer Umfrage unter Ferkelerzeugern in Norddeutschland zum Transformationsprozess der Sauenhaltung
No full textDie jüngste Novellierung der Tierschutz-Nutztierhaltungsverordnung (TierSchNutztV) im Februar 2021 betrifft insbesondere ferkelerzeugende Betriebe und stellt diese vor viele Herausforderungen.
Mit der im Rahmen dieser Studie durchgeführten Online-Umfrage unter konventionell-produzierenden Ferkelerzeugern in Norddeutschland wurde der aktuelle Stand der Umsetzung der neuen Haltungsvorschriften und die damit verbundenen Herausforderungen untersucht. Grundsätzlich konnte gezeigt werden, dass zum Ende der Umfrage im März 2023 nur wenige Betriebe mit der Umsetzung der neuen Vorschriften begonnen hatten. Besonders der Einbau einer Bewegungsbucht sowie das Platzangebot von 5 m2 pro Sau im Deckzentrum wurden als sehr herausfordernd eingeschätzt. Betriebe, die schon Teile der Novellierung umgesetzt hatten, sahen hingegen diese Neuerungen im Nachhinein als weniger herausfordernd an. Zusammenfassend wird allerdings deutlich, dass die Umsetzung der siebten Änderung der TierSchNutztV in der Ferkelerzeugung eine komplexe Aufgabe darstellt und ein großer Bedarf an geeigneten Umsetzungskonzepten und Unterstützung bei den betroffenen Betrieben besteht