Neurologic dysfunction after acute aortic dissection type A: A long-term analysis of the German Registry for Acute Aortic Dissection Type A.

Objectives: The "German Registry for Acute Aortic Dissection Type A" (GERAADA) long-term follow-up firstly investigates the neurologic outcomes over a 16-year timeframe and secondly determines whether acute Stanford type A aortic dissection (ATAAD) patients are at risk for secondary neurologic complications.

Methods: Thirty-three centers provided follow-up data of 2,686 individuals. Of those, 814 provided long-term data regarding their neurological status and incidence of stroke.

Improved pathogen identification in sepsis or septic shock by clinical metagenomic sequencing.

Objectives: Despite limited sensitivity and specificity, blood cultures (BCs) still represent the gold standard of diagnostic care in septic patients. We aimed to overcome current diagnostic limitations by unbiased next-generation sequencing (NGS) of circulating microbial cell-free DNA (mcfDNA) in plasma samples.

Methods: We performed a prospective, observational, non-interventional, multicenter study (Next GeneSiS-Trial) to compare positivity rates for NGS-based identification of causative pathogens with BCs in patients suffering from sepsis or septic shock.

Combining multiple imputation with internal model validation in clinical prediction modeling: a systematic methodological review.

Objectives: We aim to investigate how multiple imputation (MI) is combined with internal model validation (IMV) in clinical prediction modeling (CPM) studies, with particular emphasis on the challenges of balancing predictive performance, methodological complexity, and resource demands.

Study Design And Setting: We searched PubMed, Web of Science, and MathSciNet for "multiple imputation" and "validation" and reviewed all CPM articles published until December 2023. Studies were categorized based on whether MI was performed before IMV (MI-prior-IMV) or during IMV (MI-during-IMV).

Association of intrapatient tacrolimus variability and concentration-to-dose ratio with outcomes in pediatric kidney transplantation.

Background: Data on the relevance of tacrolimus intrapatient variability (TacIPV) and concentration-to-dose ratio (C/D ratio) as an approximation of tacrolimus metabolism for predicting outcomes in pediatric kidney transplant (pKTx) recipients are scarce.

Methods: We conducted a multicenter retrospective study of 255 pKTx recipients from the CERTAIN registry. TacIPV was quantified as the coefficient of variation (CV%) during months 6-12 post-transplant.

Cervical Tenderness (Parametropathy) is a Diagnostic Tool for the Chronic Pelvic Pain Syndrome.

Introduction: Chronic pelvic pain syndrome (CPPS) is a diagnosis of exclusion in the absence of pathological findings. We aimed to test the hypothesis that cervical motion tenderness (or parametropathy) may serve as a diagnostic tool for CPPS.

Methods: We examined the prevalence of parametropathy in patients with and without chronic pelvic pain by analyzing consecutive vaginal examinations in 155 women ≥ 18 years.

Correction: ENABLE-App-Based Digital Capture and Intervention of Patient-Reported Quality of Life, Adverse Events, and Treatment Satisfaction in Breast Cancer: Protocol for a Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/69855.].

ENABLE-App-Based Digital Capture and Intervention of Patient-Reported Quality of Life, Adverse Events, and Treatment Satisfaction in Breast Cancer: Protocol for a Randomized Controlled Trial.

Background: In recent years, breast cancer treatment has taken the path toward personalized medicine. Based on individual tumor biology, therapy tailored to the particular subtype of cancer is increasingly being used. The aim here is to find the most suitable therapy for the disease.

[Endoscopic Retrograde Cholangiopancreatography before Gallbladder Removal - an Unholy Alliance?].

Endoscopic retrograde cholangiopancreaticography (ERCP) is, among other indications, performed in conjunction with cholecystectomy (CHE) for suspected bile duct stones. Due to its invasiveness, ERCP is an endoscopic examination with considerable morbidity and mortality and influence the perioperative outcome after CHE.In this retrospective and monocentric study, all patients who underwent CHE in Baden-Baden from 01.

Mechanism-based modular psychotherapy versus cognitive behavioural therapy for adolescents and young adults with childhood trauma experiences: study protocol for a feasibility trial within the German Center for Mental Health.

Introduction: Patients with mental disorders and a history of childhood trauma show an early onset of psychopathology and often a poor response to standard disorder-specific treatments. They represent a patient group which requires more personalised interventions targeting the transdiagnostic mechanisms related to early trauma and its functional consequences. The mechanism-based modular psychotherapy (MeMoPsy) approach is conceptualised as an innovative framework for psychotherapy development.

Intraoperative hemodynamic management during pancreatoduodenectomy - an analysis of 525 patients.

Importance: Optimization of perioperative hemodynamic management during major pancreatic surgery can reduce postoperative complications.

Objective: In this study, we aimed to investigate the effect of intraoperative hemodynamic management, in consideration of both anesthesiologic and surgery-related aspects on major short-term complications following partial pancreatoduodenectomy (PD).

Design, Setting And Participants: Data of 525 patients undergoing PD between January 2017 and December 2018 at the Heidelberg University Hospital were retrospectively analyzed.

Vulvodynia and Chronic Vulvar Pain: Influencing Factors and Long-Term Success After Therapeutic Local Anesthesia (TLA).

Introduction: Vulvodynia is a debilitating sexual disorder with a high prevalence of 7-11%. In the study reported here, we analyzed long-term results from a prospective, non-controlled observational study to enhance our understanding of the success of therapeutic local anesthesia (TLA) and to investigate factors that predict a response or failure of therapy, with the overall aim to gain new insights into the complex medical condition of vulvodynia.

Methods: A total of 45 patients diagnosed with severe chronic vulvodynia or chronic vulvar pain (Numeric Analog Scale [NAS] ≥ 6, median 7.

Anserine reduces mortality in experimental sepsis by preventing methylglyoxal-induced capillary leakage.

Background: We previously identified methylglyoxal as a biomarker for early identification and outcome prediction in human sepsis. We hypothesised that methylglyoxal causally impacts disease severity, and the methylglyoxal-scavenging dipeptide anserine can attenuate the detrimental effects of methylglyoxal.

Methods: Using a translational approach, secondary analyses of two observational trials were performed to test the initial hypotheses.

Efficacy of Hand Cooling and Compression in Preventing Taxane-Induced Neuropathy: The POLAR Randomized Clinical Trial.

Importance: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting adverse effect of taxane-based chemotherapies. Currently, there is no established strategy for prevention or treatment.

Objective: To compare the effectiveness of 1-sided hand cooling and compression for preventing CIPN in patients with primary breast cancer receiving taxane-based chemotherapy.

Impending sepsis-induced coagulopathy (SIC) is associated with increased disease severity in SIC-negative patients: a secondary analysis of a prospective exploratory study.

Due to the intense crosstalk between the coagulation and immune systems, coagulation disorders are an integral part of the disturbed host response to infection that defines sepsis. These so-called sepsis-induced coagulopathies (SIC) are associated with increased morbidity and mortality. However, we still do not know enough about the prevalence and risk factors for SIC in different patient groups.

Evaluation of Ex Vivo Shear Wave Elastography of Axillary Sentinel Lymph Nodes in Patients with Early Breast Cancer.

The pretherapeutic assessment of axillary lymph node status is crucial in staging early breast cancer patients, significantly influencing their further treatment and prognosis. According to current guidelines, patients with clinically unsuspicious axillary status regularly undergo a biopsy of sentinel lymph nodes (SLNs), whereby metastasis is detected in up to 20% of cases. In recent years, the use of shear wave elastography (SWE) has been studied as an additional ultrasound tool for the non-invasive assessment of tumors in the breast parenchyma and axillary lymph nodes.

Using Machine Learning and Feature Importance to Identify Risk Factors for Mortality in Pediatric Heart Surgery.

The objective of this IRB-approved retrospective monocentric study was to identify risk factors for mortality after surgery for congenital heart defects (CHDs) in pediatric patients using machine learning (ML). CHD belongs to the most common congenital malformations, and remains the leading mortality cause from birth defects. The most recent available hospital encounter for each patient with an age <18 years hospitalized for CHD-related cardiac surgery between the years 2011 and 2020 was included in this study.

Associations between Psychosocial Working Conditions and Work-Specific Self-Efficacy Beliefs Among Employees Receiving Psychotherapeutic Consultation at Work.

Purpose: By considering work-related aspects during early intervention and treatment of employees with (subclinical) symptoms of common mental disorders, psychotherapeutic consultation at work (PT-W) aims to increase work-specific self-efficacy (SE) to finally reduce sickness absence and contribute to successful return to work. This study, thus, aims to investigate interrelations between working conditions and work-specific SE among employees before receiving PT-W.

Methods: The study uses baseline data of a randomized controlled trial testing the efficacy of PT-W in Germany (n = 535).

Age-Related Differences in Rejection Rates, Infections, and Tacrolimus Exposure in Pediatric Kidney Transplant Recipients in the CERTAIN Registry.

Introduction: Data on age-related differences in rejection rates, infectious episodes, and tacrolimus exposure in pediatric kidney transplant recipients (pKTRs) on a tacrolimus-based immunosuppressive regimen are scarce.

Methods: We performed a large-scale analysis of 802 pKTRs from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry from 40 centers in 14 countries. The inclusion criteria were a tacrolimus-based immunosuppressive regimen and at least 2 years of follow-up.

Neck Reflex Points: A New Clinical Test? Prevalence in Two Cohorts and Its Covariates.

: Neck reflex points (NRPs) are 2 × 6 potentially tender areas of the neck, denominated NRP-C0 to NRP-C7. They are different from muscular trigger points and become tender in response to chronic trigeminal irritation. NRP examination has a high inter-rater reproducibility.

Patient sex and use of tranexamic acid in liver transplantation.

Background: Differences in medical treatment between women and men are common and involve out-of-hospital emergency care, the intensity of pain treatment, and the use of antifibrinolytic treatment in emergency trauma patients. If woman and man receive different antifibrinolytic treatment in highly-standardized major transplant surgery is unknown.

Methods: We conducted a retrospective cohort study on patients who underwent liver transplantation at Heidelberg University Hospital, Heidelberg, Germany between 2004 and 2017.

Prevalence of relevant early complications during the first 24 h on a normal ward in patients following PACU care after medium and major surgery: a monocentric retrospective observational study.

Purpose: Even today, it remains a challenge for healthcare professionals to decide whether a clinically stable patient who is recovering from uncomplicated medium or major surgery would benefit from a postoperative intensive care unit (ICU) admission, or whether they would be at least as adequately cared for by a few hours of monitoring in the post-operative care unit (PACU).

Methods: In this monocentric retrospective observational study, all adult patients who (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) in Anästh Intensivmed (50):S486-S489, 2009) underwent medium or major surgery between 1 January 1 2014 and 31 December 2018 at the Heidelberg University Surgical Center, and (Vimlati et al. in Eur J Anaesthesiol September 26(9):715-721, 2009) were monitored for 1-12 h in the PACU, and then (De Pietri et al.

Model of integrated mental health video consultations for people with depression or anxiety in primary care (PROVIDE-C): assessor masked, multicentre, randomised controlled trial.

Objective: To evaluate whether an integrated mental health video consultation approach (PROVIDE model) can improve symptoms compared with usual care in adults with depression and anxiety disorders attending primary care.

Design: Assessor masked, multicentre, randomised controlled trial (PROVIDE-C).

Setting: In 29 primary care practices in Germany, working remotely online from one trial hub.

Prospective Validation of the Pancreatic Fistula Risk Classification by the International Study Group for Pancreatic Surgery (PARIS trial).

Objective: The aim of this study was a prospective validation of the recently established ISGPS pancreas classification as a parenchymal risk classification system for pancreatic fistula after pancreatoduodenectomy.

Summary Background Data: Postoperative pancreatic fistula (POPF) is the major driver for complications after partial pancreatoduodenectomy (PD). Recently, the International Study Group for Pancreatic Surgery (ISGPS) published a pancreas classification containing the parameters main pancreatic duct diameter (MPD) and pancreatic texture to help assess the risk of POPF development following pancreatoduodenectomy.