Open Access

Wozu sind Akademiker*innen auf Twitter? Im Unterschied zu Blogs, deren Funktion für die Wissenschaftskommunikation unstrittig ist, werden Aktivitäten auf Twitter und in anderen sozialen Medien immer noch vielfach skeptisch gesehen. Wissenschaft in 280 Zeichen? Abschreckend wirkt neben dem Verdacht extremer und letztendlich unsinniger Komplexitätsreduktion eine pauschale Kritik am Twittern. Zu den Topoi dieses Diskurses, der so verbreitet ist, dass man fast von einem eigenen journalistischen Genre sprechen könnte, gehört die Vorstellung, dass man sich auf Twitter in einem abgeschlossenen Kommunikationsraum, einer ›Bubble‹ oder ›Gemeinde‹, befinde. Diese Pauschalkritik wird, ebenso wie die weniger häufige positive Berichterstattung, auf Twitter intensiv diskutiert. Am häufigsten finden sich zwei Hinweise: erstens, dass es eben nicht die eine Twittererfahrung gibt, sondern individuelle Formen der Präsenz und der Interaktion; zweitens, dass sowohl die Idee der ›Bubble‹ als auch der ›zwei Welten‹, von Twitter auf der einen und ›realem Austausch‹ auf der anderen Seite, nicht erfasst, wie Kommunikation auf Twitter funktioniert und von Wissenschaftler*innen produktiv genutzt wird. Wer verstehen will, dass Twitter für Akademiker*innen attraktiv sein kann, sollte sich bewusst machen, dass Twitter viel Verschiedenes bietet.

Background: Concomitant radiation with BRAF inhibitor (BRAFi) therapy may increase radiation-induced side effects but also potentially improve tumour control in melanoma patients. Methods: A total of 155 patients with BRAF-mutated melanoma from 17 European skin cancer centres were retrospectively analysed. Out of these, 87 patients received concomitant radiotherapy and BRAFi (59 vemurafenib, 28 dabrafenib), while in 68 patients BRAFi therapy was interrupted during radiation (51 vemurafenib, 17 dabrafenib). Overall survival was calculated from the first radiation (OSRT) and from start of BRAFi therapy (OSBRAFi). Results: The median duration of BRAFi treatment interruption prior to radiotherapy was 4 days and lasted for 17 days. Median OSRT and OSBRAFi in the entire cohort were 9.8 and 12.6 months in the interrupted group and 7.3 and 11.5 months in the concomitant group (P=0.075/P=0.217), respectively. Interrupted vemurafenib treatment with a median OSRT and OSBRAFi of 10.1 and 13.1 months, respectively, was superior to concomitant vemurafenib treatment with a median OSRT and OSBRAFi of 6.6 and 10.9 months (P=0.004/P=0.067). Interrupted dabrafenib treatment with a median OSRT and OSBRAFi of 7.7 and 9.8 months, respectively, did not differ from concomitant dabrafenib treatment with a median OSRT and OSBRAFi of 9.9 and 11.6 months (P=0.132/P=0.404). Median local control of the irradiated area did not differ in the interrupted and concomitant BRAFi treatment groups (P=0.619). Skin toxicity of grade ≥2 (CTCAE) was significantly increased in patients with concomitant vemurafenib compared to the group with treatment interruption (P=0.002). Conclusions: Interruption of vemurafenib treatment during radiation was associated with better survival and less toxicity compared to concomitant treatment. Due to lower number of patients, the relevance of treatment interruption in dabrafenib treated patients should be further investigated. The results of this analysis indicate that treatment with the BRAFi vemurafenib should be interrupted during radiotherapy. Prospective studies are desperately needed.

Background: Refractory ascites (RA) is a frequent complication of cirrhosis, requiring large volume paracentesis or placement of a transjugular intrahepatic portosystemic shunt (TIPSS). The automated low-flow ascites pump (alfapump, Sequana Medical AG, Zurich, Switzerland) is an innovative treatment option for patients with RA. Aim: To assess safety and efficacy of this treatment in patients with a contraindication to TIPSS. Methods: Fifty-six patients (43 males; mean age 62 years) from centres in Germany, Switzerland, UK and Spain were included and followed for up to 24 months. Complications, device deficiencies, paracentesis frequency and patient survival were recorded. Results: At the time of this analysis, 3 patients completed the 24-month observation period, monitoring of 3 was ongoing, 9 underwent liver transplantation, 17 patients were withdrawn due to serious adverse events and 23 patients died. Most frequently observed technical complication was blocking of the peritoneal catheter. Twenty-three pump-related reinterventions (17 patients) and 12 pump exchanges (11 patients) were required during follow-up. The pump system was explanted in 48% of patients (in 17 patients due to serious adverse events, in 9 at the time of liver transplantation and in 1 due to recovery from RA). Median frequency of paracentesis dropped from 2.17 to 0.17 per month. Conclusions: The alfapump can expand therapeutic options for cirrhotic patients with RA. Continuous drainage of ascites in a closed loop automated system led to significant reduction in paracentesis frequency. Technical and procedural improvements are required to reduce the rate of adverse events and reinterventions.