Refine
Year of publication
Document Type
- Article (82)
- Conference Proceeding (1)
- Preprint (1)
Has Fulltext
- yes (84)
Is part of the Bibliography
- no (84)
Keywords
Institute
- Medizin (84) (remove)
Background: Acoustic Radiation Force Impulse (ARFI)-imaging is an ultrasound-based elastography method enabling quantitative measurement of tissue stiffness. The aim of the present study was to evaluate sensitivity and specificity of ARFI-imaging for differentiation of thyroid nodules and to compare it to the well evaluated qualitative real-time elastography (RTE).
Methods: ARFI-imaging involves the mechanical excitation of tissue using acoustic pulses to generate localized displacements resulting in shear-wave propagation which is tracked using correlation-based methods and recorded in m/s. Inclusion criteria were: nodules $5 mm, and cytological/histological assessment. All patients received conventional ultrasound, real-time elastography (RTE) and ARFI-imaging.
Results: One-hundred-fifty-eight nodules in 138 patients were available for analysis. One-hundred-thirty-seven nodules were benign on cytology/histology, and twenty-one nodules were malignant. The median velocity of ARFI-imaging in the healthy thyroid tissue, as well as in benign and malignant thyroid nodules was 1.76 m/s, 1.90 m/s, and 2.69 m/s, respectively. While no significant difference in median velocity was found between healthy thyroid tissue and benign thyroid nodules, a significant difference was found between malignant thyroid nodules on the one hand and healthy thyroid tissue (p = 0.0019) or benign thyroid nodules (p = 0.0039) on the other hand. No significant difference of diagnostic accuracy for the diagnosis of malignant thyroid nodules was found between RTE and ARFI-imaging (0.74 vs. 0.69, p = 0.54). The combination of RTE with ARFI did not improve diagnostic accuracy.
Conclusions: ARFI can be used as an additional tool in the diagnostic work up of thyroid nodules with high negative predictive value and comparable results to RTE.
The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
Hintergrund: Ein steigendes Einsatzaufkommen lässt sich sowohl im Rettungsdienst als auch im notärztlichen System in Deutschland verzeichnen. Oft werden dabei Fehleinsätze durch leicht erkrankte/verletzte Patienten als wachsende Problematik vermutet. Die vorliegende Untersuchung überprüft die Hypothese von steigenden Einsatzzahlen mit gleichzeitiger Zunahme von gegebenenfalls nichtindizierten Einsätzen.
Material und Methoden: Es erfolgte eine retrospektive Analyse der notärztlichen Einsätze des an der Universitätsklinik Frankfurt am Main stationierten Notarzteinsatzfahrzeugs von 2014 bis 2019. Die Analyse berücksichtigt zudem Faktoren wie die notärztliche Tätigkeit, Behandlungspriorität, Alarmierungsart und das Patientenalter.
Ergebnisse: Im beobachteten Zeitraum lässt sich ein Anstieg der notärztlichen Einsatzzahlen um mehr als 20 % erkennen. Der größte Anstieg zeigt sich bei Einsätzen, bei denen keine notärztliche Tätigkeit (+80 %) notwendig war. Einsätze der niedrigsten Behandlungspriorität (+61 %) sowie der höchsten Behandlungspriorität (+61 %) nahmen ebenfalls signifikant zu.
Diskussion: Die vorliegenden Zahlen stützen die Hypothese, dass bei signifikant gesteigertem Einsatzaufkommen mehr Einsätze durch den Notarzt bewältigt werden müssen, bei denen er rückblickend nicht notwendig gewesen wäre. Trotzdem gibt es auch mehr Patienten, die einen sofortigen Arztkontakt benötigen. Die hieraus resultierende erhöhte Einsatzfrequenz kann zu einer erhöhten Belastung sowie erschwerten zeitgerechten Disposition der notärztlichen Ressource führen.
A 23-year observational follow-up clinical evaluation of direct posterior composite restorations
(2023)
The purpose of this observational follow-up clinical study was to observe the quality of posterior composite restorations more than 23 years after application. A total of 22 patients, 13 male and 9 female (mean age 66.1 years, range 50–84), with a total of 42 restorations attended the first and second follow-up examinations. The restorations were examined by one operator using modified FDI criteria. Statistical analysis was performed with the Wilcoxon Mann–Whitney U test and Wilcoxon exact matched-pairs test with a significance level of p = 0.05. Bonferroni–Holm with an adjusted significance level of alpha = 0.05 was applied. With the exception of approximal anatomical form, significantly worse scores were seen for six out of seven criteria at the second follow-up evaluation. There was no significant difference in the first and second follow-up evaluations in the grades of the restorations with regard to having been placed in the maxilla or mandible, as well as for one-surface or multiple-surface restorations. The approximal anatomical form showed significantly worse grades at the second follow-up when having been placed in molars. In conclusion, the study results show that significant differences regarding FDI criteria in posterior composite restorations occur after more than 23 years of service. Further studies with extended follow-up time and at regular and short time intervals are recommended.