Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Nov 2024
Our approach for out-of-center initiation of extracorporeal membrane oxygenation and subsequent interhospital transport.
Extracorporeal membrane oxygenation (ECMO) initiation at a non-ECMO-capable facility by specialized mobile teams aims for a stabilization prior to center admission, internationally referred to as ECMO retrieval. It is a recommended strategy to avoid primary interhospital transfer of compromised patients with a high risk of life-threatening incidents and potentially death. ⋯ Although recommendations for the initiation of ECMO retrieval programs exist, centers globally tailor their course of action to local individual needs and so do we. The purpose of this work is to portray the decision-tree-based protocol of the intensive care unit 13i2 (Department of Medicine I, Medical University of Vienna) with its operational standards for optimal patient selection and transport organization.
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Wien. Klin. Wochenschr. · Nov 2024
Periprosthetic seromas and a third space effect after high-dose methotrexate.
Besides surgery, chemotherapy including high-dose methotrexate is a mainstay of osteosarcoma treatment. Methotrexate is known to accumulate in tissues and cavities, so-called third spaces (e.g., periprosthetic seromas) leading to local toxicity and delayed elimination (third space effect). We compared the concentrations of methotrexate in serum and periprosthetic seromas to evaluate a potential toxic risk based on a third space effect. ⋯ Methotrexate concentrations of periprosthetic seromas are significantly higher than corresponding serum concentrations possibly contributing to a third space effect. To avoid severe adverse effects punctures of these effusions should be considered.
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Wien. Klin. Wochenschr. · Nov 2024
Acute myeloid leukemia in the next-generation sequencing era : Real-world data from an Austrian tertiary cancer care center.
Next-generation sequencing (NGS) has recently entered routine acute myeloid leukemia (AML) diagnostics. It is paramount for AML risk stratification and identification of molecular therapeutic targets. Most NGS feasibility and results data are derived from controlled clinical intervention trials (CCIT). We aimed to validate these data in a real-world setting. ⋯ Our study validates data from CCIT and supports their relevance for treatment decisions in a real-world setting. Moreover, they demonstrate the feasibility and benefits of NGS within a routine clinical setting.
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Wien. Klin. Wochenschr. · Nov 2024
ReviewAmyloid-beta antibody treatment in Alzheimer's disease : An update on recent data and outlook on implementation in clinical routine.
Amyloid-beta (Aβ) antibody treatment has emerged as a promising approach for the treatment of Alzheimer's disease (AD), targeting the accumulation of Aβ plaques, which are a hallmark of the disease. This review provides an update on recent clinical trial data, highlighting the efficacy and safety of various antibodies targeting Aβ. Recent trials have demonstrated that certain Aβ antibodies can reduce amyloid plaques and slow cognitive decline in patients with early AD. ⋯ The potential for Aβ antibody therapy to be integrated into routine clinical practice is also explored. While Aβ antibody therapy represents a significant advancement in AD treatment, ongoing research is needed to optimize their use and understand their long-term impact. This review underscores the importance of personalized medicine in AD and the need for continued innovation in therapeutic strategies.