Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2023
[Artificial Intelligence for computer-aided leukemia diagnostics].
The manual examination of blood and bone marrow specimens for leukemia patients is time-consuming and limited by intra- and inter-observer variance. The development of AI algorithms for leukemia diagnostics requires high-quality sample digitization and reliable annotation of large datasets. Deep learning-based algorithms using these datasets attain human-level performance for some well-defined, clinically relevant questions such as the blast character of cells. ⋯ Using "explainable AI" methods can make the prediction process more transparent and allow users to verify the algorithm's predictions. Stability and robustness analyses are necessary for routine application of these algorithms, and regulatory institutions are developing standards for this purpose. Integrated diagnostics, which link different diagnostic modalities, offer the promise of even greater accuracy but require more extensive and diverse datasets.
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Burn injuries represent a special type of injury that requires special expertise. Both in adequate wound treatment and in intensive medical care, there are various special features that must be considered and due to which treatment by experienced medical personnel is necessary. ⋯ Intensive medical treatment as well as surgical therapy of deep burn wounds should then be performed in a burn center. The article provides an overview of the classifications of burn injuries, the management of wound care, the various therapeutic options, both conservative and surgical, and the special features of burn disease.
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Dtsch. Med. Wochenschr. · Sep 2023
[Primary and secondary prevention in hypercholesterolemia: differences relevant to patient care in the PROCYON trial].
Cardiovascular disease accounts for one third of deaths in Germany. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are considered a major risk factor. Lowering LDL-C levels is therefore an integral part of the prevention of cardiovascular events. ⋯ The comparison of primary and secondary prevention from the PROCYON survey shows overall better utilization of treatment options and higher intensity of care in the secondary prevention group. However, there is still great potential for improvement in both groups to ensure efficient prevention of cardiovascular events.
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In recent years, clinical scientific data on LDL cholesterol and atherosclerosis has led to lowering of LDL-C targets and the expansion of the indication for lipid drug therapy to larger populations or patients. The calculators SCORE2 and SCORE-OP were newly developed to calculate the cardiovascular risk in primary prevention. ⋯ Alternative medication are ACL inhibitors e.g., Bempedoic acid and Inclisiran which represent new drug therapy options for statin intolerance. Nevertheless, a dietary intervention belongs at the beginning of every lipid-lowering therapy.
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Dtsch. Med. Wochenschr. · Sep 2023
[Antagonizing anticoagulants in intracranial hemorrhage - step by step].
Intravenous thrombolysis for acute ischemic stroke is an indispensable tool and current standard of care in neurology. However, until recently direct therapeutic options for intracranial hemorrhage under existing anticoagulation were not available. With the introduction of two new medications - Idarucizumab and Andexanet alfa - neurologists take a more targeted approach in treating these patients.