Mortality of Patients with Hematological Malignancy after Admission to the Intensive Care Unit

Background: The admission of patients with malignancies to an intensive care unit (ICU) still remains a matter of substantial controversy. The identification of factors that potentially influence the patient outcome can help ICU professionals make appropriate decisions. Patients and Methods: 90 adult patients with hematological malignancy (leukemia 47.8%, high-grade lymphoma 50%) admitted to the ICU were analyzed retrospectively in this single-center study considering numerous variables with regard to their influence on ICU and day-100 mortality. Results: The median simplified acute physiology score (SAPS) II at ICU admission was 55 (ICU survivors 47 vs. 60.5 for non-survivors). The overall ICU mortality rate was 45.6%. With multivariate regression analysis, patients admitted with sepsis and acute respiratory failure had a significantly increased ICU mortality (sepsis odds ratio (OR) 9.12, 95% confidence interval (CI) 1.1-99.7, p = 0.04; respiratory failure OR 13.72, 95% CI 1.39-136.15, p = 0.025). Additional factors associated with an increased mortality were: high doses of catecholamines (ICU: OR 7.37, p = 0.005; day 100: hazard ratio (HR) 2.96, p < 0.0001), renal replacement therapy (day 100: HR 1.93, p = 0.026), and high SAPS II (ICU: HR 1.05, p = 0.038; day 100: HR 1.2, p = 0.027). Conclusion: The decision for or against ICU admission of patients with hematological diseases should become increasingly independent of the underlying malignant disease

Lifetime prevalence and determinants of hand eczema in an adolescent population in Germany: 15-year follow-up of the LISA cohort study

Background Hand eczema is a common inflammatory skin disorder in both adolescence and adulthood. Objectives We sought to assess the lifetime prevalence of hand eczema and associated exogenous and endogenous risk factors among adolescents in Germany. Methods This was a cross-sectional study embedded into a prospective population-based birth cohort in four regions of Germany, which recruited healthy neonates born between November 1997 and January 1999. We included 1736 participants who had completed the 15-year follow-up from birth cohort and 84.6% (1468/1736) had clearly reported whether they have ever had hand eczema. All the data were based on questionnaires and blood tests (immunoglobulin E). Multivariable logistic regression analysis was used to examine endogenous and exogenous factors in relation to the lifetime prevalence of hand eczema among adolescents. Results One thousand four hundred and sixty-eight adolescents (715 girls, 48.7%) were included in the final analysis. The lifetime prevalence of hand eczema among adolescents at the age of 15 was 10.4% (95% confidence interval [CI]: 8.9%-12.1%), with a significantly higher lifetime prevalence among girls than boys (12.7% vs. 8.2%, P = 0.005). Multivariable logistic regression analysis indicated statistically significant associations between the lifetime prevalence of hand eczema and having ever been diagnosed with atopic dermatitis (aOR = 1.8, 95% CI: 1.1-2.8) or having ever had dry skin (aOR = 1.9, 95% CI: 1.1-3.1), respectively. No statistically significant independent associations were found between asthma, hay fever, allergy-related clinical symptoms, immunoglobulin E positivity and other exogenous factors in relation to hand eczema. Conclusion Our study fills a research gap on the epidemiological burden of hand eczema among adolescents. One out of ten ever suffered from hand eczema until age 15 years indicating that hand eczema constitutes a significant burden in paediatric populations. The role of atopic dermatitis in hand eczema reinforces previous findings. Exogenous risk factors warrant further investigation

Epidemiologie akuter Verletzungen und Überlastungsschäden im Unterwasser-Rugby

Fragestellung: Unterwasser-Rugby (UWR) ist ein anspruchsvoller Mannschaftssport; Athleten benötigen dabei ein hohes Maß an Kraft, Ausdauer, Schnelligkeit und Koordination. Intensive Zweikämpfe sind ein wesentlicher Bestandteil des Sports und können zu Verletzungen führen. Derzeit gibt es nur wenig Daten bzgl. des Auftretens von Verletzungen im UWR-Sport. Ziel der vorliegenden Studie war es daher, die Art und Häufigkeit von Verletzungen im UWR-Sport zu untersuchen. Methodik: Zwischen 11/2020 und 03/2021 wurden UWR-Athleten mittels Online-Fragebogen (SurveyMonkey) zu Trainingsgewohnheiten, Verletzungen und chronischen Beschwerden befragt. Der Fragebogen (n = 32 bis 111 Fragen, abhängig von der Anzahl zurückliegender Verletzungen) umfasste: allgemeine und gesundheitsbezogene Daten (n = 10 Fragen), Trainingsgewohnheiten (n = 15 Fragen), Informationen über chronische Beschwerden (n = 9 Fragen) und akute Verletzungen (n = 21 bis 77 Fragen). Zur Bewertung chronischer Überlastungsschäden wurde der Oslo Sports Trauma Research Centre (OSTRC) Score verwendet. Ergebnisse und Schlussfolgerung: Insgesamt wurden 161 aktive Sportler (Ø 36,1 Jahre; Ø180,7 cm, 82,7 kg; männlich: 119, weiblich 39) in die Studie aufgenommen. Das Leistungsniveau war: 1. deutsche Bundesliga: 73x, 2. Bundesliga: 46x, Landesliga: 17x, Bezirksliga: 1x, keine Liga: 24x. Das sportartspezifische Trainingspensum betrug Ø 5,6 Stunden pro Woche, darunter UWR-Training, zusätzliches Schwimmtraining (n = 71), Krafttraining (n = 70) oder Ausdauertraining (n = 102). Zurückliegende akute Verletzungen mit einer Trainingspause und/oder einem Arztbesuch wurden bei 78,8% der Athleten festgestellt. Es handelte sich dabei um Hand/Finger- (42,2%), Hand/Ohr- (Gehirnerschütterung, gerissenes Trommelfell; 18,1%), Handgelenk- (5,5%) oder Halswirbelsäulenverletzungen (5,0%). Chronische Beschwerden wurden von 42,8% der Teilnehmer angegeben, vor allem an Hand/Finger (18,8%), Schulter/Schlüsselbein (14,1%), Halswirbelsäule und Handgelenk (je 10,7%), Kopf/Gesicht (8,7%), Sprunggelenk und Knie (je 6,7%). Die vorliegende Studie an Athleten unterschiedlicher Leistungsstufen analysiert die Verteilung von Verletzungen bei UWR. Führende Verletzungsregionen sind Hand-/Fingerverletzungen, Kopf-/Ohrverletzungen, Handgelenk- und Halswirbelsäulenverletzungen. Die gewonnenen Erkenntnisse können als Grundlage für Präventionskonzepte dienen

Refixation of the Anterior Cruciate Ligament: A Biomechanical Analysis of Suture Techniques in a Porcine Model

Purpose Refixation of acute anterior cruciate ligament (ACL) tears represents an increasingly popular treatment option. Systematic evaluations of various suture technique parameters are still pending. We therefore aimed to evaluate the mechanical pull-out outcomes of various suture methods for optimization of ACL refixation. Methods Sixty fresh knees from mature domestic pigs were dissected and the femoral attachment of the ACL was peeled off. The 60 knees were divided in 10 groups and sutured as follows: (A) one suture (1, 2, 4 and 6 passes), (B) two sutures (2, 4 and 6 passes each; sutures knotted together as a loop) and (C) two sutures (2, 4 and 6 passes each, sutures knotted separately). The pull-out test was conducted using a validated electrodynamic testing machine. First occurrence of failure, maximum pull-out load and stiffness were measured. Suture failure was defined as pull-out of the ACL. Results Two-point fixation, using two sutures, with at least two passes, showed the most favourable biomechanical stability. The maximum pull-out load was significantly higher with two sutures (529.5 N) used compared to one (310.4 N), p < 0.001. No significant differences were found for maximum pull-out loads between two-point fixation versus one-point fixation but stiffness was significantly higher with two-point fixation (107.4 N/mm vs. 79.4 N/mm, p < 0.001). More passes resulted in higher maximum pull-out loads. Conclusion The results suggest using two independent sutures, refixed separately and at least two suture passes, is appropriate for ACL refixation. More suture passes provide additional strength but are technically challenging to achieve during surgery. Level of Evidence Level IV

Soft capacitor fibers using conductive polymers for electronic textiles

A novel, highly flexible, conductive polymer-based fiber with high electric capacitance is reported. In its crossection the fiber features a periodic sequence of hundreds of conductive and isolating plastic layers positioned around metallic electrodes. The fiber is fabricated using fiber drawing method, where a multi-material macroscopic preform is drawn into a sub-millimeter capacitor fiber in a single fabrication step. Several kilometres of fibers can be obtained from a single preform with fiber diameters ranging between 500um -1000um. A typical measured capacitance of our fibers is 60-100 nF/m and it is independent of the fiber diameter. For comparison, a coaxial cable of the comparable dimensions would have only ~0.06nF/m capacitance. Analysis of the fiber frequency response shows that in its simplest interrogation mode the capacitor fiber has a transverse resistance of 5 kOhm/L, which is inversely proportional to the fiber length L and is independent of the fiber diameter. Softness of the fiber materials, absence of liquid electrolyte in the fiber structure, ease of scalability to large production volumes, and high capacitance of our fibers make them interesting for various smart textile applications ranging from distributed sensing to energy storage

Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative

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Correction: Long-term outcome after allogeneic hematopoietic stem cell transplantation for Shwachman–Diamond syndrome: a retrospective analysis and a review of the literature by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP-EBMT)

An amendment to this paper has been published and can be accessed via a link at the top of the paper

A RAB35-p85/PI3K axis controls oscillatory apical protrusions required for efficient chemotactic migration

How cells move chemotactically remains a major unmet challenge in cell biology. Emerging evidences indicate that for interpreting noisy, shallow gradients of soluble cues a system must behave as an excitable process. Here, through an RNAi-based, high-content screening approach, we identify RAB35 as necessary for the formation of growth factors (GFs)-induced waves of Circular Dorsal Ruffles (CDRs), apically restricted actin-rich migratory protrusions. RAB35 is sufficient to induce recurrent and polarized CDRs that travel as propagating waves, thus behaving as an excitable system that can be biased to control cell steering. Consistently, RAB35 is essential for promoting directed chemotactic migration and chemoinvasion of various cells in response to gradients of motogenic GFs. Molecularly, RAB35 does so by directly regulating the activity of p85/PI3K polarity axis. We propose that RAB35 is a molecular determinant for the control of an excitable, oscillatory system that acts as steering wheel for GF-mediated chemotaxis and chemoinvasion