Hietzing hospital

Abstract Background Low-density lipoprotein cholesterol (LDL-C) has an established role in the development of atherosclerotic cardiovascular disease. The 2019 ESC/EAS dyslipidaemia guidelines recommended more intensive treatment goals, however, many patients do not reach them. Bempedoic acid (BA) is a first-in-class ATP citrate lyase inhibitor that lowers LDL-C levels. There is limited data on the use of BA and BA + ezetimibe (EZE) fixed-dose combination (FDC) in clinical practice. Purpose The purpose of this snapshot of 1-year follow-up data from the MILOS study is to evaluate the effectiveness and safety of BA and its FDC in routine clinical practice in Germany. Methods MILOS is a European, prospective, observational, non-interventional study in adult patients with primary hypercholesterolaemia or mixed dyslipidaemia. Patients were recruited from 126 sites in Germany between January 2021 and January 2022, and are followed up for 1–2 years after baseline measurements. Here, we summarise 1-year follow-up data from a snapshot taken on January 13th, 2023. Results Of 992 patients enrolled in Germany, 714 had either completed their 1-year follow-up or discontinued the study prematurely, and 524 of these 714 patients attended their 1-year follow-up visit. For this snapshot, 714 patients are used when determining cardiovascular (CV) outcomes and safety endpoints, and 524 patients are used when reporting efficacy data. The overall mean (SD) age of the population (n=524) was 64.7 (10.0) years, and 60.7% were male. Patients treated with BA/BA+EZE FDC had an overall mean LDL-C level of 2.18 mmol/L (84.1 mg/dL) at 1 year compared with 3.20 mmol/L (123.6 mg/dL) pre-treatment, representing a mean relative LDL-C reduction of 27.3%. Overall, 25.8% (135/524) of patients had reached their LDL-C goal after 1 year of treatment compared with 4.0% (21/524) pre-treatment (Figure 1A and 1B). The overall incidence rate of the composite endpoint of major adverse cardiovascular event (4-component MACE) including CV death, non-fatal myocardial infarction, non-fatal stroke, and coronary revascularisation (n=714) was 3.36%. At 1-year follow-up, 19% (136/714) of patients had an adverse drug reaction (ADR) suspected to be related to BA/BA+EZE FDC, and 0.8% (6/714) had serious ADRs, as deemed by the investigator. Conclusion This snapshot analysis of 1-year follow-up data suggests that the addition of BA to other lipid-lowering therapies increases the proportion of patients at LDL-C goal by ∼6-fold in the observed cohort. The safety and tolerability profile of bempedoic acid are in line with data from randomised controlled trials.

Smoking is the main risk factor for COPD. Oscillometry is a easy to perform, not time-consuming technique with low patient burden that provides detailed assessment of respiratory impedance (Z) measurement. The study aims were to evaluate Z as a means to detect early airway abnormalities in past smokers (PS) and active smokers (AS) compared to non-smokers (NS). <b>Methods:</b> We included 7560 subjects (Age 18-82) of the Austrian LEAD general population cohort, a longitudinal single-centered, observational study. Z-measurements were obtained (Resmon Pro Full, Restech, Italy) as conducted by trained technicians. Resistance (R) and reactance (X) at 5 Hz were analysed as well as the area under X (AX) and frequency dependence of R (R5-R19). Data are reported as % of predicted (Berger et al., ERJ open 2021). Smokers were subdivided by the number of pack years (PY). <b>Results:</b> AS with &gt; 10 PY had higher R5 values than NS and PS&lt; 10 PY groups. In addition, this group has manifested higher AX than PS &gt;10 PY. PS, irrespective of the number of PY, showed no Z differences compared to the NS (Table). * p&lt;0.05 vs Smoker &gt; 10 pack/years. Data are presented as median (IQR). <b>Conclusion:</b> Oscillometry is a feasible approach to identify Z changes in active smokers.

The management of asthma has fundamentally changed during the past decades. The present guideline for the diagnosis and treatment of asthma was developed for respiratory specialists who need detailed and evidence-based information on the new diagnostic and therapeutic options in asthma. The guideline shows the new role of biomarkers, especially blood eosinophils and fractional exhaled NO (FeNO), in diagnostic algorithms of asthma. Of note, this guideline is the first worldwide to announce symptom prevention and asthma remission as the ultimate goals of asthma treatment, which can be achieved by using individually tailored, disease-modifying anti-asthmatic drugs such as inhaled steroids, allergen immunotherapy or biologics. In addition, the central role of the treatment of comorbidities is emphasized. Finally, the document addresses several challenges in asthma management, including asthma treatment during pregnancy, treatment of severe asthma or the diagnosis and treatment of work-related asthma.

BackgroundCarotidynie defines localised, unilateral neck pain in the region of the carotid bifurcation and is a relatively frequent event with a myriad of causes.Differential diagnosis include mainly arterial dissection, large vessel vasculitis or local inflammation or surrounding structures (e.g. lymphadenitis). We herein describe a patient with carotidynie caused by a TIPIC syndrome under follow up by ultrasound imaging.MethodsThe logiq S8 from GE2 with 2 different linear probes was used.GE L8-18i-D Hockey Stick probe.ML 6-15-D Matrix probe.Case presentationA 36 year old male patient was referred to our rheumatological outpatient department because of localized pain in the left lateral part of the neck, which persisted over two days. Swallowing of fluids or solid food was painful, but unimpaired. The patient mentioned no recent trauma, but he reported symptoms of an upper respiratory tract infection, without fever, two weeks before. Clinical investigation showed no signs of local swelling or palpable lymph nodes. ENT consultation ruled out inflammatory processes causing the symptoms including tonsillitis, pharyngitis or laryngitis. Analgesic treatment with tramadol was not effective.Laboratory investigations revealed slightly increased CRP and Erythrocyte Sedimentation Rate (ESR) values. ANA and subsets, as well as ANCA were negative.An ultrasound of the region showed a localized swelling of the media and adventitia of the left common carotid artery, involving half of the circumference over a length of 4 mm. Multiple lymph nodes with signs of inflammation were present on both sides of the vessel. No dissection or stenosis was detectable.Due to a typical clinical presentation and ultrasound appearance without carotid stenosis, typical lokalisation at the distal part of the carotid communis artery the diagnosis of carotidynie or TIPIC was made.Treatment with nonsteroidal antirheumatic drugs was initiated without any effect. Therefore, we initiated a treatment with steroids (0,3mg/kg body weight). 3 days after the beginning of the therapy the before unbearable pain nearly resolved. A MRI angiography of the vessel performed 5 days after the inition of the steroid treatment showed an eccentric wall thickening with diameter of 5 mm near the bifurcation of the common carotid artery, with a slightly increased enhancement of the carotid wall, but no further inflammatory structures.Awareness of this syndrome and its excellent visualization for diagnosis, exclusion of other pathologies and follow up by high resolution ultrasound could be useful to reassure patients about the benign nature of this syndrome and help the clinician to avoid more invasive imaging modalities.ConclusionThe disease is first reported by Fay in 1927. Despite only a few case reports are available in the last 20 years and mostly one case only is reported. Usually an inflammatory process is suspected. Although a rare event sonography is capable to diagnose such vessel abnormality with high precision. Treatment with NSAIDs and, if not sufficient, eventually steroids are required.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Journal of the European Academy of Dermatology and VenereologyEarly View LETTER TO THE EDITOR Prevention of severe immune-related colitis caused by combined immune checkpoint inhibition using vedolizumab: A case report J. Jochmann, Corresponding Author J. Jochmann [email protected] orcid.org/0000-0002-1204-1884 Department of Dermatology, Klinik Hietzing, Vienna, Austria Correspondence J. Jochmann, Clinic Hietzing Vienna, Department of Dermatology, Vienna Healthcare Group, Klinik Hietzing, Vienna, Austria. Email: [email protected]Search for more papers by this authorA. Fink, A. Fink Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorA. Stella, A. Stella Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorR. Feldmann, R. Feldmann Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorL. Kramer, L. Kramer Department of Gastroenterology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorC. Posch, C. Posch Department of Dermatology, Klinik Hietzing, Vienna, Austria Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, GermanySearch for more papers by this author J. Jochmann, Corresponding Author J. Jochmann [email protected] orcid.org/0000-0002-1204-1884 Department of Dermatology, Klinik Hietzing, Vienna, Austria Correspondence J. Jochmann, Clinic Hietzing Vienna, Department of Dermatology, Vienna Healthcare Group, Klinik Hietzing, Vienna, Austria. Email: [email protected]Search for more papers by this authorA. Fink, A. Fink Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorA. Stella, A. Stella Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorR. Feldmann, R. Feldmann Department of Dermatology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorL. Kramer, L. Kramer Department of Gastroenterology, Klinik Hietzing, Vienna, AustriaSearch for more papers by this authorC. Posch, C. Posch Department of Dermatology, Klinik Hietzing, Vienna, Austria Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, GermanySearch for more papers by this author First published: 13 March 2023 https://doi.org/10.1111/jdv.19028 CP has received honoraria and travel support from MSD, BMS, Almirall, Pierre-Fabre, Sanofi, Pfizer, Novartis, Pelpharma, AbbVie, Celgene, and Galderma. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Epidemiologische Untersuchungen zeigen, dass etwa 2–3 % aller Österreicher*innen einen Diabetes mellitus mit Nierenbeteiligung aufweisen. Dies betrifft somit in Österreich etwa 250.000 Menschen. Das Risiko des Auftretens und Fortschreitens der diabetischen Nierenerkrankung kann durch Lebensstilinterventionen und Optimierung des arteriellen Blutdrucks, Blutzuckers und spezielle Medikamentenklassen vermindert werden. In diesem gemeinsamen Artikel der Österreichischen Gesellschaften für Nephrologie und Diabetologie werden die entsprechende Diagnostik und therapeutische Strategien bei diabetischer Nierenerkrankung vorgeschlagen.

Programmed death-1 (PD-1) antibodies and BRAF + MEK inhibitors are widely used for adjuvant therapy of fully resected high-risk melanoma. Little is known about treatment efficacy outside of phase III trials. This real-world study reports on clinical outcomes of modern adjuvant melanoma treatment in specialized skin cancer centers in Germany, Austria and Switzerland. Multicenter, retrospective study investigating stage III-IV melanoma patients receiving adjuvant nivolumab (NIV), pembrolizumab (PEM) or dabrafenib + trametinib (D + T) between 1/2017 and 10/2021. The primary endpoint was 12-month recurrence-free survival (RFS). Further analyses included descriptive and correlative statistics, and a multivariate linear-regression machine learning model to assess the risk of early melanoma recurrence. In total, 1198 patients from 39 skin cancer centers from Germany, Austria and Switzerland were analysed. The vast majority received anti PD-1 therapies (n=1003). Twelve-month RFS for anti PD-1 and BRAF + MEK inhibitor-treated patients were 78.1% and 86.5%, respectively (hazard ratio [HR] 1.998 [95% CI 1.335-2.991]; p=0.001). There was no statistically significant difference in overall survival (OS) in anti PD-1 (95.8%) and BRAF + MEK inhibitor (96.9%) treated patients (p > 0.05) during the median follow-up of 17 months. Data indicates that anti PD-1 treated patients who develop immune-related adverse events (irAEs) have lower recurrence rates compared to patients with no irAEs (HR 0.578 [95% CI 0.443-0.754], p=0.001). BRAF mutation status did not affect overall efficacy of anti PD-1 treatment (p > 0.05). In both, anti PD-1 and BRAF + MEK inhibitor treated cohorts, data did not show any difference in 12-month RFS and 12-month OS comparing patients receiving total lymph node dissection (TLND) versus sentinel lymph node biopsy only (p > 0.05). The recurrence prediction model reached high specificity but only low sensitivity with an AUC=0.65. No new safety signals were detected. Overall, recorded numbers and severity of adverse events were lower than reported in pivotal phase III trials. Despite recent advances in adjuvant melanoma treatment, early recurrence remains a significant clinical challenge. This study shows that TLND does not reduce the risk of early melanoma recurrence and should only be considered in selected patients. Data further highlight that variables collected during clinical routine are unlikely to allow for a clinically relevant prediction of individual recurrence risk.