Ordensklinikum Linz Barmherzige Schwestern

Sepsis is defined as a dysregulated host response to an infection, leading to life-threatening organ dysfunction. While sepsis is most commonly the result of a bacterial infection, it may also be caused by viral pathogens. The aim of this study was to describe differences in organ dysfunction patterns and inflammatory markers between bacterial and viral sepsis. In this prospective multicenter cohort study, adults meeting SEPSIS-3 criteria were recruited from four Austrian ICUs between 1 August 2021 and 1 April 2024, excluding those who were immunocompromised within the preceding 12 months. Ninety patients were enrolled, of whom 57 had bacterial and 33 viral sepsis. Inflammatory markers, including IL-6 and PCT, were higher at ICU admission in bacterial sepsis. Adjusted linear regression confirmed bacterial etiology as the only significant predictor of higher 48 h peak IL-6 and PCT values. Patients with viral sepsis typically fulfilled SEPSIS-3 criteria through respiratory and cardiovascular SOFA components, while other organ dysfunctions were less frequent. Significant differences in the phenotype of bacterial and viral sepsis were observed, characterized by distinct inflammatory profiles and differing patterns of organ dysfunction. These findings may support the improved differentiation of bacterial and viral etiologies in sepsis.

Antibody‐drug conjugates (ADCs) and immunotherapy have changed the treatment landscape for locally advanced and metastatic urothelial carcinoma (la/mUC). Clinical trials have demonstrated the superiority of enfortumab vedotin (EV) combined with pembrolizumab (P) over chemotherapy. This retrospective, multicentre Austrian registry analysis evaluated the effectiveness and safety of EV + P in treatment‐naïve la/mUC patients in a real‐world setting. This study included 203 first‐line EV + P treated patients from 20 Austrian centres. The majority were male (77.3%), with a median age of 70 years (range, 26–92), while 33.5% were ≥75 years. Comorbidities were common, with 25.1% having a Charlson Comorbidity Index (CCI) ≥ 5, and 46.3% moderate to severe renal impairment. Among 195 evaluable patients, the objective response rate (ORR) was 63.6% (95% CI, 56.6–70.0), including 21.5% complete responses and 42.1% partial responses. Disease control was achieved in 75.4% (95% CI, 68.9–80.9). Median progression‐free survival (PFS) and overall survival (OS) were not reached after a median follow‐up of 5.8 months. Poor outcomes were associated with ECOG PS >2 (PFS, p = .003; OS, p< .001) and CCI ≥5 (PFS, p = .011; OS, p = .08). EV + P was generally well tolerated; grade ≥3 treatment‐related adverse events occurred in 38.4% of patients and immune‐related adverse events in 19.2%. Limitations of this study include its retrospective design and short follow‐up. These findings support the clinical use of EV + P as first‐line treatment for la/mUC, demonstrating substantial effectiveness and manageable toxicity in a large real‐world population, including elderly and comorbid patients. Extended follow‐up is warranted to determine long‐term survival and predictive markers of response.

Zusammenfassung COVID-19 zeigt biopsychosoziale Auswirkungen für Betroffene. Langzeitfolgen zeichnen sich neben medizinischen Problemen häufig vor allem durch psychosomatische und psychosoziale Belastungen aus und brauchen ein interdisziplinäres Vorgehen in der Behandlung. Neben allgemeinen Wirkfaktoren, wie Ressourcenaktivierung und Erweiterung des Bewältigungserlebens, bekommt die Gruppe dabei als Beziehungs- und Unterstützungsraum besondere Bedeutung. Wesentlich ist die Erfahrung in und mit der Gruppe zu sein, mit den Aspekten Austausch und Eingebundenheit. Sowohl die Qualität der therapeutischen Beziehung als auch das Potenzial der Gruppe können als zentrale Wirkfaktoren bestätigt werden.

BackgroundThe health-related quality of life (HRQoL) of patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) is impacted by both disease- and treatment-related factors. Treatments that preserve and maximize HRQoL in this setting represent a substantial unmet need.MethodsKEYNOTE-412 (NCT03040999) was a randomized, double-blind, placebo-controlled phase 3 study of pembrolizumab plus chemoradiotherapy (CRT) versus placebo plus CRT for maintenance therapy in participants with treatment-naïve LA HNSCC. Patient-reported outcomes (PROs) assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EORTC QLQ Head and Neck 35 (H&N35) were pre-specified secondary endpoints and administered at baseline and throughout the study. Least squares mean (LSM) change from baseline was assessed using a constrained longitudinal data analysis model. No formal statistical significance testing was performed.ResultsThe PRO analysis population included 395 participants randomized to receive pembrolizumab plus CRT and 397 to receive placebo plus CRT. Completion rates for all assessed PROs were >95% at baseline and >66% at week 45. LSM change from baseline to week 45 was similar between groups across EORTC QLQ-C30 and QLQ-H&N35 subscale scores. There were no notable differences in empirical mean change or the proportion of participants with improvement, stability, or deterioration from baseline to week 45 between treatment groups.ConclusionThe addition of pembrolizumab to CRT did not meaningfully impact HRQoL in participants with LA HNSCC.