Universitäts Frauenklinik

Chylous ascites is rare in adults and is most commonly caused by lymphatic obstruction due to non-Hodgkin B-cell lymphoma. Splenic marginal zone lymphoma (SMZL) is an uncommon etiology. We report the case of an 89-year-old man with a three-year history of refractory chylous ascites initially considered of unknown origin. Clinical examination revealed significant ascites and splenomegaly. PET imaging demonstrated hypermetabolic lymphadenopathy, and bone marrow biopsy revealed infiltration by a CD5-/CD10- B-cell lymphoma consistent with SMZL. Analysis of ascitic fluid showed a predominance of T lymphocytes without a detectable B-cell clone. This case illustrates that SMZL, although rare, should be included in the differential diagnosis of persistent chylous ascites. A comprehensive diagnostic approach combining imaging, bone marrow biopsy, and flow cytometry is essential to establish a timely diagnosis and guide appropriate management, especially in elderly patients.

Integrative oncology (IO) combines conventional cancer medicine with evidence-based complementary procedures, thereby placing special demands on the concept of evidence, research methodology, and the evaluation of care quality. This article highlights key theoretical, methodological, and practical principles. The classic concept of evidence is examined in detail through the three pillars of evidence-based medicine. Complementary research designs such as mixed methods, pragmatic studies, whole-systems approaches, and preference-based designs, are discussed as they offer new perspectives for generating valid and patient-centered evidence. In addition, regulation and practice-oriented quality criteria are presented as well as the current consensus process within the newly founded "Swiss Network for Integrative Oncology" (SNIO), which defines common standards, training structures, and research strategies. These efforts lay the foundation for the ongoing development of the field - toward an IO that is safe, effective, and truly patient-centered.

The article examines the dynamics of the use of Austrian terms in modern German mass media. The newspaper discourse was chosen for the analysis, since the spread of Austrian terms can be easily traced, in particular, in the German newspapers “Zeit”, “Berliner Zeitung” and “Tagesspiegel”. By sampling, Austrian terms were singled out whose values are focused on certain characteristics of a person. Along with the more popular analysed lexemes, which were found in all three editions, less common ones were also found, which appeared in two or one of the analysed newspapers. The results of the analysis show that the studied Austrian terms are very often used in German language, since newspaper discourse as a tool of mass communication always uses linguistic means that are relevant to society to some extent.

Background/Objectives: Endometriosis and urogenital malformation with uterus didelphys and renal agenesis might occur concomitantly, and the question arises whether both entities are associated with each other. Methods: A literature search was conducted in PubMed and Web of Science, using the following search terms: “endometriosis and uterine malformation, endometriosis and Herlyn–Werner–Wunderlich syndrome”, “endometriosis and OHVIRA (Obstructed Hemivagina and Ipsilateral Renal Anomaly) syndrome” and “uterus didelphys, renal agenesis and endometriosis”. Results: We identified and examined 36 studies, comprising a total of 563 cases with coinciding endometriosis and OHVIRA. The most prevalent symptoms were dysmenorrhea and lower abdominal pain. Renal agenesis occurred more frequently on the right side. In the majority of cases, vaginal septum resection was performed to alleviate hematometrocolpos. Among the 97 cases necessitating abdominal exploration, endometriosis was identified in 61 patients (62.9%), although this figure is most likely an overestimation. However, a significantly heightened risk of endometriosis was evident. Conclusions: This literature review highlights the importance of considering the potential for urogenital malformation and endometriosis in cases of dysmenorrhea during adolescence. Ultrasound examination has proven to be a valuable diagnostic tool for identifying uterine abnormalities and guiding subsequent diagnostic and, if necessary, surgical interventions. Thorough assessment and appropriate management are imperative to mitigating the long-term consequences associated with deep infiltrating endometriosis.

The aim of this study is to investigate the feasibility of artificial intelligence in the interpretation and application of medical guidelines to support clinical decision-making in obstetrics. ChatGPT was provided with guidelines on specific obstetric issues. Using several clinical scenarios as examples, the AI was then evaluated for its ability to make accurate diagnoses and appropriate clinical decisions. The results varied, with ChatGPT providing predominantly correct answers in some fictional scenarios but performing inadequately in others. Despite ChatGPT's ability to grasp complex medical information, the study revealed limitations in the precision and reliability of its interpretations and recommendations. These discrepancies highlight the need for careful review by healthcare professionals and underscore the importance of clear, unambiguous guideline recommendations. Furthermore, continuous technical development is required to harness artificial intelligence as a supportive tool in clinical practice. Overall, while the use of AI in medicine shows promise, its current suitability primarily lies in controlled scientific settings due to potential error susceptibility and interpretation weaknesses, aiming to safeguard the safety and accuracy of patient care.