Ludwig Maximilian University Research Articles

Characterization of Human Papilloma Virus in Prostate Cancer Patients Undergoing Radical Prostatectomy-A Prospective Study of 140 Patients.

The association between human papilloma virus (HPV) and the pathogenesis of prostate cancer (PCa) is still controversial. Existing studies often lack information about clinical risk factors, are limited by their retrospective design or only use a single detection method for HPV. A total of 140 patients undergoing radical prostatectomy (RP) for PCa at the Department of Urology, Ludwig Maximilian University of Munich, Germany, were prospectively enrolled. Knowledge of HPV and sociodemographic parameters were assessed with questionnaires. The following methods were used for HPV detection: RP specimens were tested for HPV DNA by PCR. If HPV DNA was detected, an LCD-Array hybridization technique was used for HPV subtyping, and immunohistochemical staining for p16 was performed as a surrogate marker for HPV infection. Serological titers of HPV-16 L1 antibodies were measured using an HPV-16-specific immunoassay. HPV DNA was detected in 9.3% (13/140) of RP specimens, with HPV-16 being the most predominantly detected subtype (5/13 = 39%). HPV-16 L1 antibody levels were below the limit of detection in 98% of patients (137/140). We found no significant difference between HPV PCR-positive (HPV+) and -negative (HPV-) patients in terms of HPV-16 antibody levels, history of HPV-associated diseases, level of education or marital status. Seventy-five percent of all PCa patients had never heard of HPV before. An acinar adenocarcinoma of the prostate was the most frequently detected histologic type in both HPV+ (100%) and HPV- (98%) patients (p = 0.86). HPV+ patients had fewer positive biopsy cores (3.5 vs. 5.8; p = 0.01) and a lower maximal tumor infiltration rate per core (37% vs. 57%; p = 0.03) compared to HPV- patients. However, when analyzing the whole prostate and the lymph nodes after RP, there were no significant differences in TNM stage, Gleason score or tumor volume between both groups. In a subgroup analysis of all high-risk HPV patients (n = 6), we found no significant differences in sociodemographic, clinical or histopathological parameters compared to HPV- or low-risk HPV+ patients. In our prospective study, we were not able to prove a clinically significant impact of HPV status on tumor characteristics in RP specimens. Most men with PCa had never heard of HPV, despite its proven causal association with other tumor entities.

Commentary: Diffuse Isocitrate Dehydrogenase-Mutant Gliomas With Histone H3 Alterations Are Distinguished by Unique Clinical Characteristics, Molecular Expression Profile, and Survival Prognosis.

*Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Munich, Germany; ‡German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany; Correspondence: Joerg-Christian Tonn, MD, Department of Neurosurgery, LMU University Hospital, Ludwig Maximilians University (LMU), Marchioninistrasse 15, Munich, 81377, Germany. Email: [email protected]

Antibiotic Prophylaxis of Surgical Site Infections in Cutaneous Surgery: A Prospective Observational Study.

The use of perioperative antibiotic prophylaxis in cutaneous surgery is controversial due to unclear efficacy and, thus, potentially unnecessary side-effects. This prospective observational study analysed the efficacy of oral perioperative antibiotic prophylaxis in preventing surgical site infections. Adult patients undergoing cutaneous surgery between August 2020 and May 2021 at Ludwig-Maximilian University Hospital Munich, Germany, without prior signs of infection were eligible. Propensity score weighting was used for covariate adjustment to account for non-randomized treatment assignment. Of 758 included patients, 23 received perioperative antibiotic prophylaxis (3.0%). In this group, a surgical site infection occurred in 1 of 45 lesions (2.2%) compared with 76 of 1,189 lesions (6.5%) in the group without perioperative antibiotic prophylaxis (735 patients, 97.0%). With covariate adjustment, the odds ratio for the occurrence of a surgical site infection in patients receiving perioperative antibiotic prophylaxis was 0.114 (95% confidence interval 0.073-0.182; p <0.001) on a per lesion level. The number of lesions needed to treat to prevent 1 surgical site infection was 17.6 (95% confidence interval 16.8-19.2). This prospective observational study shows a reduction in the incidence of surgical site infection in cutaneous surgery performed with perioperative antibiotic prophylaxis. The large size difference between the 2 study groups limits the study.

Optical coherence tomography-based misdiagnosis and morphological distinction in pachychoroid neovasculopathy vs. polypoidal choroidal vasculopathy

PurposeTo evaluate the rate of misdiagnosis of aneurysmatic pachychoroid type 1 choroidal neovascularization/polypoidal choroidal vasculopathy (PAT1/PCV) among cases diagnosed as non-aneurysmatic pachychoroid neovasculopathy (PNV) and to define optical coherence tomography (OCT) features facilitating their distinction.MethodsThe database of the Department of Ophthalmology, Ludwig-Maximilians University Munich, was screened for patients diagnosed with PNV. Multimodal imaging was screened for the presence of choroidal neovascularization (CNV) and aneurysms/polyps. Imaging features facilitating the diagnosis of PAT1/PCV were analysed.ResultsIn total, 49 eyes of 44 patients with a clinical PNV diagnosis were included, of which 42 (85.7%) had PNV and 7 (14.3%) represented misdiagnosed PAT1/PCV. SFCT was comparable (PNV: 377 ± 92 vs. PAT1/PCV: 400 ± 83 µm; p = 0.39). Whereas no difference was detected in total pigment epithelium detachment (PED) diameter (p = 0.46), maximum PED height was significantly higher in the PAT1/PCV group (199 ± 31 vs. 82 ± 46, p < 0.00001). In a receiver operating characteristic (ROC) analysis, the optimum cutoff for defining “peaking PED” was 158 µm with an area under the curve of 0.969, a sensitivity of 1.0 (95% CI: 0.59–1.0), and a specificity of 0.95 (95% CI: 0.84–0.99). Sub-retinal hyperreflective material (SHRM; p = 0.04), sub-retinal ring-like structures (SRRLS; p < 0.00001), and sub-RPE fluid (p = 0.04) were significantly more frequent in eyes with PAT1/PCV.ConclusionA relevant percentage of eyes diagnosed with PNV might instead suffer from PAT1/PCV. The detection of a maximum PED height (“peaking PED”) exceeding approximately 150 µm, SHRM, SRRLS, and sub-RPE fluid might greatly aid in the production of a more accurate diagnosis.

Scleral Thickness as a Risk Factor for Central Serous Chorioretinopathy and Pachychoroid Neovasculopathy.

In the pathophysiology of central serous chorioretinopathy (CSC), scleral changes inducing increased venous outflow resistance are hypothesized to be involved. This work aims to investigate anterior scleral thickness (AST) as a risk factor for pachychoroid disorders. A randomized prospective case-control study was performed at the Ludwig Maximilians University, Department of Ophthalmology. In patients with CSC or pachychoroid neovasculopathy (PNV) and in an age- and refraction-matched control group, swept source optical coherence tomography (SS-OCT) was used to measure anterior scleral thickness (AST). Subfoveal choroidal thickness (SFCT) was assessed using enhanced depth imaging OCT (EDI-OCT). In total, 46 eyes of 46 patients were included in this study, with 23 eyes in the CSC/PNV and 23 eyes in the control group. A significantly higher AST was found in the CSC/PNV compared with the control group (403.5 ± 68.6 (278 to 619) vs. 362.5 ± 62.6 (218 to 498) µm; p = 0.028). Moreover, the CSC/PNV group showed a higher SFCT (392.8 ± 92.8 (191-523) vs. 330.95 ± 116.5 (167-609) µm, p = 0.004). Compared with the age- and refraction-matched controls, patients with CSC and PNV showed a significantly thicker anterior sclera. Scleral thickness might contribute to the venous overload hypothesized to induce pachychoroid phenotypes.

Calcinosis circumscripta in a rabbit with recurrent cervical myelopathy.

Journal of Small Animal PracticeEarly View Images in Small Animal Practice Calcinosis circumscripta in a rabbit with recurrent cervical myelopathy C. Abeloos, Corresponding Author C. Abeloos clotilde.abeloos@hotmail.fr Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL UK Corresponding author email: edward.ives@andersonmoores.comSearch for more papers by this authorT. Dutton, T. Dutton Great Western Exotics, Units 10 – 16, Berkshire House, County Business Park, Shrivenham Road, Swindon, Wiltshire, SN1 2NR UKSearch for more papers by this authorD. Denk, D. Denk Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig Maximilian University of Munich, Munich, GermanySearch for more papers by this authorE. J. Ives, E. J. Ives edward.ives@andersonmoores.com Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL UKSearch for more papers by this author C. Abeloos, Corresponding Author C. Abeloos clotilde.abeloos@hotmail.fr Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL UK Corresponding author email: edward.ives@andersonmoores.comSearch for more papers by this authorT. Dutton, T. Dutton Great Western Exotics, Units 10 – 16, Berkshire House, County Business Park, Shrivenham Road, Swindon, Wiltshire, SN1 2NR UKSearch for more papers by this authorD. Denk, D. Denk Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig Maximilian University of Munich, Munich, GermanySearch for more papers by this authorE. J. Ives, E. J. Ives edward.ives@andersonmoores.com Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, SO21 2LL UKSearch for more papers by this author First published: 26 March 2023 https://doi.org/10.1111/jsap.13596Read 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

Silicone Models for Dermatological Education: Assessment of a New Teaching Tool by Dermatologists.

The coronavirus pandemic forced universities to transfer academic curricula into the digital realm and calls for the introduction of new teaching methods to adequately compensate for the limited in-patient training. Especially in the field of dermatology, the use of 3D models presents an interesting opportunity to maintain the teaching of diagnostically essential sensory and haptic characteristics of primary lesions. We developed a prototype silicone model and presented it to the medical service of the Department of Dermatology of the Ludwig-Maximilians University for evaluation. Silicone models demonstrating primary skin lesions were produced by using negative 3D-printed molds and different types of silicone. An online survey obtained evaluations from a group of dermatologists regarding the quality of previously supplied silicone 3D models and their potential use in medical education. Data from 58 dermatologists were collected and analyzed. The majority of the participants rated the models overall as positive and innovative, providing constructive feedback for additional modifications, and recommended further implementation into the regular curriculum as an additional tool after the end of the pandemic. Our study underlined the possible advantages of using 3D models as a supplement in educational training even after the end of the SARS-CoV-2 pandemic.

Interview with the Guest Editor – Anne Straube

ABSTRACT Anne Straube studied Biochemistry and Molecular Biology at the University of Hamburg, Germany. For her PhD, she joined the lab of Gero Steinberg at the Ludwig Maximilian University in Munich, and later at the Max Planck Institute for Terrestrial Microbiology in Marburg, to work on the microtubule cytoskeleton in the fungus Ustilago maydis. With funding from the Emmy Noether programme, Anne moved to the Wellcome Trust Centre for Cell Biology in Edinburgh for a postdoc with Andreas Merdes, where she studied microtubule organisation in skeletal muscle cells. Anne started her own group in 2007 at the Marie Curie Research Institute in Oxted, Surrey, UK. After the institute closed in 2010, she co-founded the Centre for Mechanochemical Cell Biology at the University of Warwick with Rob Cross and Andrew McAinsh, where she has been a Professor since 2020 and the Head of Biomedical Sciences at Warwick Medical School since 2022. Anne's lab studies cytoskeletal dynamics and molecular motors using a wide range of live-cell imaging, biochemical and biophysical approaches. She is a recipient of the Lister Institute Research Prize and two Wellcome Investigator Awards. Anne is the Guest Editor for the 2023 Cell Biology of Motors Special Issue in Journal of Cell Science.

The Nobel Prize in Physics 2023

The Nobel Prize in Physics was awarded to Pierre Agostini of Ohio State University, Ferenc Krausz of the Max Planck Institute of Quantum Optics and the Ludwig-Maximilian University of Munich and Anne L’Huillier of the Lund University for "experimental methods that generate attosecond pulses of light for the study of electron dynamics in matter". The Prize acknowledges the tremendous experimental progress in the past 35 years that eventually enabled the investigation of the fastest electron transition processes in atoms, molecules and solids by using state-of-the-art femtosecond laser technology. As a result, a new field of research emerged and shortly after the establishment of the field of femtochemistry, attophysics came of age.

A FHIR has been lit on gICS: facilitating the standardised exchange of informed consent in a large network of university medicine

BackgroundThe Federal Ministry of Education and Research of Germany (BMBF) funds a network of university medicines (NUM) to support COVID-19 and pandemic research at national level. The “COVID-19 Data Exchange Platform” (CODEX) as part of NUM establishes a harmonised infrastructure that supports research use of COVID-19 datasets. The broad consent (BC) of the Medical Informatics Initiative (MII) is agreed by all German federal states and forms the legal base for data processing. All 34 participating university hospitals (NUM sites) work upon a harmonised infrastructural as well as legal basis for their data protection-compliant collection and transfer of their research dataset to the central CODEX platform. Each NUM site ensures that the exchanged consent information conforms to the already-balloted HL7 FHIR consent profiles and the interoperability concept of the MII Task Force “Consent Implementation” (TFCI). The Independent Trusted Third-Party (TTP) of the University Medicine Greifswald supports data protection-compliant data processing and provides the consent management solutions gICS.MethodsBased on a stakeholder dialogue a required set of FHIR-functionalities was identified and technically specified supported by official FHIR experts. Next, a “TTP-FHIR Gateway” for the HL7 FHIR-compliant exchange of consent information using gICS was implemented. A last step included external integration tests and the development of a pre-configured consent template for the BC for the NUM sites.ResultsA FHIR-compliant gICS-release and a corresponding consent template for the BC were provided to all NUM sites in June 2021. All FHIR functionalities comply with the already-balloted FHIR consent profiles of the HL7 Working Group Consent Management. The consent template simplifies the technical BC rollout and the corresponding implementation of the TFCI interoperability concept at the NUM sites.ConclusionsThis article shows that a HL7 FHIR-compliant and interoperable nationwide exchange of consent information could be built using of the consent management software gICS and the provided TTP-FHIR Gateway. The initial functional scope of the solution covers the requirements identified in the NUM-CODEX setting. The semantic correctness of these functionalities was validated by project-partners from the Ludwig-Maximilian University in Munich. The production rollout of the solution package to all NUM sites has started successfully.

Approaching Transcultural Communication and the Global South: A Conversation With Prof. Herman Wasserman

Abstract Herman Wasserman is a Professor of Journalism at Stellenbosch University, South Africa. He has published widely on media, ethics and democracy in Africa and has consulted for organizations such as the United Nations, the World Health Organization and the Centre for International Media Assistance and given keynote addresses and invited lectures at universities worldwide. He has been a visiting scholar at Indiana University, Tsinghua University, the University of Houston and the Ludwig–Maximilian University. His awards include the Georg Foster Prize from the German Alexander von Humboldt Foundation, a Fulbright Fellowship, amongst others. He is often quoted in international media and serves on the editorial boards of more than fifteen international scholarly journals. He is Editor-in-Chief of the African Journalism Studies and the Annals of the International Communication Association. He is a Fellow of the International Communication Association and an elected member of the Academy of Science of South Africa. In this interview, Wasserman talks about international inequality in communication and media studies, the importance of decolonizing communication studies, and the need to include more vantage points from the Global South in communication scholarship and knowledge production in general. Wasserman also discusses about the importance of revisiting indigenous philosophy while alerting us against romanticizing or essentializing these philosophies. He further talks about his recent works on media ethics, disinformation, and how they connect to the wider debate on topics such as information disorder in the Global South.

550 Jahre Universitätsmedizin - 150 Jahre Herausgeberkollegium

550 Jahre Universitätsmedizin - 150 Jahre Herausgeberkollegium

Franz Nissl's multiple contributions

Franz Alexander Nissl (1860–1919) was a German neuropathologist and a fine clinician. While studying at the Ludwig Maximilian University of Munich (Munich, Germany), under the neuroanatomist Aloys von Gudden (1824–86), Nissl won an award for his medical doctoral thesis (The pathological changes in the nerves cells of the cerebral cortex, in our own translation from the original German title). The work described in this thesis provided the basis for the development of Nissl's staining technique, which would become crucial for studying the brain.

German medical students´ views regarding artificial intelligence in medicine: A cross-sectional survey.

Medical students will likely be most impacted by the envisaged move to artificial intelligence (AI) driven digital medicine, and there is a need to better understand their views regarding the use of AI technology in medicine. This study aimed to explore German medical students´ views about AI in medicine. A cross-sectional survey was conducted in October 2019 with all new medical students at the Ludwig Maximilian University of Munich and the Technical University Munich. This represented approximately 10% of all new medical students in Germany. A total of 844 medical students participated (91.9% response rate). Two thirds (64.4%) did not feel well informed about AI in medicine. Just over a half (57.4%) of students thought that AI has useful applications in medicine, particularly in drug research and development (82.5%), less so for clinical uses. Male students were more likely to agree with advantages of AI, and female participants were more likely to be concerned about disadvantages. The vast majority of students thought that when AI is used in medicine that it is important that there are legal rules regarding liability (97%) and oversight mechanisms (93.7%), that physicians should be consulted prior to implementation (96.8%), that developers should be able to explain to them the details of the algorithm (95.6%), that algorithms should use representative data (93.9%), and that patients should always be informed when AI is used (93.5%). Medical schools and continuing medical education organisers need to promptly develop programs to ensure that clinicians are able to fully realize the potential of AI technology. It is also important that legal rules and oversight are implemented to ensure that future clinicians are not faced with a workplace where important issues around responsibility are not clearly regulated.

Chimeric Antigen Receptor T-cell Therapy: Imaging Response Criteria and Relation to Progression-free and Overall Survival.

Chimeric Antigen Receptor T-cell Therapy: Imaging Response Criteria and Relation to Progression-free and Overall Survival.

Meet the First Authors.

HomeCirculation ResearchVol. 131, No. 8Meet the First Authors Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBMeet the First Authors Originally published29 Sep 2022https://doi.org/10.1161/RES.0000000000000574Circulation Research. 2022;131:652–653is related toExtracellular Vesicles Regulate Sympatho-Excitation by Nrf2 in Heart FailureThe Amino Acid Homoarginine Inhibits Atherogenesis by Modulating T-Cell FunctionImpaired Dynamic Sarcoplasmic Reticulum Ca Buffering in Autosomal Dominant CPVT2is related toTranscriptional and Immune Landscape of Cardiac SarcoidosisCardiac Sarcoidosis Immune Landscape (p 654)Download figureDownload PowerPointDr Jing Liu ia a resident doctor of Medicine (Cardiology). She earned her MD from Xi’an Jiaotong University and completed her medicine internship followed by a PhD program (Cardiovascular Medicine) at Xi’an Jiaotong University. She completed her PhD joint training program at Washington University in St. Louis. Supervised by Dr Kory Lavine, Dr Liu took a deep interest in cardiac immunology and set her future research focus on biological, cellular and immune mechanisms of heart failure and coronary disease. Dr Liu has published five manuscripts so far and hopes to make fundamental discoveries in cardiovascular medicine.Download figureDownload PowerPointDr Pan Ma is a postdoctoral researcher in Washington University in Saint Louis, School of Medicine. She earned her PhD from Institution of Biophysics, University of Chinese Academy of Sciences in tumor immunology and her MS from Institution of Microbiology, University of Chinese Academy of Sciences in immunology. These research experiences sparked her interest in tumor therapy-induced myocarditis and other forms of myocarditis. Her current research includes exploring the immune landscape in immune checkpoint inhibitors associated myocarditis as well as macrophage diversity in cardiac sarcoidosis and defining the spatial transcriptomic landscape of myocarditis using single-cell and spatial technologies.Impaired Dynamic SR Ca Buffering Causes AD-CPVT2 (p 673)Download figureDownload PowerPointMatthew Wleklinski is an MD/PhD student interested in the molecular and tissue mechanisms of cardiac arrhythmias and sudden death. His dissertation research focused on the protein calsequestrin and its role in catecholaminergic polymorphic ventricular tachycardia. His research career began as an undergraduate student at the University of Wisconsin-Madison, where he earned a BS in Pharmacology/Toxicology. After developing an interest in both medicine and research, he applied to and has been training in Vanderbilt’s Medical Scientist Training Program. His goal is to become a physician-scientist that specializes in pediatric cardiology.EV-Mediated Heart Brain Communication in CHF (p 687)Download figureDownload PowerPointDr Changhai Tian is an independent Assistant Professor at the University of Kentucky College of Medicine. He earned his PhD from the Chinese Academy of Sciences and then started his postdoctoral training at the University of Nebraska Medical Center (UNMC), focusing on redox regulation in cancers and neurodegenerative disorders. He has now expanded his research to the cardiovascular field and collaborated with Dr Irving Zucker (UNMC) to investigate the underlying mechanisms by which the heart communicates with the brain in the pathogenesis of heart failure and, especially, the role of extracellular vesicles in inter-organ communication. Outside of work, he enjoys cooking and fishing.Homoarginine Reduces Atherosclerosis (p 701)Download figureDownload PowerPointDr Katrin Nitz is a postdoctoral fellow in the lab of Dr Dorothee Atzler and Dr Esther Lutgens at the Institute for Cardiovascular Prevention (IPEK, LMU Munich) in Germany. Katrin studied Molecular Medicine at theUniversity of Freiburg and continued as a PhD student at the Max-Delbruck-Centrum in Berlin to study the role of neutrophils in atherosclerosis. Her current focus at IPEK is to study amino acid metabolisms in T cells in atherosclerosis. Outside of work, she is enthusiastic about cycling and getting creative with photography.Download figureDownload PowerPointDr Michael Lacy is an Assistant Professor in Immunology in the department of Medical Laboratory Sciences at Virginia Commonwealth University in Richmond, VA. Dr Lacy earned his PhD from Ludwig Maximilian University of Munich in Germany under the supervision of Dr Dorothee Atzler and Dr Esther Lutgens at the Institute for Cardiovascular Prevention (IPEK). His research interests involve developing therapies to target T cells in atherosclerosis. Currently, he is investigating the role of chromatin remodeling enzymes on T cell phenotypes and their impact on atherosclerosis. Outside of the lab, he enjoys traveling as well as discovering local highlights closer to home. Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesExtracellular Vesicles Regulate Sympatho-Excitation by Nrf2 in Heart FailureChanghai Tian, et al. Circulation Research. 2022;131:687-700The Amino Acid Homoarginine Inhibits Atherogenesis by Modulating T-Cell FunctionKatrin Nitz, et al. Circulation Research. 2022;131:701-712Impaired Dynamic Sarcoplasmic Reticulum Ca Buffering in Autosomal Dominant CPVT2Matthew J. Wleklinski, et al. Circulation Research. 2022;131:673-686Transcriptional and Immune Landscape of Cardiac SarcoidosisJing Liu, et al. Circulation Research. 2022;131:654-669 September 30, 2022Vol 131, Issue 8 Advertisement Article InformationMetrics © 2022 American Heart Association, Inc.https://doi.org/10.1161/RES.0000000000000574PMID: 36173823 Originally publishedSeptember 29, 2022 PDF download Advertisement

Vestibular syndromes after COVID-19 vaccination: A prospective cohort study.

Background and purposeDizziness and vertigo are common symptoms after COVID‐19‐vaccination. We aimed to prospectively evaluate objective central or peripheral vestibular function in patients with dizziness, vertigo, and postural symptoms that started or worsened after COVID‐19‐vaccination.MethodsOf 4137 patients who presented between January 2021 and April 2022 at the German Center for Vertigo and Balance Disorders, Ludwig Maximilian University of Munich, we identified 72 patients (mean age = 47 years) with enduring vestibular symptoms following COVID‐19 vaccination. All underwent medical history‐taking, and neurological and neuro‐otological workup with bithermal caloric test, video head‐impulse test, orthoptics, and audiometry. Diagnoses were based on international criteria. The distribution of diagnoses was compared to a cohort of 39,964 patients seen before the COVID‐19 pandemic.ResultsSymptom onset was within the first 4 weeks postvaccination. The most prevalent diagnoses were somatoform vestibular disorders (34.7%), vestibular migraine (19.4%), and overlap syndromes of both (18.1%). These disorders were significantly overrepresented compared to the prepandemic control cohort. Thirty‐six percent of patients with somatoform complaints reported a positive history of depressive or anxiety disorders. Nine patients presented with benign paroxysmal positional vertigo, three with acute unilateral vestibulopathy, and seven with different entities (vestibular paroxysmia, Ménière disease, polyneuropathy, ocular muscular paresis). Causally related central vestibular deficits were lacking. Novel peripheral vestibular deficits were found in four patients.ConclusionsNewly induced persistent vestibular deficits following COVID‐19 vaccination were rare. The predominant causes of prolonged vestibular complaints were somatoform vestibular disorders and vestibular migraine, possibly triggered or aggravated by stress‐related circumstances due to the COVID‐19 pandemic or vaccination. An increase of other central or peripheral vestibular syndromes after COVID‐19 vaccination was not observed.

Advances in Stroke: Genetics, Genomics, Precision Medicine.

Advances in Stroke: Genetics, Genomics, Precision Medicine.

Prevalence of pathological arrhythmia in patients triaged to “cardiac arrhythmia” in the emergency department: a preliminary study

BackgroundSymptoms caused by cardiac arrhythmia are common problems that lead to presentation to the emergency department. However, the prevalence of pathological heart rhythm in patients triaged for cardiac arrhythmia in the emergency department remains up to now unknown.Methods and resultsIn this retrospective study, patients triaged for cardiac arrhythmia admitted to the interdisciplinary emergency department of the Ludwig-Maximilians University Hospital in Munich within 1 year were included. Subsequently, cardiac rhythm in the 12-lead electrocardiogram, clinical presentation, admission rate, and diagnosis at discharge was analyzed. A total of 558 out of 39,798 patients were triaged for cardiac arrhythmia. Of these 42.3% of patients showed a pathological heart rhythm on the initial electrocardiogram (66.9% atrial fibrillation, 16.5% atrial flutter, 16.5% others). About 80% presented in emergency severity index III (many resources are needed without critical vitals) conditions. Sixty-two percent of the pathological electrocardiogram group and 60% of the sinus rhythm group of patients were admitted to the hospital, and 34.7% with pathological electrocardiogram underwent invasive investigations (16.8% in the sinus rhythm group). In 43.4% of patients, the diagnosis of cardiac arrhythmia was already known from previous medical contacts.ConclusionA total of 1.8% of patients who presented to our interdisciplinary emergency department were triaged for cardiac arrhythmia. With 49.5%, the hospital admission rate was quite high but the patients presented to the emergency department in our cohort were rarely in critical condition. As a high percentage of our cohort had a history of cardiac arrhythmia, better outpatient management is needed for these patients to reduce emergency department visits and save resources.

Notes on Contributors

Notes on Contributors