BACKGROUND: Digital health applications (DiGA) were included in the German healthcare system in 2020. They are available for prescription and reimbursed by public and private insurance companies. For the specialty of urology, there are currently two DiGA available: for the treatment of erectile dysfunction and benign prostatic hyperplasia/overactive bladder (BPH/OAB). The legal basis, clinical results and practical implementation are presented.
METHODS: Evaluation of websites and publications to show the regulatory requirements, mode of action, results of clinical trials and prescribing practice with DiGA.
RESULTS: Since 2020, 63 DiGA have been listed in the register of the Federal Office for Drugs and Medical Devices (BfArM), 35 of them definitively. Two urological DiGA aim to treat erectile dysfunction and BPH/OAB. Randomized, controlled studies have shown a significant and clinically relevant patient benefit for both DiGA. Further urological DiGA are in clinical development.
CONCLUSIONS: DiGAs offer multimodal therapy combinations that have not yet been used in clinical practice and show a multidimensional benefit for the patient.
UNASSIGNED: HINTERGRUND UND FRAGESTELLUNG: Digitale Gesundheitsanwendungen (DiGA) wurden 2020 in die Regelversorgung aufgenommen. Sie werden auf Rezept verschrieben und die Kosten von den Krankenkassen übernommen. Für das Fachgebiet Urologie stehen derzeit 2 DiGA zu Behandlung der erektilen Dysfunktion (ED) und der benignen Prostatahyperplasie/überaktiven Blase (BPH/OAB) zur Verfügung. Hier sollen die gesetzlichen Grundlagen, klinische Ergebnisse und die praktische Umsetzung gezeigt werden.
METHODS: Webseiten und Publikationen zur Darstellung der regulatorischen Voraussetzung, Wirkungsweise, Ergebnissen von klinischen Studien und Verschreibungspraxis mit DiGA werden ausgewertet.
UNASSIGNED: Seit 2020 wurden 63 DiGA im Verzeichnis des Bundesamts für Arzneimittel und Medizinprodukte (BfArM) gelistet, 35 davon endgültig. Bislang finden sich 2 DiGA im urologischen Fachgebiet: eine betrifft die Behandlung der ED, die andere die der BPH bzw. OAB. Bei beiden DiGA zeigte sich in randomisierten, kontrollierten Studien ein signifikanter und klinisch relevanter Patientennutzen. Weitere urologische DiGA sind in der klinischen Entwicklung.
UNASSIGNED: Die DiGA bieten multimodale Therapiekombinationen, die so in der klinischen Praxis bisher keine Anwendung fanden und zeigen einen mehrdimensionalen positiven Versorgungseffekt.

The purpose of this study was to assess the efficacy, specificity, and predictive value of a newly discovered biomarker, Zinc finger-like1 protein (referred to as neuroendocrine marker, NEM) for the detection of prostate cancer (PCa). We retrospectively analyzed banked plasma samples from 508 men, with a median age of 67 years (range 48-97), to compare the performance of NEM and PSA in predicting subsequent histologic PCa. The cohort consisted of four groups of patients visiting a urology clinic: (1) patients not diagnosed with either benign prostatic disease or prostate cancer (PCa) were defined as normal; (2) patients diagnosed with benign hyperplasia (BPH) but not PCa; (3) patients with confirmed PCa; and (4) patients with cancer other than PCa. The normal men displayed a mean NEM plasma level of 0.948 ± 0.051 ng/mL, which increased to 1.813 ± 0.315 ng/mL in men with BPH, 86.49 ± 15.51 ng/mL in men with PCa, and 10.47 ± 1.029 ng/mL in men with other Ca. The corresponding concentrations of prostate-specific antigen (PSA) in these subjects were 1.787 ± 0.135, 5.405 ± 0.699, 35.77 ± 11.48 ng/mL, and 8.036 ± 0.518, respectively. Receiver operating characteristic (ROC) curve analysis was performed to compare NEM and PSA performance, and the Jouden Index for each biomarker was calculated to determine cut-off points for each biomarker. The area under the ROC curve to predict PCa was 0.99 for NEM and 0.81 for PSA (p < 0.0001). The cut-off for NEM was at 1.9 ng/mL, with sensitivity of 98% and specificity of 97%. The corresponding PSA values were 4.4 ng/mL, with sensitivity of 76% and specificity of 95%. The predictive value of each biomarker in a patient was matched with his pathologic data to determine the accuracy of each biomarker. NEM was more accurate than PSA in differentiating cancer from benign conditions, such as BPH or prostatitis. In conclusion, NEM was a better predictor of PCa than PSA in patients visiting urology clinics. NEM tests, either alone or in conjunction with other biomarkers, provide a reliable, non-invasive, and inexpensive test to remarkably reduce false positives and thereby reduce the number of diagnostic biopsies and associated painful procedures and the loss of quality of life.

暂无摘要。

This is a case of a 61-year-old lady who presented to the lipid clinic with possible familial hypercholesterolaemia (Simon Broome Criteria). She was commenced on atorvastatin; however, 4 weeks later, she developed hepatitis, and therefore her atorvastatin was discontinued. Following that, her liver function tests normalized, and she was diagnosed with statin-induced hepatitis. Three years later, she was seen again in the lipid clinic with an uncontrolled lipid profile, and she was commenced on alirocumab, a Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitor. A few days later, she developed hepatitis, and subsequently, the alirocumab was discontinued. She underwent a liver biopsy, which confirmed that she had Autoimmune Hepatitis (AIH) with presumed superimposed drug injury. This is the first reported case of autoimmune hepatitis associated with alirocumab.

UNASSIGNED: The brainstem tumour known as diffuse intrinsic pontine glioma (DIPG), also known as pontine glioma, infiltrative brainstem glioma is uncommon and virtually always affects children. A pontine glioma develops in the brainstem\'s most vulnerable region (the \"pons\"), which regulates a number of vital processes like respiration and blood pressure. It is particularly challenging to treat due to its location and how it invades healthy brain tissue. The hunt for a solution is continually advancing thanks to advances in modern medicine, but the correct approach is still elusive. With a particular focus on brain tumours that are incurable or recur, research is ongoing to discover fresh, practical approaches to target particular areas of the brain.
UNASSIGNED: To successfully complete this task, a thorough literature search was carried out in reputable databases like Google Scholar, PubMed, and ScienceDirect.
UNASSIGNED: The present article provides a comprehensive analysis of the notable advantages of lipid nanoparticles compared to alternative nanoparticle formulations. The article delves into the intricate realm of diverse lipid-based nanoparticulate delivery systems, which are used in Diffuse Intrinsic Pontine Glioma (DIPG) which thoroughly examines preclinical and clinical studies, providing a comprehensive analysis of the effectiveness and potential of lipid nanoparticles in driving therapeutic advancements for DIPG.
UNASSIGNED: There is strong clinical data to support the promising method of using lipid-based nanoparticulate drug delivery for brain cancer treatment, which shows improved outcomes.

Joint pain is a common complaint owing to its origin in inflammatory and degenerative joint diseases. Recent research has helped narrow down inadequate angiogenesis as one of the causes. Angioembolization has emerged as a treatment option for this condition when it is refractory to conservative treatment. This review describes angioembolization by elaborating on the mechanism, safety, efficacy, comparative analysis of treatment and the road ahead, in addition to summarizing the existing data on this treatment. The inferences from this review further consolidate transcatheter arterial embolization as one of the prime options for managing joint pain when it is refractory to conservative treatment and label it as one of the most exciting prospects. A limitation of this review is that most of the data were from open label case series or case reports.
UNASSIGNED: Gelenkschmerzen sind ein weit verbreitetes Beschwerdebild, das seinen Ursprung in entzündlichen und degenerativen Gelenkerkrankungen hat. Durch aktuelle Forschungen konnte die unangemessene Angiogenese als eine der Ursachen ausgemacht werden. Die Angioembolisation hat sich bei Nichtansprechen auf eine konservative Therapie als Behandlungsoption für diese Erkrankung herauskristallisiert. In dieser Übersichtsarbeit wird die Angioembolisation beschrieben, indem der Mechanismus, die Sicherheit, die Wirksamkeit, die vergleichende Analyse der Behandlung und der weitere Weg erläutert und die vorhandenen Daten zu dieser Behandlung zusammengefasst werden. Die Ergebnisse dieser Übersichtsarbeit untermauern die Bedeutung der transkathetergestützten arteriellen Embolisation als eine der wichtigsten Optionen für die Behandlung von Gelenkschmerzen, die auf eine konservative Therapie nicht ansprechen, und bezeichnen sie als einen der bedeutungsvollsten Ansätze. Eine Einschränkung dieses Reviews ist, dass die meisten Daten aus offenen Fallserien oder Fallberichten stammen.

Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case-control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case-control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.

CRISPR has revolutionized illness detection by using precision gene editing to identify specific sequences in recent years. Using the Scopus database, this study performs a comprehensive bibliometric analysis, looking at academic papers on CRISPR that were published between 1992 and 2023. After screening a dataset of 1407 articles using Zotero, trends in annual publishing, citation patterns, author affiliations, and keyword co-occurrence are revealed using analysis tools such as VOSviewer, RStudio, and MS Excel. According to the report, there was only one CRISPR publication in 1992. By 2017, there were a meager 64 papers. Nonetheless, there is a notable upsurge between 2018 and 2023. Leading nations involved in CRISPR-based illness detection research include Germany, the United States, China, India, and the United Kingdom. Chongqing University Three Gorges Hospital, Chongqing University Medical University, and Chongqing University Bioengineering College are a few of the top institutions. With the greatest publication numbers (1688 and 1616) and strong total link strengths (TLS) of 42 and 77, respectively, authors Liu, C., and Li, Y., stand out. The field with the greatest citation counts as of 2023 is Broughton\'s 2020 study on CRISPR-based SARS-CoV-2 detection in Nature Biotechnology, with 1598 citations. Biosensors and Bioelectronics comprise 14.99% of papers. Researchers, decision-makers, and interested parties can use this thorough summary to help them make well-informed decisions about future CRISPR-based disease detection studies.

Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) emerges as a key single-chain transmembrane glycoprotein predominantly expressed in effector T cells and regulatory T cells. It plays a crucial role in tumor immunity by modulating T cell responses. Specifically, CTLA-4 dampens T cell activation and proliferation while bolstering the survival of regulatory T cell through its competitive interaction with B7 family molecules, thereby aiding tumor cells in eluding immune detection. Given CTLA-4\'s significant influence on tumor immune dynamics, an array of anti-CTLA-4 antibody therapeutics have been clinically developed to combat various malignancies, including melanoma, renal cell carcinoma, colorectal carcinoma, hepatocellular carcinoma, non-small cell lung carcinoma, and pleural mesothelioma, demonstrating notable clinical therapeutic effects. This paper aims to delve into CTLA-4\'s integral role in tumor immunity and to encapsulate the latest advancements in the clinical research of anti-CTLA-4 antibody.

BACKGROUND: In recent years intraocular lenses (IOLs) for correcting presbyopia have been significantly improved and diversified. There are currently many different IOL models based on a wide variety of optical designs.
OBJECTIVE: The wide variety of available IOL solutions to correct presbyopia can be challenging for surgeons and patients. In everyday practice, the question is which IOL is best for which patient.
METHODS: This overview describes and categorizes the currently available implants. The respective optical properties are analyzed and clinical study results are discussed, in particular those evaluating visual performance and the occurrence of photic phenomena.
RESULTS: Monofocal-plus IOLs provide improved intermediate visual acuity with optimal distant visual acuity and minimal photic phenomena. Extended depth of field (EDoF) IOLs extend the depth of field through different optical principles and provide good distant and intermediate visual acuity. Trifocal lenses enable the greatest independence from spectacles at the price of a higher probability of dysphotopsia.
CONCLUSIONS: The selection of the most suitable IOL for correction of presbyopia requires a balance between the patient\'s visual needs and possible side effects. An adequate knowledge of the currently available implants allows a patient-oriented selection of IOLs.
UNASSIGNED: HINTERGRUND: Presbyopie-korrigierende Intraokularlinsen (IOL) habe in den letzten Jahren deutliche Fortschritte gemacht und sich diversifiziert. Heute existiert eine Vielzahl verschiedener IOL-Modelle, die auf unterschiedlichsten optischen Prinzipien basieren.
UNASSIGNED: Die Vielfalt der verfügbaren IOL-Lösungen zur Korrektur der Presbyopie kann für Chirurgen und Patienten herausfordernd sein. Im Alltag stellt sich die Frage, welche IOL für welchen Patienten am besten geeignet ist.
METHODS: Die Übersicht beleuchtet und kategorisiert die heute verfügbaren Implantate. Es werden ihre jeweiligen optischen Eigenschaften analysiert sowie klinische Studienergebnisse betrachtet, die insbesondere die Visusergebnisse und das Auftreten von photischen Phänomenen bewerten.
UNASSIGNED: Monofokal-Plus-Linsen bieten eine verbesserte Intermediärsehschärfe bei optimalem Fernvisus und minimalen photischen Phänomenen. Intraokularlinsen mit erweiterter Schärfentiefe (EDoF-IOL) erweitern die Schärfentiefe durch verschiedene optische Prinzipien und bieten eine gute Fern- und Intermediärsehschärfe. Die Trifokallinsen ermöglichen die größte Brillenunabhängigkeit zum Preis einer höheren Auftretenswahrscheinlichkeit von Dysphotopsien.
CONCLUSIONS: Die Auswahl der geeignetsten IOL zur Presbyopiekorrektur erfordert die Abwägung zwischen den Sehbedürfnissen der Patienten und möglichen Nebenwirkungen. Die Vielzahl der heute verfügbaren IOL-Modelle ermöglicht bei angemessenen Kenntnissen über die Implantate eine patientenorientierte IOL-Versorgung.