共找到 20 条结果
Controlled donation after circulatory death (cDCD) offers an opportunity to expand the deceased donor pool, yet implementation remains limited in many countries. We conducted a retrospective single-center analysis of all cDCD donors (Maastricht category III) referred to the Transplant Center at the Medical University of Innsbruck between January 1, 2018, and December 31, 2024. Donor characteristics, ischemia times, organ utilization, and program-level trends were analyzed. In addition, key steps and protocols essential for establishing a cDCD program were systematically evaluated. Of 56 referred cDCD donors, 53 (94.6%) proceeded to organ recovery (i.e., actual donors), and 42 (75.0%) resulted in the transplantation of at least one organ (i.e., utilized donors). Utilized donors had significantly lower BMI than non-utilized donors (25 vs. 31 kg/m2, p = 0.003). The median functional warm ischemia time was 26 min (IQR 23-28). The mean number of transplanted organs per donor was 2.06. Organ utilization rates were highest for kidneys (60.4%). Nationwide DCD activity increased from 3% to 18% following the implementation of a structured cDCD program in Western Austria. In summary, we have outlined steps and protocols required to successfully implement a cDCD program, resulting in high utilization rates and a measurable impact on national cDCD activity.
The cumulative probability of patients with Crohn's disease (CD) requiring a stoma at a tertiary center is unknown. We sought to evaluate the time to stoma formation after diagnosis as well as risk factors for stoma formation in CD patients. This is a retrospective, longitudinal cohort study on consecutive patients with CD at an Austrian tertiary referral university center. In brief, patients with CD were identified and disease-specific data were captured prior to June 2023. The probability of stoma-free survival by subgroups of various potential risk factors was assessed by means of Kaplan-Meier estimates (Log-rank test). Of 1267 CD patients, 142 (11.2%) underwent a stoma formation (80 ileostomies, 62 colostomies), of which 51 (35.9%) were permanent stomas. The probability of stoma-free survival at 10 and 20 years after diagnosis was 92% and 86%, respectively. Ileocolonic and colonic location, penetrating behavior, and perianal disease were associated with a higher risk for stoma formation (each P < .001). If these risk factors coincided, the probability of stoma-free survival at 10 and 20 years after diagnosis was only 76.4% and 67.2%, respectively. Patients diagnosed from 2000 onward had a trend for a lower stoma risk than patients diagnosed earlier (P = .084). The coincidence of colonic or ileocolonic involvement, penetrating behavior, and perianal fistulas significantly reduced the probability of stoma-free survival to 68% 20 years after diagnosis. Identification of these risk factors for stoma formation may help identify patients at risk and thus raise awareness for this group.
In Austria, veterinary medicinal products (VMPs) containing penicillin G or cefoperazone are frequently used to treat dairy cows, which leads to the production of non-saleable waste milk. This study aimed to determine the loss of detectable antimicrobial activity of penicillin G and cefoperazone using a commercial ß-lactamase preparation, Antipen®. Ultra-high-temperature (UHT) processed and raw unpasteurized milk were spiked with penicillin G and cefoperazone (both pure pharmaceutical substances and VMPs), and the effects of temperature (37 °C, 25 °C, and 10 °C), storage time, and pH on Antipen® treatment on antibiotic activity were investigated. The aerobic mesophilic count (AMC) and Enterobacteriaceae before and after enzyme treatment in raw milk were also examined to assess the microbiological quality of milk that is potentially fed to calves. The VMPs containing penicillin G (Vanapen®) or cefoperazone (Peracef®) in 50 mL of UHT or raw milk showed a higher stability after Antipen® treatment compared to pure antibiotic substances. Concentrations of 300 μg/mL of Vanapen® tested negative by Delvotest® T under all experimental conditions (12- and 6-h treatment, at natural pH and pH 5.5, at 37-10 °C). Treatments of milk with natural pH spiked with 10 μg/mL of Peracef® tested negative for the antibiotic after 12 and 6 h at 37 °C, while after acidification of the milk to pH 5.5, 10 μg/mL Peracef® was undetectable at all temperatures and time periods. In milk with natural pH treated with Antipen® for 12 h at 10-37 °C, the values of AMC always exceeded 5.0-log cfu/mL, indicating that the milk is not suitable for use as calf feed without prior acidification or subsequent pasteurization. Reducing the exposure time to 6 h or acidifying the milk to a pH of 5.5 during 12-h treatment significantly reduced bacterial growth. This study demonstrated that Antipen® can effectively degrade penicillin, although its efficacy is lower and slower on cephalosporins. Since the study was conducted in a laboratory setting, extrapolation of the effective treatment durations to on-farm application requires validation in practical, real-world conditions.
Venous leg ulcers (VLUs) and VLUs associated with peripheral arterial disease (PAD) are common, recurrent, and costly to manage. Adjunctive biophysical therapies may improve healing outcomes when combined with standard of care (SOC). Concurrent optical and magnetic stimulation (COMS) has shown promising mechanistic and preliminary clinical results but there is a lack of robust randomized controlled trials (RCTs). This novel adjunct using concurrent optical and magnetic stimulation in a multicenter RCT in Europe (NAZARÉ) is a phase IV, post-market, multicenter, parallel-group, superiority randomized controlled trial conducted in Switzerland, France, Germany, and Austria. A total of 122 adults with VLU or mixed leg ulcers (ankle-brachial index > 0.5 and < 1.30 or ankle artery pressure > 60 mmHg), ulcer area 2-50 cm2, and ulcer duration > 30 days and < 2 years will be enrolled. Following a 2-week run-in to confirm < 30% area reduction under SOC, participants will be randomized 1:1 to SOC + COMS or SOC alone. The primary outcome is percentage wound area reduction (PWAR) at week 12, assessed by blinded evaluators using standardized digital planimetry. Secondary outcomes include complete closure, time-to-healing, pain, health-related quality of life, recurrence, and healthcare resource use. Missing outcome data will primarily be analyzed as observed and may be addressed using multiple imputation under the assumption of data being missing at random. This trial will rigorously assess the effectiveness of COMS as an adjunct to standard care for venous and mixed leg ulcers. By targeting chronic wounds and using a pragmatic, multicenter design, it aims to generate robust, generalizable evidence. If effective, COMS could offer a non-invasive, accessible option to enhance healing outcomes and reduce the burden of chronic leg ulcers. ClinicalTrials.gov NCT06528873. Registred on 26 July 2024, https://register. gov/prs/app/action/SelectProtocol?selectaction=Edit&sid=S000ERKB&uid=U0003LG4.
Peripheral nerve injuries (PNIs) cause significant disability. Autologous nerve grafts remain the gold standard but are limited by donor-site morbidity, restricted graft availability, and inconsistent functional recovery. Adipose-derived stem cells (ADSCs) have emerged as promising adjuncts due to their accessibility and regenerative potential. How has global research on ADSCs in peripheral nerve repair evolved, and what are the leading contributors, dominant themes, and emerging trends? A bibliometric analysis was performed using the Web of Science Core Collection for studies published from January 2000 to September 2025. Predefined search terms for ADSCs and peripheral nerve repair were applied. VOSviewer (v1.6.20) and CiteSpace (v6.3.R1 Advanced) were used to build co-authorship, co-citation, and keyword co-occurrence networks and to assess thematic evolution. The final dataset comprised 555 articles authored by 2750 researchers from 54 countries and 849 institutions, citing 16,466 references. Global output increased consistently after 2011, with a peak in 2019. When adjusted for population size, Switzerland showed the highest research intensity (3.22 publications per million inhabitants), followed by Sweden (1.81), Belgium (1.12), and Austria (1.11). Countries with the highest absolute output, including the United States (0.32) and China (0.12), demonstrated lower per capita contributions. Seminal work by Kingham and Coleman formed the conceptual basis for ADSC-mediated nerve regeneration. Keyword analysis revealed a shift from structural tissue engineering toward paracrine signaling, exosome-based strategies, and translational approaches. ADSCs are central to regenerative strategies for PNIs. Despite strong preclinical evidence, clinical translation remains limited, highlighting the need for standardized protocols and robust clinical trials.
Serum uric acid has been consistently associated with cardiovascular risk, yet whether this relationship reflects independent vascular pathology or cardiometabolic risk clustering remains unresolved. We examined associations of serum uric acid and hyperuricemia with imaging-defined subclinical coronary and carotid atherosclerosis in a large population-based cohort. We analyzed data from the Paracelsus 10,000 study, a population-based cohort of adults aged 40-77 years recruited from the Austrian national population registry. Coronary artery calcium (CAC) was assessed by computed tomography in 1561 participants with available cardiac computed tomography and polygenic risk score data; carotid plaque burden was assessed by ultrasonography in 8970 participants. Associations were evaluated using ordinal logistic regression - with CAC categorized by Agatston score (0, 1-99, 100-299, ≥ 300) and carotid plaque burden categorized by total plaque area - with sequential adjustment for cardiovascular risk score (SCORE2), metabolic syndrome, polygenic cardiovascular risk, lipoprotein(a) and systemic inflammation. Higher serum uric acid levels were strongly associated with greater CAC burden in unadjusted analyses (OR 1.60 per 1 mg/dL, 95% CI 1.48-1.74). This association was attenuated but remained significant after adjustment for cardiovascular risk score, metabolic syndrome, polygenic risk, lipoprotein(a), and inflammatory markers (OR 1.26, 95% CI 1.14-1.38). Hyperuricemia was independently associated with higher CAC categories after adjustment (OR 1.67, 95% CI 1.20-2.32). Carotid plaque burden showed a strong unadjusted association with serum uric acid that was substantially attenuated after multivariable adjustment, although a weak association remained statistically significant (OR 1.06, 95% CI 1.01-1.10). Serum uric acid and hyperuricemia are independently associated with subclinical coronary atherosclerosis beyond established cardiovascular risk factors, genetic susceptibility and systemic inflammation. The attenuation of carotid plaque associations after full adjustment suggests that extracoronary plaque burden is largely driven by cardiometabolic risk clustering rather than urate-specific pathways. These findings position uric acid as a clinically accessible marker of subclinical coronary atherosclerosis and raise the question of whether systematic urate assessment should inform cardiovascular risk stratification beyond established risk scores.
Microorganisms in nature are often found in porous confined environments (soils, sediments, or plant and animal tissues), self-organized in heterogeneous communities. Such an organization, resulting from complex interactions and self-generated steep chemical gradients, controls the emergent microbial community's ecological functions. The combination of microfluidics, fluorescent bacteria, and optical sensing can constitute a powerful tool to achieve new insights into these microbial dynamics. However, such a combination has remained challenging so far due to the limited compatibility of the current sensing approaches and fluorescent reporters. Here, we present a sensing microfluidic platform that enables simultaneous, real-time visualization of microscale oxygen gradients and multi-strain microbial community organization under flow. The approach combines transparent microfluidic devices, genetically encoded fluorescent bacteria, and the latest generation of near-infrared (NIR) luminescent oxygen sensors. We demonstrate that NIR oxygen sensing allows interference-free mapping of oxygen concentrations alongside GFP and mScarlet-I-labeled bacteria. Applying this platform to a heterogeneous porous geometry, we track the co-development of oxygen gradients and spatial organization in a two-strain Pseudomonas community under flowing conditions. The two strains exhibit distinct microscale spatial patterns consistent with known shape-dependent attachment and growth dynamics, while inducing sharp oxygen gradient formation. This work establishes a broadly accessible experimental framework for quantitatively linking microbial self-organization to chemical microenvironments in real time. This platform is cost-effective, customizable, and adaptable to sense different analytes, while being compatible with a range of spectrometry techniques. Therefore, this methodology opens new avenues for investigating microscale ecological processes in soils, sediments, and other confined habitats.
Candida auris is an emerging multidrug-resistant fungal pathogen posing a major global health threat. In this study, we employed a targeted drug-repurposing strategy to identify novel indications for existing FDA-approved compounds against C. auris, leading to the identification of Tavaborole as a potent fungistatic agent. Tavaborole displayed robust activity across all five tested clades of C. auris, as well as against Candida albicans and Candida glabrata. To investigate drug resistance mechanisms of C. auris, we applied quantitative proteomics analyses following exposure to Tavaborole and Amphotericin B (AmB), complemented by electron microscopy. Proteomic profiling revealed that C. auris mounts distinct but overlapping adaptive responses to antifungal stress, involving stress response pathways, metabolic reprogramming and amino acid biosynthesis. While Tavaborole primarily induced targeted stress adaptation, AmB triggered a broader, multi-pronged resistance response including oxidative stress mitigation, osmolyte production and metabolic remodeling. Shared alterations in glycogen metabolism and amino acid biosynthesis suggest conserved antifungal adaptation mechanisms. Altogether, this study highlights Tavaborole as a promising antifungal candidate against C. auris, sheds novel insights into drug resistance mechanisms employed by the pathogen and delivers a drug-repurposing procedure highly customizable to target other microorganisms.
Covered stents are often used to manage coronary perforations, but they can inadvertently obstruct side branches. Perforations in the left main artery can lead to severe haemodynamic instability, especially if the side branch, the left circumflex artery, becomes completely occluded by the covered stent. The authors describe a successful case of sealing a distal left main perforation using fenestration of a covered stent in combination with a jailed-balloon technique to preserve blood flow to the left circumflex artery.
暂无摘要（点击查看详情）
Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS) are among the most well-known and prevalent neurodegenerative disorders. These diseases result from an interaction between the environment and genetically predisposed individuals. This review examines the evidence available in the literature underlying this multifaceted interaction, focusing on various chemical substances such as metals, fertilizers, and herbicides, as well as toxic agents of microbiological origin, including cyanobacteria and their neurotoxins. In addition, the pathways through which toxic substances can enter the human body are discussed, such as air and water, which may lead to absorption through the lungs, the gastrointestinal tract, the skin, and mucosae. The routes by which neurotoxic substances gain access to the human body may help explain the increased risk of developing neurodegenerative diseases observed in sports played on soil and grass surfaces, such as soccer, American football, and golf.
Pediatric urolithiasis guidelines recommend ESWL, RIRS, or PCNL for stones within the 10-20 mm range but this broad interval often complicates treatment selection. This systematic review aimed to define a clearer, evidence-based stone size cutoff to improve clinical decision-making. A systematic review and meta-analysis were performed (PROSPERO CRD420251012163) according to PRISMA 2020 guidelines. Pediatric studies published from 2014 to 2025 were searched across major databases. Eligible studies reported stone size and at least one outcome, including stone-free rate, residual fragments, retreatment, or complications. Studies without quantitative data were excluded. Early and long-term complications as well as instrumentation were analyzed. Pooled estimates were calculated using random-effects models. Risk of bias was assessed using the Newcastle-Ottawa Scale. Seventy-six study arms (N.=5294) reported stone size data. The pooled mean was 16.03 mm (95% CI 14.60-17.47; I2=99.9%). Stones treated with ESWL averaged 12.29 mm, RIRS 12.49 mm And PCNL 20.16 mm, indicating PCNL was used for larger stones (P<0.001). In 113 studies reporting SFR, pooled rates were 0.801 for ESWL, 0.826 for RIRS And 0.893 for PCNL, with PCNL showing higher SFRs. Considerable heterogeneity was observed And differences in complication profiles and instrumentation were identified as important factors influencing treatment outcomes beyond stone-free rates alone. A 15-mm stone size threshold appears clinically meaningful and provides clearer guidance than the traditional 10-20 mm range in children. ESWL and RIRS are appropriate options for stones <15 mm, whereas PCNL is more suitable for larger stones. Beyond stone-free rates, complication profiles and instrumentation should be considered when selecting treatment. Study heterogeneity and potential publication bias remain important limitations.
Changes in decision-making (DM) are frequently observed in patients with Parkinson's disease (PD). Despite extensive research, the relationships between DM and various cognitive functions remain incompletely understood. This systematic review aims to synthesize existing evidence on the link between DM and cognition in PD, emphasizing a comprehensive perspective that considers multiple cognitive domains and various DM tasks. A systematic literature search was conducted across PubMed, PubPsych, and LIVIVO databases. Inclusion criteria encompassed studies that examined the relationship between DM performance and cognitive functions in individuals with PD. Data extraction focused on sample characteristics, types of DM tasks employed, cognitive domains assessed, and key findings on their association. A total of 38 studies, published between 2001 and 2025, involving 1,313 individuals with PD, were identified. Most of these studies used laboratory-based DM tasks-with the Iowa Gambling Task (IGT) as the most frequently used DM paradigm, followed by the Game of Dice Task (GDT)-whereas only few studies employed ecologically valid DM tasks that simulate real-life DM contexts. A substantial number of studies investigated the association of DM performance with global cognitive status, executive functions, and memory. Fewer studies explored social cognition, psychomotor speed and attention, visuo-construction and visuo-spatial skills, language, and numerical abilities. Most analyses on the association between DM and cognition in PD revealed non-significant findings. Among the studies reporting significant associations, findings did not consistently cluster around specific cognitive domains or DM tasks, indicating heterogeneity in results. This systematic review highlights the complex and often inconsistent relationship between cognitive functions and DM in individuals with PD. Despite some evidence of significant associations, most findings are non-significant, scattered, and influenced by methodological variability across studies. Future research should aim for standardized, ecologically valid assessments and consider the multifaceted nature of cognition and DM to better elucidate these relationships in PD.
Laser ablation inductively coupled plasma time-of-flight mass spectrometry (LA-ICP-TOFMS) enables the quantitative imaging of metal-based therapeutics with cellular resolution. Despite its analytical power, systematic screening of metal-containing anticancer agents remains limited by the substantial time, cost, and labor required for cell handling, staining, and analysis. Here, we present a barcoding strategy that allows us to pool multiple experiments together and analyze them simultaneously. Our labeling approach combines wheat germ agglutinin (WGA) with lanthanide-labeled anti-WGA barcodes, enabling robust discrimination of experimental conditions. Following LA-ICP-TOFMS measurement, pooled data sets can be processed using MeXpose, a data processing pipeline for single cells, to accurately assign each cell to its original barcode, i.e., experiment. In this study, we applied this novel strategy to investigate the uptake of BOLD-100 and oxaliplatin in HCT116 wild-type (WT) and oxaliplatin-resistant (OxR) colorectal cancer cells using different drug concentrations. Pooling 10 experiments into a single analytical run allowed us to reduce consumable use (mainly argon for the ICP and antibody usage if stained), measurement time, and downstream processing while increasing data consistency. Barcoding-enabled single-cell analysis confirmed a substantial reduction in oxaliplatin uptake in oxaliplatin-resistant HCT116 cells compared with the WT cell line, whereas BOLD-100 uptake was affected to a much lesser extent. These results demonstrate the utility of this strategy for the efficient and scalable assessment of metal-based therapeutics.
Atrial fibrillation (AF) is highly prevalent among cardiac amyloidosis (CA) patients and contributes significantly to their morbidity and mortality. Evidence regarding AF ablation efficacy and safety in CA patients remains limited. The aim of our study is to evaluate baseline characteristics, clinical course and outcomes of AF ablation in a series of patients with transthyretin (ATTR) or light-chain (AL) CA from a multicentre international registry. Patients with CA who underwent AF ablation were included. Co-primary endpoints were: (i) atrial arrhythmia (AA) recurrence; (ii) a composite endpoint of all-cause mortality and heart failure hospitalization (HFH). 109 patients (mean age 72.4 ± 7.4 years, females 17.4%, persistent AF 64.2%, ATTR 78%, AL 22%) were included. Radiofrequency, cryo-balloon and pulsed-field ablation were performed in 67%, 15% and 18% of patients, respectively; 49.5% received pulmonary vein isolation plus additional ablations. Low voltage zones were documented in 34 out of 44 patients undergoing electro-anatomical mapping (77.3%). During a median follow-up of 22.7 months, 63 patients (58.3%) experienced AA recurrence (32.4% persistent AF recurrence), with no significant differences between CA subtypes (ATTR 59.5% vs. AL 54.2%, log-rank P = 0.55). The composite endpoint of HFH and all-cause death occurred in 27 patients (25%). Recurrence of persistent AF was associated with three-fold higher risk (OR 2.9, P = 0.02) of the composite endpoint. CA patients undergoing AF ablation present high prevalence of persistent AF. Freedom from AA after AF ablation is achieved in 42% of patients after a two-year follow-up. Patients with persistent AF recurrence have a three-fold higher risk of HFH and death.
Total joint arthroplasty is a common surgical treatment option for trapeziometacarpal joint arthritis. The case report reflects the seldom complication of a fracture of the polyethylene liner in a double mobility trapeziometacarpal joint prosthesis (Touch). Unique about this case is that the affected patient had no symptoms despite a slight clicking during thumb abduction. X-rays and the clinical evaluation showed no abnormalities. A computed tomography scan and dynamic x-rays gave a hint about abnormal decentralization of the head. In a revision surgery, the fractured polyethylene liner was found as cause of the decentralization of the head and explained the slight clicking during thumb abduction. Changing the head of the implant restored the normal movement of the prosthesis without clicking. We suggest regular checks to detect implant failure as early as possible. This case shows that serious implant problems can be clinically unobtrusive, and early intervention can save the implant.
A systematic molecular epidemiology survey was conducted on ten viruses in 226 captive and two wild Amur tigers from Northeast China. The target viruses were: feline panleukopenia virus (FPV), feline herpesvirus-1 (FHV-1), feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), canine distemper virus (CDV), feline coronavirus (FCoV), feline calicivirus (FCV), influenza A virus (IAV), hepatitis E virus (HEV), and rotavirus A (RVA). The overall infection prevalence in captive tigers was 45.6% (103/226), with FPV (25.2%) and FHV-1 (20.4%) identified as the dominant pathogens. Other viruses detected at lower frequencies were FIV (3.1%), CDV (1.8%), FCoV (0.9%), and FeLV (0.4%); FCV, IAV, HEV, and RVA were not detected. This study reports the first detection of FeLV in this subspecies. Infection prevalence exhibited marked age and regional dependence, being highest in juveniles (56.5%) and in the facilities of Shenyang (55.8%) and Harbin (52.6%). Phylogenetic analysis of partial VP2 sequences indicated that FPV strains from captive tigers formed a distinct, well-supported monophyletic clade (bootstrap = 99). In contrast, the VP2 sequence from the wild tiger (YINGCHUN) did not group within the captive tiger clade; instead, it occupied a separate position within the broader FPV cluster. FIV strains from tigers were phylogenetically interspersed with strains from domestic cats in China. Despite existing vaccination protocols, the persistent high prevalence of FPV and FHV-1 indicates suboptimal immunoprotection. These findings clarify the current viral pathogen profile in captive Amur tigers and underscore the necessity for optimizing disease management strategies, including age-stratified immunization, enhanced biosecurity, and the establishment of transboundary surveillance.
Posterior capsule opacification (PCO) is still frequent in spite of sharp-edged optic IOLs. With primary posterior capsulorhexis (PPCCC), lens epithelial cells (LECs) may still access the central posterior optic surface. Additional posterior optic buttonholing (POBH) deviates migrating LECs towards the anterior optic surface, thus excluding retro-optical opacification. In 2004 the author started investigating POBH as a standard procedure for adult cataracts. 1000 consecutive POBH cases were evaluated and compared to standard in-the-bag IOL placement and sole PPCCC. Additional anterior capsule polishing (ACP) and capsule tension ring (CTR) implantation were also performed in sub-series. In all eyes, retro-optical opacification was eradicated, and capsular fibrosis largely reduced. CTR implantation facilitated PPCCC with loose zonules or flaccid capsule bags. Postoperative refractive and rotational stability were immediate. No pressure rises or inflammatory response was observed. Retinal detachment and macular edema were not increased. With POBH the IOL optic is placed in Berger´s space outside of instead of in the capsular bag. POBH is controlled, safe, and effective including costs. POBH is compatible with many open-loop IOL models independent of material properties. It avoids dysphotopsia as round-edged optic IOL may also be used. Planned POBH may be converted into sulcus or anterior capsule IOL fixation in case of posterior capsular complications. It provides immediate refractive and perfect rotational stability. POBH improves the performance of trifocal IOLs and facilitates delayed exchange if needed. It combines with Add-On IOLs and translimbal floaterectomy. POBH could therefore replace in-the-bag IOL implantation as standard of care.
Transurethral resection of bladder tumor (TURBT) is the standard for diagnosis and initial treatment of non-muscle-invasive bladder cancer (NMIBC) a disease with highly variable presentation. To evaluate the rate of malignancy in patients undergoing elective TURBT for suspected BC. A retrospective analysis of 217 patients undergoing primary TURBT for BC suspicion at our tertiary care center between January and June 2023 was performed.Key parameters included preoperative macroscopic cystoscopy findings, intraoperative macroscopic findings, and pathologic tumor characteristics from the TURBT specimen. The primary outcome was the detection rate of malignancy. Secondary outcomes included the correlation of the interobserver congruence on preoperative and TURBT findings. Multivariate logistic regression was performed to identify significant predictors of malignancy. Of 217 patients, 35% had no malignancy in the TURBT specimen. Interobserver congruence was observed in 80.6% of cases. Papillary findings in the initial cystoscopy (Odds ratio (OR) = 5.6, 95% Confidence interval (CI) = 2.18-14.52, p < 0.001), age (OR = 1.057, 95%CI = 1.02-1.1 p = 0.002), interobserver congruence on preoperative and TURBT findings (p < 0.001, OR = 99.3, 95%CI = 10.9-903.9), and tumor size (OR = 1.9, 95%CI = 1.33-2.71, p < 0.001) were significant predictors for malignancy. Direct TURBT may not be obligatory for all patients with suspicious bladder lesions. Our findings highlight the importance of a thorough preoperative diagnostic setup to avoid unnecessary procedures and spare the burden for patients. There is a need to establish more selective criteria for TURBT.
暂无摘要（点击查看详情）