The Klinikum St. Georg is the oldest, and, after Leipzig University Hospital, the second largest hospital in Leipzig, Germany. It was founded in 1212. It consists of the Klinikum St. Georg gGmbH, and the Municipal Hospital "St. Georg" Leipzig (operated by the City of Leipzig). The hospital currently employs over 3,500 people and has 1,066 beds in 25 clinics. In addition, the gGmbH and the municipal hospital function as an academic teaching hospital of Leipzig University..
Importance:Severe burn injury triggers systemic inflammation that can lead to multiple organ dysfunctions and death. High-dose intravenous vitamin C has been proposed to mitigate these effects, but strong evidence in patients with burn injury is lacking. Objective:To evaluate the efficacy of high-dose intravenous vitamin C in patients with severe burn injury. Design, Setting, and Participants:Randomized, double-blind, placebo-controlled phase 3 trial conducted across 24 burn centers in North, Central, and South America; Europe; and Asia. Adults (≥18 years) with deep second- and/or third-degree burns covering 20% or more of total body surface area and requiring skin grafting were enrolled between August 18, 2020, and September 12, 2025. Final follow-up was completed in March 2026. The trial was stopped early after the first prespecified interim analysis for futility/harm. Interventions:Patients were randomly assigned (1:1) to receive intravenous vitamin C (50 mg/kg every 6 hours for 96 hours) or matched placebo. Main Outcomes and Measures:The primary outcome was a composite of 28-day mortality and persistent organ dysfunction (defined as dependence on mechanical ventilation, kidney replacement therapy, or vasopressor/inotrope support at day 28). The main secondary outcome was time to discharge alive from hospital within 90 days. Results:Among 238 patients enrolled (mean age, 48.9 [SD, 19.1] years; 79% male; mean total body surface area, 37.0% [SD, 14.6%]), 120 were assigned to vitamin C and 118 to placebo. The primary composite outcome occurred in 49 patients (40.8%) in the vitamin C group and 35 patients (29.7%) in the placebo group (adjusted risk ratio [RR], 1.28 [95% CI, 0.99-1.65]; P = .06), crossing the prespecified futility/harm threshold and prompting early trial termination. Time to discharge alive from hospital within 90 days was not improved (adjusted subdistribution hazard ratio, 0.85 [95% CI, 0.62-1.16]; P = .31). Twenty-eight-day mortality was higher in the vitamin C group (15.0% vs 7.6%; adjusted RR, 1.96 [95% CI, 1.32-2.90]; P = .001), as was hospital mortality (23.3% vs 16.1%; adjusted RR, 1.44 [95% CI, 1.03-2.00]; P = .03). Conclusions and Relevance:Among patients with severe burn injury, high-dose intravenous vitamin C did not reduce 28-day mortality and persistent organ dysfunction and is possibly harmful. Trial Registration:ClinicalTrials.gov Identifier: NCT04138394.
Penile cancer (PC) is a rare but aggressive malignancy with limited systemic treatment options, particularly in advanced stages. Targeted therapies against receptor tyrosine kinases such as EGFR and HER2 have demonstrated clinical benefit in other cancer types, yet their role in PC remains poorly defined. Understanding their expression patterns in primary tumors and metastases is essential for identifying new therapeutic avenues. In this study, we aimed to systematically assess the expression of EGFR and HER2 in a large multicenter PSCC cohort and evaluate their potential relevance not only as therapeutic targets but also as prognostic biomarkers. In addition, we analyzed possible correlations with key clinicopathological features, including HPV status, tumor stage and histological subtype. Among 208 patients, moderate to strong EGFR expression was detected in 27.0
Introduction:Postoperative imaging surveillance is essential in the management of glioma patients. However, new or progressive contrast-enhancing lesions do not always indicate true tumor recurrence. Foreign body granulomas (FBG), also known as textilomas, may arise as inflammatory reactions to hemostatic or sealing materials used during surgery and can closely mimic tumor progression on MRI. Distinguishing between these entities remains a major diagnostic challenge with important therapeutic implications. Methods:We retrospectively analyzed glioma re-operations performed for suspected recurrence at a tertiary neurosurgical center between 2016 and 2020. Demographic data, tumor histology, intraoperative foreign material, adjuvant therapy, and time to re-operation were assessed. Histological findings were classified as recurrence or no tumor. Preoperative MRI was reviewed according to RANO criteria, with emphasis on diffusion-weighted imaging and apparent diffusion coefficient (ADC) values. Univariate analyses were conducted. Results:Of 211 glioma patients, 38 (18 %) underwent re-operation for suspected recurrence. Histological recurrence was confirmed in 27 cases (71.1 %), while 11 (28.9 %) showed no tumor. Foreign material was identified in three non-tumor cases; the remaining showed post-inflammatory or unclear changes. All non-tumor cases had been radiologically classified as progressive disease. ADC values tended to be lower in the non-tumor group, suggesting diffusion restriction, but without statistical significance. Oxidized cellulose was frequently used in both groups. Conclusion:FBG are a relevant and likely underrecognized differential diagnosis in suspected glioma recurrence. Conventional MRI and RANO criteria alone may be insufficient. Diffusion-weighted imaging may provide additional clues but is not definitive. Increased awareness and multidisciplinary evaluation are essential to avoid unnecessary interventions and overtreatment.
Introduction: Various scoring systems are applied to burn patients to assess the perioperative and mortality risks as well as comorbidities. Objective: The purpose of this study was to compare the predictive accuracies for mortality of different scoring systems: the Abbreviated Burn Severity Index (ABSI), Bogenhausen ABSI (BABSI), American Society of Anesthesiologists (ASA) classification, Charlson Comorbidity Index (CCI) and modified Frailty Index-5 (mFI-5). Materials and Methods: We retrospectively analyzed 644 burn patients treated at one burn center between September 2018 and May 2022. Results: Median scores were 5 (range: 1-16), 5 (range: 2-17.5), 2 (range: 1-5), 0 (range: 0-14) and 0 (range: 0-5) for the ABSI, BABSI, ASA, CCI and mFI-5, respectively. Significantly different median score results were observed between survivors and non-survivors: ABSI: 5 vs. 10; BABSI: 5 vs. 10.5; ASA: 2 vs. 4; CCI: 0 vs. 5; and mFI-5: 0 vs. 2 (p < 0.001 for all scores). Predictive accuracies were excellent for the BABSI (AUC = 0.963), ABSI (AUC = 0.952), and ASA (AUC = 0.916), whereas fair predictive accuracies were found for the CCI (AUC = 0.851) and mFI-5 (AUC = 0.760). Good calibration was observed for the BABSI, ABSI, CCI, and mFI-5, whereas calibration was poor for the ASA. Conclusion: All five scores significantly differentiate between survivors and non-survivors. However, the strongest discriminatory power and best calibration for mortality prediction were observed for the BABSI and ABSI scores. Therefore, the application of both scores is recommended in daily routine.
