BackgroundProlonged preterm premature rupture of membranes (PPROM) in the second trimester is associated with heterogeneous neonatal respiratory outcomes, ranging from mild transitional respiratory impairment to dry lung syndrome (DL), pulmonary hypoplasia (PH), bronchopulmonary dysplasia (BPD) and death. Risk assessment is challenging because outcomes are influenced by both gestational maturity and PPROM-specific exposures. This study aimed to evaluate respiratory outcomes after prolonged PPROM using a multifactorial and longitudinal approach that integrates gestational age, amniotic fluid status, inflammatory signs, and maternal characteristics.MethodsWe retrospectively analyzed 66 pregnancies with second-trimester PPROM and prolonged latency. Short-term respiratory outcomes were classified as no respiratory disease, dry lung (DL), or pulmonary hypoplasia (PH); neonatal death and BPD were also assessed. Gestational age (GA) at PPROM and at birth were analyzed using ordered groupings with trend testing. Multivariable logistic regression was used to identify independent risk factors. Serial weekly measurements of the single deepest vertical pocket (SDP) were evaluated longitudinally using repeated-measures analysis to compare amniotic fluid trajectories between outcome groups.ResultsRespiratory morbidity and death decreased stepwise with increasing GA at PPROM and GA at birth. Lower SDP values were consistently associated with PH, BPD, and death, particularly when median SDP was <2 cm. Longitudinal analysis demonstrated persistently lower SDP values in pregnancies resulting in PH, without evidence of differing SDP trajectories over time between groups. Inflammatory signs were associated with BPD, while maternal age and GA at PPROM were associated with PH and death. DL showed a distinct pattern, with weaker associations to gestational age and amniotic fluid parameters compared with PH.ConclusionOutcomes after prolonged second-trimester PPROM reflect a multifactorial risk profile in which gestational maturity, amniotic fluid impairment, inflammatory status, and maternal characteristics interact. Integrating longitudinal ultrasound data with gestational-age–based risk stratification can improve counseling and support individualized management strategies in PPROM pregnancies.
Abstract Background Multiple Endocrine Neoplasia type 1 (MEN1) is a rare hereditary syndrome associated with significant morbidity and reduced life expectancy due to a high penetrance of several endocrine tumors and other related manifestations. International collaborations are essential for gaining deeper insights into this condition by generating robust high-quality clinical data and patient experiences through patient reported outcomes. Purpose and Methods The European Registries for Rare Endocrine and Bone Conditions (EuRREB) within the Core Registry platform allows to collect a set of core data elements and specific dataset within the condition specific modules (CSM) as well as patient reported outcome measures. Within the registry, the MEN1 module was created through the multi-stakeholder collaboration of clinicians, researchers and patient advocacy groups over the course of 2 years (with 10 experts from 4 different countries and 2 patient representatives). The purpose was to build a scalable framework to capture essential clinical information and patient-reported outcomes, with the capacity to support future observational studies, eventually leading to more knowledge about thepathophysiology, natural history and impact of MEN1 related manifestations. Results The initial dataset was launched December, 2023 with over 250 variables. Seven feedback sessions were conducted over the course of development of the module, based upon which the dataset was finalized with 118 unique variables, with the opportunity to collect repeated data to adequately capture the longitudinal follow-up of MEN1 patients. As a result of the consensus, a beta version was launched in July 2025 and recently, the final version of the module was officially launched on 01-12-2025 to be available for all MEN1 patients, and clinicians within expertise centers throughout Europe. Conclusions This MEN1 module within EuRREB has the potential to serve as a multicenter international registry, providing an ideal foundation for advancing healthcare outcomes for this group of patients. All clinicians with experience in MEN1 are encouraged to take part in the module.
Die anästhesiologische Versorgung von Kindern stellt besondere Anforderungen an die Kenntnisse und Kompetenzen der betreuenden Anästhesist:innen. In Deutschland existiert derzeit keine strukturierte Weiterbildung in diesem Bereich. Im Rahmen eines Konsensusverfahrens wurde ein Curriculum für ein Fellowship-Programm in der Kinderanästhesiologie entwickelt. Aufbauend auf der anästhesiologischen Facharztweiterbildung soll dieses Programm spezifische Kenntnisse und Kompetenzen für die Versorgung von Kindern vermitteln. Die definierten Abschlussfertigkeiten wurden in Basis- und erweiterte Fertigkeiten unterteilt. Basisfertigkeiten werden an allen Fellowship-Standorten vermittelt, während die Vermittlung der erweiterten Fertigkeiten von den strukturellen Voraussetzungen der Zentren abhängt. Ergänzend zum klinischen Kompetenzerwerb umfasst das Fellowship verpflichtende Zusatzbausteine wie eine qualitätsverbessernde Projektarbeit, Fortbildungen, zertifizierte Kindernotfallkurse und Webinare. Der Kompetenzfortschritt der Fellows wird durch regelmäßige, standardisierte Evaluationsgespräche begleitet und im Rahmen einer strukturierten Evaluation dokumentiert. Das „Fellowship Kinderanästhesiologie“ ist ein kompetenzbasiertes, curricular aufgebautes Weiterbildungsprogramm. Aufbauend auf der anästhesiologischen Facharztweiterbildung soll es dazu beitragen, die Patientensicherheit und Versorgungsqualität in der anästhesiologischen Versorgung von Kindern nachhaltig zu verbessern.
Alloplastic reconstruction is often required following segmental mandibular resection (SMR). Hardware-associated complications, especially hardware fractures, almost invariably necessitate explantation. Recent advances in manufacturing techniques promise potential advantages over traditional methods, including increased fracture resistance. However, to date, there is no scientific evidence confirming whether these benefits translate to real-life clinical conditions. A total of 210 patients underwent SMR followed by alloplastic reconstruction between 2007 and 2019 at Hannover Medical School. The indications for SMR were tumor (n = 208; n = 196 squamous cell carcinoma) and osteoradionecrosis (n = 2). The mean patient age was 60.61 years, with a range of 14 to 89 years. The cohort comprised 146 male patients (69.52
