The Medical University of Innsbruck (German: Medizinische Universität Innsbruck) is a university in Innsbruck, Austria. It used to be one of the four historical faculties of the Leopold-Franzens-Universität Innsbruck and became an independent university in 2004..
Atherosclerosis reflects a chronic inflammatory process of arteries. The origin of chronic vascular inflammation has been associated over a long time primarily with lipid disorders, but evidence from the past years has suggested that lipid-independent pathways are also involved. Recent research has demonstrated that the gastrointestinal microbiota has an impact on the development of atherosclerosis. Many clinical studies have revealed that there exist altered gut microbiota and increased intestinal abundance of bacteria from the oral cavity in atherosclerosis-related disorders such as cardiovascular disease or stroke, while several studies have demonstrated insights into underlying mechanisms. Various microbial-derived metabolites, such as the pathogen-associated molecular pattern endotoxin, trimethylamine N-oxide or imidazole propionate, contribute to atherosclerosis, while other bacterial metabolites, such as some tryptophan derivatives, might be protective. Furthermore, gut microbiota and lipid pathways are highly interactive, and the gut microbiota affects lipid absorption and storage, and the gut microbiota also contributes to vascular ageing. Interference with the gut microbiota by prebiotics, probiotics and antibiotics has demonstrated beneficial effects on atherosclerosis mainly in preclinical models. Overall, the gut microbiota has appeared as an important rheostat for vascular inflammation in atherosclerosis, which is controlled by host-microbe interactions that may be therapeutically exploited in the future.
Renal replacement therapy (RRT) is frequently used in critically ill patients with acute kidney injury (AKI). Here, we provide guidelines for the management of RRT in critically ill patients on the intensive care unit (ICU). We convened a systemic literature research and a Delphi process with a bi-national multidisciplinary consensus panel including 22 clinicians of 12 different German-speaking societies (Germany and Austria) with expertise in RRT. This structured guideline process was the basis for the evidence-based statements and recommendations. We identified seven clinical areas needing guidance: (1) start, (2) modality (diffusion and convection), (3) continuous/ intermittent, (4) anticoagulation, (5) dose (6) pharmacotherapy, (7) stopping criteria. The consensus produced 73 statements and recommendations regarding key clinical areas, the most important 47 statements and recommendations are summarized in this overview. This evidence-based bi-national guideline should provide physicians with guidance for delivering best practice to critically ill patients with a dialysis-dependent AKI.
Multi-omic and multimodal datasets with detailed clinical annotations offer significant potential to advance our understanding of inflammatory bowel diseases (IBD), refine diagnostics, and enable personalized therapeutic strategies. In this multi-cohort study, we performed an extensive multi-omic and multimodal analysis of 1,002 clinically annotated patients with IBD and non-IBD controls, incorporating whole-exome and RNA sequencing of normal and inflamed gut tissues, serum proteomics, and histopathological assessments from images of H&E-stained tissue sections. Transcriptomic profiles of normal and inflamed tissues revealed distinct site-specific inflammatory signatures in Crohn's disease (CD) and ulcerative colitis (UC). Leveraging serum proteomics, we developed an inflammatory protein severity signature that reflects underlying intestinal molecular inflammation. Furthermore, foundation model-based deep learning accurately predicted histologic disease activity scores from images of H&E-stained intestinal tissue sections, offering a robust tool for clinical evaluation. Our integrative analysis highlights the potential of combining multi-omics and advanced computational approaches to improve our understanding and management of IBD.
Hallucinations and delusions are among the most disabling long-term complications of Parkinson's disease (PD). Their pathogenesis is based on a complex interaction of neurodegeneration in critical areas for visual and cognitive processing and PD medication effects. Management rests on the identification and treatment of acute triggers, simplification of PD medication and treatment with antipsychotics. Despite the high prevalence of psychosis in advanced PD there is still a lack of familiarity with its manifestations and therapeutic approaches. This gap is further enhanced by recent developments in drug availability and therapeutic monitoring. Pimavanserin is the only approved drug for the treatment of PD psychosis in the U.S., but currently not marketed elsewhere. The aim of this review is to provide an update on the management options for PD psychosis in other regions of the world with a focus on clinical practice in Europe. Quetiapine and clozapine remain cornerstones of treatment of PD psychosis in Europe. Despite limited evidence for efficacy, quetiapine is often used as first-line therapy, whereas severe PD psychosis usually requires treatment with clozapine, with clozapine demonstrating efficacy without worsening of motor symptoms in randomised, controlled trials. Other antipsychotics should be avoided in PD psychosis due to their ineffectiveness or high potential for worsening parkinsonian motor symptoms. Novel drugs with a better risk-benefit ratio in the treatment of PD psychosis are needed. Non-pharmacological treatments should be explored in relation to their potential to prevent or mitigate psychotic reactions in prospective studies.
