The Uniklinikum Aachen, full German name Universitätsklinikum Aachen ("University Hospital Aachen", abbreviated UKA), formerly known as Neues Klinikum ("New Clinic"), is the university hospital of the city of Aachen, Germany. It is part of the RWTH Aachen and contains its whole medical faculty.In addition to wards and common hospital facilities such as laundry and sterilization units, the Uniklinikum Aachen houses educational and research facilities including specialized clinics, theoretical and clinical institutes, lecture halls and training rooms.The hospital's exterior has extensive visible pipes, which give the building an industrial appearance reminiscent of an oil refinery.
Hemorrhagic transformation (HT) within ischemic infarcts is a critical post-stroke complication that significantly influences secondary prevention strategies, particularly the timing and safety of anticoagulation. Ultra-low field (ULF) MRI (0.064 T, Swoop, Hyperfine) offers bedside neuroimaging, but its ability to detect hemorrhagic transformation compared to standard MRI (1.5 T or 3 T) and CT remains uncertain. This study aimed to evaluate the diagnostic accuracy of ULF-pMRI for detecting hemorrhagic transformation in ischemic stroke patients. We retrospectively analyzed 97 patients with ischemic infarcts who underwent both ULF-pMRI and standard neuroimaging (standard MRI or CT). The presence of hemorrhagic transformation was assessed by two independent readers (trained neuroradiologists) and by consensus reading in univariate analysis using the Heidelberg Bleeding Classification (HBC). Diagnostic accuracy metrics sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with the standard method (standard MRI or CT within two days of ULF-pMRI) as the reference. Agreement was quantified using Cohen’s Kappa. Of 97 stroke patients, n = 21 (21.6
The Commission on Laboratory Diagnostics in Diabetology was founded in 2015 at the suggestion and with the support of the Executive Board of the German Diabetes Society (DDG) and the German Society of Clinical Chemistry and Laboratory Medicine (DGKL), with the aim of addressing methodological aspects for the reliable measurement of clinical chemistry measurands such as glucose, HbA1c, insulin, C-peptide, antibodies, etc. This mini-review looks back on the work of the KLD over the past 10 years and briefly outlines current activities and future steps.
PURPOSE:Enfortumab vedotin (EV) is standard therapy for metastatic urothelial carcinoma (mUC), yet the predictive relevance of NECTIN4 expression-especially membranous versus cytoplasmic-remains unclear. Here, we sought to extend previous findings on NECTIN4 gene amplification in parallel with a systematic subcellular evaluation of NECTIN4 expression. EXPERIMENTAL DESIGN:We retrospectively analyzed 179 EV-treated mUC patients. NECTIN4 amplification was assessed by FISH and NECTIN4 protein levels by IHC. A four-tier membranous scoring algorithm (0,1+,2+,3+) adapted from CAP HER2 gastric guidelines was benchmarked against H-score. We integrated amplification status with membranous staining to refine predictive stratification and compared associations with objective response rate (ORR) to EV-301 data. RESULTS:Combining membranous and cytoplasmic compartments resulted in a median composite H-score of 260 (78.2% ≥150), closely matching NECTIN4 expression prevalence reported in EV-301 (median 250; 82.6% ≥ 150). A ≥150 cut-off enriched for EV responders in both cohorts; in EV-301 with ORR of 45.8% vs. 20% (P = 0.001). High membranous expression based on the scoring (2+/3+) predicted response (ORR 55.1% vs. 25.5%; P < 0.001), with longer PFS (7.1 vs. 2.9 months; HR 0.45) and OS (12.3 vs. 6.9 months; HR 0.57), whereas cytoplasmic expression lacked predictive value. NECTIN4-amplified tumors showed particularly favorable outcomes (PFS 12.2 months; OS 30.1 months). An integrated three-tier model-amplified, non-amplified/high-membranous, and non-amplified/low-membranous-yielded ORRs of 77.2%, 42.9%, and 26.1% and separated survival outcomes. CONCLUSIONS:Our NECTIN4 scoring system integrating NECTIN4 amplification with membranous NECTIN4 expression accurately predicts outcomes, supporting combined genomic and membranous assessment as complementary biomarkers for optimizing EV selection.
BACKGROUND:Endovascular procedures using a mobile C-arm are commonly performed in patients with peripheral artery disease. During these procedures, digital subtraction angiography (DSA) requires intra-arterial administration of contrast agent and exposes both patients and staff to radiation from the C-arm. The Vascular Navigation PAD system (Brainlab, Germany) may reduce the number of DSAs performed and thereby decrease both contrast agent use and radiation exposure. The objective of this study is to evaluate the safety and clinical performance of the Vascular Navigation PAD system compared with standard care in endovascular PAD treatment. The primary aim is to determine whether the device reduces the volume of contrast agent used during lower-extremity procedures. Secondary objectives include assessing patient and physician radiation exposure, patient air kerma, and the device's ability to support accurate endovascular navigation. METHODS:This is a multicenter, prospective, randomized confirmatory trial comparing navigation-assisted procedures with conventional procedures without navigation assistance. Patients allocated to the intervention group will undergo treatment using Vascular Navigation PAD in addition to a mobile C-arm. A total of 160 patients will be randomized in a 1:1 ratio, with 40 patients per group enrolled at each of the two participating hospitals. The primary endpoint is contrast agent volume. Secondary endpoints include patient radiation exposure, physician radiation exposure, fluoroscopy time, and the number of DSAs performed per intervention. DISCUSSION:This study will evaluate whether the Vascular Navigation PAD system can reduce the number of DSAs in endovascular treatment. A reduction in DSAs may lead to lower contrast agent use and reduced radiation exposure for both patients and staff. TRIAL REGISTRATION:The clinical trial is registered at the German Clinical Trials Register (ID: DRKS00035267). Registered on 10.Jan.2025.
