The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by a highlighted short practical recommendation. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing, and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.
LBA5500 Background: Optimal timing of cytoreduction in non-frail patients (pts) with seemingly resectable stage IIIB-IVB ovarian, tubal, and peritoneal carcinoma (OC) remains controversial. Methods: TRUST is an international randomized multicenter phase III trial in pts with stage IIIB-IVB OC and good performance status (ECOG 0/1) comparing primary cytoreductive surgery (PCS) followed by 6 cycles of intravenous (iv) chemotherapy to 3 cycles of neoadjuvant iv chemotherapy (NACT) followed by interval cytoreductive surgery (ICS) and 3 further iv cycles. Maintenance treatment with bevacizumab and/or PARP inhibitors was allowed if selection criteria was similar for both arms. Pts were eligible for the study if preoperative clinical and radiologic assessment identified them as potential candidates for PCS. To ensure surgical quality, participating centers complied with an onsite surgery quality assurance audit, had adequate infrastructure, surgical proficiency (complete resection rates ≥50% in PCS) and sufficient volume (≥36 PCS/year). The intent to treat analysis population included all eligible pts with confirmed stage IIIB-IVB disease. The primary endpoint was overall survival (OS). Superiority was tested using a two-sided stratified log-rank test with significance level 0.05. Secondary endpoints were progression-free survival (PFS) and surgical complications. Results: A total of 688 eligible pts (median age: 63y; range: 32-83) underwent randomization: 345 were assigned to PCS and 343 to NACT/ICS. 91% had high-grade serous histology. Complete resection was achieved in 61.7%/62.9% of all randomized/all operated pts in the PCS group and 72%/76.6% in the ICS group. Median PFS was 22.2 months in the PCS group, and 19.7 months in the ICS group (HR 0.80 95%CI: 0.66-0.96; p=0.02). Median OS was 54.3 months in the PCS group and 48.3 months in the ICS group (HR 0.89 95%CI: 0.74-1.08; p=0.24). Pts with complete cytoreduction after PCS had the most favorable outcome, with a median PFS and OS of 27.9 and 67.0 months, respectively. A long-term benefit from PCS was seen in all analyzed subgroups. The benefit of PCS was most prominent in stage III pts (n=468): median PFS for PCS vs ICS, 26.3 vs 21.4 mos; median OS for PCS vs ICS, 63.7 vs 53.2 months. Major postoperative complication rates were acceptable, with a 30-day postoperative mortality rate of < 1% in both groups. Conclusions: In expert centers with proven surgical quality, PCS followed by iv chemotherapy resulted in a significantly longer median PFS and a numerically longer OS compared to NACT/ICS in non-frail OC pts. Although statistical significance in the primary endpoint was not reached, this is the first randomized trial to show a benefit of PCS over ICS. This benefit is likely to be associated with the high complete resection rate, reinforcing PCS as a standard of care in non-frail pts with seemingly resectable advanced OC. Clinical trial information: NCT02828618 .
Growth factor independent 1 (Gfi1) controls myeloid differentiation by regulating gene expression and limits the activation of p53 by facilitating its de-methylation at Lysine 372. In human myeloid leukemia, low GFI1 levels correlate with an inferior prognosis. Here, we show that knockdown (KD) of Gfi1 in mice causes a fatal myeloproliferative disease (MPN) that could progress to leukemia after additional mutations. Both KO and KD mice accumulate myeloid cells that show signs of metabolic stress and high levels of reactive oxygen species. However, only KO cells have elevated levels of Lysine 372 methylated p53. This suggests that in contrast to absence of GFI1 , KD of GFI1 leads to the accumulation of myeloid cells because sufficient amount of GFI1 is present to impede p53-mediated cell death, leading to a fatal MPN. The combination of myeloid accumulation and the ability to counteract p53 activity under metabolic stress could explain the role of reduced GF1 expression in human myeloid leukemia.
OBJECTIVE:This review summarizes recent advances in three-dimensional (3D) printing for removable prosthodontics, including complete dentures, removable partial dentures, implant-retained overdentures, and occlusal splints. The aim is to provide clinicians with an overview of current technologies, clinical performance, and future perspectives. OVERVIEW:While subtractive methods are well established, additive manufacturing has recently gained exponential importance, especially in removable restorations. Vat-photopolymerization resins are widely applied for denture bases, teeth, and occlusal splints, while laser sintering enables fabrication of metal frameworks and implant attachments with high accuracy. Clinical studies indicate that printed complete dentures achieve outcomes in adaptation and patient satisfaction comparable to conventional or milled prostheses, with reduced appointment numbers and digital reproducibility. Removable partial denture frameworks and implant-overdenture attachments fabricated by selective laser melting demonstrate promising accuracy and mechanical properties, though process variability and post-processing remain critical aspects. Printed occlusal splints are widely adopted and offer adequate fit and comfort, though material-related challenges and limited long-term data are concerns. CONCLUSIONS:3D printing emerges as a reliable option for removable dentures, frameworks, and occlusal devices. Future developments in multi-material printing, durable and bioactive resins, and standardized clinical protocols will further define its role in prosthodontics. CLINICAL SIGNIFICANCE:3D printing is transforming removable prosthodontics. Clinicians can already benefit from streamlined workflows, a standardized process chain, reduced treatment time, and the ability to reproduce dentures, while patients gain from improved comfort and fewer visits. Awareness of material limitations and processing-related specifics remains essential for long-term success. Looking ahead, multi-material printing-allowing simultaneous fabrication of denture bases, teeth, and maybe frameworks-holds promise for improving structural integrity, esthetics, and overall clinical efficiency.
Precision psychiatry is an approach designed to improve diagnosis and treatment of mental disorders by leveraging biological insights and developing innovative, mechanism-based treatment strategies unconstrained by current diagnostic boundaries. At its core, precision psychiatry aims to pinpoint the underlying neurobiological mechanisms responsible for the emergence and persistence of symptoms of mental health conditions. This approach strives to create diagnostic tools and therapies targeting these mechanisms, potentially addressing previously resistant aspects of mental health conditions by providing more precise symptom management and possibly altering the disease trajectory. Although still in its nascent stages, the realization of precision psychiatry will result in a more refined and biology-informed diagnostic system for mental disorders, requiring significant adaptations for clinicians, industry, patients and regulators. Identifying, validating and applying both fluid and functional biomarkers are critical steps in the development, testing and application of new precision psychiatry diagnostics and treatments. As part of the 2025 Precision Psychiatry Roadmap initiative meeting in Frankfurt, experts came together to present and discuss the current status of biomarker identification and validation, patient subtyping, and targeted interventions for stratified patient groups. This report features lecture summaries, meeting outcomes, and recommendations from both online and in-person audiences. In general, the recommendations emphasize standardization, collaboration, clinical implementation, digital innovation, long-term planning, and, importantly, patient engagement, as key priorities for advancing precision psychiatry. Despite existing challenges, there is strong optimism for the future of precision psychiatry, with continuous efforts to refine diagnostic tools and treatment strategies.
