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Books: 236	Journals: 18	Articles: 21479

Abstract

Koki Takeda¹, Naoki Yoshikawa²,³, Hidehiko Koreeda³, Shuhei Urata³, Yuki Matsusaki³, Tsubasa Yokota³, Akira Okada⁴,⁵, Ayane Higuchi¹, Rin Taguchi¹, Asako Nishimura¹, Nobuhito Shibata¹, Ryota Tanaka², Hiroki Itoh², and Ryuji Ikeda³

¹Laboratory of Medical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women’s College of Liberal Arts, Kyotanabe, Kyoto, ²Department of Clinical Pharmacy, University of Oita Hospital, Yufu, Oita, ³Department of Pharmacy, University of Miyazaki Hospital, Miyazaki, ⁴Laboratory of Regulatory Science, Faculty of Pharmacy, and ⁵Research Institute of Pharmaceutical Sciences, Musashino University, Nishi-tokyo, Tokyo, Japan
Objectives: i) To improve the accuracy of initial dosing design in vancomycin therapeutic drug monitoring (TDM) using a free web application of practical antimicrobial TDM (PAT) for vancomycin, ii) to identify patient subgroups in emergency and critical care settings with overestimated predicted population mean serum vancomycin concentrations (PRED), and iii) to calculate appropriate PRED scaling factors. Materials and methods: Vancomycin serum concentrations in patients treated at the Emergency and Critical Care Centers of the University of Miyazaki Hospital, Japan, were simulated using a population pharmacokinetic model. Patients were classified based on the ratio of observed-to-predicted serum vancomycin concentrations (OBS/PRED). Those with a ratio < 0.67 were assigned to the low-trough group, while those with values ≥ 0.67 were the control group. Changes in patient data in the period from admission to immediately before vancomycin administration were analyzed, and scaling factors minimizing the mean squared error (MSE) between PRED and OBS were determined for subgroups more common in the lowtrough group. MSE and root mean squared error (RMSE) values before and after PRED scaling were compared. Results: A total of 47 patients were analyzed, of which 23 were assigned to the low-trough group and 24 to the control group. The low-trough group showed a significantly higher prevalence of patients with creatinine clearance (CCR) < 15 mL/min, albumin < −0.5 g/dL, and trauma. For these subgroups, PRED scaling factors ranged from 0.53 to 0.64. The optimal scaling factor was 0.53 for ΔCCR > 15 mL/min, reducing the RMSE from 5.1 to 4.0 (μg/mL). Conclusion: PRED scaling factors were derived to potentially improve the accuracy of initial vancomycin dosing using PAT, and ΔCCR > 15 mL/min, ΔALB < −0.5 g/dL, and trauma were identified as key factors.Correspondence to:
Koki Takeda, PhD, Laboratory of Medical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women’s College of Liberal Arts, Kyotanabe, Kyoto 610-0332, Japan, or Naoki Yoshikawa, PhD, Department of Clinical Pharmacy, University of Oita Hospital, Yufu, Oita 879-5593, Japan
Email: [email protected]

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 64 – No. 11/2026 (600-612)

Sleep apnea–hypopnea in children: Evidence that Lize Tongqi decoction with acupuncture, moxibustion, and Xinwu acupoint stimulation is superior to standard Western treatment using montelucast/mometasone furoate 

Yu-Jie Wang, Miao-Yuan Li, Yong Zheng, Bei Wang, Juan Wang, Min Zhang, Huo-Qing Lu, and Qin-Yuan Guo

Department of Traditional Chinese Medicine, Liuzhou Maternal and Child Healthcare Hospital, Liuzhou, Guangxi Zhuang Autonomous Region, China
Objective: To assess the clinical efficacy of a modified Lize Tongqi decoction in combination with acupuncture, moxibustion, and local stimulation of the Xinwu acupoint in the treatment of pediatric snoring.
Materials and methods: A randomized controlled trial was conducted in a cohort of 60 pediatric patients (mean age of 7.9 years) diagnosed with snoring. Patients were assigned to either a study group (n = 30) or a control group (n = 30). The study group was treated using modified Lize Tongqi decoction, acupuncture, moxibustion, and stimulation of the Xinwu acupoint (twice weekly for 8 weeks) whereas the control group was treated with conventional Western medicine (oral montelukast once nightly and mometasone furoate nasal spray once nightly for 8 weeks). The severity of symptoms including nasal congestion, nocturnal snoring, and breathing through the mouth was assessed prior to, and following the treatment intervention. Changes in the Obstructive Sleep Apnea-18 (OSA-18) quality of life score and the adenoid-to-nasopharyngeal (A/N) ratio were measured and compared between groups.
Results: Post-treatment comparisons showed significantly greater improvements in nasal congestion, snoring, and breathing through the mouth in the study group, and the reductions in both OSA-18 scores and A/N ratios were significantly greater. (Between-group differences p < 0.05). No adverse events were observed in either group.
Conclusion: The combination of modified Lize Tongqi decoction with acupuncture, moxibustion, and Xinwu acupoint stimulation effectively reduced symptoms of airway obstruction and improved quality of life in pediatric patients with snoring. The combination therapy is a new, non-surgical therapeutic option for the clinical management of this potentially serious disorder.Correspondence to:
Qin-Yuan Guo, MM
Department of Traditional Chinese Medicine
Liuzhou Maternal and Child Healthcare Hospital
No. 50, Yingshan Street, Chengzhong District,
Liuzhou 545001, Guangxi Zhuang Autonomous Region, China
Email: [email protected]

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 64 – No. 11/2026 (559-561)

Therapy challenges and child cohorts: Where the need to treat is the only option

Barrington (Barry) G. Woodcock-Kloberdanz

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 64 – No. 11/2026 (591-599)

Pharmacotherapy of heart failure: Impact of the 2021 guideline update on guideline-directed medical therapy assessed using a Japanese employee health insurance claims database 

Takaya Uno, Kouichi Hosomi, and Satoshi Yokoyama

Division of Drug Informatics, School of Pharmacy, Kindai University, Higashi-Osaka, Osaka, Japan
Objective: To investigate the impact of the 2021 guideline update on guideline-directed medical therapy (GDMT) utilization in patients with heart failure (HF).
Background: The 2021 update of the Japanese guidelines for HF management followed the introduction of sacubitril/valsartan and dapagliflozin into clinical practice. However, the impact of this guideline update on drug utilization patterns remains unclear.
Materials and methods: Patient data were obtained from the Japanese employee health insurance claims database (JMDC). The simple GDMT score was determined based on the combination and dose of four key pharmacological classes: β-blockers, renin–angiotensin system inhibitors, mineralocorticoid receptor antagonists, and sodium–glucose cotransporter 2 inhibitors. Because a simple GDMT score of ≥ 5 has been associated with improved prognosis in patients with HF, patients with scores ≥ 5 were classified into the high-score group for analysis.
Results: Following the guideline update, the proportion of patients in the high-score group increased from 6.97% (n = 4,013) to 9.33% (n = 6,363), standardized difference 0.09. The mean simple GDMT score also showed a small but statistically significant increase (5.72 ± 0.79 vs. 6.00 ± 1.09) with standardized difference 0.28. This upward trend was particularly marked for the prescription rates of sacubitril/valsartan and dapagliflozin (sacubitril/valsartan: 1.40% before the update vs. 22.57% after the update; standardized difference, 0.69; dapagliflozin: 12.41% before the update vs. 26.64% after the update; standardized difference, 0.36).
Conclusion: The 2021 guideline update was associated with increased use of sacubitril/valsartan and dapagliflozin, resulting in greater overall GDMT intensity. However, these findings are limited to data from 2021, and further long-term studies are needed to evaluate trends in GDMT utilization.Correspondence to:
Takaya Uno, PhD
Division of Drug Informatics
School of Pharmacy
Kindai University
3-4-1 Kowakae, Higashi-Osaka
Osaka 577-8502, Japan
Email: [email protected]

Abstract

Clinical Nephrology – Case Studies, Vol. 14/2026 (58-62)

A case of lupus nephritis in an art student

Kamyar Pournazari¹, Adrienne Flowers¹, Sarah H. Khan¹, Cinthia Drachenberg², and Valeriu Cebotaru¹,³

¹Division of Nephrology, Departments of Medicine, ²Department of Pathology, University of Maryland School of Medicine, and ³Division of Nephrology, Departments of Medicine, Baltimore VAMC, Baltimore, MD, USA
Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can be triggered by environmental factors. We report a novel case of a 22-year-old female that was exposed to volatile organic solvents (VOCs) while diluting oil-based paint colors prior to presenting with nephrotic syndrome and acute kidney injury, later confirmed as class IV lupus nephritis (LN). Multidisciplinary management resulted in significant clinical improvement, with a return to normal renal function and stabilization of SLE markers. This case highlights possible association between VOCs exposure and LN.Correspondence to:
Valeriu Cebotaru, Division of Nephrology, Departments of Medicine, University of Maryland School of Medicine, 22 S. Greene St., Room N3W143, Baltimore, MD 21201, USA
Email: [email protected]

Abstract

Yi Liu and Jianjun Lai

Surgical Outpatient Nursing, Shandong First Medical University Affiliated Provincial Hospital, Ji’nan, Shandong, China
Objective: This study aimed to evaluate the effectiveness of evidence-based personalized nutritional support combined with precision nursing strategies in patients undergoing hepatectomy. Materials and methods: A total of 80 patients with hepatocellular carcinoma who underwent laparoscopic hepatectomy were randomly allocated into a control group (n = 40) receiving standard care and a study group (n = 40) receiving an integrated intervention of evidence-based personalized nutritional support and precision nursing. Key outcomes included postoperative recovery time, nutritional markers (globulin (GLOB), hemoglobin (Hb), albumin (ALB), prealbumin (PA), transferrin (TF)), liver function tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL)), inflammatory markers (C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)), complication incidence, and nursing satisfaction. Results: The study group showed earlier recovery of bowel sounds, first flatus, first defecation, and shorter postoperative hospital stay (p < 0.05). One week post-surgery, nutritional indicators (GLOB, Hb, ALB, PA, and TF) were significantly higher, whereas liver function and inflammatory markers (AST, ALT, TBIL, DBIL, CRP, TNF-α, and IL-6) were significantly lower in the study group (all p < 0.05). Although fewer complications were observed in the study group, the difference was not statistically significant (p > 0.05). Nursing satisfaction was notably higher in the study group (p < 0.05). Conclusion: Combining evidence-based nutritional support with precision nursing enhances postoperative outcomes in hepatectomy patients by improving nutritional and liver function, reducing inflammation, accelerating recovery, and increasing patient satisfaction. Correspondence to:
Jianjun Lai, BD, Department of Surgical Outpatient Nursing, Shandong First Medical University Affiliated Provincial Hospital, Ji’nan 250021, Shandong, China
Email: [email protected]

Abstract

Jae Sung Lee¹, Minji Noh¹, Eun Hee Park¹, Kyung Sun Park¹, Jong Ha Park¹, Jong Soo Lee¹,², and Kyung Don Yoo¹,²,³

¹Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, ²Basic-Clinical Convergence Research Institute, and ³Department of Medical Science Convergence, Graduate School of Medical Science, University of Ulsan, Ulsan, South Korea
Aims: Kidney transplantation (KT) improves survival in end-stage renal disease (ESRD); however, the post-transplant fracture risk remains uncertain. This study aimed to compare the fracture incidence between kidney transplant recipients (KTRs) and waitlisted dialysis patients and to examine the association between fracture events and all-cause mortality in each group. Materials and methods: This study included a single-center cohort of 504 KTRs and 423 waitlisted dialysis patients treated at a tertiary hospital in South Korea from 1998 to 2019. Fractures were identified through radiological report review, and mortality data were retrieved from medical records. Multivariate Cox regression models were used to evaluate mortality predictors, including fracture events, as covariates. Results: The fracture incidence did not differ significantly between KTRs (9.1%) and dialysis patients (12.5%). Moreover, fractures were not significantly associated with increased mortality in either group (KTRs: hazard ratio (HR), 2.03; 95% confidence interval (CI), 0.62 – 6.67; p = 0.24; dialysis: HR, 0.97; 95% CI, 0.12 – 8.08; p = 0.98). Age was the strongest mortality predictor. Among KTRs, tacrolimus use was associated with lower mortality compared with cyclosporine (HR, 0.18; 95% CI, 0.05 – 0.66; p = 0.009). Conclusion: KTRs have a fracture risk comparable to that of dialysis patients, and fractures were not significantly associated with mortality. The survival benefits of KT are driven by factors other than fracture-related complications. Ongoing, proactive bone health management remains essential in KTRs because transplantation does not eliminate the elevated fracture risk. Correspondence to:
Kyung Don Yoo, MD, PhD, Associate Professor, Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Basic-Clinical Convergence Research Institute, University of Ulsan, Department of Medical Science Convergence, Graduate School of Medical Science, University of Ulsan, 25 Daehakbyeongwon-ro, Dong-gu, Ulsan 44030, Korea
Email: [email protected]

Abstract

Hiromi Koshizuka¹,², Kenji Momo², Masaki Kida¹,², Ayako Watanabe¹,², Akihisa Tanaka¹, Yuka Kashiwabara¹,², Mayo Tanabe³, Naoyuki Uragami³, Haruhiro Inoue³, and Katsumi Tanaka²

¹Department of Pharmacy, Showa Medical University Koto Toyosu Hospital, Koto-ku, ²Department of Hospital Pharmaceutics, School of Pharmacy, Showa Medical University, Shinagawa-ku, and ³Digestive Diseases Center, Showa Medical University Koto Toyosu Hospital, Koto-ku, Tokyo, Japan
Objectives: To report the occurrence of elevations (spikes) in interstitial fluid glucose concentrations (IFGC) following magnesium citrate administration during preparation for colonoscopy in a patient with type 1 diabetes mellitus (T1DM). To ascertain, using a comprehensive analysis of large claims databases, the proportion of diabetes mellitus (DM) patients who are vulnerable to showing elevated blood glucose levels following magnesium citrate administration. Case presentation: A female patient aged 35 years received pretreatment with 100 g of magnesium citrate in 1.8 L of water 2 hours before a colonoscopy. After an interval of 41 minutes, the patient self-administered insulin to correct an IFGC increase from 108 to 176 mg/dL. However, the IFGC reached a peak of 251 mg/dL, resulting in marked thirst, frequent urination, and palpitations. Based on a database cohort of ~ 3 million patients, there were 105,348 patients with a risk for elevations in the blood glucose level after receiving magnesium citrate, of whom 9.5% (n = 9,957) had DM and 96 had T1DM. Conclusion: Analysis of a colonoscopy patient with T1DM and magnesium citrate-induced elevations in IFGC, and evaluation of patients in a large database with a similar risk, emphasizes the need for caution when administering such agents and in particular in patients with T1DM. We suggest that alternative preparations for colonoscopy in diabetic patients may be warranted. Correspondence to:
Kenji Momo, PhD, Department of Hospital Pharmaceutics, School of Pharmacy, Showa Medical University; 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
Email: [email protected]

Abstract

Zichao Ji, Xin Wang, and Jiawei Wang

Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
Objective: We aimed to evaluate the rationality of proton pump inhibitor (PPI) prescription in elderly outpatients aged ≥ 65 years, characterize inappropriate prescription patterns, and identify the factors associated with label-discordant prescription. Materials and methods: A retrospective single-center study was conducted at Beijing Tongren Hospital. Data were extracted for outpatients aged ≥ 65 years who received PPIs between November 2024 and October 2025. Only the first visit of each patient was included (n = 3,038) to avoid non-independence. Prescription rationality was assessed using the Clinical Application Guidelines for Proton Pump Inhibitors (2020 Edition) and package inserts. Two binary outcomes were defined: any label-discordant prescription (composite of inappropriate indication, dose, drug interaction, or label-discordant frequency) and pure excessive frequency (twice-daily dosing without other discordance). Logistic regression analysis was conducted to identify the associated factors. Results: Among 3,038 first-visit patients, 281 (9.25%) had label-discordant prescriptions (rational use rate: 90.75%). Excessive frequency (twice-daily dosing) was the most common type of label-discordant prescription (206 patients, 73.31% of discordant cases), of whom 204 exhibited no other discordance (pure excessive frequency). Inappropriate drug interactions were observed in 34 patients (12.10%), inappropriate indications were detected in 19 (6.76%) patients, and inappropriate single-dose was found in 13 (4.63%) patients. Multivariable analysis showed that male sex (OR = 0.681), having ≥ 5 diagnoses (OR = 0.721), and non-gastroenterology department (OR = 0.235) were associated with lower odds of label-discordant prescription, while senior physician title (OR = 1.628) was associated with higher odds of label-discordant prescription. Age ≥ 75 years did not show a significant association (p = 0.981). Results for pure excessive frequency were directionally consistent. Conclusion: In this sample of elderly outpatients, the label-discordant prescription rate of PPI was 9.25%, with excessive frequency representing the predominant type. Male sex, a higher number of diagnoses, and non-gastroenterology departments were associated with lower odds, whereas a senior physician title was associated with higher odds. Given the exclusion of prophylactic use and single-center design, these findings should not be generalized to all PPI prescription practices. Future studies should include prophylactic prescriptions and disease severity measures. Correspondence to:
Zichao Ji, MSc, Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
Email: [email protected]

Abstract

Clinical Nephrology – Case Studies, Vol. 14/2026 (63-68)

New-onset lupus nephritis and neuropsychiatric lupus following COVID-19 vaccination: A case report

Paulo Simão¹, Micael Pompermayer², Joana Coutinho², and Ernesto Rocha²

¹Department of Internal Medicine, Hospital Pêro da Covilhã, Unidade Local de Saúde da Cova da Beira, Covilhã, and ²Department of Nephrology, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
Although COVID-19 mRNA vaccines have demonstrated excellent safety profiles, rare autoimmune complications – including new-onset systemic lupus erythematosus (SLE) and lupus nephritis (LN) – have been reported. We describe a case of new-onset class IV LN with neuropsychiatric lupus (NPSLE) occurring shortly after COVID-19 vaccination in a previously healthy adult. This case highlights a rare presentation of new-onset SLE manifesting with both severe renal and neuropsychiatric involvement following COVID-19 mRNA vaccination. While causality cannot be established, the temporal association and absence of alternative triggers suggest vaccine-induced immune dysregulation as a potential precipitating factor. Awareness of such atypical presentations may facilitate earlier diagnosis and management, although these events remain exceedingly uncommon relative to the overwhelming benefits of vaccination.Correspondence to:
Paulo Simão, MD, Department of Internal Medicine, Hospital Pêro da Covilhã, Unidade Local de Saúde da Cova da Beira, Quinta do Alvito, 6200-251 Covilhã, Portugal
Email: [email protected]

Abstract

Allergologie select, Vol. 10/2026 (209-218)

In vitro diagnostics of drug hypersensitivity reactions

Christian Möbs¹,², Sophie C. Hermann Lang¹,², Valerie Härtel¹,², and Wolfgang Pfützner¹,²

¹Clinical & Experimental Allergology, Department of Dermatology and Allergology, Philipps-Universität Marburg, and ²Allergy Section, Department of Dermatology and Allergology, Allergy Center Hesse, University Hospital Marburg, Marburg, Germany
In vitro diagnostics of drug hypersensitivity reactions comprises different tests that can add important information for identifying the culprit drug. Depending on the patients’ clinical history and underlying immune mechanisms, these tests can be classified into immediate-type and late-type in vitro assays. While they are currently mostly not part of routine diagnostics, knowledge of when to apply which test and what distinct benefits and specific limitations each assay carries, can be helpful when considering the referral of patients with adverse drug reactions for appropriate further testing to specialized centers.Correspondence to:
Prof. Dr. med. Wolfgang Pfützner, Department of Dermatology and Allergology, Philipps-Universität Marburg, University Hospital Marburg, Baldingerstraße, 35043 Marburg, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 10/2026 (219-225)

The involvement of human breastmilkderived extracellular vesicles in the development of infant atopic sensitization

Tinevimbo Weidner Baricholo¹,², Amiq Gazdhar¹,³, Matthias V. Kopp¹,², and Emilie Seydoux¹,²

¹Lung Precision Medicine (LPM), Department for Biomedical Research (DBMR), ²Division of Pediatric Respiratory Medicine and Allergology, Department of Pediatrics, and ³Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Breastmilk, with its unique biological components, is the optimal source of neonatal nutrition, and WHO global feeding guidance recommends that all infants are exclusively breastfed for the first 6 months. The composition of human milk depends on multiple factors such as maternal diet, exposure to pathogens, metabolic or autoimmune disorders, smoking, mental health, and genetics. Breastfeeding not only transfers nutrients to the child, but it also influences the infant immune function, through the transfer of immune cells, antibodies, microbiota from the mother, cytokines, or growth factors. Among these, human milkderived extracellular vesicles (hMEVs) are emerging as key yet understudied elements in neonatal growth, development, and immunity. This review explores their structure, formation, uptake, and roles in supporting development, modulating immune responses during early life, and influencing allergic outcomes, highlighting their potential significance in infant health.Correspondence to:
Dr. Emilie Seydoux, Lung Precision Medicine, Department for Biomedical Research, University of Bern, Murtenstrasse 28, 3008 Bern, Switzerland
Email: [email protected]

Abstract

Allergologie select, Vol. 10/2026 (226-233)

Olfactory dysfunction in children is associated with atopic dermatitis and allergic rhinitis, but not bronchial asthma

Elisabeth C. Lohrer¹,², Janine Gellrich¹, M. Antonia Hinkelmann¹, Rene F. Drosdek¹, Christian Vogelberg², and Valentin A. Schriever³

¹Department of Neuropediatrics, Department of Pediatrics, ²Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and ³Goethe University Frankfurt, Department of Pediatrics, Division of Pediatric Neurology, Neurometabolics and Prevention, Frankfurt (Main), Germany
Aims: To investigate associations between olfactory dysfunction and atopic dermatitis (AD), allergic rhinitis (AR), and bronchial asthma (BA) in children. Materials and methods: In a prospective study, 250 children (6 – 17 years) with AD, AR, BA, combined atopy, or healthy controls (n = 50 each) were assessed using olfactory tests (“Sniffin’ Sticks”, “U-Sniff”), questionnaires, prick tests, and spirometry. Results: Atopic patients showed poorer odor identification than controls. Children with AD had impaired odor identification. AR patients displayed more hyposmia in threshold testing, but mean scores did not differ significantly. BA patients showed no significant impairment, though lung function correlated positively with olfactory performance. Conclusion: Pediatric AD and AR are associated with specific olfactory dysfunctions, whereas BA is not. Awareness of olfactory deficits in these groups is warranted; further studies should assess neurodevelopmental aspects in AD.Correspondence to:
Dr. Janine Gellrich, Department of Neuropediatrics, Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
Email: [email protected]

Abstract

Pengfei Dong¹, Daolian Zheng², Cong Huang³,⁴, Feng Wen⁴, Peng He⁵, Yujun Wang⁶, and Ruimin Zeng¹

¹Department of Radiology, Cangnan County People’s Hospital, Wenzhou, Zhejiang, ²Department of Radiology, Fuding City Hospital, Fuding, Fujian, ³Department of Radiology, No. ⁹²⁶ Hospital, Joint Logistics Support Force of PLA, Kaiyuan, Yunnan, ⁴Department of Radiology, The First Affiliated Hospital of Army Medical University, Chongqing, ⁵Department of Radiology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong, and ⁶Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
Objective: To characterize routine magnetic resonance imaging (MRI) manifestations of molecularly defined isocitrate dehydrogenase (IDH)-mutant, 1p/19q codeleted oligodendroglioma, to introduce two newly proposed intratumoral imaging signs, assess their diagnostic efficacy, and interpret their histologic basis via voxel-wise imaging-pathology matching. Materials and methods: 36 surgically validated oligodendrogliomas were retrospectively analyzed per the 2021 WHO CNS tumor criteria; MRI signals were correlated with histologic indices such as cellular density and myxoid microcystic change. Results: The cohort comprised 24 males and 12 females with a mean age of (30.9 ± 16.1) years. All supratentorial lesions were mostly cystic-solid, showing T1-hypointense solid parts, T2/fluid-attenuated inversion recovery (FLAIR) slightly hyperintense parenchyma, T2-hyperintense cysts, and heterogeneous enhancement, predominantly WHO grade 2. No intergrade differences in baseline MRI/clinical features were found (p > 0.05). Cross-sectional prevalence: isolated ripple sign 16.7%, isolated finger-like cystic sign 8.3%, dual signs 5.6%, total positivity 30.6%. Separate κ values (0.81 and 0.83) revealed excellent inter-rater consistency; the two signs occurred independently (p > 0.05) with high specificity but low sensitivity. Histologically, the ripple sign stemmed from alternating hypercellular and microcystic grey-white matter bands, whereas finger-like cysts arose from tract-aligned fused microcysts. Conclusion: This glioma entity mostly presents as infiltrative supratentorial cystic-solid masses. The two novel signs serve as high-specificity auxiliary markers but lack sufficient sensitivity; large multi-center validation is warranted. Integrated MRI and pathological correlation elevate preoperative diagnostic accuracy. Correspondence to:
Zeng Ruimin, Chief Physician, Department of Radiology, Cangnan County People‘s Hospital, Wenzhou, Zhejiang 325800, China
Email: [email protected]

Abstract

Lingyan Kong and Xuechun Gu

The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang Province, China
Objective: We evaluated the effects of sodium-dependent glucose transporter 2 inhibitors (SGLT2i) on bone mineral density (BMD) and fracture risk in patients with type 2 diabetes mellitus (T2DM) and osteoporosis. Materials and methods: Randomized controlled trials (RCTs) published before April 2024 were systematically searched in PubMed, MEDLINE, Web of Science, the Cochrane Library, and EMBASE. Quality assessment was performed by Cochrane Risk of Bias 2 tool. RevMan 5.3 software was employed to conduct meta-analysis. The outcome indicators included glycosylated hemoglobin A1c (HbA1c), BMD change, and fracture incidence rate. Results: A total of 8 studies covering 1,998 subjects were included (1,094 in the SGLT2i group and 904 in the control group). Analysis of 5 studies showed that HbA1c level was significantly lower in the SGLT2i group (mean difference (MD) = –0.11, 95% CI (–0.18 to –0.05) , p = 0.0008). In the 3 studies evaluating bone density, BMD change was significantly higher in the SGLT2i group (standardized MD = 0.69, 95% CI (0.45 – 0.93), p < 0.00001). Based on the 2 studies reporting fracture events, the incidence rate was lower in the SGLT2i group (risk ratio (RR) = 0.09, 95% CI (0.02 – 0.47), p = 0.004). Conclusion: Preliminary evidence suggests that SGLT2i may be associated with modest improvements in BMD and no signal of increased fracture risk in patients with T2DM and osteoporosis. These findings remain to be confirmed in larger and longer-term randomized controlled trials. Correspondence to:
Xuechun Gu, Bachelor of Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao 315400, Zhejiang Province, China
Email: [email protected]

Abstract

Dermatologie in Beruf und Umwelt, Nr. 3/2026

Abstract

Dermatologie in Beruf und Umwelt, Jahrgang 74, Nr. 3/2026, S. 93-94

Optimierungspotenziale in der Kommunikation

C. Skudlik, A. Bauer und P. Elsner

Abstract

Dermatologie in Beruf und Umwelt, Jahrgang 74, Nr. 3/2026, S. 95-102

Neue Erkenntnisse zu Epoxidharzallergien in der Bauindustrie

K. Kersting, P. Lindemann, T. Opitz und D. Engel

Berufsgenossenschaft der Bauwirtschaft, Berlin
Hintergrund: Epoxidharze sind in Deutschland einer der häufigsten Auslöser von beruflich bedingten allergischen Hauterkrankungen im Baugewerbe. Die Studie gibt ein Update aus Sicht des betroffenen Unfallversicherungsträgers.
Methoden: Anhand einer Fallauswertung von 147 Erkrankungsfällen im Zeitraum von 2019 bis 2023 wurden Schwerpunkte im Krankheitsgeschehen ermittelt. Darüber hinaus wurde die Beständigkeit von Chemikalienschutzhandschuhen gegenüber benzylalkoholhaltigen Epoxidharzen untersucht.
Ergebnisse: Die Zeit zwischen dem Auftreten der Erkrankung und der Meldung des Verdachtsfalls beim Unfallversicherungsträger zeigte sich als ein wesentlicher Einflussfaktor auf die Entwicklung der Krankheitsschwere. Hände, Gesicht und Arme waren am häufigsten betroffen. Bei den Berufsgruppen dominierten Bodenleger. Die Aufgabe der Tätigkeit war in 78,7% der Fälle erforderlich. Permeationsmessungen belegten, dass die am häufigsten eingesetzten Chemikalienschutzhandschuhe keinen ausreichenden Schutz bieten.
Schlussfolgerung: Eine frühzeitige ärztliche Behandlung und eine Optimierung der Verhältnisse am Arbeitsplatz werden empfohlen, um der Aufgabe der Tätigkeit und einem schweren Krankheitsverlauf vorzubeugen. Unternehmen sollten frühzeitig und regelmäßig arbeitsmedizinische Beratungen in Anspruch nehmen. Beim Einsatz von Epoxidharzen ist auf eine bestimmungsgemäße Nutzung geeigneter Chemikalienschutzhandschuhe zu achten. Der neue Prüfgrundsatz GS-PS-20 bietet eine gute Hilfestellung, da die Eignung für den Einsatz mit Epoxidharzen anhand eines entsprechenden Piktogramms ersichtlich wird.Correspondence to:
Daniel Engel
Berufsgenossenschaft der Bauwirtschaft
Bundesallee 210
10719 Berlin
Email: [email protected]

Abstract

Dermatologie in Beruf und Umwelt, Jahrgang 74, Nr. 3/2026, S. 103-112

Auswirkung einer arbeitsbedingten Kontaktallergie gegen Kobalt bei der BK 5101

E. Weisshaar¹, M. Waitek¹, A. Bauer², R. Brans³⁴⁴, D. Becker⁵, H. Dickel⁶, M. Gina⁷, A. Heratizadeh⁸, S. Krohn⁹, S. Nestoris¹⁰, S. Schliemann¹¹, C. Skudlik³#⁴ und V. Mahler¹²* für die Arbeitsgruppe „Bewertung der Allergene bei BK ⁵¹⁰¹“ der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie und der Deutschen Kontaktallergie-Gruppe in der Deutschen Dermatologischen Gesellschaft

¹Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, ²Klinik und Poliklinik für Dermatologie, Universitäts-AllergieCentrum, Universitätsklinikum Carl Gustav Carus, TU Dresden, ³Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück, ⁴Abteilung Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, ⁵Hautklinik der Universitätsmedizin Mainz, ⁶Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum (UK RUB), ⁷Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA), Referat Berufsdermatologie, Ruhr-Universität Bochum, ⁸Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, ⁹Deutsche Gesetzliche Unfallversicherung (DGUV), Berlin, ¹⁰Dermatologische Klinik, Klinikum Lippe-Detmold, ¹¹Privatpraxis, Hautklinik SRH Klinikum Gera, ¹²Paul-Ehrlich-Institut, Langen (Hessen)
Diese Empfehlung dient zur Beurteilung der Auswirkung einer arbeitsbedingt erworbenen Kontaktallergie gegen Kobalt im Hinblick auf die dadurch verschlossenen Arbeitsmöglichkeiten, wie sie für die Einschätzung der Minderung der Erwerbsfähigkeit bei arbeitsbedingten Hauterkrankungen nach der BK-Nr. 5101 der Anlage 1 zur Berufskrankheiten-Verordnung notwendig ist. Bei Kobalt handelt es sich um ein Metall, das in Legierungen (z. B. für Zahnprothesen und Implantate), in der Lederverarbeitung, Keramik- und Glasherstellung (z. B. als Bestandteil von Farben) und in Zement vorkommen kann. Die Typ IV-Sensibilisierung gegen Kobalt(II)-chlorid kann in Kombination mit einer Typ IV-Sensibilisierung gegenüber anderen Metallen, insbesondere Nickel(II)-sulfat und Kaliumdichromat, auftreten. Eine isolierte Typ IV-Sensibilisierung gegen Kobalt(II)-chlorid ist selten und sollte an eine berufliche Sensibilisierung denken lassen. Relevante Expositionen zu Kobalt können in Metallberufen einschließlich der Galvanik, in der Keramik- und Glasindustrie, im Baugewerbe sowie gelegentlich in der Lederverarbeitung und in der Zahntechnik gegeben sein. Die Auswirkung einer arbeitsbedingten Kontaktallergie gegen Kobalt auf dem allgemeinen Arbeitsmarkt ist in der Regel als „geringgradig“ einzustufen.

*V. Mahler gibt an, dass die in dieser Stellungnahme geäußerten Inhalte und Positionen die persönliche Experten- Meinung der Autorin wiedergeben und diese nicht so ausgelegt oder zitiert werden dürfen, als wären sie im Auftrag der zuständigen nationalen Bundesoberbehörde, der Europäischen Arzneimittel-Agentur oder eines ihrer Ausschüsse oder Arbeitsgruppen abgegeben worden oder gebe deren Position wieder.Correspondence to:
apl. Prof. Dr. med. Elke Weisshaar
Universitätsklinikum Heidelberg
Sektion Berufsdermatologie, Zentrum Hautklinik
Voßstraße 2
69115 Heidelberg
Email: [email protected]

Abstract

Dermatologie in Beruf und Umwelt, Jahrgang 74, Nr. 3/2026, S. 113-119

Präzisionsdiagnostik bei Dermatosen der Hände: Wie molekulare Klassifikation die Einordnung einer BK-Nr. 5101 unterstützen kann – Ein Fallbericht

P. Bentz und E. Weisshaar

Sektion Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg, Heidelberg
Die differenzialdiagnostische Abgrenzung zwischen chronischem Handekzem und Psoriasis manuum stellt in der Berufsdermatologie eine besondere Herausforderung dar. Vorgestellt wird der Fall eines 59-jährigen Poliers und Tiefbaufacharbeiters mit anerkannter Berufskrankheit BK-Nr. 5101 aufgrund eines seit 2018 bestehenden, therapierefraktären Handekzems. Trotz intensiver ambulanter und stationärer dermatologischer Behandlung und einer 16-monatigen Systemtherapie mit Alitretinoin konnte keine anhaltende Abheilung erreicht werden. Im Rahmen einer Maßnahme der Tertiären Individualprävention (TIP) ergaben sich aufgrund des klinischen Erscheinungsbildes Zweifel an der bisherigen Diagnose. Die ergänzend eingesetzte Molekulardiagnostik bestätigte den Verdacht auf eine Psoriasis manuum. Daraufhin erfolgte eine zielgerichtete Therapie mit Acitretin sowie Lokaltherapie, intensive Hautpflege und Schulungsmaßnahmen zu Hautschutz und Hautpflege. Hierunter kam es zu einer kontinuierlichen Besserung mit anhaltender klinischer Abheilung. 12 Wochen nach Abschluss der TIP-Maßnahme ist die Hauterkrankung unter fortgesetzter Systemtherapie trotz Wiederaufnahme der beruflichen Tätigkeit abgeheilt. Der Fall verdeutlicht den hohen Stellenwert moderner molekulardiagnostischer Verfahren bei chronischen, therapierefraktären Handdermatosen. Eine präzise Diagnosestellung ermöglicht eine zielgerichtete Therapie und besitzt dadurch erhebliche versicherungsrechtliche sowie gesundheitsökonomische Bedeutung. Der frühzeitige Einsatz molekularer Diagnostik kann Diagnosen sichern und therapeutische sowie sozialmedizinische Entscheidungen wesentlich verbessern.Correspondence to:
apl. Prof. Dr. med. Elke Weisshaar
Universitätsklinikum Heidelberg
Sektion Berufsdermatologie, Zentrum Hautklinik
Voßstraße 2
69115 Heidelberg
Email: [email protected]

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