Hanusch Hospital

Vienna, Austria

Hanusch Hospital

Vienna, Austria
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Pfeilstocker M.,Hanusch Hospital
Memo - Magazine of European Medical Oncology | Year: 2017

Summary: For heterogeneous myelodysplastic syndromes (MDS), patient management is still a challenge. Despite the progress achieved in recent years, there is need for improvement at least for specific situations such as failure of hypomethylating agents or in patients with thrombocytopenia or with anemia failing erythropoiesis stimulating agents. This review covers studies for MDS presented at the American Society of Hematology (ASH) 2016 annual meeting. New treatment approaches, for which results from phase 1/2 studies were reported, will now move into phase 3 and hopefully into clinical practice in the future. Choosing the right agent and individualizing treatment will be the next challenges. © 2017 Springer-Verlag Wien

Mahr A.,University Paris Diderot | Moosig F.,Universitatsklinikum Schleswig Holstein | Neumann T.,Jena University Hospital | Szczeklik W.,Jagiellonian University | And 3 more authors.
Current Opinion in Rheumatology | Year: 2014

PURPOSE OF REVIEW: Eosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss syndrome) is a peculiar hybrid condition of a systemic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and a hypereosinophilic disorder with frequent lung involvement that occurs in people with asthma. This review focuses on areas of evidence or persistent uncertainty in the classification, epidemiology, clinical presentation, diagnosis, prognosis and management of EGPA and attempts to identify clues to the mechanisms in the development or course of the disease. RECENT FINDINGS: The 2013 revision of the EGPA definition formally placed the disease in the subset of ANCA-associated vasculitides. Recently published large case series underlined that the presence of ANCAs, found in 30-40% of EGPA, determines distinct but partly overlapping disease expression and the major detrimental effect of heart involvement on survival. There is some evidence that asthma in EGPA resembles a nonallergic eosinophilic asthma phenotype. Encouraging results have been reported for the treatment of EGPA with rituximab or with the eosinophil-targeted antiinterleukin-5 agent mepolizumab. SUMMARY: The understanding of EGPA continues to advance, but many gaps in knowledge remain. The nomenclature remains a source of conceptual variance in terms of demonstrated presence or not of vessel inflammation or ANCAs in the diagnosis of EGPA. Distinguishing EGPA from hypereosinophilic syndromes can be problematic, and an understanding of the mechanistic relation between the vasculitis and the eosinophilic proliferation is profoundly lacking. Some evidence suggests distinct disease phenotypes, but this concept has not yet been translated to phenotype-adapted therapy. © 2013 Wolters Kluwer Health Lippincott Williams & Wilkins.

Hirnschall N.,Hanusch Hospital | Maedel S.,Hanusch Hospital | Weber M.,Hanusch Hospital | Findl O.,Hanusch Hospital | Findl O.,Moorfields Eye Hospital
American Journal of Ophthalmology | Year: 2014

Purpose To evaluate the visual performance and rotational stability of the Tecnis Toric 1-piece intraocular lens (IOL) during the first 3 postoperative months. Design Prospective, single-center study. Methods In this study, patients with age-related cataract and corneal astigmatism of 1.0 to 3.0 diopters measured with the IOLMaster 500 (Carl Zeiss Meditec AG) were included. Before surgery, rotating Scheimpflug scans (Pentacam HR; Oculus) were performed and the cornea was marked in the sitting position at the slit lamp. Patients received a single-piece toric hydrophobic acrylic IOL (Tecnis Toric; AMO). Immediately and 3 months after surgery, retroillumination photographs were obtained to assess the rotational stability of the IOL. Additionally, Autorefraction (Topcon), subjective refraction, uncorrected and distance-corrected visual acuity, keratometry, and Scheimpflug and ocular wavefront (WASCA, Carl Zeiss Meditec AG) measurements were performed at the 3-month follow-up. Results Thirty eyes of 30 patients were included in this study. Mean absolute difference between the IOL axis at the 3-month and 1-hour follow-up was 2.7 degrees (standard deviation, 3.0 degrees). The IOL rotation was less than 3 degrees and less than 6 degrees in 62% and 95% of all cases, respectively. Conclusions The Tecnis Toric 1-piece IOL is rotationally stable and shows excellent capsule bag performance and refractive outcomes. © 2014 BY ELSEVIER INC. ALL RIGHTS RESERVED.

Mikosch P.,Hanusch Hospital | Mikosch P.,Hanusch Hospital of WGKK
Best Practice and Research: Clinical Rheumatology | Year: 2011

Gaucher disease (GD) is an inherited lysosomal storage disorder affecting multiple organs. Non-neuronopathic GD, the most common form, can present with hepatosplenomegaly, anaemia, bleeding tendencies, thrombocytopenia, skeletal pathologies, growth retardation and, in severe cases, with pulmonary disease. The bone manifestations include bone infarcts, avascular bone necrosis, lytic lesions, osteosclerosis, fractures due to osteoporosis and, rarely, acute osteomyelitis. Bone pain of varying intensity, fractures and joint collapses increase the patients' morbidity and impair their mobility and quality of life. Currently available therapies - enzyme replacement therapy and substrate reduction therapy - have shown to improve blood count and the visceral manifestations within a short time. Beneficial effects have also been documented on bone pain, bone crises and the extent of osteoporosis. The article focusses on the bone pathologies of GD including its pathophysiology, current diagnostics, clinical management and therapeutic effects of enzyme replacement therapy, substrate reduction therapy and bone-specific therapies. © 2011 Elsevier Ltd. All rights reserved.

Findl O.,Hanusch Hospital | Findl O.,Moorfields Eye Hospital NHS Foundation Trust | Hirnschall N.,Hanusch Hospital | Maedel S.,Hanusch Hospital
Investigative Ophthalmology and Visual Science | Year: 2013

PURPOSE. The aim of this study was to assess, if measuring the position of the lens capsule intraoperatively with a continuous intraoperative optical coherence tomography (OCT) device could be useful to improve the prediction of the intraocular lens (IOL) position. METHODS. This prospective study included patients who were scheduled for cataract surgery. A prototype operating microscope with an integrated continuous OCT device was used to measure the anterior and posterior lens capsule position at different time points during cataract surgery. In all cases, a capsular tension ring (CTR) was used to tauten the lens capsule. Partial coherence interferometry was used to measure anterior chamber depth (ACD) immediately before, and 1 hour and 3 months postoperatively. Partial least squares regression (PLSR) was used to assess the influence of different pre- and intraoperatively measured parameters. RESULTS. In total, 70 eyes of 70 patients were included. Mean axial eye length was 23.6 mm (range, 20.6 mm-30.8 mm), mean used IOL power was 22.2 diopters (D; range, 6.0 D-31.5 D). PLSR showed that the anterior lens capsule measured after removing the crystalline lens and after implanting a CTR was a significantly better predictor for the postoperative ACD compared with preoperative ACD measurements. CONCLUSIONS. The main problem of IOL power calculation, the prediction of the IOL position after surgery, could possibly be reduced by using intraoperative lens capsule measurements instead of preoperative ACD measurements. (ClinicalTrials.gov number, NCT01867541.) © 2013 The Association for Research in Vision and Ophthalmology, Inc.

Al Kaissi A.,Hanusch Hospital
Orthopaedic surgery | Year: 2013

We describe two unrelated patients aged 9 and 12 years. The first patient presented with multiple congenital contractures not associated with webbing (pterygia). Interestingly, his genetic testing showed the typical genotypic criteria of Escobar syndrome (CHRNG heterozygous mutation). The characteristics of the second child were compatible with the phenotypic and genotypic criteria for Escobar syndrome. Both patients manifested the typical facial features suggestive of Escobar syndrome. The aim of this paper is twofold: first, to illustrate that the absence of popliteal webbing is not a sufficient reason to exclude Escobar syndrome in patients with multiple contractures and second, dysmorphic facial features and the presence of certain radiological abnormalities might be considered baseline diagnostic tools in favor of this syndromic entity. © 2013 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Stefanska B.,Medical University of Lódz | Stefanska B.,McGill University | Karlic H.,Ludwig Boltzmann Research Institute | Varga F.,Hanusch Hospital | And 2 more authors.
British Journal of Pharmacology | Year: 2012

The hallmarks of carcinogenesis are aberrations in gene expression and protein function caused by both genetic and epigenetic modifications. Epigenetics refers to the changes in gene expression programming that alter the phenotype in the absence of a change in DNA sequence. Epigenetic modifications, which include amongst others DNA methylation, covalent modifications of histone tails and regulation by non-coding RNAs, play a significant role in normal development and genome stability. The changes are dynamic and serve as an adaptation mechanism to a wide variety of environmental and social factors including diet. A number of studies have provided evidence that some natural bioactive compounds found in food and herbs can modulate gene expression by targeting different elements of the epigenetic machinery. Nutrients that are components of one-carbon metabolism, such as folate, riboflavin, pyridoxine, cobalamin, choline, betaine and methionine, affect DNA methylation by regulating the levels of S-adenosyl-L-methionine, a methyl group donor, and S-adenosyl-L-homocysteine, which is an inhibitor of enzymes catalyzing the DNA methylation reaction. Other natural compounds target histone modifications and levels of non-coding RNAs such as vitamin D, which recruits histone acetylases, or resveratrol, which activates the deacetylase sirtuin and regulates oncogenic and tumour suppressor micro-RNAs. As epigenetic abnormalities have been shown to be both causative and contributing factors in different health conditions including cancer, natural compounds that are direct or indirect regulators of the epigenome constitute an excellent approach in cancer prevention and potentially in anti-cancer therapy. © 2012 The Authors. British Journal of Pharmacology.

Background: For decades, heparins and vitamin K antagonists (VKAs) have been the gold standards in therapy of venous thromboembolism (VTE). The advent of factor IIa and Xa inhibitors provides new therapeutic options. Th e aim of this analysis is to compare the currently available new oral anticoagulants (NOACs) with VKAs and also indirectly the NOACs with each other, as it is unlikely that a head-to-head comparison will ever be available. Patients and methods: In total, 27,024 patients were included in the RE-COVER, RE-COVER II, EINSTEIN DVT and PE, AMPLIFY and HOKUSAI studies with 13,511 in the VKA arm and 13,513 in the NOAC arm. Efficacy and safety endpoints were assessed by relative risks (RR) and absolute risk reductions (ARR) relative to VKA. Th e indirect comparison between the NOACs was performed according to ISPOR guidelines. Results: No differences between NOACs and VKA were found regarding recurrent VTE and death. Bleeding was significantly reduced by NOACs: major bleeding by rivaroxaban (RR 0.55; 0.38-0.81) and apixaban (RR 0.31; 0.17-0.55); major and clinically relevant non-major bleeding by dabigatran (RR 0.63; 0.51-0.77), apixaban (RR 0.44; 0.36-0.55) and edoxaban (RR 0.81; 0.71-0.93). The ARR for major bleeding was 1 % for rivaroxaban and apixaban; and for the composite bleeding endpoint 3.2 % for dabigatran, 5.4 % for apixaban, and 1.9 % for edoxaban. Regarding efficacy, no differences were found between NOACs. Apixaban reduced incidence of major bleeding more than dabigatran and edoxaban. Regarding occurrence of the composite bleeding endpoint, apixaban performed better than all other NOACs and dabigatran better than rivaroxaban and edoxaban. Conclusions: NOACs are as efficient in the treatment of VTE as VKA but with reduced risk of bleeding complications. Indirect comparisons indicate differences in the risk of clinically relevant bleeding events. Important issues such as monitoring and reversal of anticoagulation are still unresolved, but introduction of NOACs increased the therapeutic spectrum and thereby the potential for individualized therapy. © 2014 Hans Huber Publishers, Hogrefe AG, Bern.

Chen Y.-A.,Hanusch Hospital | Hirnschall N.,Hanusch Hospital | Findl O.,Hanusch Hospital
Journal of Cataract and Refractive Surgery | Year: 2011

Purpose: To compare the corneal wetting properties of balanced salt solution (BSS) and a viscous eye lubricant during cataract surgery. Setting: Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Design: Prospective randomized controlled study. Methods: This randomized controlled subject- and examiner-masked study comprised patients scheduled for cataract surgery. The patients were randomly assigned to receive either BSS or hydroxypropyl methylcellulose (HPMC) 2% gel (Cornea-Protect). Fluorescein staining, optical clarity during surgery, application frequency, subjective grading of discomfort, and subjective dryness of the eye were assessed. Results: One hundred one eyes of 97 patients (mean age 73.6 years; range 53 to 87 years) were included in the study. Mean grade of fluorescein staining was 9.46 ± 3.64 (SD) and 9.76 ± 3.27 (SD) in the BSS group and the HPMC 2% group, respectively (P=.67). Median grade of optical clarity during surgery was 2.0 in the BSS group and 1.0 in the HPMC 2% group, a statistically significant difference (P=.03). Median application frequency of BSS was 10 times higher than median application frequency of 1 time for HPMC 2%, a statistically significant difference (P<.001). Conclusions: Hydroxypropyl methylcellulose 2% provided significantly better optical clarity than BSS during cataract surgery. Because frequent irrigation is not needed and HPMC 2% provides a better view for the surgeon, the use of HPMC 2% results in increased comfort for the patient, especially under topical anaesthesia, and in a simpler and possibly safer surgical procedure. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. © 2011 ASCRS and ESCRS.

Chen Y.-A.,Hanusch Hospital | Hirnschall N.,Hanusch Hospital | Findl O.,Hanusch Hospital
Journal of Cataract and Refractive Surgery | Year: 2011

Purpose: To compare 2 new optical biometry devices with the present gold standard biometer. Setting: Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Design: Evaluation of diagnostic test or technology. Methods: In patients scheduled for cataract surgery, measurements performed with the current gold standard optical biometer (IOLMaster) were compared with those of 2 new optical biometers, the Lenstar LS 900 (optical low-coherence reflectometry [OLCR] device; substudy 1) and the IOLMaster 500 (partial coherence interferometry [PCI] device; substudy 2). The duration of patient data entry and of the actual measurement process and the time from intraocular lens power calculation to printout were calculated. Results: The mean difference in axial length measurements was 0.01 mm ± 0.05 (SD) between the gold standard device and the new OLCR device and 0.01 ± 0.02 mm between the gold standard device and the new PCI device (P=.12 and P < .001, respectively). Measurements with the new OLCR device took significantly longer than with the gold standard device (mean difference 209 ± 127 seconds), and measurements with the gold standard device took significantly longer than with the new PCI device (mean difference 82 ± 46 seconds) (both P < .001). Conclusions: All 3 devices were easy to use for biometry before cataract surgery. Measurements with the new PCI device took half as long as those with the gold standard device. Measurements with the new OLCR device took twice as long as those with the gold standard device. © 2011 ASCRS and ESCRS.

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