testing-cochlear-implant-electrode-insertion-training-system-for

Testing a Cochlear Implant Electrode Insertion Training System for Optimal Electrode Array Placement in Different Inner Ear Anatomies

Successful intracochlear placement of the cochlear implant (CI) electrode array is a key surgical step in cochlear implantation. Without it, ...

LMU Munich

The current coronavirus disease 2019 (COVID-19) pandemic is a challenge for physicians in triaging patients in emergency rooms. We found a potentially dangerous overlap of classical urinary symptoms and the as yet not fully described symptoms of COVID-19. After a patient was primarily triaged as a urosepsis case and then subsequently diagnosed with COVID-19, we focused on an increase in urinary frequency as a symptom of COVID-19 and identified this in seven males out of 57 patients currently being treated in our COVID-19 wards. In the absence of any other causes, urinary frequency may be secondary to viral cystitis due to underlying COVID-19 disease. We propose consideration of urinary frequency as an anamnestic tool in patients with infective symptoms to increase awareness among urologists during the current COVID-19 pandemic to prevent fatal implications of misinterpreting urological symptoms.

Urinary Frequency as a Possibly Overlooked Symptom in COVID-19 Patients: Does SARS-CoV-2 Cause Viral Cystitis?

[Epistaxis: Osler's disease as an important differential diagnosis].

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by recurrent episodes of upper airway obstruction and subsequent hypoxia. In patients with OSA, severity and number of these hypoxic events positively correlate with the extent of associated cardiovascular pathology. The molecular mechanisms underlying intermittent hypoxia (IH)-driven cardiovascular disease in OSA, however, remain poorly understood-partly due to the lack of adequate experimental models. Here, we present a novel experimental approach that utilizes primary human endothelial cells cultivated under shear stress. Oxygen partial pressure dynamics were adopted in our  model according to the desaturation-reoxygenation patterns identified in polysomnographic data of severe OSA patients ( = 10, with 892 severe desaturations, SpO<80%). Using western blot analysis, we detected a robust activation of the two major inflammatory pathways ERK and NF-κB in endothelial cells, whereas no HIF1α and HIF2α protein stabilization was observed. In line with these findings, mRNA and protein expression of the pro-inflammatory adhesion and signaling molecule ICAM-1 and the chemokine CCL2 were significantly increased. Hence, we established a novel  model for deciphering OSA-elicited effects on the vascular endothelium. First data obtained in this model point to the endothelial activation of pro-inflammatory rather than hypoxia-associated pathways in OSA. Future studies in this model might contribute to the development of targeted strategies against OSA-induced, secondary cardiovascular disease.

A novel OSA-related model of intermittent hypoxia in endothelial cells under flow reveals pronounced inflammatory pathway activation.

Antibody therapy for chronic rhinosinusitis with nasal polyps (CRSwNP) has been established in Germany since 2019. With limited long-term data on biologic treatment for CRSwNP, we conducted a comprehensive evaluation of our 4-year data. This monocentric study aims to assess the real-world effects of this treatment on clinical course, quality of life, treatment adherence, biologic switching, dual therapy, and comorbidities.

The use of biologics in patients suffering from chronic rhinosinusitis with nasal polyps - a 4-year real life observation.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition associated with significant morbidity. While established treatments such as functional endoscopic sinus surgery (FESS) and biologic therapy have demonstrated efficacy, they come with limitations, including cost, accessibility, and patient adherence. Growing evidence suggests that dietary factors, particularly arachidonic acid and salicylic acid, influence inflammatory pathways relevant to CRSwNP, yet real-world data on dietary interventions remain scarce. This retrospective study evaluates the mid-term effects of a structured dietary intervention in patients with CRSwNP who were either unwilling to undergo FESS or biologic therapy. The outcomes were compared to those of patients receiving either FESS or dupilumab. The dietary intervention was based on the avoidance of arachidonic acid and salicylates, an increase in fiber-rich foods, and the exclusion of nonsteroidal anti-inflammatory drugs. A total of 45 patients (mean age 46.5 ± 14.1 years; 25 female and 20 male) were included, with 15 undergoing dietary intervention, 15 FESS, and 15 dupilumab therapy. Disease burden was assessed using the sino-nasal outcome test (SNOT-22), visual analog scale, endoscopy scoring, and the brief smell identification test at baseline and follow-ups at 3 and 6 months. Patients undergoing dietary intervention experienced significant symptom improvement, although the response was less pronounced compared to FESS or dupilumab. At 6 months, mean SNOT-22 scores improved from 69.8 to 19.7 (FESS), 58.0 to 16.1 (dupilumab), and 39.5 to 24.2 (dietary intervention). visual analog scale scores showed a similar trend, decreasing from 8.4 to 2.9 (FESS), 8.1 to 2.2 (dupilumab), and 5.6 to 3.5 (dietary). While objective olfactory scores (brief smell identification test) improved in all groups, it was less pronounced in the dietary intervention group. Notably, patients in the dietary intervention group reported continued adherence and tolerability of the intervention. Dietary intervention may serve as a viable adjunct for CRSwNP patients who are unable or unwilling to undergo surgery or biologics. Despite lower efficacy, its safety and accessibility merit further investigation.

Real life data with a six months follow-up from dietary interventions, biologic therapy and functional endoscopic surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

Chronic rhinosinusitis with nasal polyps (CRSwNP) affects up to 4.5% of the population and is frequently driven by type 2 inflammation. Dupilumab, targeting IL‑4 and IL‑13 pathways, was approved in 2019 as the first biologic for CRSwNP in Germany. This single-center, retrospective study analyzed 174 patients initiating dupilumab between 2019 and 2023. Patients were grouped by year and assessed for trends in demographics, surgical history, and treatment response. Only adherent patients with ≥ 6 months of follow-up were included. Age and baseline disease severity were stable across cohorts. However, the proportion of patients with > 3 prior sinus surgeries declined from 28.3% in 2019/20 to 13.0% in 2023, suggesting earlier biologic initiation over time. All patients met at least three EPOS 2020 criteria. Significant and clinically meaningful improvements were observed in all cohorts for Nasal Polyp Score (NPS), SNOT‑22, VAS, and olfactory testing, with changes exceeding established minimal clinically important differences (MCIDs). No cohort showed superior outcomes. Tese findings highlight consistent real-world efficacy of dupilumab and evolving prescribing patterns that favor earlier intervention, while reflecting continued cautious patient selection in the context of high treatment costs.

Article	Year
Urinary Frequency as a Possibly Overlooked Symptom in COVID-19 Patients: Does SARS-CoV-2 Cause Viral Cystitis? European urology\| PubMed ID: 32475747	2020
[Epistaxis: Osler's disease as an important differential diagnosis]. MMW Fortschritte der Medizin\| PubMed ID: 35274264	2022
A novel OSA-related model of intermittent hypoxia in endothelial cells under flow reveals pronounced inflammatory pathway activation. Frontiers in physiology\| PubMed ID: 37123277	2023
The use of biologics in patients suffering from chronic rhinosinusitis with nasal polyps - a 4-year real life observation. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery\| PubMed ID: 38977481	2024
Real life data with a six months follow-up from dietary interventions, biologic therapy and functional endoscopic surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CR... Medicine\| PubMed ID: 40797394	2025
Evolving trends in dupilumab use for chronic rhinosinusitis with nasal polyps (CRSwNP): a 4-year cohort analysis. Scientific reports\| PubMed ID: 41413070	2025

Clemens Stihl

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