Journals
2026 EN
Delmas Clément · Simoni AnneSophie · Goeminne Céline
+10 more
ABSTRACT Background Left‐ventricular assist devices (LVADs) are a major therapeutic option in advanced heart failure (adHF), improving survival rates and quality of life (QoL). Complications, however, can alter their prognosis. Specialized telemonitoring could facilitate LVAD follow‐ups and improve outcomes. This study aimed to evaluate the usefulness of telemonitoring for LVAD patients. Methods Patients, followed up with a web application (SateliaLVAD), were included in a national retrospective study at nine tertiary hospitals in France. Characteristics and detected hospitalization risk alerts data were collected. The risk of hospitalization was categorized based on a clinical algorithm (green: no risk, orange: heightened risk, and red: emergent contact with patient and possible hospitalization). Results In total, 161 patients were included (male: 82.0%, mean age: 62.2 years). Indications for LVAD were mainly ischemic cardiomyopathy (82.0%) and bridge to transplant (50.3%). The mean follow‐up duration lasted 19.9 [1–45] months with 76 (47.2%) patients continuing telemonitoring. Compliance was high (79.0%). The main reason for cessation was death (30.6%). Total hospitalization risk alerts detected by telemonitoring were: orange alerts ( n = 8265, 72.3%) and red alerts ( n = 1613, 14.1%) with 48.5% of cases resolved (orange: 50.8% vs. red: 54.8%). The most frequent type of resolved alert was for a measured risk of cardiac decompensation (orange: 2227 vs. red: 382). Conclusion To our knowledge, this is the first extensive study to describe the follow‐up of LVAD patients by a dedicated telemonitoring application. Telemonitoring as a specific follow‐up tool may be feasible for this subpopulation. Future randomized studies on specific prospective evaluations such as survival and QoL are needed.
Journals
2026 EN
Van Compernolle Robin · Lemmens Sophie · Cassiman Catherine
Abstract Optic disc drusen (ODD) concern highly prevalent anatomical features that are increasingly recognised as a risk factor for various pathological conditions. In clinical practice, differentiation between ODD and true papilloedema poses considerable challenges, often resulting in the effectuation of unnecessary, potentially invasive examinations. Furthermore, recent years have witnessed a notable expansion in imaging modalities employed to map ODD, primarily novel optical coherence tomography (OCT) modalities. A growing necessity arises for literature providing a profound comparison between most of the various available techniques, as well as furnishing clinicians with practical guidelines to manage a patient with suspected ODD. A comprehensive search of the current literature formed the foundation of this narrative review. We primarily focused on data from recent studies, each of which was thoroughly analysed and interpreted by all the authors. We formulate a straightforward diagnostic model to approach a patient with suspected ODD, wherein a primary distinction is made between patients with a high and low suspicion for papilloedema. Enhanced Depth Imaging OCT (EDI‐OCT) emerges as the most potent modality and is thus recommended as the new gold standard technique. Fluorescein angiography exhibits excellent specificity and therefore proves useful to exclude papilloedema, although not with full certainty. Fundus autofluorescence and ultrasonography appear to be most beneficial for screening purposes and in a population with very low suspicion of papilloedema. This narrative review is the first to present a clinically relevant diagnostic model to discriminate between ODD and papilloedema, identifying EDI‐OCT as the primary imaging modality in ODD diagnosis.
Journals
2026 EN
Yaïci Rémi · Filipe Helena Prior · Solecki Lauriana
+20 more
Abstract Purpose Analyse the results of a European Board of Ophthalmology (EBO) survey on post‐residency training (fellowship) opportunities across Europe, providing insights from ophthalmic educators on the current landscape. Methods A cross‐sectional study was conducted using an anonymous 31‐question online survey distributed to educators in all EBO‐affiliated countries. Results The response rate was 61% with participation of 392 ophthalmic educators. Despite broad participation, Southwestern Europe was overrepresented, while Northern and Central Europe were underrepresented, affecting regional balance. Respondents had a mean age of 51 ± 11 years, with 37.8% as professors and 46.6% as department heads. Most (54.1%) were affiliated with university hospitals. The reported median percentage of residents pursuing post‐residency training was 25%, varying between 15% and 100%, with 15.3% of respondents uncertain about their existence, especially in non‐university hospitals. Post‐residency training durations were predominantly 1 or 2 years. National diplomas were highly valued except in the United Kingdom; language proficiency was required in 84.2% of countries. Respondents reported a median of three positions per department, with 60% filled by local residents. Surgical activity accounted for 65%, with regional variations, whereas 40% of positions involved research. Observerships remained rare (10%). Financial compensation was provided in 67% of cases. A national medical licence was deemed essential, whereas the EBO diploma and letters of recommendation were moderately valued, especially in Northern Europe. Fellowships were highly recommended by 76.2%, while 63% believed that grants would improve access to positions. Conlusion This survey represents the largest data set on post‐residency training in Europe. Results highlight a lack of cohesion in fellowship opportunities, with many respondents uncertain about national programmes. A national medical licence remains the primary requirement, while language proficiency and financial support are key factors influencing access. Institutional support for medical educators is increasing, yet challenges persist regarding time, resources and funding. Focusing on subspecialty training and research, fellowships are crucial for career progression. Expanding training opportunities through international initiatives could further enhance accessibility and standardisation across Europe.
Journals
2026 EN
Filipe Helena Prior · Yaïci Rémi · Ivekovic Renata
+26 more
Abstract Purpose Ophthalmology encompasses comprehensive medical and surgical care for patients with diverse visual system disorders, significantly impacting eye health, vision, and quality of life. European ophthalmologists undergo specialized residency training to acquire necessary competencies, emphasizing theoretical knowledge, clinical and surgical skills, and professional behaviour. The European Union of Medical Specialists (UEMS) and the European Board of Ophthalmology (EBO) advocate for competency‐based medical education (CBME), standardized training frameworks, and harmonized assessments across Europe. Methods In 2023, a survey among European ophthalmologists demonstrated broad consensus on establishing unified training requirements. Subsequently, a Core Working Group developed European Training Requirements (ETRs) for ophthalmology, detailing curricula, subspecialty rotations, and Entrustable Professional Activities (EPAs) across a structured four‐year residency. Results These ETRs, formally approved by UEMS in October 2024, incorporate simulation‐based training, workplace‐based assessments (WPBA), and innovative evaluation methods such as electronic portfolios. Certification as a European Specialist in Ophthalmology involves passing rigorous summative assessments, including the European Board of Ophthalmology Diploma (EBOD) examination. Training institutions must offer substantial clinical exposure, robust infrastructure, and comprehensive educational resources. Faculty support, continuous quality assurance, regular audits, and clinical governance frameworks are essential. Conclusion The ETRs also highlight the importance of interprofessional collaboration and encourage subspecialty expansion in emerging areas like ophthalmic oncology and global ophthalmology. Designed as a dynamic, “living document,” the ETRs will evolve with scientific and technological advancements, supporting high‐quality ophthalmic education and practice while respecting national diversity and sovereignty.
Journals
2026 EN
Eidenberger Anna · Reiter Gregor S. · Mares Virginia
+13 more
Abstract Purpose To investigate the association between best‐corrected visual acuity (BCVA) and quantitative macular fluid volumes, compared to central subfield thickness (CST) in treatment‐naïve and previously treated patients with active neovascular age‐related macular degeneration (nAMD). Methods and Analysis Baseline data were collected from 290 eyes of 290 participants consecutively enrolled in a prospective, randomized phase III clinical trial. Intraretinal fluid (IRF), subretinal fluid (SRF) and pigment epithelial detachment (PED) volumes were quantified and localized using an MDR‐certified AI algorithm (Fluid Monitor, RetInSight). Fluid volumes and CST were included in linear regression models for comparison. Results Significantly greater IRF volumes within each macular region were observed in treatment‐naïve patients, whereas larger PED volumes contributed to higher CST values in pretreated patients. In both subgroups, the largest proportion of BCVA variance could be explained by measuring IRF and SRF volumes within the entire 6‐mm area (adjusted R 2 = 0.140 and 0.225, respectively). In pre‐treated eyes, CST explained only half as much BCVA variance as the 6‐mm fluid model, and the model's fit was even poorer when compared to the CST model in the treatment‐naïve subgroup (adjusted R 2 = 0.078 vs. 0.198). Conclusion The examination of IRF and SRF volumes significantly impacts BCVA in nAMD. The weaker association of CST highlights its limitations as a parameter of disease activity. These findings emphasize the necessity of distinct fluid volume quantification as a relevant surrogate for visual function loss or benefit in nAMD, with particular emphasis on treatment duration and fluid in regions beyond the central 1‐mm.
Journals
2026 EN
Loveys Kate · Haskell Libby · Cotterell Elizabeth
+7 more
ABSTRACT Aim To synthesise evidence on the efficacy and safety of azithromycin in infants presenting or admitted to hospital with bronchiolitis in an updated systematic review. Methods MEDLINE, EMBASE, PubMed, Cochrane Library and CINAHL were searched (last search 19/02/25) for trials evaluating the efficacy and safety of azithromycin in infants with bronchiolitis. Primary outcomes were hospital length of stay (LOS), intensive care unit (ICU) admission and mechanical ventilation. Risk of bias (RoB2) and the certainty of evidence (GRADE) were evaluated. Data were pooled using fixed‐effect meta‐analyses. Results Six RCTs and one pilot RCT were included ( N = 867). Azithromycin was associated with a significantly shorter LOS in infants with bronchiolitis, compared to placebo (MD –0.30 days (95% CI –0.58 to –0.02), p = 0.04; low certainty). However, statistical significance was lost in sensitivity analyses. There was no significant difference between the azithromycin and placebo groups in rates of adverse events, ICU admission, mechanical ventilation, readmission within 6 months and in most evaluations of persistent respiratory symptoms. The evidence certainty was low to very low across outcomes. Conclusions There is insufficient evidence to support the use of azithromycin as part of hospital care for infants with bronchiolitis, with inconclusive findings on its role in reducing LOS. Registration PROSPERO registration number: CRD42023463917
Journals
2026 EN
Korman Catherine · Elhaoua Doha · Blain Sarah
+10 more
ABSTRACT Aim Limited Canadian data on paediatric acute pancreatitis exist. A meta‐analysis of 48 studies reported equal prevalence of acute pancreatitis among various aetiologies, with rates of severe acute pancreatitis at 13.7% in North America. The 2018 NASPGHAN Pancreas Committee position statement highlighted the need for evidence on fluid management and early enteral nutrition. We aimed to evaluate the epidemiology and management of acute pancreatitis at a tertiary care centre. Methods Data were extracted from a hospital database for children diagnosed with acute pancreatitis from January 2014 to December 2021. Descriptive analyses were conducted using SAS software. Results Two hundred eight patients (49.0% female) developed acute pancreatitis. The median age was 12.5 years. The most common aetiologies were medication (20.2%), biliary disease (16.4%) and infections (15.4%). The prevalence of moderately severe acute pancreatitis was 10.6%; no patients developed severe acute pancreatitis. Nearly all patients (95.7%) received intravenous fluids. Dietary management during the first 24 h included enteral nutrition (8.2%), oral feeding (32.2%) and fasting (49.5%). Conclusions Paediatric acute pancreatitis has diverse aetiologie, and its management generally aligns with NASPGHAN guidelines. Future studies should focus on the identification of predictive factors of severity in the paediatric population based on recent severity classifications.
Journals
2026 EN
Pansu Nathalie · Drakulovski Pascal · Krasteva Donika
+7 more
ABSTRACT Gut microbiota plays a key role in triggering various diseases. However, translocation studies focus on bacteria, neglecting fungal elements, while fungi seem also involved in triggering various diseases. Aim of this study was to assess whether fungal elements were able to translocate in patients with AUD (alcohol use disorder) and to verify if withdrawal from alcohol was beneficial on such translocation. Sixty‐five patients with AUD were included. Blood samples were collected at baseline and 3 and 6 weeks after alcohol withdrawal. Total DNA was extracted from blood. Fungal DNA was searched by qRT‐PCR with panfungal primers and sequenced to determine the species detected. Out of 42 patients tested, 30.9% (13/42) had positive signals on one or several of their samples. Identified DNAs were mostly Candida albicans . No significant variation in mean level of fungal DNA copies was found over time in these patients. No correlation was found between intestinal integrity markers and fungal translocation. Fungal DNA was found in the blood of AUD patients, showing that fungal elements can translocate across the intestinal barrier. Absence of correlation between intestinal integrity markers and fungal translocation indicates that fungal elements may be able to translocate independently of the integrity of gut barrier.
Journals
2026 EN
Tang Catherine Z. · Delau Olivia R. · Katz Seymour
+4 more
ABSTRACT Background The benefits of achieving endoscopic remission among older adults with inflammatory bowel disease (IBD) who have mild persistent disease activity are unknown. Methods This was a retrospective study of adults ≥ 60 with IBD who had mild or no disease activity on endoscopy from January 1, 2018–January 1, 2023. The primary outcome was a composite of major IBD‐specific adverse events (hospitalizations, surgery, and prescription of corticosteroids for IBD‐related symptoms) within 1 year of endoscopic assessment. Our secondary outcome was a composite of 1‐year morbidity‐related events (mortality, all‐cause hospitalization, infection requiring antibiotics, venous thromboembolism, cardiovascular events, and osteoporotic fractures). We also assessed outcomes at 5 years. Results Among 504 patients, 192 (38.1%) had mild endoscopic disease and 312 (61.9%) were in endoscopic remission, with a median disease duration of 11 years. On multivariable analysis, mild endoscopic disease activity increased the odds of a 1‐year adverse IBD‐specific outcome (aOR 4.16, 95% CI 2.10–8.24), with similar results at 5 years. Furthermore, mild endoscopic disease was associated with increased odds of experiencing an adverse morbidity‐related outcome within 1 year as compared to endoscopic remission (aOR 1.56, 95% CI 1.01–2.43). Conclusions Among older adults with prevalent IBD, mild endoscopic disease activity, as compared to endoscopic remission, was associated with increased odds of adverse IBD‐specific and morbidity‐related outcomes at 1 year, with this risk persisting for IBD‐specific outcomes at 5 years. These findings highlight the importance of achieving endoscopic remission, which may confer both short‐ and longer‐term benefits in this population.
Journals
2026 EN
Rouveyre Raphaëlle · Coudol Sandrine · Collins Michael
+8 more
ABSTRACT Background Small bowel (SB) capsule endoscopy (SBCE) is a key tool in patients with Crohn's disease (CD). Optimal bowel preparation remains debated. Aims To compare the efficacy of a simplified preparation (clear liquid diet with 500 mL of water pre‐ and 1 L post‐capsule ingestion) to a polyethylene glycol (PEG)‐based preparation (24 h‐residue‐free diet with 2 L of PEG) in patients with established CD. Methods In this randomised, controlled, single‐blind, superiority, multicentre trial, patients were assigned 1:1 to either the simplified preparation or the PEG‐based preparation. Intestinal cleanliness (quantified by the KODA score and qualitatively evaluated), patient acceptability, diagnostic yield, capsule completion rate, and SB transit time (SBTT) were compared between groups. Results With 142 SBCE, we observed no difference in intestinal cleanliness. Patients' acceptability of preparation and SBCE procedure was significantly higher with the simplified preparation. Diagnostic yield was similar, as well as the capsule completion rate and SBTT. The area under the receiver operating characteristic curve of the KODA score was 0.87 (95% CI: 0.84–0.90). Using a threshold of 2.25, the score allowed us to discriminate images with ‘good’ and ‘fair or poor’ cleanliness with accuracy, sensitivity, and specificity of 80%, 76%, and 84%, respectively. Conclusions A simplified preparation consisting of a clear liquid diet and water is a viable alternative to a PEG‐based preparation prior to SBCE in patients with CD, offering comparable SB cleanliness and diagnostic outcomes while improving acceptability. Trial Registration ClinicalTrials.gov identifier: NCT05117996 and the article was written in line with the Consolidated Standards of Reporting Trials (CONSORT) checklist