[Relevant interprofessional knowledge of the (general/abdominal) surgeon-Information security and data protection in everyday clinical practice]. / Relevantes interprofessionelles Wissen des (Allgemein­/Viszeral­)Chirurgen ­ Informationssicherheit und Datenschutz im chirurgischen Klinikalltag.

AIM AND METHOD: Short narrative overview based on regulations by law, individual experiences from daily practice and selected references from current literature. RESULTS (SELECTIVE CORNER POINTS): Information security and data protection are mandatory and indispensable elements by law of general, professional and social actions, which can be also considered substantial parts of quality management. Therefore, (general/abdominal) surgeon underlies it too. INFORMATION SECURITY: It comprises the protection of information of each type and origin - it serves the warranty of the basic aims such as confidentiality, integrity, availability and authenticity of information, which supports both aims of a clinician, patient safety and treatment effectiveness. DATA PROTECTION: It is considered a basic right to protect personal data against abusive processing - however, data security is not the primary aim, but rather the right for informational self-determination. IT EMERGENCY MANAGEMENT: It implies that in case of an IT emergency (released by a persisting system failure or cyberattack), logistic operations are transferred into previously defined emergency procedures well organized and possibly with no interruption - digital logistic operations become suddenly complete analogous processes, with exclusive responsibility of the single institutes and departments. CONCLUSION: Both sides benefit equally from a regular bilateral exchange between the surgeon and the information security and data protection officer and are able to ensure the common goals of patient safety and treatment effectiveness through a proportionate integration of information security and data protection into everyday clinical practice.

Serum Myo-Inositol, Dimethyl Sulfone, and Valine in Combination with Creatinine Allow Accurate Assessment of Renal Insufficiency-A Proof of Concept.

Evaluation of renal dysfunction includes estimation of glomerular filtration rate (eGFR) as the initial step and subsequent laboratory testing. We hypothesized that combined analysis of serum creatinine, myo-inositol, dimethyl sulfone, and valine would allow both assessment of renal dysfunction and precise GFR estimation. Bio-banked sera were analyzed using nuclear magnetic resonance spectroscopy (NMR). The metabolites were combined into a metabolite constellation (GFRNMR) using n = 95 training samples and tested in n = 189 independent samples. Tracer-measured GFR (mGFR) served as a reference. GFRNMR was compared to eGFR based on serum creatinine (eGFRCrea and eGFREKFC), cystatin C (eGFRCys-C), and their combination (eGFRCrea-Cys-C) when available. The renal biomarkers provided insights into individual renal and metabolic dysfunction profiles in selected mGFR-matched patients with otherwise homogenous clinical etiology. GFRNMR correlated better with mGFR (Pearson correlation coefficient r = 0.84 vs. 0.79 and 0.80). Overall percentages of eGFR values within 30% of mGFR for GFRNMR matched or exceeded those for eGFRCrea and eGFREKFC (81% vs. 64% and 74%), eGFRCys-C (81% vs. 72%), and eGFRCrea-Cys-C (81% vs. 81%). GFRNMR was independent of patients' age and sex. The metabolite-based NMR approach combined metabolic characterization of renal dysfunction with precise GFR estimation in pediatric and adult patients in a single analytical step.