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"text": "\n127468\nTwo major pathways of penile carcinogenesis: HPV-induced penile cancers overexpress p16ink4a, HPV-negative cancers associated with dermatoses express p53, but lack p16ink4a overexpression.\n\nMannweiler, S\n\nSygulla, S\n\nWinter, E\n\nRegauer, S\n\nBeiträge in Fachzeitschriften\nISI:000320510100025\n23474228.0\n10.1016/j.jaad.2012.12.973\nNone\nBackground: Penile squamous cell carcinomas (SCC) arise either through transforming infections with human papillomavirus (HPV) or independent of HPV, often in the background of lichen sclerosus (LS) and lichen planus (LP). Despite impact on therapy and prognosis, etiologic stratifications are missing in most histological diagnoses and publications about penile cancers/precursors. Objective: Classification of penile lesions into HPV-induced or HPV-negative via immunohistochemical demonstration of p16(ink4a) overexpression, a surrogate marker for transforming HPV-high-risk infections, and p53 expression in the absence of p16(ink4a) overexpression. Methods: Archival formalin-fixed material of 123 invasive penile cancers and 43 pre-invasive lesions was evaluated for the presence of LS, LP, 28 HPV genotypes, and expression of p53 and p16(ink4a). Results: Seventy-two of 123 SCCs and 33 of 43 pre-invasive lesions showed p16(ink4a) overexpression independent of HPV-HR genotypes involved; 66 of 72 SCCs and 29 of 43 precursor lesions revealed a single HPV-high-risk-genotype (HPV-HR16 in 76% followed by HPV33, HPV31, HPV45, HPV18, HPV56); 5 of 72 SCCs and 4 of 43 precursor lesions revealed multiple HPV-HR-genotypes. One SCC revealed HPV-LR and HR-DNA. Fifty-one of 123 SCCs and 10 precursor lesions were p16(ink4a) negative, but showed nuclear p53 expression in tumor cells and basal keratinocytes. Forty-nine of 51 SCCs and 10 of 10 precursor lesions lacked HPV DNA. Two of 51 SCCs contained HPV18 and HPV45 DNA, respectively, but p16(ink4a) negativity classified them as noneHPV-induced. Twenty-seven of 51 SCCs showed peritumoral LS, 13 of 51 SCCs showed peritumoral LP, and 11 SCCs revealed no peritumoral tissue. Histologically, HPV-negative precursors showed hyperkeratotic, verrucous, atrophic, and basaloid differentiation. Limitations: This was a retrospective study. Conclusions: p16(ink4a) overexpression identifies HPV-HR-induced penile carcinogenesis independent of HPV-HR genotype. p53 expression along with p16(ink4a) negativity identifies HPV-negative cancers. Correct etiologic classification of penile lesions during diagnostic work-up allows optimal therapy decisions.\n\nMannweiler, Sebastian\n\nRegauer, Sigrid\n\nSygulla, Stephan\n\nWinter, Elke\n\n\n"
},
{
"text": "\n128470\nHomoarginine and progression of chronic kidney disease: results from the Mild to Moderate Kidney Disease Study.\n\nDrechsler, C\n\nKollerits, B\n\nMeinitzer, A\n\nMärz, W\n\nRitz, E\n\nKönig, P\n\nNeyer, U\n\nPilz, S\n\nWanner, C\n\nKronenberg, F\n\nMMKD Study Group\n\nBeiträge in Fachzeitschriften\nISI:000319052700048\n23691067.0\n10.1371/journal.pone.0063560\nPMC3655120\nHomoarginine is an amino acid derivative mainly synthesized in the kidney. It is suggested to increase nitric oxide availability, enhance endothelial function and to protect against cardiovascular diseases. We aimed to investigate the relation between homoarginine, kidney function and progression of chronic kidney disease (CKD).\n We measured plasma homoarginine concentrations in baseline samples of the Mild to Moderate Kidney Disease (MMKD) Study, a prospective cohort study of 227 patients with CKD in Europe. Homoarginine concentrations were available in 182 of the baseline samples and in 139 of the prospectively-followed patients. We correlated homoarginine concentrations to parameters of kidney function. The association between homoarginine and progression of CKD was assessed during a follow-up of up to seven years (median 4.45 years, interquartile range 2.54-5.19) using Cox regression analysis. Progression of CKD was defined as doubling of baseline serum creatinine and/or end-stage renal disease.\n Study participants were at baseline on average 47±13 years old and 65% were male. Mean±standard deviation of homoarginine concentrations were 2.5±1.1 µmol/L and concentrations were incrementally lower at lower levels of GFR with mean concentrations of 2.90±1.02 µmol/L (GFR>90 ml/min), 2.64±1.06 µmol/L (GFR 60-90 ml/min), 2.52±1.24 µmol/L (GFR 30-60 ml/min) and 2.05±0.78 µmol/L (GFR<30 ml/min), respectively (p = 0.002). The age- and sex-adjusted risk to reach the renal endpoint was significantly higher by 62% with each decrease by one standard deviation (1.1 µmol/L) of homoarginine (HR 1.62, 95% CI 1.16-2.27, p = 0.005). This association was independent of proteinuria (HR 1.56, 95% CI 1.11-2.20, p = 0.01), and was slightly attenuated when adjusting for GFR (HR 1.40 (95% CI 0.98-1.98, p = 0.06).\n Homoarginine concentrations are directly correlated with kidney function and are significantly associated with the progression of CKD. Low homoarginine concentrations might be an early indicator of kidney failure and a potential target for the prevention of disease progression which needs further investigations.\n\nMärz, Winfried\n\nMeinitzer, Andreas\n\nPilz, Stefan\n\n\n"
},
{
"text": "\n130850\nAre hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry.\n\nMaggioni, AP\n\nAnker, SD\n\nDahlström, U\n\nFilippatos, G\n\nPonikowski, P\n\nZannad, F\n\nAmir, O\n\nChioncel, O\n\nLeiro, MC\n\nDrozdz, J\n\nErglis, A\n\nFazlibegovic, E\n\nFonseca, C\n\nFruhwald, F\n\nGatzov, P\n\nGoncalvesova, E\n\nHassanein, M\n\nHradec, J\n\nKavoliuniene, A\n\nLainscak, M\n\nLogeart, D\n\nMerkely, B\n\nMetra, M\n\nPersson, H\n\nSeferovic, P\n\nTemizhan, A\n\nTousoulis, D\n\nTavazzi, L\n\nHeart Failure Association of the ESC\n\nBeiträge in Fachzeitschriften\nISI:000325175700013\n23978433.0\n10.1093/eurjhf/hft134\nNone\nTo evaluate how recommendations of European guidelines regarding pharmacological and non-pharmacological treatments for heart failure (HF) are adopted in clinical practice.\n The ESC-HF Long-Term Registry is a prospective, observational study conducted in 211 Cardiology Centres of 21 European and Mediterranean countries, members of the European Society of Cardiology (ESC). From May 2011 to April 2013, a total of 12, 40 patients were enrolled, 40.5% with acute HF and 59.5% with chronic HF. Intravenous treatments for acute HF were heterogeneously administered, irrespective of guideline recommendations. In chronic HF, with reduced EF, renin-angiotensin system (RAS) blockers, beta-blockers, and mineralocorticoid antagonists (MRAs) were used in 92.2, 92.7, and 67.0% of patients, respectively. When reasons for non-adherence were considered, the real rate of undertreatment accounted for 3.2, 2.3, and 5.4% of the cases, respectively. About 30% of patients received the target dosage of these drugs, but a documented reason for not achieving the target dosage was reported in almost two-thirds of them. The more relevant reasons for non-implantation of a device, when clinically indicated, were related to doctor uncertainties on the indication, patient refusal, or logistical/cost issues.\n This pan-European registry shows that, while in patients with acute HF, a large heterogeneity of treatments exists, drug treatment of chronic HF can be considered largely adherent to recommendations of current guidelines, when the reasons for non-adherence are taken into account. Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be seriously considered when clinical practice guidelines have to be written.\n\nFruhwald, Friedrich\n\n\n"
},
{
"text": "\n132102\nMetal contamination and retention of the former mining site Schwarzwand (Salzburg, Austria).\n\nAdlassnig, W\n\nSassmann, S\n\nLendl, T\n\nWernitznig, S\n\nHofhansl, F\n\nLang, I\n\nLichtscheidl, IK\n\n\n\nBeiträge in Fachzeitschriften\nISI:000322065800020\nNone\n10.1016/j.apgeochem.2013.04.012\nNone\nThe Schwarzwand is a unique hygric, Cu-contaminated habitat formed by mining activities from the 16th to 18th century. Today, a large spoil heap and several creeks fed by Cu-rich mine drainage are present. The vegetation of the Schwarzwand differs clearly from the surrounding subalpine forests. It is by no means impoverished but rather a hotspot of biodiversity. Interestingly, most of the Cu precipitates within the Schwarzwand and the creeks leave the Schwarzwand virtually clean. This study maps the distribution of Cu within the Schwarzwand and within selected vascular plants, moss and microorganisms and correlates them with water and soil chemistry in order to identify the sinks of Cu and to elucidate the remarkable capability of the Schwarzwand for natural attenuation.\nTwo types of water could be distinguished, one acidic precipitating limonite with a constant Cu content of about 0.6 mg L (1), and one circumneutral, which decreases far more rapidly in Cu content than would be expected due to chemical considerations. A dense microbial mat covering most of the bed of the circumneutral creeks could be identified as the main sink. It consists of the cyanobacterium Phormidium sp. and retains Cu both by adsorption to mucilaginous sheaths and by precipitation as secondary minerals such as sampleite. Layers of dead biofilm can be found covered by a few centimetres of soil at the banks of the circumneutral creeks; the extremely high concentration and the low solubility of Cu in this soil indicates permanent immobilisation of the metals. High concentrations of Cu were also found in mosses of the family Bryaceae which, however, play a negligible role for the metal retention of the habitat due to their low biomass.\nThe retention of Cu within the Schwarzwand is a remarkable example of the sustainable self-cleaning of a contaminated habitat which takes place without any human intervention. The artificial establishment of microbial communities similar to the Schwarzwand could result in cheap and sustainable strategies for the remediation of suitable metal-contaminated waters. (C) 2013 Elsevier Ltd. All rights reserved.\n\nWernitznig, Stefan\n\n\n"
},
{
"text": "\n137889\nRobotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control study.\n\nSarlos, D\n\nKots, L\n\nStevanovic, N\n\nSchaer, G\n\nBeiträge in Fachzeitschriften\nISI:000277873200020\n20207063.0\n10.1016/j.ejogrb.2010.02.012\nNone\nRobotic surgery, with its technical advances, promises to open a new window to minimally invasive surgery in gynaecology. Feasibility and safety of this surgical innovation have been demonstrated in several studies, and now a critical analysis of these new developments regarding outcome and costs is in place. So far only a few studies compare robotic with conventional laparoscopic surgery in gynaecology. Our objective was to evaluate our initial experience performing total robot-assisted hysterectomy with the da Vinci surgical system and compare peri-operative outcome and costs with total laparoscopic hysterectomy.\n For this prospective matched case-control study at our institution, peri-operative data from our first 40 consecutive total robot-assisted hysterectomies for benign indications were recorded and matched 1:1 with total laparoscopic hysterectomies according to age, BMI and uterus weight. Surgical costs were calculated for both procedures. Surgeons' subjective impressions of robotics were evaluated with a self-developed questionnaire.\n No conversions to laparotomy or severe peri-operative complications occurred. Mean operating time was 109 (113; 50-170) min for the robotic group and 83 (80; 55-165) min for the conventional laparoscopic group. Mean postoperative hospitalisation for robotic surgery was 3.3 (3; 2-6) days versus 3.9 (4; 2-7) days for the conventional laparoscopic group. Average surgical cost of a robot-assisted laparoscopic hysterectomy was 4067 euros compared to 2151 euros for the conventional laparoscopic procedure at our institution. For the robotic group wider range of motion of the instruments and better ergonomics were considered to be an advantage, and lack of direct access to the patient was stated as a disadvantage.\n Robot-assited hysterectomy is a feasible and interesting new technique with comparable outcome to total laparoscopic hysterectomy. Operating times of total laparoscopic hysterectomy seem to be achieved quickly especially for experienced laparoscopic surgeons. However, costs of robotic surgery are still higher than for conventional laparoscopy. Randomised clinical trials need to be conducted to further evaluate benefits of this new technology for patients and surgeons and analyse its cost-effectiveness in gynaecology.\n Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.\n\n\n"
},
{
"text": "\n139756\nApolipoprotein A-IV concentrations and clinical outcomes in haemodialysis patients with type 2 diabetes mellitus--a post hoc analysis of the 4D Study.\n\nKollerits, B\n\nKrane, V\n\nDrechsler, C\n\nLamina, C\n\nMärz, W\n\nRitz, E\n\nWanner, C\n\nKronenberg, F\n\nGerman Diabetes and Dialysis Study Investigators\n\nBeiträge in Fachzeitschriften\nISI:000311390400007\n22891946.0\n10.1111/j.1365-2796.2012.02585.x\nNone\nApolipoprotein A-IV (apoA-IV) is an anti-atherogenic and anti-oxidative plasma glycoprotein involved in reverse cholesterol transport. The aim of this study was to examine the association between apoA-IV and all-cause mortality, cardiovascular endpoints and parameters of protein-energy wasting and nutrition in haemodialysis patients.\n This post hoc analysis was performed in the German Diabetes Dialysis Study (4D Study) evaluating atorvastatin in 1255 haemodialysis patients with type 2 diabetes mellitus, followed for a median of 4 years. The association between apoA-IV and relevant outcomes was analysed using Cox proportional hazards regression analyses. Body mass index (BMI) was used as a marker of protein-energy wasting. In addition, a definition of extended wasting was applied, combining median values of BMI, serum albumin, creatinine and sensitive C-reactive protein, to classify patients.\n Mean (±SD) apoA-IV concentration was 49.8 ± 14.2 mg dL(-1). Age- and gender-adjusted apoA-IV concentrations were strongly associated with the presence of congestive heart failure at baseline [odds ratio = 0.81, 95% confidence interval (CI) 0.74-0.88 per 10 mg dL(-1) increase; P < 0.001). During the prospective follow-up, the strongest association was found for all-cause mortality [hazard ratio (HR) = 0.89, 95% CI 0.85-0.95, P = 0.001), which was mainly because of patients with BMI > 23 kg m(-2) (HR = 0.87, 95% CI 0.82-0.94, P < 0.001) and those in the nonwasting group according to the extended definition (HR = 0.89, 95% CI 0.84-0.96, P = 0.001). This association remained significant after additionally adjusting for parameters associated with apoA-IV at baseline. Further associations were observed for sudden cardiac death. ApoA-IV was less strongly associated with atherogenic events such as myocardial infarction.\n Low apoA-IV levels seem to be a risk predictor of all-cause mortality and sudden cardiac death. This association might be modified by nutritional status.\n © 2012 The Association for the Publication of the Journal of Internal Medicine.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n155959\nImpact of neo-adjuvant Sorafenib treatment on liver transplantation in HCC patients - a prospective, randomized, double-blind, phase III trial.\n\nHoffmann, K\n\nGanten, T\n\nGotthardtp, D\n\nRadeleff, B\n\nSettmacher, U\n\nKollmar, O\n\nNadalin, S\n\nKarapanagiotou-Schenkel, I\n\nvon Kalle, C\n\nJäger, D\n\nBüchler, MW\n\nSchemmer, P\n\nBeiträge in Fachzeitschriften\nISI:000355401800001\n25957784.0\n10.1186/s12885-015-1373-z\nPMC4449604\nLiver Transplantation (LT) is treatment of choice for patients with hepatocellular carcinoma (HCC) within MILAN Criteria. Tumour progression and subsequent dropout from waiting list have significant impact on the survival. Transarterial chemoembolization (TACE) controls tumour growth in the treated HCC nodule, however, the risk of tumour development in the untreated liver is increased by simultaneous release of neo-angiogenic factors. Due to its anti-angiogenic effects, Sorafenib delays the progression of HCC. Aim of this study was to determine whether combination of TACE and Sorafenib improves tumour control in HCC patients on waiting list for LT.\n Fifty patients were randomly assigned on a 1:1 ratio in double-blinded fashion at four centers in Germany and treated with TACE plus either Sorafenib (n = 24) or placebo (n = 26). The end of treatment was development of progressive disease according to mRECIST criteria or LT. The primary endpoint of the trial was the Time-to-Progression (TTP). Other efficacy endpoints were Tumour Response, Progression-free Survival (PFS), and Time-to-LT (TTLT).\n The median time of treatment was 125 days with Sorafenib and 171 days with the placebo. Fourteen patients (seven from each group) developed tumour progression during the course of the study period. The Hazard Ratio of TTP was 1.106 (95% CI: 0.387, 3.162). The results of the Objective Response Rate, Disease Control Rate, PFS, and TTLT were comparable in both groups. The incidence of AEs was comparable in the placebo group (n = 23, 92%) and in the Sorafenib group (n = 23, 96%). Twelve patients (50%) on Sorafenib and four patients (16%) on placebo experienced severe treatment-related AEs.\n The TTP is similar after neo-adjuvant treatment with TACE and Sorafenib before LT compared to TACE and placebo. The Tumour Response, PFS, and TTLT were comparable. The safety profile of the Sorafenib group was similar to that of the placebo group.\n ISRCTN24081794.\n\nSchemmer, Peter\n\n\n"
},
{
"text": "\n159324\nOutcomes in patients with chronic kidney disease not on dialysis receiving extended dosing regimens of darbepoetin alfa: long-term results of the EXTEND observational cohort study.\n\nGalle, JC\n\nAddison, J\n\nSuranyi, MG\n\nClaes, K\n\nDi Giulio, S\n\nGuerin, A\n\nHerlitz, H\n\nKiss, I\n\nFarouk, M\n\nManamley, N\n\nWirnsberger, G\n\nWinearls, C\n\nBeiträge in Fachzeitschriften\nISI:000393059700018\n27190334.0\n10.1093/ndt/gfw047\nPMC5146706\nExtended dosing of the erythropoiesis-stimulating agent (ESA) darbepoetin alfa (DA) once biweekly or monthly reduces anaemia treatment burden. This observational study assessed outcomes and dosing patterns in patients with chronic kidney disease not on dialysis (CKD-NoD) commencing extended dosing of DA.\n Adult CKD-NoD patients starting extended dosing of DA in Europe or Australia in June 2006 or later were followed up until December 2012. Outcomes included haemoglobin (Hb) concentration, ESA dosing, mortality rates and receipt of dialysis and renal transplantation. Subgroup analyses were conducted for selected outcomes.\n Of 6035 enrolled subjects, 5723 (94.8%) met analysis criteria; 1795 (29.7%) received dialysis and 238 (3.9%) underwent renal transplantation. Mean (standard deviation) Hb concentration at commencement of extended dosing was 11.0 (1.5) g/dL. Mean [95% confidence interval (CI)] Hb 12 months after commencement of extended dosing (primary outcome) was 11.6 g/dL (11.5, 11.6) overall and was similar across countries, with no differences between subjects previously treated with an ESA versus ESA-naïve subjects, subjects with versus without prior renal transplant or diabetics versus non-diabetics. Weekly ESA dose gradually decreased following commencement of extended DA dosing and was similar across subgroups. The decrease in weekly DA dose was accompanied by an increase in the proportion of patients receiving iron therapy. Hb concentrations declined following changes in ESA labels and treatment guidelines. The mortality rate (95% CI) was 7.06 (6.68, 7.46) deaths per 100 years of follow-up. Subjects alive at study end had stable Hb concentrations in the preceding year, while those who died had lower and declining Hb concentrations in their last year.\n Long-term, extended dosing of DA maintained Hb concentrations in patients already treated with an ESA and corrected and maintained Hb in ESA-naïve patients.\n © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.\n\nWirnsberger, Gerhard\n\n\n"
},
{
"text": "\n164825\nImpact of lymph node dissection at the time of radical nephrectomy with tumor thrombectomy on oncological outcomes: Results from the International Renal Cell Carcinoma-Venous Thrombus Consortium (IRCC-VTC).\n\nTilki, D\n\nChandrasekar, T\n\nCapitanio, U\n\nCiancio, G\n\nDaneshmand, S\n\nGontero, P\n\nGonzalez, J\n\nHaferkamp, A\n\nHohenfellner, M\n\nHuang, WC\n\nLinares Espinós, E\n\nLorentz, A\n\nMartinez-Salamanca, JI\n\nMaster, VA\n\nMcKiernan, JM\n\nMontorsi, F\n\nNovara, G\n\nPahernik, S\n\nPalou, J\n\nPruthi, RS\n\nRodriguez-Faba, O\n\nRusso, P\n\nScherr, DS\n\nShariat, SF\n\nSpahn, M\n\nTerrone, C\n\nVera-Donoso, C\n\nZigeuner, R\n\nLibertino, JA\n\nEvans, CP\n\nBeiträge in Fachzeitschriften\nISI:000425058300013\n29129353.0\n10.1016/j.urolonc.2017.10.008\nNone\nTo study the effect of lymph node dissection (LND) at the time of nephrectomy and tumor thrombectomy on oncological outcomes in patients with renal cell carcinoma (RCC) and tumor thrombus.\n The records of 1, 78 patients with RCC and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1985 to 2014 at 24 centers were analyzed. None of the patients had distant metastases. Extent and pathologic results of LND were compared with respect to cancer-specific survival (CSS). Multivariable Cox regression models were used to quantify the effect of multiple covariates.\n LND was performed in 1, 26 patients. In multivariable analysis, the presence of LN metastasis, the number of positive LNs, and LN density were independently associated with cancer-specific mortality (CSM). Clinical node-negative (cN-) disease was documented in 573 patients, 447 of them underwent LND with 43 cN- patients (9.6%) revealing positive LNs at pathology. LN positive cN- patients showed significantly better CSS when compared to LN positive cN+ patients. In multivariable analysis, positive cN status in LN positive patients was a significant predictor of CSM (HR, 2.923; P = 0.015).\n The number of positive nodes harvested during LND and LN density was strong prognostic indicators of CSS, while number of removed LNs did not have a significant effect on CSS. The rate of pN1 patients among clinically node-negative patients was relatively high, and LND in these patients suggested a survival benefit. However, only a randomized trial can determine the absolute benefit of LND in this setting.\n Copyright © 2018 Elsevier Inc. All rights reserved.\n\nZigeuner, Richard\n\n\n"
},
{
"text": "\n165629\nDiagnostic accuracy of low and high tube voltage coronary CT angiography using an X-ray tube potential-tailored contrast medium injection protocol.\n\nAlbrecht, MH\n\nNance, JW\n\nSchoepf, UJ\n\nJacobs, BE\n\nBayer, RR\n\nLitwin, SE\n\nReynolds, MA\n\nOtani, K\n\nMangold, S\n\nVarga-Szemes, A\n\nDe Santis, D\n\nEid, M\n\nApfaltrer, G\n\nTesche, C\n\nGoeller, M\n\nVogl, TJ\n\nDe Cecco, CN\n\nBeiträge in Fachzeitschriften\nISI:000429104200038\n29181587.0\n10.1007/s00330-017-5150-z\nNone\nTo compare the diagnostic accuracy between low-kilovolt peak (kVp) (≤ 100) and high-kVp (> 100) third-generation dual-source coronary CT angiography (CCTA) using a kVp-tailored contrast media injection protocol.\n One hundred twenty patients (mean age = 62.6 years, BMI = 29.0 kg/m2) who underwent catheter angiography and CCTA with automated kVp selection were separated into two cohorts (each n = 60, mean kVp = 84 and 117). Contrast media dose was tailored to the kVp level: 70 = 40 ml, 80 = 50 ml, 90 = 60 ml, 100 = 70 ml, 110 = 80 ml, and 120 = 90 ml. Contrast-to-noise ratio (CNR) was measured. Two observers evaluated image quality and the presence of significant coronary stenosis (> 50% luminal narrowing).\n Diagnostic accuracy (sensitivity/specificity) with ≤ 100 vs. > 100 kVp CCTA was comparable: per patient = 93.9/92.6% vs. 90.9/92.6%, per vessel = 91.5/97.8% vs. 94.0/96.8%, and per segment = 90.0/96.7% vs. 90.7/95.2% (all P > 0.64). CNR was similar (P > 0.18) in the low-kVp vs. high-kVp group (12.0 vs. 11.1), as ws subjective image quality (P = 0.38). Contrast media requirements were reduced by 38.1% in the low- vs. high-kVp cohort (53.6 vs. 86.6 ml, P < 0.001) and radiation dose by 59.6% (4.3 vs. 10.6 mSv, P < 0.001).\n Automated tube voltage selection with a tailored contrast media injection protocol allows CCTA to be performed at ≤ 100 kVp with substantial dose reductions and equivalent diagnostic accuracy for coronary stenosis detection compared to acquisitions at > 100 kVp.\n • Low-kVp coronary CT angiography (CCTA) enables reduced contrast and radiation dose. • Diagnostic accuracy is comparable between ≤ 100 and > 100 kVp CCTA. • Image quality is similar for low- and high-kVp CCTA. • Low-kVp image acquisition is facilitated by automated tube voltage selection. • Tailoring contrast injection protocols to the automatically selected kVp-level is feasible.\n\nApfaltrer, Georg\n\n\n"
},
{
"text": "\n171509\nSelf-initiated continuation of and adherence to HIV pre-exposure prophylaxis (PrEP) after PrEP demonstration project roll-off in men who have sex with men: associations with risky decision making, impulsivity/disinhibition, and sensation seeking.\n\nHoenigl, M\n\nMorgan, E\n\nFranklin, D\n\nAnderson, PL\n\nPasipanodya, E\n\nDawson, M\n\nHanashiro, M\n\nEllorin, EE\n\nBlumenthal, J\n\nHeaton, R\n\nMoore, DJ\n\nMorris, SR\n\nCalifornia Collaborative Treatment Group (CCTG) 601 Team\n\nBeiträge in Fachzeitschriften\nISI:000475688500004\n30617849.0\n10.1007/s13365-018-0716-3\nPMC6612450\nThe objective of this study was to examine differences in the levels of risky decision making and other frontal system behavior constructs in relation to self-initiated continuance of HIV pre-exposure prophylaxis (PrEP) and PrEP adherence outcomes among men who have sex with men (MSM) following completion of a clinical PrEP trial. At the last PrEP trial visit, study provided PrEP was discontinued and participants were navigated to the community for PrEP continuation. In this cross-sectional analysis, 84/187 (45%) MSM who completed a prospective observational post-PrEP trial follow-up visit at the University of California San Diego were included. PrEP adherence was measured using dried blood spot tenofovir diphosphate (TFV-DP) levels. Risky decision making was assessed using the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART), while impulsivity/disinhibition, sensation seeking, and substance use were assessed via standardized self-report questionnaires. A total of 58/84 (69%) of MSM who completed the 12-month post-study visit continued PrEP. Of those, n = 46 (79%) reached TFV-DP levels associated with adequate adherence. Individuals who elected to continue PrEP 12 months post-trial had riskier decision making on BART, but less impulsivity/disinhibition compared to individuals who did not continue PrEP. Neither risky decision making nor impulsivity/disinhibition/sensation seeking nor substance use correlated with PrEP adherence. Our findings suggest that those with risky decision making may have greater insight into their HIV risks, and therefore be more likely to continue to use PrEP. However, elevated impulsivity/disinhibition, indicative of greater neurobehavioral alterations, was negatively associated with PrEP continuance and is a potential target for future interventions to help people link to PrEP.\n\nHönigl, Martin\n\n\n"
},
{
"text": "\n174649\nChronic heart failure patients' experiences of German healthcare services: a protocol for a scoping review.\n\nDieckelmann, M\n\nReinhardt, F\n\nJeitler, K\n\nSemlitsch, T\n\nPlath, J\n\nGerlach, FM\n\nSiebenhofer, A\n\nPetersen, JJ\n\nBeiträge in Fachzeitschriften\nISI:000471124600225\n30782940.0\n10.1136/bmjopen-2018-025685\nPMC6377537\nChronic heart failure (CHF) is a heterogeneous condition requiring complex treatment from diverse healthcare services. An increasingly holistic understanding of healthcare has resulted in contextual factors such as perceived quality of care, as well as patients' acceptance, preferences and subjective expectations of health services, all gaining in importance. How patients with CHF experience the use of healthcare services has not been studied within the scope of a systematic review in a German healthcare context. The aim of this scoping review is therefore to review systematically the experiences of patients affected by CHF with healthcare services in Germany in the literature and to map the research foci. Further objectives are to identify gaps in evidence, develop further research questions and to inform decision makers concerned with improving healthcare of patients living with CHF.\n This scoping review will be based on a broad search strategy involving systematic and comprehensive electronic database searches in MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Cochrane's Database of Systematic Reviews, grey literature searches, as well as hand searches through reference lists and non-indexed key journals. The methodological procedure will be based on an established six-stage framework for conducting scoping reviews that includes two independent reviewers. Data will be systematically extracted, qualitatively and quantitatively analysed and summarised both narratively and visually. To ensure the research questions and extracted information are meaningful, a patient representative will be involved.\n Ethical approval will not be required to conduct this review. Results will be disseminated through a clearly illustrated report that will be part of a wider research project. Furthermore, it is intended that the review's findings should be made available to relevant stakeholders through conference presentations and publication in peer-reviewed journals (knowledge transfer). Protocol registration in PROSPERO is not applicable for scoping reviews.\n © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.\n\nJeitler, Klaus\n\nSemlitsch, Thomas\n\nSiebenhofer-Kroitzsch, Andrea\n\n\n"
},
{
"text": "\n175266\nProteomic Analysis of Vocal Fold Fibroblasts Exposed to Cigarette Smoke Extract: Exploring the Pathophysiology of Reinke's Edema.\n\nGugatschka, M\n\nDarnhofer, B\n\nGrossmann, T\n\nSchittmayer, M\n\nHortobagyi, D\n\nKirsch, A\n\nKarpf, E\n\nBrcic, L\n\nBirner-Gruenberger, R\n\nKarbiener, M\n\nBeiträge in Fachzeitschriften\nISI:000482263500003\n31123107.0\n10.1074/mcp.RA119.001272\nPMC6683006\nReinke's edema is a smoking-associated, benign, mostly bilateral lesion of the vocal folds leading to difficulties in breathing and voice problems. Pronounced histological changes such as damaged microvessels or immune cell infiltration have been described in the vocal fold connective tissue, the lamina propria Thus, vocal fold fibroblasts, the main cell type of the lamina propria, have been postulated to play a critical role in disease mediation. Yet information about the pathophysiology is still scarce and treatment is only surgical, i.e. symptomatic. To explore the pathophysiology of Reinke's edema, we exposed near-primary human vocal fold fibroblasts to medium conditioned with cigarette smoke extract for 24 h as well as 4 days followed by quantitative mass spectrometry.Proteomic analyses after 24 h revealed that cigarette smoke increased proteins previously described to be involved in oxidative stress responses in other contexts. Correspondingly, gene sets linked to metabolism of xenobiotics and reactive oxygen species were significantly enriched among cigarette smoke-induced proteins. Among the proteins most downregulated by cigarette smoke, we identified fibrillar collagens COL1A1 and COL1A2; this reduction was validated by complementary methods. Further, we found a significant increase of UDP-glucose 6-dehydrogenase, generating a building block for biosynthesis of hyaluronan, another crucial component of the vocal fold lamina propria In line with this result, hyaluronan levels were significantly increased because of cigarette smoke exposure. Long term treatment of 4 days did not lead to significant changes.The current findings corroborate previous studies but also reveal new insights in possible disease mechanisms of Reinke's edema. We postulate that changes in the composition of the vocal folds' extracellular matrix -reduction of collagen fibrils, increase of hyaluronan- may lead to the clinical findings. This might ease the identification of better, disease-specific treatment options.\n © 2019 Gugatschka et al.\n\nBirner-Grünberger, Ruth\n\nBrcic, Luka\n\nDarnhofer, Barbara\n\nGrossmann, Tanja\n\nGugatschka, Markus\n\nHortobagyi, David\n\nKampelmühler, Eva\n\nKirsch, Andrijana\n\nSchittmayer-Schantl, Matthias\n\n\n"
},
{
"text": "\n177799\nErythritol as a single carbon source improves cultural isolation of Burkholderia pseudomallei from rice paddy soils.\n\nTrinh, TT\n\nAssig, K\n\nTran, QTL\n\nGoehler, A\n\nBui, LNH\n\nWiede, C\n\nFolli, B\n\nLichtenegger, S\n\nNguyen, TT\n\nWagner, GE\n\nKohler, C\n\nSteinmetz, I\n\nBeiträge in Fachzeitschriften\nISI:000494982700043\n31634353.0\n10.1371/journal.pntd.0007821\nPMC6822774\nIsolation of the soil bacterium Burkholderia pseudomallei from tropical environments is important to generate a global risk map for man and animals to acquire the infectious disease melioidosis. There is increasing evidence, that the currently recommended soil culture protocol using threonine-basal salt solution with colistin (TBSS-C50) for enrichment of B. pseudomallei and Ashdown agar for subsequent subculture lacks sensitivity. We therefore investigated, if the otherwise rarely encountered erythritol catabolism of B. pseudomallei might be exploited to improve isolation of this bacterium from soil.\n Based on TBSS-C50, we designed a new colistin-containing medium with erythritol as the single carbon source (EM). This medium was validated in various culture protocols by analyzing 80 soil samples from 16 different rice fields in Vietnam. B. pseudomallei enrichment was determined in all culture supernatants by a specific quantitative PCR (qPCR) targeting the type three secretion system 1. 51 out of 80 (63.8%) soil samples gave a positive qPCR signal in at least one of the culture conditions. We observed a significantly higher enrichment shown by lower median cycle threshold values for B. pseudomallei in a two-step culture with TBSS-C50 for 48 h followed by EM for 96h compared to single cultures in TBSS-C50 for either 48h or 144h (p<0.0001, respectively). Accordingly, B. pseudomallei could be isolated on Ashdown agar in 58.8% (30/51) of samples after subcultures from our novel two-step enrichment culture compared to only 9.8% (5/51) after standard enrichment with TBSS-C50 for 48h (p<0.0001) or 25.5% (13/51; p<0.01) after TBSS-C50 for 144h.\n In the present study, we show that specific exploitation of B. pseudomallei metabolic capabilities in enrichment protocols leads to a significantly improved isolation rate of this pathogen from soil compared to established standard procedures. Our new culture method might help to facilitate the creation of environmental risk maps for melioidosis in the future.\n\nAssig, Karoline\n\nMosbacher, Bettina\n\nSteinmetz, Ivo\n\nWagner-Lichtenegger, Gabriel\n\nWagner-Lichtenegger, Sabine\n\n\n"
},
{
"text": "\n182647\nComments on the guidelines (2019) of the ESC/EAS on the diagnostics and treatment of dyslipidemias.\n\nWeingartnerl, O\n\nLandmesser, U\n\nMarz, W\n\nKatzmann, JL\n\nLaufs, U\n\nBeiträge in Fachzeitschriften\nISI:000539165500001\nNone\n10.1007/s12181-020-00399-9\nNone\nThe goal of lipid-lowering therapy is to achieve the greatest possible absolute reduction in cardiovascular events. The absolute risk reduction is determined by the individual global vascular risk, the initial level of low-density lipoprotein (LDL-C) and, both the duration and the extent of the achieved LDL-C reduction. The LDL-C targets of the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines are a recommandation of an expert panel to translate evidence-based principles into therapeutic strategies. Guideline authors have to consider issues of practical feasibility to achieve LDL-C targets (but also frustrations when failing to achieve these) and guide all parties involved in terms of a more effective LDL-C lowering. Recently published trails on PCSK9 inhibitors (PCSK9I) demonstrated that there is no lower limit for the relationship between achieved LDL-C serum concentration and cardiovascular risk reduction, i.e. the lower LDL-C, the lower the cardiovascular risk. Moreover - and this is one of the most important findings in recent years - there is no evidence for severe side-effects induced by statins, ezetimibe or PCSK9I. High-intensity statins and ezetimibe are generically available and combination therapy (e.g. IMPROVE-IT) has demonstrated an effective and safe LDL-C reduction in the range of the newly recommended LDL-C targets for very high risk patients (55 & x202f;mg/dl; 1.4 & x202f;mmol/L), which is another reason why these limits were chosen. In the light of the positive PCSK9I studies which included patients at very high cardiovascular risk, the 2019 ESC/EAS guidelines focus primarily on high risk patients. A more detailed analysis of low risk patients, in whom a large proportion of heart attacks occur, is expected in the next revision of these guidelines. A shortcoming in the present guidelines are the incomplete evidence-based nutritional recommendations. Other important new aspects of the revised version of the guidelines which are of practical relevance are a more prominent inclusion of vascular imaging techniques, triglyceride-rich lipoproteins (ApoB, non-HDL targets) and Lp(a).\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n186138\nThe IL-33/ST2 axis is crucial in type 2 airway responses induced by Staphylococcus aureus-derived serine protease-like protein D.\n\nTeufelberger, AR\n\nNordengrün, M\n\nBraun, H\n\nMaes, T\n\nDe Grove, K\n\nHoltappels, G\n\nO'Brien, C\n\nProvoost, S\n\nHammad, H\n\nGonçalves, A\n\nBeyaert, R\n\nDeclercq, W\n\nVandenabeele, P\n\nKrysko, DV\n\nBröker, BM\n\nBachert, C\n\nKrysko, O\n\nBeiträge in Fachzeitschriften\nNone\n28532656.0\n10.1016/j.jaci.2017.05.004\nNone\nChronic airway inflammatory diseases, such as chronic rhinosinusitis with nasal polyps and asthma, show increased nasal Staphylococcus aureus colonization. Staphylococcus aureus-derived serine protease-like protein (Spl) D and other closely related proteases secreted by S aureus have recently been identified as inducers of allergic asthma in human subjects and mice, but their mechanism of action is largely unknown.\n We investigated the role of recombinant SplD in driving TH2-biased responses and IgE formation in a murine model of allergic asthma.\n Allergic asthma was induced in C57BL/6 J wild-type mice, Toll-like receptor (TLR) 4 knockout (Tlr4-/-) mice, and recombination-activating gene (Rag2) knockout (Rag2-/-) mice by means of repeated intratracheal applications of SplD. Inflammatory parameters in the airways were assessed by means of flow cytometry, ELISA, Luminex, and immunohistochemistry. Serum SplD-specific IgE levels were analyzed by using ELISA.\n We observed that repeated intratracheal exposure to SplD led to IL-33 and eotaxin production, eosinophilia, bronchial hyperreactivity, and goblet cell hyperplasia in the airways. Blocking IL-33 activity with a soluble ST2 receptor significantly decreased the numbers of eosinophils, IL-13+ type 2 innate lymphoid cells and IL-13+CD4+ T cells and IL-5 and IL-13 production by lymph node cells but had no effect on IgE production. SplD-induced airway inflammation and IgE production were largely dependent on the presence of the functional adaptive immune system and independent of TLR4 signaling.\n The S aureus-derived protein SplD is a potent allergen of S aureus and induces a TH2-biased inflammatory response in the airways in an IL-33-dependent but TRL4-independent manner. The soluble ST2 receptor could be an efficient strategy to interfere with SplD-induced TH2 inflammation but does not prevent the allergic sensitization.\n Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.\n\nTeufelberger, Andrea Renate\n\n\n"
},
{
"text": "\n404\nCD44 and variants in melanocytic skin neoplasms.\n\nSchaider, H\n\nSoyer, HP\n\nHeider, KH\n\nHofmann-Wellenhof, R\n\nZatloukal, K\n\nSmolle, J\n\nKerl, H\n\nBeiträge in Fachzeitschriften\nISI:000073188100002\n9609138.0\n10.1111/j.1600-0560.1998.tb01719.x\nNone\nExpression of cell surface molecules that mediate cell-matrix and cell-cell interactions largely contributes to the ability of melanoma cells to migrate and spread beyond the primary site of the tumor. CD44, the principal cell-surface receptor for hyaluronate, and its numerous splice variants have been reported to play a crucial role in invasion and the metastatic process of different human neoplasms, including primary malignant melanoma (PMM). The aim of this study was to clarify which isoforms of CD44 (standard CD44 and CD44 variants) are distributed in PMM with a vertical tumor thickness of >1.4 mm. Staining of CD44 standard (CD44s) and splice variants was further examined for diagnostic and prognostic relevance in a panel of melanocytic skin lesions. Ten cases of PMM with Breslow >1.4 mm were analysed by immunohistochemistry using monoclonal antibodies specific for CD44s and the splice variants v3, v5, v6, v7, v7-8, and v10. In addition, using anti-CD44s, v5, and v6 antibodies, 55 melanocytic lesions, including dermal nevi (n=12), Clark nevi (dysplastic nevi) (CN; n=11), melanoma in situ (Mis; n=8), PMM (n=18), and cutaneous metastasis of malignant melanoma (cMMM; n=6) were assessed. Staining intensities were scored visually and evaluated by means of a staining index. In ten cases of PMM with a Breslow index >1.4 mm positive staining was ascertained for CD44s, v5 and for v6 in three cases. No staining was found for v3, v7, v7-8, and v10. Examination of CD44s, v5, and v6 in 55 melanocytic skin lesions revealed a high index for CD44s in all specimens and a weak staining of v5 in Mis; dermal nevi and CN did not stain for v5. However, in PMM and cMMM we found v5 to be strongly positive. The isoform v6 showed a variable index only in PMM, but without connection to established prognostic criteria. We conclude that CD44s and splice variants can not be regarded as indicators for tumor progression in malignant melanomas. However, v5 may potentially serve as a diagnostic marker for melanocytic skin lesions.\n\nHofmann-Wellenhof, Rainer\n\nKerl, Helmut\n\nSmolle, Josef\n\nZatloukal, Kurt\n\n\n"
},
{
"text": "\n4438\nEconomic burden of illness imposed by severe sepsis in Austria.\n\nSchmid, A\n\nSchneider, H\n\nAdlof, A\n\nSmolle, KH\n\nEdelmann, G\n\nSporn, P\n\nFrass, M\n\nSumann, G\n\nKoller, W\n\nSchobersberger, W\n\nBeiträge in Fachzeitschriften\nISI:000177884000009\n12602114.0\nNone\nNone\nINTRODUCTION: Sepsis is a life-threatening disease, requiring instant treatment in an intensive care unit (ICU). The aim of this study was to determine the direct and indirect costs occurring in Austria due to this disease. PATIENTS AND METHODS: Direct costs were calculated based on a retrospective chart analysis in four adult Austrian ICUs, evaluating 74 patient records from the years 2000/2001. Patients were identified to have suffered from severe sepsis using ACCP-definitions. Assessed resource use (medication, laboratory analysis, microbiology analysis, consumer-goods, diagnostic procedures, staff costs, and basic bed costs) was linked with related center specific costs to determine direct costs per patient. Indirect costs due to productivity losses were calculated using official statistical material. RESULTS: The mean length of ICU stay (LOS ICU) of a severely septic patient was 18.1 days. Overall ICU mortality was found to be 43.2% and showed no gender difference. The mean daily direct ICU costs of care for severely septic patients were [symbol: see text] 1, 17 and the mean total direct ICU costs per septic patient were [symbol: see text] 28, 82. In total costs, survivors were equally expensive as non-survivors ([symbol: see text] 28, 99 vs. 28, 63) although their length of study was considerably longer (21.9 vs. 13.2 days). Considering a range of patients with severe sepsis in Austria from 6, 00 to 9, 00 per year, total direct costs in Austria range from [symbol: see text] 192 million to [symbol: see text] 272 million. Indirect costs determined by productivity losses due to unfitness for work (temporary and permanent) and premature death amount to [symbol: see text] 484 million to [symbol: see text] 686 million in Austria per year (same incidence range). Total costs, i.e. burden of illness, combining direct costs with indirect costs, range from [symbol: see text] 676 million to [symbol: see text] 958 million. CONCLUSION: Patients with severe sepsis have a high mortality rate, spend prolonged periods of time in the ICU, and are expensive to treat. Indirect costs of severe sepsis due to productivity losses, particularly by premature death, are considerable.\n\n\n"
},
{
"text": "\n113026\nMinimal residual disease values discriminate between low and high relapse risk in children with B-cell precursor acute lymphoblastic leukemia and an intrachromosomal amplification of chromosome 21: the Austrian and German acute lymphoblastic leukemia Berlin-Frankfurt-Munster (ALL-BFM) trials.\n\nAttarbaschi, A\n\nMann, G\n\nPanzer-Grümayer, R\n\nRöttgers, S\n\nSteiner, M\n\nKönig, M\n\nCsinady, E\n\nDworzak, MN\n\nSeidel, M\n\nJanousek, D\n\nMöricke, A\n\nReichelt, C\n\nHarbott, J\n\nSchrappe, M\n\nGadner, H\n\nHaas, OA\n\nBeiträge in Fachzeitschriften\nISI:000256879700021\n18565891.0\n10.1200/JCO.2008.16.1117\nNone\nPurpose We aimed to identify relapse predictors in children with a B-cell precursor acute lymphoblastic leukemia (ALL) and an intrachromosomal amplification of chromosome 21 (iAMP21), a novel genetic entity associated with poor outcome. Patients and Methods We screened 1, 25 patients who were enrolled onto the Austrian and German ALL -Berlin-Frankfurt- Munster (ALL-BFM) trials 86, 90, 95, and 2000 with ETV6/RUNX1-specific fluorescent in situ hybridization probes, and we identified 29 patient cases (2%) who had an iAMP21. Minimal residual disease (MRD) was quantified with clone-specific immunoglobulin and T-cell receptor gene rearrangements. Results Twenty-five patients were good responders to prednisone, and all achieved remission after induction therapy. Eleven patients experienced relapse, which included eight who experienced relapse after cessation of front-line therapy. Six-year event-free and overall survival rates were 37% +/- 14% and 66% +/- 11%, respectively. Results of MRD analysis were available in 24 (83%) of 29 patients: nine (37.5%) belonged to the low-risk, 14 (58.5%) to the intermediate-risk, and one (4%) to the high-risk group. MRD results were available in 8 of 11 patients who experienced a relapse. Seven occurred among the 14 intermediate-risk patients, and one occurred in the high-risk patient. Conclusion The overall and early relapse rates in the BFM study were lower than that in a previous United Kingdom Medical Research Council/Childhood Leukemia Working Party study (38% v 61% and 27% v 47%, respectively), which might result from more intensive induction and early reintensification therapy in the ALL-BFM protocols. MRD values were the only reliable parameter to discriminate between a low and high risk of relapse (P = .02).\n\nSeidel, Markus\n\n\n"
},
{
"text": "\n123400\nShort communication: Effect of supplementation with Lactobacillus casei Shirota on insulin sensitivity, β-cell function, and markers of endothelial function and inflammation in subjects with metabolic syndrome--a pilot study.\n\nTripolt, NJ\n\nLeber, B\n\nBlattl, D\n\nEder, M\n\nWonisch, W\n\nScharnagl, H\n\nStojakovic, T\n\nObermayer-Pietsch, B\n\nWascher, TC\n\nPieber, TR\n\nStadlbauer, V\n\nSourij, H\n\nBeiträge in Fachzeitschriften\nISI:000312524300010\n23164226.0\n10.3168/jds.2012-5863\nNone\nBased on animal studies, intake of probiotic bacteria was suggested to improve insulin sensitivity by reducing endotoxinemia and inflammation. The objective of this study was to determine the effects of supplementation with the probiotic strain Lactobacillus casei Shirota (LcS) over 12 wk on insulin sensitivity, β-cell function, inflammation, and endothelial dysfunction parameters in subjects with metabolic syndrome. In a randomized-controlled study, 30 subjects with metabolic syndrome either received Lactobacillus casei Shirota 3 times daily for 12 wk or served as controls with standard medical therapy. Fasting blood samples were taken and a 75-g oral glucose tolerance test was performed to derive indices for insulin sensitivity and β-cell function. In addition, parameters to assess endothelial function and inflammation markers were determined. Even though the insulin sensitivity index significantly improved after 3 mo of probiotic supplementation (0.058±0.021 vs. 0.038±0.025), the change was not significantly different compared with the control group. No improvements were seen in additional indices of insulin sensitivity (quantitative insulin sensitivity check index, insulin sensitivity by oral glucose tolerance test, and homeostasis model assessment for insulin resistance) and β-cell function (first and second phase insulin secretion, and homeostasis model assessment for β-cell function). Probiotic supplementation resulted in a significant reduction in soluble vascular cell adhesion molecule-1 (sVCAM-1) level (1, 14±343 vs. 1, 18±265 ng/mL). No significant changes in parameters used to assess low-grade inflammation or endothelial dysfunction were observed. Intake of LcS for 12 wk in subjects with metabolic syndrome did not improve insulin sensitivity, β-cell function, endothelial function, or inflammation markers in this trial.\n Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.\n\nLeber, Bettina\n\nObermayer-Pietsch, Barbara\n\nPieber, Thomas\n\nScharnagl, Hubert\n\nSourij, Harald\n\nStadlbauer-Köllner, Vanessa\n\nSteinberger, Michaela\n\nTripolt, Norbert\n\nWonisch, Willibald\n\n\n"
}
]
}