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"text": "\n169631\nColesevelam attenuates cholestatic liver and bile duct injury in <i>Mdr2<sup>-/-</sup></i> mice by modulating composition, signalling and excretion of faecal bile acids.\n\nFuchs, CD\n\nPaumgartner, G\n\nMlitz, V\n\nKunczer, V\n\nHalilbasic, E\n\nLeditznig, N\n\nWahlström, A\n\nStåhlman, M\n\nThüringer, A\n\nKashofer, K\n\nStojakovic, T\n\nMarschall, HU\n\nTrauner, M\n\nBeiträge in Fachzeitschriften\nISI:000445080300015\n29636383.0\n10.1136/gutjnl-2017-314553\nPMC6109278\nInterruption of the enterohepatic circulation of bile acids (BAs) may protect against BA-mediated cholestatic liver and bile duct injury. BA sequestrants are established to treat cholestatic pruritus, but their impact on the underlying cholestasis is still unclear. We aimed to explore the therapeutic effects and mechanisms of the BA sequestrant colesevelam in a mouse model of sclerosing cholangitis.\n Mdr2-/- mice received colesevelam for 8 weeks. Gene expression profiles of BA homeostasis, inflammation and fibrosis were explored in liver, intestine and colon. Hepatic and faecal BA profiles and gut microbiome were analysed. Glucagon-like peptide 1 (GLP-1) levels in portal blood were measured by ELISA. Furthermore, Mdr2-/- mice as well as wild-type 3, -diethoxy-carbonyl-1, -dihydrocollidine-fed mice were treated with GLP-1-receptor agonist exendin-4 for 2 weeks prior to analysis.\n Colesevelam reduced serum liver enzymes, BAs and expression of proinflammatory and profibrogenic markers. Faecal BA profiling revealed increased levels of secondary BAs after resin treatment, while hepatic and biliary BA composition showed a shift towards more hydrophilic BAs. Colonic GLP-1 secretion, portal venous GLP-1 levels and intestinal messenger RNA expression of gut hormone Proglucagon were increased, while ileal Fgf15 expression was abolished by colesevelam. Exendin-4 treatment increased bile duct mass without promoting a reactive cholangiocyte phenotype in mouse models of sclerosing cholangitis. Microbiota analysis showed an increase of the phylum δ-Proteobacteria after colesevelam treatment and a shift within the phyla Firmicutes from Clostridiales to Lactobacillus.\n Colesevelam increases faecal BA excretion and enhances BA conversion towards secondary BAs, thereby stimulating secretion of GLP-1 from enteroendocrine L-cells and attenuates liver and bile duct injury in Mdr2-/- mice.\n © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.\n\nKashofer, Karl\n\n\n"
},
{
"text": "\n177431\nHow much force is required to perforate a colon during colonoscopy? An experimental study.\n\nJohnson, S\n\nSchultz, M\n\nScholze, M\n\nSmith, T\n\nWoodfield, J\n\nHammer, N\n\nBeiträge in Fachzeitschriften\nISI:000458942100017\n30579111.0\n10.1016/j.jmbbm.2018.11.024\nNone\nColonoscopy is a commonly-performed procedure to diagnose pathology of the large intestine. Perforation of the colon is a rare but feared complication. It is currently unclear how much force is actually required to cause such injury nor how this is altered in certain diseases. Our aim was to analyze the forces required to perforate the colon in experiments using porcine tissues.\n Using 3D printing technology, models of two commercially available colonoscope heads were printed under three configurations: straight (I), 90°- bent (L) and fully bent (U). Samples of porcine colon were assessed with the models and configurations under perpendicular and angular load application and these data compared to the maximum force typically exerted by experienced colonoscopists.\n The force required for perforation was significantly lower for the I compared to the L of the larger colonoscope head configuration under angular loading (14.1 vs. 46.5 N). Similar differences were found for linear stiffness when loaded (I vs. L small when loaded perpendicular: 0.8 vs. 2.4 N/mm, I vs. L large when loaded angled 0.7 vs. 2.1 N/mm). The mode and site of failure varied significantly between the scopes, with delamination of the mucosa/submucosa below the sample (96%) for the I, blunt mucosa/submucosa/muscularis failure adjacent to the loading site (77%) for the L, and failure of all colon layers lateral to the loading site (59%) for the U configuration, respectively. Perpendicular and angulated loading resulted in similar load-deformation values. Maximum forces typically exerted by colonoscopists averaged 13.9-27.9 N, depending on the colonoscope model and head configuration.\n The force required for colon perforation varies depending on the type mode of loading and is likely lower than the force an experienced colonoscopist would exert in daily practice. There is a real risk of perforation, especially when the end of the scope is advancing directly into the colonic wall. The given experimental setup allowed to obtain reliable data of the colon in a standardized scenario, forming the basis for further experiments.\n Copyright © 2018 Elsevier Ltd. All rights reserved.\n\nHammer, Niels\n\n\n"
},
{
"text": "\n180016\nPromoter methylation status of ASC/TMS1/PYCARD is associated with decreased overall survival and TNM status in patients with early stage non-small cell lung cancer (NSCLC)\n\nSutic, M\n\nMotzek, A\n\nBubanovic, G\n\nLinke, M\n\nSabol, I\n\nVugrek, O\n\nOzretic, P\n\nBrcic, L\n\nSeiwerth, S\n\nDebeljak, Z\n\nJakovcevic, A\n\nJanevski, Z\n\nStancic-Rokotov, D\n\nVukic-Dugac, A\n\nJakopovic, M\n\nSamarzija, M\n\nZechner, U\n\nKnezevic, J\n\nBeiträge in Fachzeitschriften\nISI:000505217600026\n32010578.0\n10.21037/tlcr.2019.12.08\nPMC6976376\nLung cancer is the leading cause of cancer-related death worldwide, with 5-year overall survival less than 15%. Therefore, it is essential to find biomarkers for early detection and prognosis. Aberrant DNA methylation is a common feature of human cancers and its utility is already recognized in cancer management. The aim of this study was to explore the diagnostic and prognostic value of the promoter methylation status of the ASC/TMS1/PYCARD and MyD88 genes, key adaptor molecules in the activation of the innate immune response and apoptosis pathways.\n A total of 50 non-small cell lung cancer (NSCLC) patients were enrolled in the study. Methylation of bisulphite converted DNA was quantified by pyrosequencing in fresh frozen malignant tissues and adjacent non-malignant tissues. Associations between methylation and lung function, tumor grade and overall survival were evaluated using receiver-operating characteristics (ROC) analysis and statistical tests of hypothesis.\n Methylation level of tested genes is generally low but significantly decreased in tumor tissues (ASC/TMS1/PYCARD, P<0.0001; MyD88, P<0.0002), which correlates with increased protein expression. Three CpG sites were identified as promising diagnostic marker candidates; CpG11 (-63 position) in ASC/TMS1/PYCARD and CpG1 (-253 position) and 2 (-265 position) in MyD88. The association study showed that the methylation status of the ASC/TMS1 CpG4 site (-34 position) in malignant and non-malignant tissues is associated with the overall survival (P=0.019) and the methylation status of CpG8 site (-92 position) is associated with TNM-stage (P=0.011).\n The methylation status of the ASC/TMS1/PYCARD and MyD88 promoters are promising prognostic biomarker candidates. However, presented results should be considered as a preliminary and should be confirmed on the larger number of the samples.\n 2019 Translational Lung Cancer Research. All rights reserved.\n\nBrcic, Luka\n\n\n"
},
{
"text": "\n181407\nMultilevel analyses of related public health indicators: The European Surveillance of Congenital Anomalies (EUROCAT) Public Health Indicators.\n\nBest, KE\n\nRankin, J\n\nDolk, H\n\nLoane, M\n\nHaeusler, M\n\nNelen, V\n\nVerellen-Dumoulin, C\n\nGarne, E\n\nSayers, G\n\nMullaney, C\n\nO'Mahony, MT\n\nGatt, M\n\nDe Walle, H\n\nKlungsoyr, K\n\nCarolla, OM\n\nCavero-Carbonell, C\n\nKurinczuk, JJ\n\nDraper, ES\n\nTucker, D\n\nWellesley, D\n\nZymak-Zakutnia, N\n\nLelong, N\n\nKhoshnood, B\n\nBeiträge in Fachzeitschriften\nISI:000516132100003\n32101337.0\n10.1111/ppe.12655\nPMC7064886\nPublic health organisations use public health indicators to guide health policy. Joint analysis of multiple public health indicators can provide a more comprehensive understanding of what they are intended to evaluate.\n To analyse variaitons in the prevalence of congenital anomaly-related perinatal mortality attributable to termination of pregnancy for foetal anomaly (TOPFA) and prenatal diagnosis of congenital anomaly prevalence.\n We included 55 363 cases of congenital anomalies notified to 18 EUROCAT registers in 10 countries during 2008-12. Incidence rate ratios (IRR) representing the risk of congenital anomaly-related perinatal mortality according to TOPFA and prenatal diagnosis prevalence were estimated using multilevel Poisson regression with country as a random effect. Between-country variation in congenital anomaly-related perinatal mortality was measured using random effects and compared between the null and adjusted models to estimate the percentage of variation in congenital anomaly-related perinatal mortality accounted for by TOPFA and prenatal diagnosis.\n The risk of congenital anomaly-related perinatal mortality decreased as TOPFA and prenatal diagnosis prevalence increased (IRR 0.79, 95% confidence interval [CI] 0.72, 0.86; and IRR 0.88, 95% CI 0.79, 0.97). Modelling TOPFA and prenatal diagnosis together, the association between congenital anomaly-related perinatal mortality and TOPFA prevalence became stronger (RR 0.70, 95% CI 0.61, 0.81). The prevalence of TOPFA and prenatal diagnosis accounted for 75.5% and 37.7% of the between-country variation in perinatal mortality, respectively.\n We demonstrated an approach for analysing inter-linked public health indicators. In this example, as TOPFA and prenatal diagnosis of congenital anomaly prevalence decreased, the risk of congenital anomaly-related perinatal mortality increased. Much of the between-country variation in congenital anomaly-related perinatal mortality was accounted for by TOPFA, with a smaller proportion accounted for by prenatal diagnosis.\n © 2020 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.\n\n\n"
},
{
"text": "\n187672\nHypophosphatemia in critically ill adults and children-A systematic review\n\nBlaser, AR\n\nGunst, J\n\nIchai, C\n\nCasaer, MP\n\nBenstoem, C\n\nBesch, G\n\nDauger, S\n\nFruhwald, SM\n\nHiesmayr, M\n\nJoannes-Boyau, O\n\nMalbrain, MLNG\n\nPerez, MH\n\nSchaller, SJ\n\nde Man, A\n\nStarkopf, J\n\nTamme, K\n\nWernerman, J\n\nBerger, MM\n\nBeiträge in Fachzeitschriften\nISI:000640403100035\n33268142.0\n10.1016/j.clnu.2020.09.045\nNone\n28 prospective and 31 retrospective studies, and 20 case reports. Relevant risk of bias regarding selection and comparability was identified for most of the studies. No meta-analysis could be performed. The prevalence of hypophosphatemia varied substantially in critically ill adults and children, but no study assessed consecutive admissions to intensive care. In both critically ill adults and children, several studies report that hypophosphatemia is associated with worse outcome (prolonged length of stay and the need for respiratory support, and higher mortality). However, there was insufficient evidence regarding the optimal threshold upon which hypophosphatemia becomes critical and requires treatment. We found no studies regarding the optimal frequency of phosphate measurements, and regarding the time window to correct hypophosphatemia. In adults, nutrient restriction on top of phosphate repletion in patients with refeeding syndrome may improve survival, although evidence is weak. Conclusions: Evidence on the definition, outcome and treatment of clinically relevant hypophosphatemia Background & aims: Phosphate is the main intracellular anion essential for numerous biological processes. Symptoms of hypophosphatemia are non-specific, yet potentially life-threatening. This systematic review process was initiated to gain a global insight into hypophosphatemia, associated morbidity and treatments. Methods: A systematic review was conducted (PROSPERO CRD42020163191). Nine clinically relevant questions were generated, seven for adult and two for pediatric critically ill patients, and prevalence of hypophosphatemia was assessed in both groups. We identified trials through systematic searches of Medline, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. Quality assessment was performed using the Cochrane risk of bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. Results: For all research questions, we identified 2727 titles in total, assessed 399 full texts, and retained 82 full texts for evidence synthesis, with 20 of them identified for several research questions. Only 3 randomized controlled trials were identified with two of them published only in abstract form, as well as\n\nFruhwald, Sonja\n\n\n"
},
{
"text": "\n2603\nThe Relation Between the Number of Symptoms and Other Health Indicators in Working Men and Women\n\nFoppa, I\n\nNoack, RH\n\nBeiträge in Fachzeitschriften\nISI:A1997WZ15600003\n8890412.0\n10.1016%2F0277-9536%2896%2900032-9\nNone\nBack pain causes a considerable loss of working days as well as health care costs and therefore represents a major public health problem in industrialized countries. Psychosocial factors have received increasing attention from researchers studying the causal factors of non-specific back pain. However, most studies focus on few dimensions, like individual or work-related factors. We studied the simultaneous association of various factors representing psychosocial, behavioral, and health-related dimensions to self-reported back pain. Data from the Berne Workplace Health Project on 850 employed men and women was analyzed. Back pain was operationalized by a dichotomized variable (having suffered moderately to severely from back pain in the preceding four weeks). The theoretical model guiding the underlying project was a general demand-resource model. Variables that--according to that model--were hypothesized to be related to back pain as well as more specific factors--like physical work load--were analyzed by stepwise logistic regression analysis. In men, there was a statistical trend (P < 0.1) for several work-related factors (low job discretion, high job demands, low job satisfaction). In women, dissatisfaction with salary was the only work-related factor associated with back pain. There was no significant association between private context factors, like poor social network or high demands/low control, and back pain. Only in men, the likelihood of back pain increased with age, while only in women, back pain was associated with emotional problems (individual factors). Among the behavioral factors, smoking was associated to back pain in men, while in women none of the behavioral factors was significant. In both men and women reporting more than two functional symptoms and a history of intestinal problems were associated to back pain. All of our findings were in the expected direction, i.e., it was invariably unfavorable categories of explanatory variables that were associated with higher prevalence of back pain. However, most associations seem to be quite unspecific. There is a need for theoretically guided research aiming at the development of a more complex process model of back pain.\n\nNoack, Richard-Horst\n\n\n"
},
{
"text": "\n89891\nSurgical treatment of pathologic fractures of the humerus and femur.\n\nGruber, G\n\nZacherl, M\n\nLeithner, A\n\nGiessauf, C\n\nGlehr, M\n\nClar, H\n\nWindhager, R\n\nBeiträge in Fachzeitschriften\nISI:000265038100004\n19296079.0\n10.1007/s00132-008-1376-4\nNone\nThe life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compare the different operative treatment options for patients with pathologic fractures of the humerus and femur in terms of complications, postoperative recovery, and survival.From 2000 to 2005, 109 patients were surgically treated for pathologic fractures of the humerus (n=19) or femur (n=90). The study group consisted of 60 women and 43 men, with a mean age of 67 years (13-88). Breast carcinoma (36%) was the most common primary tumour, followed by kidney (17%) and bronchial (16%) carcinoma. Of all patients, 75 (73%) had numerous skeletal metastases, and 38 (37%) had visceral metastases.Wide or marginal resection was performed in seven fractures of the humerus and 14 fractures of the femur; intralesional resection was done in seven humeral and 73 femoral fractures; and stabilisation alone was done in five fractures of the humerus and three fractures of the femur. The median survival time for all patients was 6 months (0-102). The survival rate at 1 year was 25% (25% for both humeral and femoral fractures), 15% at 2 years (17% for humeral and 15% for femoral fractures), and 8% at 3 years (16% for humeral and 7% for femoral fractures). The overall complication rate was 11%, and revision surgeries were performed in seven patients (6.4%). The majority of patients (n=65; 60%), especially those with fractures close to the articular joint, were successfully treated with endoprosthetic replacement. Patients with fractures stabilised by intramedullary nails had shorter operating times, a shorter hospital stay, and fewer complications than patients treated with plating systems. Therefore, we recommend intralesional resection of the metastasis and stabilisation with intramedullary devices, supported by bone cement, as the treatment of choice for pathologic fractures of the diaphysis and metaphysis of the humerus and femur. Wide resection should be reserved for selected cases, such as solitary bone metastasis of kidney carcinoma.\n\nGlehr, Mathias\n\nLeithner, Andreas\n\nZacherl, Maximilian\n\n\n"
},
{
"text": "\n98635\nLung and heart volumes by three-dimensional ultrasound in normal fetuses at 12-32 weeks' gestation.\n\nPeralta, CF\n\nCavoretto, P\n\nCsapo, B\n\nFalcon, O\n\nNicolaides, KH\n\nBeiträge in Fachzeitschriften\nISI:000235372700003\n16388511.0\n10.1002/uog.2670\nNone\nOBJECTIVE: To establish reference intervals for the fetal right, left and total lung volumes and heart volume between 12 and 32 weeks of gestation. METHODS: Fetal lung and heart volumes were measured using three-dimensional (3D) ultrasound in 650 normal singleton pregnancies at 12-32 weeks. The VOCAL (Virtual Organ Computer-aided AnaLysis) technique was used to obtain a sequence of six sections of each lung and the heart around a fixed axis, each after a 30 degrees rotation from the previous one. The rotation axis for the lungs extended from the apex to the upper limit of the diaphragm dome, and the rotation axis for the heart extended from its apex to its connection to the great vessels. The contour of each of these organs was drawn manually in the six different rotation planes to obtain the 3D volume measurement. In 60 cases the fetal lungs and heart volumes were measured by the same sonographer twice and also by a second sonographer once in order to compare the measurements and calculate intra- and interobserver agreement. RESULTS: The total lung volume and heart volume increased with gestation, from respective mean values of 1.6 and 0.6 mL at 12 weeks to 10.9 and 4.3 mL at 20 weeks and 49.3 and 26.6 mL at 32 weeks. The right to left lung volume ratio did not change significantly with gestation (median, 0.7), whereas the heart to total lung volume ratio increased with gestation from about 0.3 at 12 weeks to 0.5 at 32 weeks. In the Bland-Altman plot, the difference between paired measurements by two sonographers was, in 95% of the cases, less than 0.05, 0.5 and 1.9 mL for each lung at 12-13, 19-22 and 29-32 weeks, respectively, and the corresponding values for the heart volumes were 0.04, 0.4 and 2.3 mL. CONCLUSIONS: In normal fetuses the lung and heart volumes increase between 12 and 32 weeks of gestation. The extent to which in pathological pregnancies possible deviations in these measurements from normal prove to be useful in the prediction of outcome remains to be determined.\n\nCsapo, Bence Daniel\n\n\n"
},
{
"text": "\n127078\nPeripheral morphine analgesia in dental surgery.\n\nLikar, R\n\nSittl, R\n\nGragger, K\n\nPipam, W\n\nBlatnig, H\n\nBreschan, C\n\nSchalk, HV\n\nStein, C\n\nSchäfer, M\n\nBeiträge in Fachzeitschriften\nISI:000074398700016\n9696467.0\n10.1016/S0304-3959(98)00036-0\nNone\nThe recent identification of opioid receptors on peripheral nerve endings of primary afferent neurons and the expression of their mRNA in dorsal root ganglia support earlier experimental data about peripheral analgesic effects of locally applied opioids. These effects are most prominent under localized inflammatory conditions. The clinical use of such peripheral analgesic effects of opioids was soon investigated in numerous controlled clinical trials. The majority of these have tested the local, intraarticular administration of morphine in knee surgery and have demonstrated potent and long-lasting postoperative analgesia. As the direct application of morphine into the pain-generating site of injury and inflammation appears most promising, we examined direct morphine infiltration of the surgical site in a unique clinical model of inflammatory tooth pain. Forty-four patients undergoing dental surgery entered into this prospective, randomized, double-blind study. Before surgery they received, together with a standard local anesthetic solution (articaine plus epinephrine) a submucous injection of either 1 mg of morphine (group A) or saline (group B). Postoperative pain intensity was assessed using the visual analog scale (VAS) and numeric rating scale (NRS) at 2, 4, 6, 8, 10, 12, 16, 20 and 24 h after surgery. In addition, patients recorded the occurrence of side effects and the supplemental consumption of diclofenac tablets. Results of 27 patients were analyzed (group A: n=14, group B: n=13). Pain scores which were moderate to severe preoperatively were reduced to a similar extent in both groups up to 8 h postoperatively. Thereafter, pain scores in group A were significantly lower than those in group B for up to 24 h, demonstrating the analgesic efficacy of additional morphine. The time to first analgesic intake and the total amount of supplemental diclofenac were less in group A than in group B. No serious side effects were reported. Our results show that 1 mg of morphine added to a local anesthetic for dental surgery results in significant improvement of postoperative analgesia. Since the majority of dental surgeries is accompanied with an inflammatory reaction, supplemental morphine may be of benefit for the relief of postoperative dental pain.\n\nBreschan, Christian\n\n\n"
},
{
"text": "\n151077\nOne million haemopoietic stem-cell transplants: a retrospective observational study.\n\nGratwohl, A\n\nPasquini, MC\n\nAljurf, M\n\nAtsuta, Y\n\nBaldomero, H\n\nFoeken, L\n\nGratwohl, M\n\nBouzas, LF\n\nConfer, D\n\nFrauendorfer, K\n\nGluckman, E\n\nGreinix, H\n\nHorowitz, M\n\nIida, M\n\nLipton, J\n\nMadrigal, A\n\nMohty, M\n\nNoel, L\n\nNovitzky, N\n\nNunez, J\n\nOudshoorn, M\n\nPassweg, J\n\nvan Rood, J\n\nSzer, J\n\nBlume, K\n\nAppelbaum, FR\n\nKodera, Y\n\nNiederwieser, D\n\nWorldwide Network for Blood and Marrow Transplantation (WBMT)\n\nBeiträge in Fachzeitschriften\nISI:000362071800006\n26687803.0\n10.1016/S2352-3026(15)00028-9\nNone\nThe transplantation of cells, tissues, and organs has been recognised by WHO as an important medical task for its member states; however, information about how to best organise transplantation is scarce. We aimed to document the activity worldwide from the beginning of transplantation and search for region adapted indications and associations between transplant rates and macroeconomics.\n Between Jan 1, 2006, and Dec 31, 2014, the Worldwide Network for Blood and Marrow Transplantation collected data for the evolution of haemopoietic stem-cell transplantation (HSCT) activity and volunteer donors in the 194 WHO member states.\n 953, 51 HSCTs (553, 50 [58%] autologous and 400, 01 [42%] allogeneic) were reported by 1516 transplant centres from 75 countries. No transplants were done in countries with fewer than 300, 00 inhabitants, a surface area less than 700 km(2), and a gross national income per person of US$1260 or lower. Use of HSCT increased from the first transplant in 1957 to almost 10, 00 by 1985. We recorded a cumulative total of about 100, 00 transplants by 1995, and an estimated 1 million by December, 2012. Unrelated donor registries contributed 22·3 million typed volunteer donors and 645, 46 cord blood products by 2012. Numbers of allogeneic HSCTs increased in the past 35 years with no signs of saturation (R(2)=0·989). Transplant rates were higher in countries with more resources, more transplant teams, and an unrelated donor infrastructure.\n Our findings show achievements and high unmet needs and give guidance for decisions; to grant access for patients, to provide a donor infrastructure, and to limit overuse by defining risk and region adapted indications for HSCT as an efficient and cost-effective approach for life-threatening, potentially curable diseases.\n Funding for this study was indirectly provided by support of the WBMT.\n Copyright © 2015 Elsevier Ltd. All rights reserved.\n\nGreinix, Hildegard\n\n\n"
},
{
"text": "\n160200\nA Call for New Communication Channels for Gynecological Oncology Trainees: A Survey on Social Media Use and Educational Needs by the European Network of Young Gynecological Oncologists.\n\nZalewski, K\n\nLindemann, K\n\nHalaska, MJ\n\nZapardiel, I\n\nLaky, R\n\nChereau, E\n\nLindquist, D\n\nPolterauer, S\n\nSukhin, V\n\nDursun, P\n\nBeiträge in Fachzeitschriften\nISI:000394574500031\n28187096.0\n10.1097/IGC.0000000000000917\nNone\nThe aim of the study was to assess patterns in the use of social media (SM) platforms and to identify the training needs among European gynecologic oncology trainees.\n In 2014, a web-based survey was sent to 633 trainees from the European Network of Young Gynaecological Oncologists (ENYGO) database. The 14-item questionnaire (partially using a 1- to 5-point Likert scale) assessed respondents' use of SM and preference for workshop content and organization. Descriptive analysis was used to describe the mean scores reported for different items, and the internal reliability of the questionnaire was assessed by Cronbach α.\n In total, 170 ENYGO members (27%) responded to the survey. Of those, 91% said that they use SM platforms, mostly for private purposes. Twenty-three percent used SM professionally and 43% indicated that they would consider SM to be a clinical discussion forum. The respondents said that they would like updates on conferences and professional activities to be shared on SM platforms. Complication management, surgical anatomy, and state of the art in gynecologic oncology were identified as preferred workshops topics. The most frequently indicated hands-on workshops were laparoscopic techniques and surgical anatomy. Consultants attached a higher level of importance to palliative care education and communication training than trainees. The mean duration of the workshop preferred was 2 days.\n This report highlights the significance of ENYGO trainees' attachment to SM platforms. Most respondents expect ENYGO to use these online channels for promoting educational activities and other updates. Using SM for clinical discussion will require specific guidelines to secure professional and also consumer integrity. This survey confirms surgical management and the state of the art as important knowledge gaps, and ENYGO has tailored its activities according to these results. Future activities will further direct attention and resources to education in palliative care and molecular tumor biology.\n\nLaky, Rene Walter\n\n\n"
},
{
"text": "\n174246\nAccess to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries\n\nde Sousa, DA\n\nvon Martial, R\n\nAbilleira, S\n\nGattringer, T\n\nKobayashi, A\n\nGallofre, M\n\nFazekas, F\n\nSzikora, I\n\nFeigin, V\n\nCaso, V\n\nFischer, U\n\nBeiträge in Fachzeitschriften\nISI:000460530600003\n31165091.0\n10.1177/2396987318786023\nPMC6533860\nAcute stroke unit care, intravenous thrombolysis and endovascular treatment significantly improve the outcome for patients with ischaemic stroke, but data on access and delivery throughout Europe are lacking. We assessed best available data on access and delivery of acute stroke unit care, intravenous thrombolysis and endovascular treatment throughout Europe.\n A survey, drafted by stroke professionals (ESO, ESMINT, EAN) and a patient organisation (SAFE), was sent to national stroke societies and experts in 51 European countries (World Health Organization definition) requesting experts to provide national data on stroke unit, intravenous thrombolysis and endovascular treatment rates. We compared both pooled and individual national data per one million inhabitants and per 1000 annual incident ischaemic strokes with highest country rates. Population estimates were based on United Nations data, stroke incidences on the Global Burden of Disease Report.\n We obtained data from 44 European countries. The estimated mean number of stroke units was 2.9 per million inhabitants (95% CI 2.3-3.6) and 1.5 per 1000 annual incident strokes (95% CI 1.1-1.9), highest country rates were 9.2 and 5.8. Intravenous thrombolysis was provided in 42/44 countries. The estimated mean annual number of intravenous thrombolysis was 142.0 per million inhabitants (95% CI 107.4-176.7) and 72.7 per 1000 annual incident strokes (95% CI 54.2-91.2), highest country rates were 412.2 and 205.5. Endovascular treatment was provided in 40/44 countries. The estimated mean annual number of endovascular treatments was 37.1 per million inhabitants (95% CI 26.7-47.5) and 19.3 per 1000 annual incident strokes (95% CI 13.5-25.1), highest country rates were 111.5 and 55.9. Overall, 7.3% of incident ischaemic stroke patients received intravenous thrombolysis (95% CI 5.4-9.1) and 1.9% received endovascular treatment (95% CI 1.3-2.5), highest country rates were 20.6% and 5.6%.\n We observed major inequalities in acute stroke treatment between and within 44 European countries. Our data will assist decision makers implementing tailored stroke care programmes for reducing stroke-related morbidity and mortality in Europe.\n\nFazekas, Franz\n\nGattringer, Thomas\n\n\n"
},
{
"text": "\n182328\nWhite matter hyperintensity burden in acute stroke patients differs by ischemic stroke subtype.\n\nGiese, AK\n\nSchirmer, MD\n\nDalca, AV\n\nSridharan, R\n\nDonahue, KL\n\nNardin, M\n\nIrie, R\n\nMcIntosh, EC\n\nMocking, SJT\n\nXu, H\n\nCole, JW\n\nGiralt-Steinhauer, E\n\nJimenez-Conde, J\n\nJern, C\n\nKleindorfer, DO\n\nLemmens, R\n\nWasselius, J\n\nLindgren, A\n\nRundek, T\n\nSacco, RL\n\nSchmidt, R\n\nSharma, P\n\nSlowik, A\n\nThijs, V\n\nWorrall, BB\n\nWoo, D\n\nKittner, SJ\n\nMcArdle, PF\n\nMitchell, BD\n\nRosand, J\n\nMeschia, JF\n\nWu, O\n\nGolland, P\n\nRost, NS\n\nInternational Stroke Genetics Consortium and the MRI-GENIE Investigators\n\nBeiträge in Fachzeitschriften\nISI:000559750000017\n32493718.0\n10.1212/WNL.0000000000009728\nPMC7371377\nTo examine etiologic stroke subtypes and vascular risk factor profiles and their association with white matter hyperintensity (WMH) burden in patients hospitalized for acute ischemic stroke (AIS).\n For the MRI Genetics Interface Exploration (MRI-GENIE) study, we systematically assembled brain imaging and phenotypic data for 3, 01 patients with AIS. All cases underwent standardized web tool-based stroke subtyping with the Causative Classification of Ischemic Stroke (CCS). WMH volume (WMHv) was measured on T2 brain MRI scans of 2, 29 patients with a fully automated deep-learning trained algorithm. Univariable and multivariable linear mixed-effects modeling was carried out to investigate the relationship of vascular risk factors with WMHv and CCS subtypes.\n Patients with AIS with large artery atherosclerosis, major cardioembolic stroke, small artery occlusion (SAO), other, and undetermined causes of AIS differed significantly in their vascular risk factor profile (all p < 0.001). Median WMHv in all patients with AIS was 5.86 cm3 (interquartile range 2.18-14.61 cm3) and differed significantly across CCS subtypes (p < 0.0001). In multivariable analysis, age, hypertension, prior stroke, smoking (all p < 0.001), and diabetes mellitus (p = 0.041) were independent predictors of WMHv. When adjusted for confounders, patients with SAO had significantly higher WMHv compared to those with all other stroke subtypes (p < 0.001).\n In this international multicenter, hospital-based cohort of patients with AIS, we demonstrate that vascular risk factor profiles and extent of WMH burden differ by CCS subtype, with the highest lesion burden detected in patients with SAO. These findings further support the small vessel hypothesis of WMH lesions detected on brain MRI of patients with ischemic stroke.\n © 2020 American Academy of Neurology.\n\nSchmidt, Reinhold\n\n\n"
},
{
"text": "\n184135\nAre quality promotion initiatives in Austrian and Italian general practices associated with higher patient satisfaction and quality of life? Results from the interventional study 'IQuaB'.\n\nMahlknecht, A\n\nAbuzahra, ME\n\nPiccoliori, G\n\nEngl, A\n\nSönnichsen, A\n\nBeiträge in Fachzeitschriften\nISI:000585249100001\n33151008.0\n10.1111/hsc.13212\nNone\nThe objective was to assess the changes in quality of life (QoL) and patient satisfaction of chronically ill patients in general practices in Salzburg (Austria) and South Tyrol (Italy) after implementation of a combined intervention addressing quality of care of general practitioners (GPs). Furthermore, the correlation between QoL/patient satisfaction and quality of care provided by the GPs (measured by a quality score based on quality indicators [QIs]) was investigated. The non-controlled pre-post study involved GPs and patients with chronic conditions. The intervention consisted of self-audit, benchmarking and quality circles. QIs were extracted in the participating practices in 2012 (preintervention) and 2014 (postintervention). Before and after the intervention, a patient survey was conducted including EQ-5D (measuring health-related QoL), a patient participation scale and parts of the European Task Force on Patient Evaluations of General Practice questionnaire (measuring patient satisfaction). Mann-Whitney U-tests, chi-square tests and Spearman's rank correlation were applied for statistical analysis. Fifty-six GPs participated in the study. 1, 10 patients returned the questionnaire in 2012, and 1, 74 in 2014. Mean EQ-5D index (QoL) was similar in Salzburg and South Tyrol in both years: 2012 Salzburg 0.85 (95% CI 0.84-0.87), South Tyrol 0.85 (95% CI 0.84-0.86); 2014 Salzburg 0.84 (95% CI 0.83-0.86), South Tyrol 0.84 (95% CI 0.83-0.86). Patient satisfaction was higher in Salzburg than in South Tyrol at baseline (EUROPEP: mean percentage of best response 61.5% vs. 49.1%, p < 0.000) and also at follow-up (61.9% vs. 49.2%; p < 0.000). No significant correlation between quality score and QoL/patient satisfaction was detected. Thus, the impact of the intervention was not significant within the intermediate time periods analysed in the study. Improvements in quality of care do not necessarily also improve patient-relevant outcomes, which are probably more associated with other factors than with medical quality (e.g. availability of the GP, waiting times and communication-related issues).\n © 2020 John Wiley & Sons Ltd.\n\nAbuzahra, Muna\n\n\n"
},
{
"text": "\n185389\nAnatomical and radiological evaluation of less invasive stabilisation system (LISS) in correlation with knee lateral collateral ligament insertion.\n\nFreimoser, F\n\nGrechenig, S\n\nOfenhitzer, A\n\nBakota, B\n\nStaresinic, M\n\nPfeifer, CG\n\nBeiträge in Fachzeitschriften\nNone\n29122124.0\n10.1016/S0020-1383(17)30741-6\nNone\nThe Less Invasive Stabilisation System (LISS) is an angle-stable plate that enables treatment of distal femoral comminuted and periprosthetic fracture. As it is placed through a minimally-invasive lateral approach, lateral knee pain is a commonly described symptom after its application. This study investigates knee lateral collateral ligament (LCL) iatrogenic injury during LISS plate fixation. A cadaver study was performed and a retrospective radiological investigation with the analysis of its clinical application was conducted to evaluate possible knee LCL damage.\n The cadaver study included 13 human lower extremities, treated with LISS. After application, lateral knee side was dissected, implants were removed and distances between the drill holes and LCL origin were measured. In the retrospective radiological evaluation, postoperative X-rays for patients treated with distal femoral LISS plate in the University Hospital Regensburg, Germany from January 2010 to December 2015 were examined. Following a protocol described by Pietrini et al., the LCL origin on postoperative X-rays was calculated, both in lateral and anterior-posterior (AP) view, and distances between the plate and its closest locking screw to the LCL origin were measured.\n In the cadaver study, the mean distance between the closest drilling hole and the ligament origin was 14.0mm (range 9-21mm; SD 3.8mm). Twenty-two patients matched the inclusion criteria for the retrospective radiological study. In lateral view, the mean distance between the origin and the closest locking screw was 6.3mm (range 0-16.4mm; SD 4.7mm); the mean distance between the origin and the plate was 3.1mm (range 0-13.9mm; SD 4.1mm). In AP view, the mean distance between LCL origin and the nearest screw was 2.4mm (range 0-7.6mm; SD 2.4mm). The mean distance between the origin and the most distal locking screw was 9.2mm (range 0-17.5mm; SD 4.0mm).\n The LISS is a safe option to treat distal femoral fractures in respect to the LCL. Due to close proximity, the LCL might be harmed; therefore, lateral knee pain or lateral instability after implantation should be assessed in further treatment.\n © 2017 Elsevier Ltd. All rights reserved.\n\n\n"
},
{
"text": "\n187271\nAdjuvant therapy of histopathological risk factors of retinoblastoma in Europe: A survey by the European Retinoblastoma Group (EURbG).\n\nDittner-Moormann, S\n\nReschke, M\n\nAbbink, FCH\n\nAerts, I\n\nAtalay, HT\n\nFedorovna Bobrova, N\n\nBiewald, E\n\nBrecht, IB\n\nCaspi, S\n\nCassoux, N\n\nCastela, G\n\nDiarra, Y\n\nDuncan, C\n\nEbinger, M\n\nGarcia Aldana, D\n\nHadjistilianou, D\n\nKepák, T\n\nKlett, A\n\nKiratli, H\n\nMaka, E\n\nOpocher, E\n\nPawinska-Wasikowska, K\n\nRascon, J\n\nRusso, I\n\nRutynowska-Pronicka, O\n\nSábado Álvarez, C\n\nPacheco, SSR\n\nSvojgr, K\n\nTimmermann, B\n\nVishnevskia-Dai, V\n\nEggert, A\n\nRitter-Sovinz, P\n\nBechrakis, NE\n\nJenkinson, H\n\nMoll, A\n\nMunier, FL\n\nPopovic, MB\n\nChantada, G\n\nDoz, F\n\nKetteler, P\n\nBeiträge in Fachzeitschriften\nISI:000628887900001\n33720495.0\n10.1002/pbc.28963\nNone\nAdvanced intraocular retinoblastoma can be cured by enucleation, but spread of retinoblastoma cells beyond the natural limits of the eye is related to a high mortality. Adjuvant therapy after enucleation has been shown to prevent metastasis in children with risk factors for extraocular retinoblastoma. However, histological criteria and adjuvant treatment regimens vary and there is no unifying consensus on the optimal choice of treatment.\n Data on guidelines for adjuvant treatment in European retinoblastoma referral centres were collected in an online survey among all members of the European Retinoblastoma Group (EURbG) network. Extended information was gathered via personal email communication.\n Data were collected from 26 centres in 17 countries. Guidelines for adjuvant treatment were in place at 92.3% of retinoblastoma centres. There was a consensus on indication for and intensity of adjuvant treatment among more than 80% of all centres. The majority of centres use no adjuvant treatment for isolated focal choroidal invasion or prelaminar optic nerve invasion. Patients with massive choroidal invasion or postlaminar optic nerve invasion receive adjuvant chemotherapy, while microscopic invasion of the resection margin of the optic nerve or extension through the sclera are treated with combined chemo- and radiotherapy.\n Indications and adjuvant treatment regimens in European retinoblastoma referral centres are similar but not uniform. Further biomarkers in addition to histopathological risk factors could improve treatment stratification. The high consensus in European centres is an excellent foundation for a common European study with prospective validation of new biomarkers.\n © 2021 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.\n\nRitter-Sovinz, Petra\n\n\n"
},
{
"text": "\n6742\nNon-small cell lung cancer: evaluation of pleural abnormalities on CT scans with 18F FDG PET.\n\nSchaffler, GJ\n\nWolf, G\n\nSchoellnast, H\n\nGroell, R\n\nMaier, A\n\nSmolle-Jüttner, FM\n\nWoltsche, M\n\nFasching, G\n\nNicoletti, R\n\nAigner, RM\n\nBeiträge in Fachzeitschriften\nISI:000221585200037\n15105451.0\n10.1148/radiol.2313030785\nNone\nPURPOSE: To evaluate the accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in differentiation of pleural malignancy and cancer-unrelated pleural disease in patients with non-small cell lung cancer (NSCLC) and pleural abnormalities at computed tomography (CT). MATERIALS AND METHODS: In 92 patients, pleural abnormalities were detected at contrast material-enhanced thoracic CT, which was performed for newly diagnosed NSCLC (n = 41) or restaging (n = 51). CT findings were negative for pleural malignancy when pleural effusion with attenuation of 10 HU or less and/or rib fractures with no evidence of pathologic fracture were present; findings were indeterminate when pleural effusion with attenuation greater than 16 HU and/or solid pleural abnormalities without osseous destruction of the chest wall were present; and findings were positive if any osseous destruction of the chest wall adjacent to a pleural mass was present. All patients underwent FDG PET. Findings were negative for pleural malignancy if pleural activity was absent, equal to, or less than mediastinal background activity; findings were positive if pleural activity was higher than mediastinal background activity. Reading of CT and FDG PET scans was first performed, separately and then was combined. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPP), and accuracy were calculated for CT and FDG PET separately and for CT and FDG PET combined, with cytologic and/or histologic analysis as standard of reference. RESULTS: In detection of pleural malignancies, CT findings were indeterminate in 65 (71%) patients and true-negative in 27 (29%). Respective sensitivity, specificity, PPV, NPV, and accuracy of FDG PET in detection of pleural malignancies were 100%, 71%, 63%, 100%, and 80%; and those of CT and FDG PET combined, 100%, 76%, 67%, 100%, and 84%. CONCLUSION: Findings suggest that a negative FDG PET scan for indeterminate pleural abnormalities at CT indicates a benign character, while positive findings on an FDG PET scan are sensitive for malignancy. (C) RSNA, 2004.\n\nAigner, Reingard\n\nMaier, Alfred\n\nSchaffler, Gottfried\n\nSchoellnast, Helmut\n\nSmolle-Juettner, Freyja-Maria\n\nWolf, Gerhard\n\n\n"
},
{
"text": "\n7830\nA study of the concentrations of substance P and neurotensin in the gastrointestinal tract of various mammals.\n\nHolzer, P\n\nBucsics, A\n\nSaria, A\n\nLembeck, F\n\nBeiträge in Fachzeitschriften\nISI:A1982PT75200030\n6185881.0\n10.1016/0306-4522(82)90114-2\nNone\nImmunoreactive substance P and neurotensin in extracts of the digestive tract of man, cat, guinea-pig, pig, rabbit, and rat were measured by radioimmunoassay using antisera directed against the C-terminal portions of the two peptides. In all species except the cat, the concentrations of substance P were highest in the small intestine, intermediate in the large intestine and lowest in the stomach and oesophagus: the digestive tract of the cat displayed a rather even distribution of substance P. As observed in the ileum of guinea-pig, rabbit, and rat, the external muscle layer including the myenteric plexus contained 2-5 times higher concentrations of substance P than the whole ileal wall, whereas the substance P concentrations in the mucosa were only about one sixth of those in the whole wall. High performance liquid chromatography of extracts of human, feline and rabbit ileum showed that all the immunoreactive substance P eluted at the positions of substance P and substance P sulfoxide. The distribution of immunoreactive neurotensin along the digestive system of all six species was very similar. The highest concentrations of neurotensin were measured in the distal part of the small intestine, whereas the large intestine, stomach and oesophagus contained only low concentrations of neurotensin relative to the concentrations in the ileum. As examined in the ileum of guinea-pig, rabbit, and rat, the mucosa exhibited 2.5-4 times higher concentrations of neurotensin than the whole ileal wall, while the concentrations of neutrotensin in the external muscle layer including the myenteric plexus were only 4-20% of those in the whole wall. High performance liquid chromatography of the immunoreactive neurotensin extracted from the cat ileum yielded a single peak corresponding to neurotensin while the immunoreactive neurotensin extracted from the ileum of man and rabbit was eluted in two peaks, 55 and 72% of the recovered immunoreactivity, respectively, corresponding to neurotensin. These findings are in line with the proposed roles of substance P in the neural, and neurotensin in the endocrine, control and maintenance of gastrointestinal motility.\n\nHolzer, Peter\n\n\n"
},
{
"text": "\n64754\nPredictors of failure to cure atrial fibrillation with the mini-maze operation.\n\nSzalay, ZA\n\nSkwara, W\n\nKlövekorn, WP\n\nBrunner-La Rocca, HP\n\nKnez, I\n\nGraves, K\n\nVogt, PR\n\nBauer, EP\n\nBeiträge in Fachzeitschriften\nISI:000188886100001\n15108781.0\n10.1111/j.0886-0440.2004.04001.x\nNone\nMaze-III is a complex surgical procedure designed to treat chronic atrial fibrillation. A reduction in the number of right and left atrial incisions could decrease the operative time. The aim of this study was to assess the results of a mini-maze operation and to define predictors of its failure.\n Between 1995 and 2000, 72 patients (mean age 64 +/- 9 years) undergoing cardiac surgery had a concomitant mini-maze operation for symptomatic chronic atrial fibrillation. Three and 12 months post-operatively, heart rhythm and left atrial transport functions were assessed by electrophysiology, echocardiography, and magnetic resonance imaging. Multivariate analysis was performed to identify predictors of failure of the mini-maze operation.\n Operative mortality was 1.4% (1/72). Death during follow-up occurred in 5.6% of patients (4/71), in one due to chronic heart failure. After 1 year, 80% of patients (48/60) were either in sinus rhythm (n = 43; 72%) or had a pacemaker (n = 5; 8%) implanted due to sick sinus syndrome. Intermittent and chronic atrial fibrillation was found in 20% of patients (12/60). Preoperative duration of atrial fibrillation (p = 0.05), preoperative left atrial diameter (p = 0.001), preoperative right atrial diameter (p = 0.02), a reduced left ventricular ejection fraction (p = 0.03), an increased left ventricular end-diastolic diameter (p = 0.04), and the presence of mitral valve stenosis (p = 0.001) were found to be univariate predictors of failure of the mini-maze operation 1 year postoperatively. Multivariate analysis defined preoperative diagnosis of mitral valve stenosis (p = 0.005; OR 117.5), longer duration of preoperative atrial fibrillation (p = 0.01; OR 1.33), and increased preoperative left ventricular end-systolic diameter (p = 0.02; OR 1.2) as incremental independent risk factors for failure of the mini-maze operation to cure chronic atrial fibrillation.\n The mini-maze operation is a safe procedure with similar results to that of Cox's Maze-III operation. The less-invasive mini-maze operation could be applicable even to patients with severely reduced left ventricular function, in whom complex cardiac surgery has to be performed concomitantly as well as in those presenting severe comorbidities.\n\nKnez, Igor\n\n\n"
},
{
"text": "\n92426\nTime course of serum inhibitory activity for facilitated allergen-IgE binding during bee venom immunotherapy in children.\n\nVarga, EM\n\nFrancis, JN\n\nZach, MS\n\nKlunker, S\n\nAberer, W\n\nDurham, SR\n\nBeiträge in Fachzeitschriften\nISI:000268759000012\n19538349.0\n10.1111/j.1365-2222.2009.03303.x\nNone\nP>Background Immunotherapy for bee venom allergy is effective and provides long-term protection. Venom-specific IgG4 levels are increased but with no correlation with clinical improvement. Following grass pollen immunotherapy, elevation of antigen-specific IgG4 is accompanied by increases in IgG-dependent serum inhibitory activity for IgE-facilitated binding of allergen-IgE complexes to B cells. As this 'functional' assay of inhibitory antibodies may be more predictive of clinical efficacy, we investigated the time course of serum inhibitory activity for IgE-facilitated antigen binding during venom immunotherapy (VIT) in children and following 2 years of VIT withdrawal. Methods Ten bee venom-allergic children (mean age: 9.3 years; m/f, 7/3) with moderate to severe allergic reactions to bee stings received VIT. A separate group of seven children (mean age: 14 years; m/f, 5/2) were investigated 2 years after VIT withdrawal. Ten age- and gender-matched children served as non-allergic controls. Allergen-specific serum IgG4 and IgE levels were measured by ELISA at baseline, after 2 years of VIT and 2 years after VIT withdrawal. Serum inhibitory activity was assessed using the facilitated-allergen binding (FAB) assay. Results Sera obtained during VIT significantly inhibited allergen-IgE binding to B-cells (pre-treatment=104 +/- 23%; 2 years=46 +/- 15%; P < 0.001) when compared with sera obtained after treatment withdrawal and sera from normal controls. In parallel to FAB inhibition during VIT, significantly higher IgG4 levels were noted after immunotherapy (pre-treatment=8.6 +/- 2.3 AU; 2 years=26.7 +/- 3.5 AU; P < 0.001) compared with those observed after withdrawal and in the controls. In contrast, progressively lower IgE concentrations were observed compared with pre-treatment (44 +/- 7 AU) in sera obtained after 2 years of VIT (25 +/- 5 AU; P < 0.01) and 2 years following the withdrawal of VIT (10 +/- 3 AU; P < 0.05). Conclusions In contrast to grass pollen immunotherapy, the persistent decline in venom-specific IgE levels, rather than serum inhibitory activity for FAB, may be more relevant for long-term clinical efficacy of VIT.\n\nAberer, Werner\n\nVarga, Eva-Maria\n\n\n"
}
]
}