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"text": "\n146870\nThe Nasopalatine Canal in Adults on Cone Beam Computed Tomograms-A Clinical Study and Review of the Literature.\n\nFriedrich, RE\n\nLaumann, F\n\nZrnc, T\n\nAssaf, AT\n\nBeiträge in Fachzeitschriften\nISI:000360504100007\n26130792.0\nNone\nNone\nThe aims of this study were to assess the location, morphology and anatomical dimensions of the nasopalatine canal (NPC) on cone beam computed tomographic (CBCT) images and to compare our findings with recent reports on this matter. A detailed knowledge of anatomical variations is mandatory in skeletal surgery of the anterior maxilla.\n Two hundred CBCT scans of the mid-facial region were analyzed from adult patients at the Outpatient Clinic of the Department of Oral and Craniomaxillofacial Surgery, University of Hamburg, Germany. Patients were scanned using standard exposure time at normal patient positioning inside the CBCT device. Three-dimensional (3D) CBCT images were carefully analyzed regarding NPC location, morphology and anatomical dimensions, and variations of radiological morphology, with respect to age and gender.\n In the sagittal plane, the NPC typically appeared as a canal with a mean length±standard deviation (SD) of 11.15±2.87 mm. The oral cavity opening of the canal is the incisive foramen, with a mean diameter of 4.49±1.71 mm. At the entrance to the nasal floor, in most cases, two apertures were found (Y-canal morphology), but also three or four openings were observed. In particular cases, the canal presented a cylindrical aperture with only one exit to the nasal floor. The average width of the NPC at the level of the nasal floor was 3.43±1.54 mm. The labiopalatal width of the NPC measured perpendicular to the long axis of the canal on sagittal plane was 2.48±1.33 mm. Interpretation of NPC morphology was significantly different when analyzing the images in the sagittal plane only, but the technique allowed demonstration of all aspects using the combined 2D/3D interpretation.\n The NPC may exhibit important anatomical variations, both with regard to morphology and its dimensions. To avoid any potential complications during dentoalveolar surgery, careful preoperative evaluation is required. 3D imaging is recommended to determine canal topography and dimensions, and to assess the individual anterior maxilla's dimensions prior to surgical procedures, such as dental implant insertion or bone augmentation.\n Copyright © 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.\n\nZrnc, Tomislav\n\n\n"
},
{
"text": "\n148379\nPaclitaxel-Coated Balloon in Infrapopliteal Arteries: 12-Month Results From the BIOLUX P-II Randomized Trial (BIOTRONIK'S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries).\n\nZeller, T\n\nBeschorner, U\n\nPilger, E\n\nBosiers, M\n\nDeloose, K\n\nPeeters, P\n\nScheinert, D\n\nSchulte, KL\n\nRastan, A\n\nBrodmann, M\n\nBeiträge in Fachzeitschriften\nISI:000363268600019\n26493253.0\n10.1016/j.jcin.2015.07.011\nNone\nThe aim of BIOLUX P-II (BIOTRONIK'S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries) trial was to compare the safety and efficacy of a novel paclitaxel-coated drug-eluting balloon (DEB) versus an uncoated balloon (percutaneous transluminal angioplasty [PTA]) in de novo or native restenotic lesions of the infrapopliteal arteries in patients with claudication and critical limb ischemia.\n DEB have shown promising results in femoropopliteal lesions, but data for infrapopliteal lesions are scarce.\n In this prospective, multicenter, randomized first-in-man study, 72 patients were randomized 1:1 to either a Passeo-18 Lux DEB (Biotronik AG, Buelach, Switzerland) (n = 36) or Passeo-18 PTA (n = 36). Follow-up assessments were scheduled at 1, 6, and 12 months, with angiographic assessment at 6 months. Adverse events were adjudicated by an independent clinical events committee, and angiographic parameters were assessed by an independent core laboratory.\n The primary safety endpoint (a composite of all-cause mortality, target extremity major amputation, target lesion thrombosis, and target vessel revascularization at 30 days) was 0% in the DEB group versus 8.3% in the PTA group (p = 0.239). The primary performance endpoint (patency loss at 6 months) was 17.1% in the DEB group versus 26.1% in the PTA group (p = 0.298), and major amputations of the target extremity occurred in 3.3% versus 5.6% of the patients at 12 months, respectively.\n The Passeo-18 Lux DEB has been proven to be safe and effective in infrapopliteal lesions with comparable outcomes to PTA.\n Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.\n\nBrodmann, Marianne\n\nPilger, Ernst\n\n\n"
},
{
"text": "\n151734\nDepression-Burnout Overlap in Physicians.\n\nWurm, W\n\nVogel, K\n\nHoll, A\n\nEbner, C\n\nBayer, D\n\nMörkl, S\n\nSzilagyi, IS\n\nHotter, E\n\nKapfhammer, HP\n\nHofmann, P\n\nBeiträge in Fachzeitschriften\nISI:000371434500073\n26930395.0\n10.1371/journal.pone.0149913\nPMC4773131\nWhether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three "core" components (emotional exhaustion, depersonalization and low personal accomplishment) are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians.\n In a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI), the Hamburg Burnout Inventory (HBI), as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8%) participated. The data of 5897 participants were suitable for analysis.\n Of the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21-4.06) for physicians with mild, 10.14 (95% CI 7.58-13.59) for physicians with moderate, 46.84 (95% CI 35.25-62.24) for physicians with severe burnout and 92.78 (95% CI 62.96-136.74) for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components). The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization) tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy) than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92) explained more HBI_sum variance than the three "core" components (adj.R2 = 0.85) of burnout combined. Cronbach's alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three "core" components.\n This study demonstrates the overlap of burnout and major depression in terms of symptoms and the deficiency of the three-dimensional concept of burnout. In our opinion, it might be preferable to use multidimensional burnout inventories in combination with valid depression scales than to rely exclusively on MBI when clinically assessing burnout.\n\nHoll, Anna\n\nKapfhammer, Hans-Peter\n\nMörkl, Sabrina\n\nSzilagyi, Istvan - Szilard\n\nWurm, Walter Ernst\n\n\n"
},
{
"text": "\n164320\nIn Situ Detection and Quantification of AR-V7, AR-FL, PSA, and <i>KRAS</i> Point Mutations in Circulating Tumor Cells.\n\nEl-Heliebi, A\n\nHille, C\n\nLaxman, N\n\nSvedlund, J\n\nHaudum, C\n\nErcan, E\n\nKroneis, T\n\nChen, S\n\nSmolle, M\n\nRossmann, C\n\nKrzywkowski, T\n\nAhlford, A\n\nDarai, E\n\nvon Amsberg, G\n\nAlsdorf, W\n\nKönig, F\n\nLöhr, M\n\nde Kruijff, I\n\nRiethdorf, S\n\nGorges, TM\n\nPantel, K\n\nBauernhofer, T\n\nNilsson, M\n\nSedlmayr, P\n\nBeiträge in Fachzeitschriften\nISI:000426295200020\n29301749.0\n10.1373/clinchem.2017.281295\nNone\nLiquid biopsies can be used in castration-resistant prostate cancer (CRPC) to detect androgen receptor splice variant 7 (AR-V7), a splicing product of the androgen receptor. Patients with AR-V7-positive circulating tumor cells (CTCs) have greater benefit of taxane chemotherapy compared with novel hormonal therapies, indicating a treatment-selection biomarker. Likewise, in those with pancreatic cancer (PaCa), KRAS mutations act as prognostic biomarkers. Thus, there is an urgent need for technology investigating the expression and mutation status of CTCs. Here, we report an approach that adds AR-V7 or KRAS status to CTC enumeration, compatible with multiple CTC-isolation platforms.\n We studied 3 independent CTC-isolation devices (CellCollector, Parsortix, CellSearch) for the evaluation of AR-V7 or KRAS status of CTCs with in situ padlock probe technology. Padlock probes allow highly specific detection and visualization of transcripts on a cellular level. We applied padlock probes for detecting AR-V7, androgen receptor full length (AR-FL), and prostate-specific antigen (PSA) in CRPC and KRAS wild-type (wt) and mutant (mut) transcripts in PaCa in CTCs from 46 patients.\n In situ analysis showed that 71% (22 of 31) of CRPC patients had detectable AR-V7 expression ranging from low to high expression [1-76 rolling circle products (RCPs)/CTC]. In PaCa patients, 40% (6 of 15) had KRAS mut expressing CTCs with 1 to 8 RCPs/CTC. In situ padlock probe analysis revealed CTCs with no detectable cytokeratin expression but positivity for AR-V7 or KRAS mut transcripts.\n Padlock probe technology enables quantification of AR-V7, AR-FL, PSA, and KRAS mut/wt transcripts in CTCs. The technology is easily applicable in routine laboratories and compatible with multiple CTC-isolation devices.\n © 2017 American Association for Clinical Chemistry.\n\nBauernhofer, Thomas\n\nChen, Shukun\n\nEl-Heliebi, Amin\n\nHaudum, Christoph\n\nKroneis, Thomas\n\nSedlmayr, Peter\n\nSmolle, Maria Anna\n\n\n"
},
{
"text": "\n169074\nHuman fetoplacental arterial and venous endothelial cells are differentially programmed by gestational diabetes mellitus, resulting in cell-specific barrier function changes.\n\nCvitic, S\n\nNovakovic, B\n\nGordon, L\n\nUlz, CM\n\nMühlberger, M\n\nDiaz-Perez, FI\n\nJoo, JE\n\nSvendova, V\n\nSchimek, MG\n\nTrajanoski, S\n\nSaffery, R\n\nDesoye, G\n\nHiden, U\n\nBeiträge in Fachzeitschriften\nISI:000446122800015\n30091044.0\n10.1007/s00125-018-4699-7\nPMC6182654\nAn adverse intrauterine environment can result in permanent changes in the physiology of the offspring and predispose to diseases in adulthood. One such exposure, gestational diabetes mellitus (GDM), has been linked to development of metabolic disorders and cardiovascular disease in offspring. Epigenetic variation, including DNA methylation, is recognised as a leading mechanism underpinning fetal programming and we hypothesised that this plays a key role in fetoplacental endothelial dysfunction following exposure to GDM. Thus, we conducted a pilot epigenetic study to analyse concordant DNA methylation and gene expression changes in GDM-exposed fetoplacental endothelial cells.\n Genome-wide methylation analysis of primary fetoplacental arterial endothelial cells (AEC) and venous endothelial cells (VEC) from healthy pregnancies and GDM-complicated pregnancies in parallel with transcriptome analysis identified methylation and expression changes. Most-affected pathways and functions were identified by Ingenuity Pathway Analysis and validated using functional assays.\n Transcriptome and methylation analyses identified variation in gene expression linked to GDM-associated DNA methylation in 408 genes in AEC and 159 genes in VEC, implying a direct functional link. Pathway analysis found that genes altered by exposure to GDM clustered to functions associated with 'cell morphology' and 'cellular movement' in healthy AEC and VEC. Further functional analysis demonstrated that GDM-exposed cells had altered actin organisation and barrier function.\n Our data indicate that exposure to GDM programs atypical morphology and barrier function in fetoplacental endothelial cells by DNA methylation and gene expression change. The effects differ between AEC and VEC, indicating a stringent cell-specific sensitivity to adverse exposures associated with developmental programming in utero.\n DNA methylation and gene expression datasets generated and analysed during the current study are available at the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database ( http://www.ncbi.nlm.nih.gov/geo ) under accession numbers GSE106099 and GSE103552, respectively.\n\nDesoye, Gernot\n\nHiden, Ursula\n\nSchimek, Michael\n\nTokic, Silvija\n\nTrajanoski, Slave\n\nUlz, Christine Maria\n\n\n"
},
{
"text": "\n176809\nIntraoperative acidosis and hypercapnia during thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula.\n\nZani, A\n\nLamas-Pinheiro, R\n\nParaboschi, I\n\nKing, SK\n\nWolinska, J\n\nZani-Ruttenstock, E\n\nEaton, S\n\nPierro, A\n\nBeiträge in Fachzeitschriften\nISI:000405082800011\n28631351.0\n10.1111/pan.13178\nNone\nIntraoperative hypercapnia and acidosis have been associated with thoracoscopic repair of both congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula.\n The aim of the present study was to investigate whether thoracoscopic repair of congenital diaphragmatic hernia or esophageal atresia/tracheoesophageal fistula was associated with acidosis and hypercapnia in a large group of neonates, and to analyze the effects of acidosis and hypercapnia on early postoperative outcomes.\n We reviewed the charts of neonates who underwent open or thoracoscopic congenital diaphragmatic hernia or esophageal atresia/tracheoesophageal fistula repair (2004-2014). Patients with available intraoperative arterial gas values were included. Data (PaCO2 : mm Hg) were compared using paired/unpaired tests and are reported as difference [95% confidence interval].\n Congenital diaphragmatic hernia: 187 neonates underwent open (n=153) or thoracoscopic (n=34) repair. Intraoperative arterial gas values were recorded in 96 open and in 23 thoracoscopic operations. Both groups had similar preoperative pH and PaCO2 , and developed intraoperative acidosis (open -0.08 [-0.11, -0.05] P<.001, thoracoscopic -0.14 [-0.24, -0.04] P=.01) and hypercapnia (open: 7.8 [3.2, 12.4], P=.002; thoracoscopic: 20.2 [-2.5, 43, P=.07). Intraoperatively, neonates undergoing thoracoscopic repair developed lower pH than those having open surgery (-0.06 [-0.01, -0.10] P=.018), but maintained similar levels of PaCO2 (-4.0 [-9.0, 4.4] P=.39). Esophageal atresia/tracheoesophageal fistula: 205 neonates underwent open (n=180) or thoracoscopic (n=25) repair. Intraoperative arterial gas values were recorded in 62 open and in 14 thoracoscopic operations. Both groups had similar preoperative pH and PaCO2 , and developed intraoperative acidosis (open: -0.09 [-0.14, -0.04], P<.001; thoracoscopic: 0.21 [-0.28, -0.14], P<.001) and hypercapnia (open: 9.2 [2.6, 15.7] P=.008; thoracoscopic: 15.2 [1.6, 28.7], P=.03). Intraoperatively, neonates undergoing thoracoscopic repair developed lower pH than those having open surgery (difference 0.08 [0.01, 0.15], P=.02) but maintained similar levels of PaCO2 (difference -1 [-9, 3], P=.35).\n Neonates undergoing operative repair of congenital diaphragmatic hernia and esophageal atresia/tracheoesophageal fistula develop intraoperative acidosis and hypercapnia, regardless of the approach used. However, this phenomenon is more severe during thoracoscopic repair. Novel modalities to reduce intraoperative gas derangements, particularly during thoracoscopic repair, need to be established.\n © 2017 John Wiley & Sons Ltd.\n\n\n"
},
{
"text": "\n187673\nScoring the Risk of Having Systemic Mastocytosis in Adult Patients with Mastocytosis in the Skin\n\nFuchs, D\n\nKilbertus, A\n\nKofler, K\n\nvon Bubnoff, N\n\nShoumariyeh, K\n\nZanotti, R\n\nBonadonna, P\n\nScaffidi, L\n\nDoubek, M\n\nElberink, HO\n\nSpan, LFR\n\nHermine, O\n\nElena, C\n\nBenvenuti, P\n\nYavuz, AS\n\nBrockow, K\n\nZink, A\n\nAberer, E\n\nGorska, A\n\nRomantowski, J\n\nHadzijusufovic, E\n\nFortina, AB\n\nCaroppo, F\n\nPerkins, C\n\nIllerhaus, A\n\nPanse, J\n\nVucinic, V\n\nJawhar, M\n\nSabato, V\n\nTriggiani, M\n\nParente, R\n\nBergstrom, A\n\nBreynaert, C\n\nGotlib, J\n\nReiter, A\n\nHartmann, K\n\nNiedoszytko, M\n\nArock, M\n\nKluin-Nelemans, HC\n\nSperr, WR\n\nGreul, R\n\nValent, P\n\nBeiträge in Fachzeitschriften\nISI:000637779800035\n33346151.0\n10.1016/j.jaip.2020.12.022\nNone\nBACKGROUND: Mastocytosis in adults often presents with skin lesions. A bone marrow biopsy is necessary to confirm or exclude the presence of systemic mastocytosis (SM) in these cases. When a bone marrow biopsy is not performed, the provisional diagnosis is mastocytosis in the skin (MIS). No generally accepted scoring system has been established to estimate the risk of SM in these patients. OBJECTIVE: To develop a risk score to predict SM in adults with MIS. METHODS: We examined 1145 patients with MIS from the European Competence Network on Mastocytosis Registry who underwent a bone marrow biopsy. A total of 944 patients had SM and 201 patients had cutaneous mastocytosis; 63.7% were female, and 36.3% were male. Median age was 44 +/- 13.3 years. The median serum tryptase level amounted to 29.3 +/- 81.9 ng/mL. We established a multivariate regression model using the whole population of patients as a training and validation set (bootstrapping). A risk score was developed and validated with receiver-operating curves. RESULTS: In the multivariate model, the tryptase level (P < .001), constitutional/cardiovascular symptoms (P = .014), and bone symptoms/osteoporosis (P < .001) were independent predictors of SM (P < .001; sensitivity, 90.7%; specificity, 69.1%). A 6-point risk score was established (risk, 10.7%-98.0%) and validated. CONCLUSIONS: Using a large data set of the European Competence Network on Mastocytosis Registry, we created a risk score to predict the presence of SM in patients with MIS. Although the score will need further validation in independent cohorts, our score seems to discriminate safely between patients with SM and with pure cutaneous mastocytosis. (C) 2020 American Academy of Allergy, Asthma & Immunology\n\n\n"
},
{
"text": "\n2272\nReversal of Borrelia burgdorferi associated dilated cardiomyopathy by antibiotic treatment?\n\nGasser, R\n\nFruhwald, F\n\nSchumacher, M\n\nSeinost, G\n\nReisinger, E\n\nEber, B\n\nKeplinger, A\n\nHorvath, R\n\nSedaj, B\n\nKlein, W\n\nPierer, K\n\nBeiträge in Fachzeitschriften\nISI:A1996VE92100010\n8877079.0\nNone\nNone\nIt is suggested that Borrelia burgdorferi infection could be associated with dilated cardiomyopathy (IDC). Stanek et al. were able to cultivate Borrelia burgdorferi from myocardial biopsy tissue of a patient with longstanding dilated cardiomyopathy. Here we present a study in which we examined the effect of standard antibiotic treatment on the left ventricular ejection fraction (LVEF) in patients with dilated cardiomyopathy associated with Borrelia burgdorferi infection. In this study we assessed the serum (IgG, IgM Elisa) and history of 46 IDC patients with specific regard to Borrelia burgdorferi infection (mean LVEF 30.4 +/- 1.3%, measured by cardiac catheterization and echocardiography with the length-area-volume method). All 46 patients received standard treatment for dilated cardiomyopathy: ACE inhibitors, digitalis, and diuretics. Eleven (24%) patients showed positive serology and a history of Borrelia burgdorferi infection; nine of these also had a typical history of tick bite and erythema chronicum migrans (ECM) and/or other organ involvement, and two had no recollection of tick bite or ECM but showed other Borrelia burgdorferi-associated disorders (neuropathy, oligoarthritis). These 11 patients with Borrelia burgdorferi infection received standard antibiotic treatment with intravenous ceftriaxone 2 g bid for 14 days. Six (55%) recovered completely and showed a normal LVEF after 6 months, three (27%) improved their LVEF, and two (18%) did not improve at all. This amounts to nine (82%) patients with recovery/improvement in the Borrelia burgdorferi group. The 35 patients who did not show positive serology or a history of Borrelia burgdorferi infection did not receive antibiotic treatment. In this group without Borrelia burgdorferi infection 12 (26%), showed recovery/improvement following the standard treatment of dilated cardiomyopathy (see earlier). Our results indicate that Borrelia burgdorferi infection could play a decisive role in the development of dilated cardiomyopathy, especially in a geographical region such as Graz, where Borrelia burgdorferi is endemic. While we are aware of the small number of Borrelia burgdorferi patients in this study, we nevertheless conclude that in a remarkable number of patients with signs of Borrelia burgdorferi infection, dilated cardiomyopathy could be reversed and LVEF improved.\n\nFruhwald, Friedrich\n\nGasser, Robert\n\nSchumacher, Martin\n\nSeinost, Gerald\n\n\n"
},
{
"text": "\n2684\nToward universal criteria for gestational diabetes: relationships between seventy-five and one hundred gram glucose loads and between capillary and venous glucose concentrations.\n\nWeiss, PA\n\nHaeusler, M\n\nKainer, F\n\nPürstner, P\n\nHaas, J\n\nBeiträge in Fachzeitschriften\nISI:000073362100029\n9579452.0\n10.1016/S0002-9378(98)70500-9\nNone\nOBJECTIVES: Replacement of the two-step, 100 gm, 3-hour National Diabetes Data Group procedure by the one-step, 75 gm, 2-hour World Health Organization oral glucose tolerance test has been hindered by a paucity of data comparing the two tests during pregnancy. The current series compared 100 gm and 75 gm glucose loads and glucose measurements in venous plasma or capillary blood. STUDY DESIGN: After a 75 gm oral glucose tolerance test 30 gestational diabetics and 30 metabolically healthy pregnant women were randomly assigned to a second 75 or 100 gm test within 3 +/- 1.3 (mean +/- SD) days. Glucose levels at both tests was measured in capillary blood and venous plasma, as were insulin and C peptide. RESULTS: In controls 1-hour maternal glucose levels (112 vs 128 mg/dl) and 2-hour levels (104 vs 113 mg/dl) differed significantly after a 75 or 100 gm load (paired t test). In gestational diabetes mellitus, however, there was no difference (176 vs 178 mg/dl) but a low insulin/glucose quotient at 1 hour. Only 2-hour levels differed significantly (133 vs 149 mg/dl). In controls glucose measurement in capillary blood and venous plasma differed significantly at 1 hour (126 vs 115 mg/dl) and 2 hours (111 vs 104 mg/dl) independently of the glucose load. In gestational diabetes mellitus, however, glucose measurement in capillary blood and venous plasma differed neither in 1-hour levels (179 vs 174 mg/dl) nor in 2-hour levels (142 vs 139 mg/dl). CONCLUSION: In metabolically healthy women both different loading and different blood fractions lead to statistically different blood glucose levels at 1 and 2 hours. In gestational diabetes mellitus, however, 1-hour glucose levels do not differ after a 75 or 100 gm load or after glucose measurement in capillary blood or venous plasma. This is due to elevated insulin resistance shown by a low insulin/glucose quotient at 1 hour. For comparison of tests in gestational diabetes mellitus only, 2-hour values must be adjusted by 16 mg/dl after different loading.\n\nHaas, Josef\n\n\n"
},
{
"text": "\n89978\nTreatment Modalities of Obesity What fits whom?\n\nHainer, V\n\nToplak, H\n\nMitrakou, A\n\nBeiträge in Fachzeitschriften\nISI:000264701200028\n18227496.0\n10.2337/dc08-s265\nNone\nThe prevalence of obesity is increasing in both developed and developing countries, with rates reaching approximately 10-35% among adults in the Euro-American region. Obesity is associated with increased risks of cardiovascular diseases, type 2 diabetes, arthritis, and some type of cancers. Obesity significantly affects the quality of life and reduces the average life expectancy. The effective treatment of obesity should address both the medical and the social burden of this disease. Obesity needs to be treated within the health care system as any other complex disease, with empathy and without prejudice. Both health care providers and patients should know that the obesity treatment is a lifelong task. They should also set realistic goals before starting the treatment, whereas keeping in mind that even a modest weight loss of 5-15% significantly reduces obesity-related health risks. Essential treatment of obesity includes low-calorie low-fat diets, increased physical activity, and strategies contributing to the modification of lifestyle. Anti-obesity drugs facilitate weight loss and contribute to further amelioration of obesity-related health risks. A short-term weight loss, up to 6 months, is usually achieved easily. However, the long-term weight management is often associated with a lack of compliance, failures, and a high dropout rate. Regular physical activity, cognitive behavioral modification of lifestyle, and administration of anti-obesity drugs improve weight loss maintenance. Bariatric surgery is an effective strategy to treat severely obese patients. Bariatric surgery leads to a substantial improvement of comorbidities as well as to a reduction in overall mortality by 25-50% during the long-term follow-up. Obesity treatment should be individually tailored and the following factors should be taken into account: sex, the degree of obesity, individual health risks, psychobehavioral and metabolic characteristics, and the outcome of previous weight loss attempts. In the future, an evaluation of hormonal and genetic determinants of weight loss could also contribute to a better choice of individual therapy for a particular obese patient. A multilevel obesity management network of mutually collaborating facilities should be established to provide individually tailored treatment. Centers of excellence in obesity management represented by multidisciplinary teams should provide comprehensive programs for the treatment of obesity derived from evidence-based medicine.\n\nToplak, Hermann\n\n\n"
},
{
"text": "\n110519\nLipoprotein (a) and risk of cardiovascular disease--a systematic review and meta analysis of prospective studies.\n\nGenser, B\n\nDias, KC\n\nSiekmeier, R\n\nStojakovic, T\n\nGrammer, T\n\nMaerz, W\n\nBeiträge in Fachzeitschriften\nISI:000290595200002\n21500721.0\nNone\nNone\nBackground: Several studies have investigated the role of Lipoprotein (a) as a risk factor for cardiovascular disease (CVD) and have produced controversial results. Data Sources: We conducted a systematic literature review in the databases MEDLINE, EMBASE, and COCHRANE aimed at retrieving prospective studies that investigated the prognostic value of Lipoprotein (a) concentrations on cardiovascular risk and mortality. Methods: From each study we extracted estimates of risk ratios (RR) with respect to the risk of CVD (endpoints: all coronary heart disease (CHD) events pooled, major coronary events, myocardial infarction, stroke) and all cause mortality. Study specific risk ratios were standardised to contrast the top third with the bottom third of the study specific Lipoprotein (a) distribution. Pooled summary estimates were calculated by using fixed and random effects meta analysis techniques, in total and stratified by study design and study population. Results: For the present meta analysis we selected 67 prospective studies including 181, 83 individuals. Synthesising data from 37 studies that reported estimates for the endpoint 'CHD events' resulted in a RR of 1.57 (95 % Cl: 1.41 to 1.75, p < 0.001). For this endpoint subgroup analyses by design and population showed significant estimates: population based cohort studies: n = 15 studies, RR = 1.48 (95 % Cl: 1.26 to 1.74, p < 0.001), cohort studies including patients with previous disease: total: n = 11 studies, RR = 1.67 (95 % Cl: 1.28 to 2.17, p < 0.001), with CHD: n = 6 studies, RR = 2.37 (95 % Cl: 1.41 to 3.97, p = 0.001), nested case control studies: n = 11 studies, RR = 1.64 (95 % Cl: 1.47 to 1.83, p < 0.001). We did not find any significant effect on risk of stroke (n = 16 studies, RR = 1.10 (95 % Cl: 0.97 to 1.25, p = 0.137)) and mortality (n = 9 studies, RR = 1.12 (95 % Cl: 0.94 to 1.33, p = 0.200)). Conclusions: This meta analysis of prospective studies shows a clear association between elevated Lipoprotein (a) levels and increased risk of CHD. This effect is substantially higher in individuals with previous CHD. Our systematic review showed no evidence of an effect on stroke and all cause mortality. (Clin. Lab. 2011;57:143-156)\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n114262\nCollecting system invasion and Fuhrman grade but not tumor size facilitate prognostic stratification of patients with pT2 renal cell carcinoma.\n\nBrookman-May, S\n\nMay, M\n\nZigeuner, R\n\nShariat, SF\n\nScherr, DS\n\nChromecki, T\n\nMoch, H\n\nWild, PJ\n\nMohamad-Al-Ali, B\n\nCindolo, L\n\nWieland, WF\n\nSchips, L\n\nDe Cobelli, O\n\nRocco, B\n\nSantoro, L\n\nDe Nunzio, C\n\nTubaro, A\n\nComan, I\n\nFeciche, B\n\nTruss, M\n\nDalpiaz, O\n\nHohenfellner, M\n\nGilfrich, C\n\nWirth, MP\n\nBurger, M\n\nPahernik, S\n\nCORONA Project (Collaborative Research on Renal Neoplasms Association)\n\nBeiträge in Fachzeitschriften\nISI:000296758600008\n22014800.0\n10.1016/j.juro.2011.07.105\nNone\nPurpose: The 7th edition of TNM for renal cell carcinoma introduced a subdivision of pT2 tumors at a 10 cm cutoff. In the present multicenter study the influence of tumor size as well as further clinical and histopathological parameters on cancer specific survival in patients with pT2 tumors was evaluated. Materials and Methods: A total of 670 consecutive patients with pT2 tumors (10.4%) of 6, 42 surgically treated patients with all tumor stages were pooled (mean followup 71.4 months). Tumors were reclassified according to the current TNM classification, and subdivided in stages pT2a and pT2b. Cancer specific survival was analyzed using the Kaplan-Meier method, and univariable and multivariable analyses were used to assess the influence of several parameters on survival. Results: Tumor size continuously applied and subdivided at 10 cm or alternative cutoffs did not significantly influence cancer specific survival. In addition to N/M stage, Fuhrman grade and collecting system invasion also had an independent influence on survival. Integration of a dichotomous variable subsuming Fuhrman grade and collecting system invasion (grade 3/4 and/or collecting system invasion present vs grade 1/2 and collecting system invasion absent) into multivariate models including established prognostic parameters resulted in improvement of predictive abilities by 11% (HR 2.3, p <0.001) for all pT2 cases and 151% (HR 3.1, p <0.001) for stage pT2N0M0 cases. Conclusions: Tumor size did not have a significant influence on cancer specific survival in pT2 tumors, neither continuously applied nor based on various cutoff values. To enhance prognostic discrimination, multifactorial staging systems including pathological features should be implemented. The prognostic relevance of the variable subsuming Fuhrman grade and collecting system invasion should be considered for future evaluation.\n\nDalpiaz, Orietta\n\nZigeuner, Richard\n\n\n"
},
{
"text": "\n115064\nPositive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study.\n\nEherer, AJ\n\nNetolitzky, F\n\nHögenauer, C\n\nPuschnig, G\n\nHinterleitner, TA\n\nScheidl, S\n\nKraxner, W\n\nKrejs, GJ\n\nHoffmann, KM\n\nBeiträge in Fachzeitschriften\nISI:000301496600005\n22146488.0\n10.1038/ajg.2011.420\nNone\nThe lower esophageal sphincter (LES), surrounded by diaphragmatic muscle, prevents gastroesophageal reflux. When these structures become incompetent, gastric contents may cause gastroesophageal reflux disease (GERD). For treatment, lifestyle interventions are always recommended. We hypothesized that by actively training the crura of the diaphragm as part of the LES using breathing training exercises, GERD can be positively influenced.\n A prospective randomized controlled study was performed. Patients with non-erosive GERD or healed esophagitis without large hernia and/or previous surgery were included. Patients were randomized and allocated either to active breathing training program or to a control group. Quality of life (QoL), pH-metry, and on-demand proton pump inhibitor (PPI) usage were assessed at baseline and after 4 weeks of training. For long-term follow-up, all patients were invited to continue active breathing training and were further assessed regarding QoL and PPI usage after 9 months. Paired and unpaired t-test was used for statistical analysis.\n Nineteen patients with non-erosive GERD or healed esophagitis were randomized into two groups (10 training group and 9 control group). There was no difference in baseline patient characteristics between the groups and all patients finished the study. There was a significant decrease in time with a pH<4.0 in the training group (9.1±1.3 vs. 4.7±0.9%; P<0.05), but there was no change in the control group. QoL scores improved significantly in the training group (13.4±1.98 before and 10.8±1.86 after training; P<0.01), but no changes in QoL were seen in the control group. At long-term follow-up at 9 months, patients who continued breathing exercise (11/19) showed a significant decrease in QoL scores and PPI usage (15.1±2.2 vs. 9.7±1.6; 98±34 vs. 25±12 mg/week, respectively; P<0.05), whereas patients who did not train had no long-term effect.\n We show that actively training the diaphragm by breathing exercise can improve GERD as assessed by pH-metry, QoL scores and PPI usage. This non-pharmacological lifestyle intervention could help to reduce the disease burden of GERD.\n\nEherer, Andreas\n\nHoegenauer, Christoph\n\nHoffmann, Karl Martin\n\nKrejs, Günter Josef\n\nScheidl, Stefan\n\n\n"
},
{
"text": "\n125143\nDriving cessation and dementia: results of the prospective registry on dementia in Austria (PRODEM).\n\nSeiler, S\n\nSchmidt, H\n\nLechner, A\n\nBenke, T\n\nSanin, G\n\nRansmayr, G\n\nLehner, R\n\nDal-Bianco, P\n\nSanter, P\n\nLinortner, P\n\nEggers, C\n\nHaider, B\n\nUranues, M\n\nMarksteiner, J\n\nLeblhuber, F\n\nKapeller, P\n\nBancher, C\n\nSchmidt, R\n\nPRODEM Study Group\n\nBeiträge in Fachzeitschriften\nISI:000313618800128\n23300746.0\n10.1371/journal.pone.0052710\nPMC3530518\nObjective: To assess the influence of cognitive, functional and behavioral factors, co-morbidities as well as caregiver characteristics on driving cessation in dementia patients.\nMethods: The study cohort consists of those 240 dementia cases of the ongoing prospective registry on dementia in Austria (PRODEM) who were former or current car-drivers (mean age 74.2 (+/- 8.8) years, 39.6% females, 80.8% AlzheimerANDapos;s disease). Reasons for driving cessation were assessed with the patientsANDapos; caregivers. Standardized questionnaires were used to evaluate patient-and caregiver characteristics. Cognitive functioning was determined by Mini-Mental State Examination (MMSE), the CERAD neuropsychological test battery and Clinical Dementia Rating (CDR), activities of daily living (ADL) by the Disability Assessment for Dementia, behavior by the Neuropsychiatric Inventory (NPI) and caregiver burden by the Zarit burden scale.\nResults: Among subjects who had ceased driving, 136 (93.8%) did so because of ANDquot;Unacceptable riskANDapos;ANDapos; according to caregiverANDapos;s judgment. Car accidents and revocation of the driving license were responsible in 8 (5.5%) and 1(0.7%) participant, respectively. Female gender (OR 5.057; 95% CI 1.803-14.180; p = 0.002), constructional abilities (OR 0.611; 95% CI 0.445-0.839; p = 0.002) and impairment in Activities of Daily Living (OR 0.941; 95% CI 0.911-0.973; pANDlt;0.001) were the only significant and independent associates of driving cessation. In multivariate analysis none of the currently proposed screening tools for assessment of fitness to drive in elderly subjects including the MMSE and CDR were significantly associated with driving cessation.\nConclusion: The risk-estimate of caregivers, but not car accidents or revocation of the driving license determines if dementia patients cease driving. Female gender and increasing impairment in constructional abilities and ADL raise the probability for driving cessation. If any of these factors also relates to undesired traffic situations needs to be determined before recommendations for their inclusion into practice parameters for the assessment of driving abilities in the elderly can be derived from our data.\n\nKapeller, Peter\n\nSchmidt, Helena\n\nSchmidt, Reinhold\n\n\n"
},
{
"text": "\n138006\nAntibodies in the diagnosis of coeliac disease: a biopsy-controlled, international, multicentre study of 376 children with coeliac disease and 695 controls.\n\nWolf, J\n\nHasenclever, D\n\nPetroff, D\n\nRichter, T\n\nUhlig, HH\n\nLaaß, MW\n\nHauer, A\n\nStern, M\n\nBossuyt, X\n\nde Laffolie, J\n\nFlemming, G\n\nVillalta, D\n\nSchlumberger, W\n\nMothes, T\n\nBeiträge in Fachzeitschriften\nISI:000336789500126\n24830313.0\n10.1371/journal.pone.0097853\nPMC4022637\nDiagnosis of coeliac disease (CD) relies on a combination of clinical, genetic, serological and duodenal morphological findings. The ESPGHAN suggested that biopsy may not be necessary in all cases. New guidelines include omission of biopsy if the concentration of CD-specific antibodies exceeds 10 times the upper limit of normal (10 ULN) and other criteria are met. We analysed the 10 ULN criterion and investigated multiple antibody-assays. Serum was collected from 1071 children with duodenal biopsy (376 CD patients, 695 disease-controls). IgA-antibodies to tissue transglutaminase (IgA-aTTG), IgG-antibodies to deamidated gliadin peptides (IgG-aDGL) and IgA-endomysium antibodies (IgA-EMA) were measured centrally. We considered 3 outcomes for antibody test procedures utilizing IgA-aTTG and/or IgG-aDGL: positive (≥10 ULN, recommend gluten-free diet), negative (<1 ULN, no gluten-free diet) or unclear (perform biopsy). Positive (PPV) and negative (NPV) predictive values were based on clear test results. We required that they and their lower confidence bounds (LCB) be simultaneously very high (LCB >90% and PPV/NPV >95%). These stringent conditions were met for appropriate antibody-procedures over a prevalence range of 9-57%. By combining IgG-aDGL with IgA-aTTG, one could do without assaying total IgA. The PPV of IgG-aDGL was estimated to be extremely high, although more studies are necessary to narrow down the LCB. The proportion of patients requiring a biopsy was <11%. The procedures were either equivalent or even better in children <2 years compared to older children. All 310 of the IgA-aTTG positive children were also IgA-EMA positive. Antibody-assays could render biopsies unnecessary in most children, if experienced paediatric gastroenterologists evaluate the case. This suggestion only applies to the kits used here and should be verified for other available assays. Confirming IgA-aTTG positivity (≥10 ULN) by EMA-testing is unnecessary if performed on the same blood sample. Prospective studies are needed.\n\nHauer, Almuthe\n\n\n"
},
{
"text": "\n151382\nCurrent management strategies and long-term clinical outcomes of upper extremity venous thrombosis.\n\nBleker, SM\n\nvan Es, N\n\nKleinjan, A\n\nBüller, HR\n\nKamphuisen, PW\n\nAggarwal, A\n\nBeyer-Westendorf, J\n\nCamporese, G\n\nCosmi, B\n\nGary, T\n\nGhirarduzzi, A\n\nKaasjager, K\n\nLerede, T\n\nMarschang, P\n\nMeijer, K\n\nOtten, HM\n\nPorreca, E\n\nRighini, M\n\nVerhamme, P\n\nvan Wissen, S\n\nDi Nisio, M\n\nBeiträge in Fachzeitschriften\nISI:000379163300014\n26866515.0\n10.1111/jth.13291\nNone\nEssentials Few data exist on outcome of upper extremity deep and superficial vein thrombosis (UEDVT and UESVT). We followed 102 and 55 patients with UEDVT or UESVT, respectively, for a median of 3.5 years. Risk of recurrent venous thromboembolism was low in both diseases, and the mortality high. Postthrombotic symptoms were infrequent and cancer patients had a higher risk of recurrent VTE.\n Background There is scant information on the optimal management and clinical outcome of deep and superficial vein thrombosis of the upper extremity (UEDVT and UESVT). Objectives To explore treatment strategies and the incidence of recurrent venous thromboembolism (VTE), mortality, postthrombotic symptoms, and bleeding in patients with UEDVT and UESVT and to assess the prognosis of cancer patients with UEDVT. Patients/methods Follow-up of patients with UEDVT or UESVT, who were enrolled previously in a diagnostic management study. Results We followed 102 and 55 patients with UEDVT and UESVT, respectively, both for a median of 3.5 years. Anticoagulant treatment was started in 100 patients with UEDVT (98%) and in 40 (73%) with UESVT. Nine patients with UEDVT (9%) developed recurrent VTE, 26 (26%) died, 6 (8%) of 72 patients had moderate postthrombotic symptoms, and 5 (5%) experienced major bleeding. One patient with UESVT had a recurrent VTE, 18 (33%) died, none had moderate postthrombotic symptoms, and none had major bleeding. Of the cancer patients with UEDVT, 18% had recurrent VTE vs. 7.5% in non-cancer patients (adjusted hazard ratio 2.2, 95%CI 0.6-8.2). The survival rate was 50% in cancer patients with UEDVT vs. 60% in those without (adjusted HR 0.8, 95%CI 0.4-1.4). Conclusions The risk of recurrent VTE was low in patients with UEDVT, and negligible for UESVT. Mortality was high for both diseases. Postthrombotic symptoms were infrequent and mild. Anticoagulant therapy of UEDVT carried a substantial risk of major bleeding. Cancer patients had a significant risk of recurrent VTE.\n © 2016 International Society on Thrombosis and Haemostasis.\n\nGary, Thomas\n\n\n"
},
{
"text": "\n154246\n1-Oleyl-lysophosphatidic acid (LPA) promotes polarization of BV-2 and primary murine microglia towards an M1-like phenotype.\n\nPlastira, I\n\nBernhart, E\n\nGoeritzer, M\n\nReicher, H\n\nKumble, VB\n\nKogelnik, N\n\nWintersperger, A\n\nHammer, A\n\nSchlager, S\n\nJandl, K\n\nHeinemann, A\n\nKratky, D\n\nMalle, E\n\nSattler, W\n\nBeiträge in Fachzeitschriften\nISI:000382878200008\n27565558.0\n10.1186/s12974-016-0701-9\nPMC5002165\nMicroglia, the immunocompetent cells of the CNS, rapidly respond to brain injury and disease by altering their morphology and phenotype to adopt an activated state. Microglia can exist broadly between two different states, namely the classical (M1) and the alternative (M2) phenotype. The first is characterized by the production of pro-inflammatory cytokines/chemokines and reactive oxygen and/or nitrogen species. In contrast, alternatively activated microglia are typified by an anti-inflammatory phenotype supporting wound healing and debris clearance. The objective of the present study was to determine the outcome of lysophosphatidic acid (LPA)-mediated signaling events on microglia polarization.\n LPA receptor expression and cyto-/chemokine mRNA levels in BV-2 and primary murine microglia (PMM) were determined by qPCR. M1/M2 marker expression was analyzed by Western blotting, immunofluorescence microscopy, or flow cytometry. Cyto-/chemokine secretion was quantitated by ELISA.\n BV-2 cells express LPA receptor 2 (LPA2), 3, 5, and 6, whereas PMM express LPA1, 2, 4, 5, and 6. We show that LPA treatment of BV-2 and PMM leads to a shift towards a pro-inflammatory M1-like phenotype. LPA treatment increased CD40 and CD86 (M1 markers) and reduced CD206 (M2 marker) expression. LPA increased inducible nitric oxide synthase (iNOS) and COX-2 levels (both M1), while the M2 marker Arginase-1 was suppressed in BV-2 cells. Immunofluorescence studies (iNOS, COX-2, Arginase-1, and RELMα) extended these findings to PMM. Upregulation of M1 markers in BV-2 and PMM was accompanied by increased cyto-/chemokine transcription and secretion (IL-1β, TNFα, IL-6, CCL5, and CXCL2). The pharmacological LPA5 antagonist TCLPA5 blunted most of these pro-inflammatory responses.\n LPA drives BV-2 and PMM towards a pro-inflammatory M1-like phenotype. Suppression by TCLPA5 indicates that the LPA/LPA5 signaling axis could represent a potential pharmacological target to interfere with microglia polarization in disease.\n\nBernhart, Eva Maria\n\nGöritzer, Madeleine\n\nHammer, Astrid\n\nHeinemann, Akos\n\nHinteregger, Helga\n\nJandl, Katharina\n\nKratky, Dagmar\n\nMalle, Ernst\n\nPlastira, Ioanna\n\nSattler, Wolfgang\n\nWintersperger, Andrea\n\n\n"
},
{
"text": "\n178772\nRadiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art-outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).\n\nDiez-Perez, A\n\nBrandi, ML\n\nAl-Daghri, N\n\nBranco, JC\n\nBruyère, O\n\nCavalli, L\n\nCooper, C\n\nCortet, B\n\nDawson-Hughes, B\n\nDimai, HP\n\nGonnelli, S\n\nHadji, P\n\nHalbout, P\n\nKaufman, JM\n\nKurth, A\n\nLocquet, M\n\nMaggi, S\n\nMatijevic, R\n\nReginster, JY\n\nRizzoli, R\n\nThierry, T\n\nBeiträge in Fachzeitschriften\nISI:000498621300003\n31422565.0\n10.1007/s40520-019-01294-4\nPMC6763416\nThe purpose of this paper was to review the available approaches for bone strength assessment, osteoporosis diagnosis and fracture risk prediction, and to provide insights into radiofrequency echographic multi spectrometry (REMS), a non-ionizing axial skeleton technique.\n A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review the current image-based methods for bone strength assessment and fracture risk estimation, and to discuss the clinical perspectives of REMS.\n Areal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the consolidated indicator for osteoporosis diagnosis and fracture risk assessment. A more reliable fracture risk estimation would actually require an improved assessment of bone strength, integrating also bone quality information. Several different approaches have been proposed, including additional DXA-based parameters, quantitative computed tomography, and quantitative ultrasound. Although each of them showed a somewhat improved clinical performance, none satisfied all the requirements for a widespread routine employment, which was typically hindered by unclear clinical usefulness, radiation doses, limited accessibility, or inapplicability to spine and hip, therefore leaving several clinical needs still unmet. REMS is a clinically available technology for osteoporosis diagnosis and fracture risk assessment through the estimation of BMD on the axial skeleton reference sites. Its automatic processing of unfiltered ultrasound signals provides accurate BMD values in view of fracture risk assessment.\n New approaches for improved bone strength and fracture risk estimations are needed for a better management of osteoporotic patients. In this context, REMS represents a valuable approach for osteoporosis diagnosis and fracture risk prediction.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n184554\nBiologic drug survival rates in the era of anti-Il-17 antibodies: a time period-adjusted registry analysis.\n\nGraier, T\n\nSalmhofer, W\n\nJonak, C\n\nWeger, W\n\nKölli, C\n\nGruber, B\n\nSator, PG\n\nPrillinger, K\n\nMlynek, A\n\nSchütz-Bergmayr, M\n\nRichter, L\n\nRatzinger, G\n\nPainsi, C\n\nSelhofer, S\n\nHäring, N\n\nWippel-Slupetzky, K\n\nSkvara, H\n\nTrattner, H\n\nTanew, A\n\nInzinger, M\n\nTatarski, R\n\nBangert, C\n\nEllersdorfer, C\n\nLichem, R\n\nGruber-Wackernagel, A\n\nHofer, A\n\nLegat, F\n\nSchmiedberger, E\n\nStrohal, R\n\nLange-Asschenfeldt, B\n\nSchmuth, M\n\nVujic, I\n\nHoetzenecker, W\n\nTrautinger, F\n\nSaxinger, W\n\nMüllegger, R\n\nQuehenberger, F\n\nWolf, P\n\nBeiträge in Fachzeitschriften\nISI:000620332100001\n33289075.0\n10.1111/bjd.19701\nNone\nDrug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time-dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options.\n To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis, or previous biologic treatment.\n This observational, retrospective, multicenter cohort study analyzed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between January 1, 2015 and November 30, 2019.\n A total of 1572 patients who received 1848 treatment cycles were included in this analysis. Highest long-term PASI improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naivety, its superiority vanished and drug survival rates were similar for ixekizumab (89.1%), secukinumab (88.8%), and ustekinumab (92.5%), all of them superior to adalimumab (76.7%) and etanercept (72.1%) at 12 months and beyond. Besides biologic non-naivety (2.10, p=0.00000067), introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1.6, p=0.0013) and female gender (1.50, p=0.019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (0.89, p=0.21).\n The time-dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.\n This article is protected by copyright. All rights reserved.\n\nGraier, Thomas\n\nGruber-Wackernagel, Alexandra\n\nHofer, Angelika\n\nLegat, Franz\n\nPainsi, Clemens\n\nQuehenberger, Franz\n\nSalmhofer, Wolfgang\n\nSchmiedberger, Erich\n\nWeger, Wolfgang\n\nWolf, Peter\n\n\n"
},
{
"text": "\n2695\nTraction on the mesentery as a model of visceral nociception.\n\nHolzer-Petsche, U\n\nBrodacz, B\n\nBeiträge in Fachzeitschriften\nISI:000079378600034\n10204745.0\n10.1016%2FS0304-3959%2898%2900233-4\nNone\nTraction of the mesentery is known to induce strong autonomic reactions in patients undergoing abdominal surgery. An experimental model using this stimulus in anaesthetized rats has been developed, which allows the comparison of noxious mechanical and chemical stimulation of the mesentery. Graded traction on a bundle of jejunal vessels with 2-30 g led to reflex changes in blood pressure and intragastric pressure, the size of which correlated with the strength of the stimulus. Comparable responses were elicited by clamping the same vessels either at their distal or proximal end or by applying 100 microl 0.6% acetic acid or 0. microM bradykinin. These reflexes are fairly insensitive towards impairment of the autonomic system. Only the combination of phentolamine and propranolol reduced the cardiovascular responses to all stimuli but at the same time, significantly lowered basal blood pressure. The adrenoceptor antagonists affected the gastric response to acid only. Atropine on its own was ineffective. Administered together with the combination of adrenoceptor blockers it had no further influence on the cardiovascular reflexes but significantly reduced the gastric responses to stretch, proximal clamping and acid. Acute desensitization of small diameter afferents with capsaicin almost abolished the reflex responses to acid. The cardiovascular, but not the gastric, response to traction was reduced by capsaicin. Morphine led to dose-dependent reductions of the reflex responses in a naloxone-reversible manner, whereas indomethacin was inactive. The bradykinin B2-antagonist icatibant abolished the reflex in response to the application of bradykinin but not to acid or traction. It is concluded that the measurement of the cardiovascular and gastric responses of anaesthetized rats to traction on the mesentery is a suitable method to investigate acute visceral nociception. Chemical stimuli to the mesentery are transmitted by capsaicin-sensitive afferents, but there is a dichotomy regarding capsaicin's influence on visceral mechanonociception. Opioid mechanisms are always involved, whereas prostaglandins or bradykinin have no role in the reflexes evoked by acid or traction. Intact alpha- or beta-adrenergic (as tested with unselective receptor antagonists) or muscarinic mechanisms are required for the reaction of the end organs in the reflex but they have no role in the afferent or central processing.\n\nHolzer, Ulrike\n\n\n"
}
]
}