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"text": "\n169853\nCoronary magnetic resonance imaging after routine implantation of bioresorbable vascular scaffolds allows non-invasive evaluation of vascular patency.\n\nvon Zur Mühlen, C\n\nReiss, S\n\nKrafft, AJ\n\nBesch, L\n\nMenza, M\n\nZehender, M\n\nHeidt, T\n\nMaier, A\n\nPfannebecker, T\n\nZirlik, A\n\nReinöhl, J\n\nStachon, P\n\nHilgendorf, I\n\nWolf, D\n\nDiehl, P\n\nWengenmayer, T\n\nAhrens, I\n\nBode, C\n\nBock, M\n\nBeiträge in Fachzeitschriften\nISI:000423416600053\n29370208.0\n10.1371/journal.pone.0191413\nPMC5784929\nEvaluation of recurrent angina after percutaneous coronary interventions is challenging. Since bioresorbable vascular scaffolds (BVS) cause no artefacts in magnetic resonance imaging (MRI) due to their polylactate-based backbone, evaluation of vascular patency by MRI might allow for non-invasive assessment and triage of patients with suspected BVS failure.\n Patients with polylactate-based ABSORB-BVS in proximal coronary segments were examined with 3 Tesla MRI directly (baseline) and one year after implantation. For assessment of coronary patency, a high-resolution 3D spoiled gradient echo pulse sequence with fat-saturation, T2-preparation (TE: 40 ms), respiratory and end-diastolic cardiac gating, and a spatial resolution of (1.08 mm)3 was positioned parallel to the course of the vessel for bright blood imaging. In addition, a 3D navigator-gated T2-weighted variable flip angle turbo spin echo (TSE) sequence with dual-inversion recovery black-blood preparation and elliptical k-space coverage was applied with a voxel size of (1.14 mm)3. For quantitative evaluation lumen diameters of the scaffolded areas were measured in reformatted bright and black blood MR angiography data.\n 11 patients with implantation of 16 BVS in the proximal coronary segments were included, of which none suffered from major adverse cardiac events during the one year follow up. Vascular patency in all segments implanted with BVS could be reliably assessed by MRI at baseline and after one year, whereas segments with metal stents could not be evaluated due to artefacts. Luminal diameter within the BVS remained constant during the one year period. One patient with atypical angina after BVS implantation was noninvasively evaluated showing a patent vessel, also confirmed by coronary angiography.\n Coronary MRI allows contrast-agent free and non-invasive assessment of vascular patency after ABSORB-BVS implantation. This approach might be supportive in the triage and improvement of diagnostic workflows in patients with postinterventional angina and scaffold implantation.\n German Register of Clinical Studies DRKS00007456.\n\nZirlik, Andreas\n\n\n"
},
{
"text": "\n178909\nOutcome of Men With Relapses After Adjuvant Bleomycin, Etoposide, and Cisplatin for Clinical Stage I Nonseminoma.\n\nFischer, S\n\nTandstad, T\n\nCohn-Cedermark, G\n\nThibault, C\n\nVincenzi, B\n\nKlingbiel, D\n\nAlbany, C\n\nNecchi, A\n\nTerbuch, A\n\nLorch, A\n\nAparicio, J\n\nHeidenreich, A\n\nHentrich, M\n\nWheater, M\n\nLangberg, CW\n\nStåhl, O\n\nFankhauser, CD\n\nHamid, AA\n\nKoutsoukos, K\n\nShamash, J\n\nWhite, J\n\nBokemeyer, C\n\nBeyer, J\n\nGillessen, S\n\nGlobal Germ-Cell Cancer Group\n\nBeiträge in Fachzeitschriften\nISI:000526812000011\n31877087.0\n10.1200/JCO.19.01876\nPMC7164488\nClinical stage I (CSI) nonseminoma (NS) is a disease limited to the testis without metastases. One treatment strategy after orchiectomy is adjuvant chemotherapy. Little is known about the outcome of patients who experience relapse after such treatment.\n Data from 51 patients with CSI NS who experienced a relapse after adjuvant bleomycin, etoposide, and cisplatin (BEP) from 18 centers/11 countries were collected and retrospectively analyzed. Primary outcomes were overall and progression-free survivals calculated from day 1 of treatment at first relapse. Secondary outcomes were time to, stage at, and treatment of relapse and rate of subsequent relapses.\n Median time to relapse was 13 months, with the earliest relapse 2 months after start of adjuvant treatment and the latest after 25 years. With a median follow-up of 96 months, the 5-year PFS was 67% (95% CI, 54% to 82%) and the 5-year OS was 81% (95% CI, 70% to 94%). Overall, 19 (37%) of 51 relapses occurred later than 2 years. Late relapses were associated with a significantly higher risk of death from NS (hazard ratio, 1.10 per year; P = .01). Treatment upon relapse was diverse: the majority of patients received a combination of chemotherapy and surgery. Twenty-nine percent of patients experienced a subsequent relapse. At last follow-up, 41 patients (80%) were alive and disease-free, eight (16%) had died of progressive disease, and one patient (2%) each had died from therapy-related or other causes.\n Outcomes of patients with relapse after adjuvant BEP seem better compared with patients who experience relapse after treatment of metastatic disease but worse compared with those who have de-novo metastatic disease. We found a substantial rate of late and subsequent relapses. There seem to be three patterns of relapse with different outcomes: pure teratoma, early viable NS relapse (< 2 years), and late viable NS relapse (> 2 years).\n\nTerbuch, Angelika\n\n\n"
},
{
"text": "\n182415\nUrgent need for off-label use of PAH medications and reimbursement for children with pulmonary hypertension Statement of the Working Group on Pulmonary Hypertension of the German Society for Pediatric Cardiology and Congenital Cardiac Defects (DGPK).\n\nHansmann, G\n\nApitz, C\n\nHumpl, T\n\nKoestenberger, M\n\nMichel-Behnke, I\n\nSchulze-Neick, I\n\nQuandt, D\n\nLammers, AE\n\nBeiträge in Fachzeitschriften\nISI:000535872600002\nNone\n10.1007/s00112-020-00924-w\nNone\nPulmonary hypertension (PH) is a pathological increase in pressure in the pulmonary arteries. The causes of PH are multifactorial and include pathological changes in the pulmonary vessels, diseases of the lung parenchyma or interstitium, or anomalies/dysfunction of left heart structures. Pulmonary arterial hypertension (PAH) is a chronic, progressive and fatal condition for which there is currently no curative treatment, apart from bilateral lung transplantation. Before modern specific medications became available, for children the average survival after the diagnosis PAH was less than 1 year. Due to the latest developments and availability of new PAH-targeted drugs (advanced or targeted therapies), which are approved for PAH in adults, the life expectation and quality of life of adults and children with PAH have substantially improved. In view of (1) the lack of PAH medications approved for children, (2) the solid rationale for combination pharmacotherapy in pediatric PH, and (3) the lack of severe adverse effects, the available advanced pharmacological treatment options should not be withheld, especially not for young PH patients. Such an off-label use and the unbureaucratic reimbursement of PAH medications by healthcare insurances are urgently needed. The decision on specific treatment options for PH with the possibility of combinations of PAH medications from all classes of substances, including off-label medications and preparations, should be the responsibility of pediatric cardiologists. A prerequisite is that the pediatric cardiologist must have sufficient experience with the treatment of PH in children, particularly experience with vasoactive medications. Initiation of PAH-targeted pharmacotherapy should be followed by continuous outpatient monitoring and care of these patients. The lack of approval of advanced (modern) medications for PAH and the paucity of evidence-based implications on their use in children should not prevent expert physicians from offering these pharmacotherapies to young patients with a fatal disease.\n\nKoestenberger, Martin\n\n\n"
},
{
"text": "\n182509\nPeriplocin mediates TRAIL-induced apoptosis and cell cycle arrest in human myxofibrosarcoma cells via the ERK/p38/JNK pathway.\n\nLohberger, B\n\nBernhart, E\n\nStuendl, N\n\nGlaenzer, D\n\nLeithner, A\n\nRinner, B\n\nBauer, R\n\nKretschmer, N\n\nBeiträge in Fachzeitschriften\nISI:000556569600020\n32559583.0\n10.1016/j.phymed.2020.153262\nNone\nPeriploca sepium is traditionally used in Chinese medicine to treat particularly rheumatic disorders and as a tonic. Periplocin was found as the most cytotoxic compound of its root bark and induced death receptor mediated apoptosis in liposarcoma cells. Sarcomas are a rare type of cancer with only a few treatment options. The five-year survival rate of advanced tumors is low.\n In this study, we investigated the effects of periplocin in two myxofibrosarcoma (MFS)cell lines, MUG-Myx2a and MUG-Myx2b, which are subclones of the same tumor and reflect the tumor´s heterogeneity, and in T60 primary myxofibrosarcoma cells.\n The xCELLigence system and the CellTiter 96® AQueous assay were used for studying cell viability. FACS and Western blot experiments were used to investigate the effects of periplocin on apoptosis induction, cell cycle distribution, and the expression of cleaved PARP, caspase 3, p53, phospho-histone γH2AX, ERK/phospho ERK, p38/phospho p38, and, finally, JNK/phospho JNK. Additionally, the expression of the apoptotic markers Bim, NOXA, Bak, Bcl-2, Bcl-xl, and the death receptors IGFR, FADD, TRADD, TNFR1A, TRAIL-R1, and TRAIL-R2 were evaluated using reversed real-time PCR.\n Periplocin decreased dose-dependently the viability of all MFS cell lines and was more effective than the standard chemotherapeutic doxorubicin. It arrested the cells in the G2/M phase and led to caspase activation. Moreover, periplocin increased the mRNA expression of NOXA, Bak, Bcl-2, and death receptors such as TRAIL-R1 and TRAIL-R2 and the protein expression of ERK/phospho ERK, p38/phospho p38, and JNK/phospho JNK. In all cases, differences in the effects in the different subclones were observed.\n Periplocin showed promising effects in MFS cells. The higher effectiveness compared to doxorubicin is an important aspect for further research with regard as a treatment option. The different effects of periplocin in the two subclones showed the great importance of intratumoral heterogeneity in MFS therapy.\n Copyright © 2020 The Authors. Published by Elsevier GmbH.. All rights reserved.\n\nBernhart, Eva Maria\n\nEck, Nicole\n\nGlänzer, Dietmar\n\nLeithner, Andreas\n\nLohberger, Birgit\n\nRinner, Beate\n\n\n"
},
{
"text": "\n182661\nDoes Offline Beat Inline Treatment: Investigation into Extracorporeal Photopheresis.\n\nHelmberg, W\n\nSipurzynski, S\n\nGroselje-Strehle, A\n\nGreinix, H\n\nSchlenke, P\n\nBeiträge in Fachzeitschriften\nISI:000542582600002\n32595424.0\n10.1159/000506750\nPMC7315144\nExtracorporeal photopheresis is a therapy based on the induction of apoptosis to cells harvested from peripheral blood, followed by direct retransfusion. Currently, there are two approaches: inline procedures, where cell harvesting, 8-methoxypsoralen (8-MOP) incubation, and UV irradiation is performed with a single device, and offline procedures, with collection in one device, followed by 8-MOP incubation/UV irradiation using a second device.\n In a prospective crossover study, we compared an inline (Cellex, Therakos) with an established offline procedure (Optia, Terumo, and MacoGenic G2, Macopharma) in 6 patients, focusing on cell composition and apoptosis induction after 24 h. In total, 32 photopheresis treatments per device were performed.\n We observed an overall 2-fold higher number of apoptotic "target" cells for each patient with offline treatment. All yields were stratified per patient. Yields were compared as ratio offline/inline for CD3+ (2.5-fold), CD4+ (2-fold), CD8+ (2.8-fold), CD56+ (2.8-fold), CD19+ (1.8-fold), CD15+ (0.5-fold), and CD14+ (2.2-fold) cells. Apoptosis induction was measured after 24 h with Annexin V/7-AAD for early and late apoptosis rates of CD3+ (CD4+, CD8+) and CD56+ cells. CD3+ cells of the inline treatment had an average of 88% (26% early, 62% late) of apoptotic cells compared to 75% (34% early, 41% late) in the offline treatment. Procedure duration ranged from 80 to 100 min inline, with a maximum of 1, 00 mL processed blood, and 125-140 min offline, with at least 3, 00 mL processed blood, depending on blood flow. Average hematocrit levels of the products were 2.7% inline versus 1.7% offline.\n The offline procedure, as established in our department, provides more apoptotic cells for treatment. The increased number of mononuclear cells collected outweighs a slightly reduced apoptosis rate after 24 h in comparison to the inline procedure. Besides this, the final decision for one or the other procedure has to take into account additional aspects, such as peripheral white blood cell count, hematocrit, and weight of the patient, required before apheresis, extracorporeal volume, and, last but not least, overall costs. The final criterion, however, has to be the reported clinical efficacy of the system applied.\n Copyright © 2020 by S. Karger AG, Basel.\n\nGreinix, Hildegard\n\nGroselj-Strele, Andrea\n\nHelmberg, Wolfgang\n\nSchlenke, Peter\n\n\n"
},
{
"text": "\n22655\nDifferential effects of intragastric acid and capsaicin on gastric emptying and afferent input to the rat spinal cord and brainstem.\n\nHolzer, P\n\nPainsipp, E\n\nSchuligoi, R\n\nBeiträge in Fachzeitschriften\nISI:000232280100001\n16162281.0\n10.1186/1471-2202-6-60\nPMC1239919\nBACKGROUND: Hydrochloric acid (HCl) is a potential threat to the integrity of the gastric mucosa and is known to contribute to upper abdominal pain. We have previously found that gastric mucosal challenge with excess HCl is signalled to the rat brainstem, but not spinal cord, as visualized by expression of c-fos messenger ribonucleic acid (mRNA), a surrogate marker of neuronal excitation. This study examined whether gastric mucosal exposure to capsaicin, a stimulant of nociceptive afferents that does not damage the gastric mucosa, is signalled to both brainstem and spinal cord and whether differences in the afferent signalling of gastric HCl and capsaicin challenge are related to different effects on gastric emptying. RESULTS: Rats were treated intragastrically with vehicle, HCl or capsaicin, activation of neurons in the brainstem and spinal cord was visualized by in situ hybridization autoradiography for c-fos mRNA, and gastric emptying deduced from the retention of intragastrically administered fluid. Relative to vehicle, HCl (0.5 M) and capsaicin (3.2 mM) increased c-fos transcription in the nucleus tractus solitarii by factors of 7.0 and 2.1, respectively. Capsaicin also caused a 5.2-fold rise of c-fos mRNA expression in lamina I of the caudal thoracic spinal cord, although the number of c-fos mRNA-positive cells in this lamina was very small. Thus, on average only 0.13 and 0.68 c-fos mRNA-positive cells were counted in 0.01 mm sections of the unilateral lamina I following intragastric administration of vehicle and capsaicin, respectively. In contrast, intragastric HCl failed to induce c-fos mRNA in the spinal cord. Measurement of gastric fluid retention revealed that HCl suppressed gastric emptying while capsaicin did not. CONCLUSION: The findings of this study show that gastric mucosal exposure to HCl and capsaicin is differentially transmitted to the brainstem and spinal cord. Since only HCl blocks gastric emptying, it is hypothesized that the two stimuli are transduced by different afferent pathways. We infer that HCl is exclusively signalled by gastric vagal afferents whereas capsaicin is processed both by gastric vagal and intestinal spinal afferents.\n\nHolzer, Peter\n\nSchuligoi, Rufina\n\n\n"
},
{
"text": "\n65952\nSafety of low-density lipoprotein cholestrol reduction with atorvastatin versus simvastatin in a coronary heart disease population (the TARGET TANGIBLE trial).\n\nMärz, W\n\nWollschläger, H\n\nKlein, G\n\nNeiss, A\n\nWehling, M\n\nBeiträge in Fachzeitschriften\nISI:000083513000004\n10404843.0\nNone\nNone\nReduction in plasma lipids has been recognized as one of the primary cardiovascular risk reduction strategies in the secondary prevention of coronary heart disease (CHD). The primary end points of TARGET TANGIBLE were the safety (adverse events and laboratory measurements) and efficacy (responder rates) of therapy with atorvastatin versus simvastatin with the aim of achieving low-density lipoprotein (LDL) cholesterol lowering to < or =100 mg/dl (2.6 mmol/L). A total of 3, 48 CHD patients with LDL cholesterol levels > or =130 mg/dl (3.4 mmol/L) entered a run-in diet phase of 6 weeks without any lipid-lowering drug therapy. At the end of the diet phase, 2, 56 patients met the lipid criteria and were randomized to active treatment for 14 weeks. Patients received 10 to 40 mg of either drug in an optional titration design at 2:1 randomization for atorvastatin versus simvastatin. Adverse event rates were statistically equivalent (p<0.01) for simvastatin (35.7%) and for atorvastatin patients (36.3%). Both drugs were well tolerated; <5% of patients in both groups were withdrawn due to adverse events. In all, 37 atorvastatin patients (2%) and 27 simvastatin patients (3%) had serious adverse events. Drug-related side effects (elevations in creatine kinase, liver enzymes) occurred in both groups at similar rates with 10 atorvastatin patients (0.5%) and 5 simvastatin patients (0.5%) presenting confirmed transaminase elevations >3 x the upper limit of the normal range. Significantly fewer patients in the atorvastatin group (n = 724) required titration to 40 mg compared with the simvastatin group (n = 514) (38% vs. 54%, respectively; p<0.001). Atorvastatin resulted in a significantly greater number of patients reaching the LDL cholesterol goal than those treated with simvastatin, with 67% of atorvastatin patients and 53% of simvastatin patients reaching the target LDL cholesterol level of < or =100 mg/dl (2.6 mmol/L) (p<0.001). Both atorvastatin and simvastatin are safe for use by patients in the secondary prevention of CHD, with patients in both drug groups having similar adverse event rates. Despite the use of concomitant medications there was no drug-induced rhabdomyolysis with either atorvastatin or simvastatin.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n114562\nOfficial Positions for FRAX® clinical regarding international differences from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.\n\nCauley, JA\n\nEl-Hajj Fuleihan, G\n\nArabi, A\n\nFujiwara, S\n\nRagi-Eis, S\n\nCalderon, A\n\nChionh, SB\n\nChen, Z\n\nCurtis, JR\n\nDanielson, ME\n\nHanley, DA\n\nKroger, H\n\nKung, AW\n\nLesnyak, O\n\nNieves, J\n\nPluskiewicz, W\n\nEl Rassi, R\n\nSilverman, S\n\nSchott, AM\n\nRizzoli, R\n\nLuckey, M\n\nFRAX(®) Position Conference Members\n\nBeiträge in Fachzeitschriften\nISI:000293989900012\n21810532.0\n10.1016/j.jocd.2011.05.015\nNone\nOsteoporosis is a serious worldwide epidemic. Increased risk of fractures is the hallmark of the disease and is associated with increased morbidity, mortality and economic burden. FRAX® is a web-based tool developed by the Sheffield WHO Collaborating Center team, that integrates clinical risk factors, femoral neck BMD, country specific mortality and fracture data and calculates the 10 year fracture probability in order to help health care professionals identify patients who need treatment. However, only 31 countries have a FRAX® calculator at the time paper was accepted for publication. In the absence of a FRAX® model for a particular country, it has been suggested to use a surrogate country for which the epidemiology of osteoporosis most closely approximates the index country. More specific recommendations for clinicians in these countries are not available. In North America, concerns have also been raised regarding the assumptions used to construct the US ethnic specific FRAX® calculators with respect to the correction factors applied to derive fracture probabilities in Blacks, Asians and Hispanics in comparison to Whites. In addition, questions were raised about calculating fracture risk in other ethnic groups e.g., Native Americans and First Canadians. In order to provide additional guidance to clinicians, a FRAX® International Task Force was formed to address specific questions raised by physicians in countries without FRAX® calculators and seeking to integrate FRAX® into their clinical practice. The main questions that the task force tried to answer were the following: The Task Force members conducted appropriate literature reviews and developed preliminary statements that were discussed and graded by a panel of experts at the ISCD-IOF joint conference. The statements approved by the panel of experts are discussed in the current paper.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n120515\nPrevalence, pathophysiology, health consequences and treatment options of obesity in the elderly: a guideline.\n\nMathus-Vliegen, EM\n\nBasdevant, A\n\nFiner, N\n\nHainer, V\n\nHauner, H\n\nMicic, D\n\nMaislos, M\n\nRoman, G\n\nSchutz, Y\n\nTsigos, C\n\nToplak, H\n\nYumuk, V\n\nZahorska-Markiewicz, B\n\nBeiträge in Fachzeitschriften\nISI:000306051700017\n22797374.0\n10.1159/000341193\nNone\nThe prevalence of obesity is rising progressively, even among older age groups. By the year 2030-2035 over 20% of the adult US population and over 25% of the Europeans will be aged 65 years and older. The predicted prevalence of obesity in Americans, 60 years and older was 37% in 2010. The predicted prevalence of obesity in Europe in 2015 varies between 20 and 30% dependent on the model used. This means 20.9 million obese 60+ people in the USA in 2010 and 32 million obese elders in 2015 in the EU. Although cut-off values of BMI, waist circumference and percentages of fat mass have not been defined for the elderly (nor for the elderly of different ethnicity), it is clear from several meta-analyses that mortality and morbidity associated with overweight and obesity only increases at a BMI above 30 kg/m(2). Thus, treatment should only be offered to patients who are obese rather than overweight and who also have functional impairments, metabolic complications or obesity-related diseases, that can benefit from weight loss. The weight loss therapy should aim to minimize muscle and bone loss but also vigilance as regards the development of sarcopenic obesity - a combination of an unhealthy excess of body fat with a detrimental loss of muscle and fat-free mass including bone - is important in the elderly, who are vulnerable to this outcome. Life-style intervention should be the first step and consists of a diet with a 500 kcal (2.1 MJ) energy deficit and an adequate intake of protein of high biological quality together with calcium and vitamin D, behavioural therapy and multi-component exercise. Multi-component exercise includes flexibility training, balance training, aerobic exercise and resistance training. The adherence rate in most studies is around 75%. Knowledge of constraints and modulators of physical inactivity should be of help to engage the elderly in physical activity. The role of pharmacotherapy and bariatric surgery in the elderly is largely unknown as in most studies people aged 65 years and older have been excluded.\n\nToplak, Hermann\n\n\n"
},
{
"text": "\n125552\nLong-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and MAL for the treatment of actinic keratosis.\n\nThe AK-CT002 and AK-CT003 Study Groups\n\nDirschka, T\n\nRadny, P\n\nDominicus, R\n\nMensing, H\n\nBrüning, H\n\nJenne, L\n\nKarl, L\n\nSebastian, M\n\nOster-Schmidt, C\n\nKlövekorn, W\n\nReinhold, U\n\nTanner, M\n\nGröne, D\n\nDeichmann, M\n\nSimon, M\n\nHübinger, F\n\nHofbauer, G\n\nKrähn-Senftleben, G\n\nBorrosch, F\n\nReich, K\n\nBerking, C\n\nWolf, P\n\nLehmann, P\n\nMoers-Carpi, M\n\nHönigsmann, H\n\nWernicke-Panten, K\n\nHahn, S\n\nPabst, G\n\nVoss, D\n\nFoguet, M\n\nSchmitz, B\n\nLübbert, H\n\nSzeimies, RM\n\nBeiträge in Fachzeitschriften\nISI:000317016100037\n23252768.0\n10.1111/bjd.12158\nPMC3660784\nBackground Two phase III trials of photodynamic therapy (PDT) with BF-200 ALA, a recently approved nanoemulsion formulation of 5-aminolaevulinic acid (ALA) demonstrated high clearance rates in mild-to-moderate actinic keratosis (AK). The comparison to a registered methyl aminolaevulinate (MAL) cream demonstrated significantly superior total patient clearance rates. Objectives To evaluate long-term efficacy and safety of PDT for AK 6 and 12 months after the last PDT with BF-200 ALA, MAL or placebo. Methods The follow-up phase (FUP) was performed with patients of two phase III studies. Both studies compared BF-200 ALA with placebo, one of the studies additionally with MAL. Overall recurrence rates and various subgroups (light source, lesion severity, lesion location, complete responders after first PDT) were assessed 6 and 12 months after the last PDT. Results Recurrence rates were similar for BF-200 ALA and MAL, with a tendency to lower recurrence rates for BF-200 ALA. The proportion of patients who were fully cleared during PDT and remained completely clear for at least 12 months after PDT were 47% for BF-200 ALA (both studies) and 36% for MAL treatment. The subgroup that was illuminated with narrow wavelength LED lamps reached 69% and 53% for BF-200 ALA (both studies, respectively) and 41% for MAL. No safety concerns were reported. Conclusions The FUP data confirmed the high efficacy and safety of PDT with BF-200 ALA. The slightly lower recurrence rates after BF-200 ALA treatment compared with MAL treatment enhanced the better treatment outcome due to the significantly superior efficacy.\n\nWolf, Peter\n\n\n"
},
{
"text": "\n142615\nS-nitroso human serum albumin attenuates pulmonary hypertension, improves right ventricular-arterial coupling, and reduces oxidative stress in a chronic right ventricle volume overload model.\n\nRungatscher, A\n\nHallström, S\n\nLinardi, D\n\nMilani, E\n\nGasser, H\n\nPodesser, BK\n\nScarabelli, TM\n\nLuciani, GB\n\nFaggian, G\n\nBeiträge in Fachzeitschriften\nISI:000352331900026\n25511748.0\n10.1016/j.healun.2014.09.041\nNone\nThis study examined the acute effect of intravenous S-nitroso human serum albumin (S-NO-HSA) infusion on overall hemodynamics and oxidative stress in a chronic left-to-right shunt-induced pulmonary arterial hypertension model with right ventricle (RV) failure.\n An aortocaval fistula (pulmonary-to-systemic blood flow ratio [Qp/Qs] > 2.0) was surgically created in 50 male Wistar rats. After 10 weeks, they were randomly treated with S-NO-HSA (n = 20) or human serum albumin (HSA; n = 25) infusion (0.5 µmol/kg/h) for 60 minutes. A sham group (n = 10) received S-NO-HSA. RV contractility, RV-vascular coupling, and ventricular interdependence were assessed in vivo at different pre-loads by biventricular conductance catheters. Heart and lung biopsy specimens were obtained for determination of high-energy phosphates, oxidative stress (oxidized glutathione/reduced glutathione), and endothelial nitric oxide synthase protein expression.\n S-NO-HSA, compared with HSA infusion, reduced RV afterload expressed by effective pulmonary arterial elastance (Ea; 0.49 ± 0.3 vs 1.2 ± 0.2 mm Hg/ml; p = 0.0005) and improved RV diastolic function (slope of end-diastolic pressure-volume relationship) as well as contractility indicated by slope of end-systolic pressure-volume relationship (Ees). Therefore an increase in efficiency of ventricular-vascular coupling (Ees/Ea) occurred after S-NO-HSA (0.35 ± 0.17 to 0.94 ± 0.21; p = 0.005), but not HSA infusion, leading to positive effect on ventricular interdependence with increased left ventricular stroke volume (56% ± 4% vs 19% ± 5%; p = 0.0013). S-NO-HSA, compared with HSA, treatment improved adenosine 5'-triphosphate (13.9 ± 1.1 vs 7.0 ± 1.8 µmol/g protein) and phosphocreatine (5.9 ± 3.3 vs 1.9 ± 0.6 µmol/g protein; p = 0.01) RV content and decreased the tissue oxidized glutathione/reduced glutathione ratio (p = 0.001).\n S-NO-HSA reduces pulmonary hypertension and improves RV systolic and diastolic function and RV-arterial coupling, with a positive effect on ventricular interdependence by increasing energetic reserve and reducing oxidative stress.\n Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.\n\nHallström, Seth\n\n\n"
},
{
"text": "\n144757\nIPO: a tool for automated optimization of XCMS parameters.\n\nLibiseller, G\n\nDvorzak, M\n\nKleb, U\n\nGander, E\n\nEisenberg, T\n\nMadeo, F\n\nNeumann, S\n\nTrausinger, G\n\nSinner, F\n\nPieber, T\n\nMagnes, C\n\nBeiträge in Fachzeitschriften\nISI:000353101400001\n25888443.0\n10.1186/s12859-015-0562-8\nPMC4404568\nUntargeted metabolomics generates a huge amount of data. Software packages for automated data processing are crucial to successfully process these data. A variety of such software packages exist, but the outcome of data processing strongly depends on algorithm parameter settings. If they are not carefully chosen, suboptimal parameter settings can easily lead to biased results. Therefore, parameter settings also require optimization. Several parameter optimization approaches have already been proposed, but a software package for parameter optimization which is free of intricate experimental labeling steps, fast and widely applicable is still missing.\n We implemented the software package IPO ('Isotopologue Parameter Optimization') which is fast and free of labeling steps, and applicable to data from different kinds of samples and data from different methods of liquid chromatography - high resolution mass spectrometry and data from different instruments. IPO optimizes XCMS peak picking parameters by using natural, stable (13)C isotopic peaks to calculate a peak picking score. Retention time correction is optimized by minimizing relative retention time differences within peak groups. Grouping parameters are optimized by maximizing the number of peak groups that show one peak from each injection of a pooled sample. The different parameter settings are achieved by design of experiments, and the resulting scores are evaluated using response surface models. IPO was tested on three different data sets, each consisting of a training set and test set. IPO resulted in an increase of reliable groups (146% - 361%), a decrease of non-reliable groups (3% - 8%) and a decrease of the retention time deviation to one third.\n IPO was successfully applied to data derived from liquid chromatography coupled to high resolution mass spectrometry from three studies with different sample types and different chromatographic methods and devices. We were also able to show the potential of IPO to increase the reliability of metabolomics data. The source code is implemented in R, tested on Linux and Windows and it is freely available for download at https://github.com/glibiseller/IPO . The training sets and test sets can be downloaded from https://health.joanneum.at/IPO .\n\nPieber, Thomas\n\nSinner, Frank Michael\n\n\n"
},
{
"text": "\n157435\nResults of a population-based-assessment: we need better communication and more profound patient involvement.\n\nSendlhofer, G\n\nPregartner, G\n\nLeitgeb, K\n\nHoffmann, M\n\nBerghold, A\n\nSmolle, C\n\nBrunner, G\n\nKamolz, LP\n\nBeiträge in Fachzeitschriften\nISI:000399888100007\n28101668.0\n10.1007/s00508-016-1165-8\nPMC5399065\nIn Austria several regulations were published in order to support initiatives to increase patient safety. Since then, many patient safety projects were implemented in Austrian hospitals; therefore, it was the aim of the current survey to examine the perceptions of Austrian citizens with respect to topics relevant to patient safety.\n Between 8 and 22 October 2015 a qualitative cross-sectional telephone interview study was performed. A sample of citizens above 14 years of age was randomly drawn. The survey contained 6 questions. In each of the nine states of Austria, a representative number of citizens were interviewed.\n In total 1021(female: 52.3%) telephone interviews were performed and 249 (24.7%) citizens stated that trust/confidence in patient safety is very high, 571 (55.9%) assessed the reputation of a hospital as very important and 739 (72.4%) stated that a detailed explanation of the treatment as well as information on associated risk factors and possibilities of further treatments is very important. Of the respondents 722 (70.7%) stated that patient safety measures in a given hospital are very important, 807 (79.0%) stated that it is important to be informed about patient safety measures and 547 (53.6%) stated that if something did not satisfactorily function they would complain to the hospital. Significant differences occurred for states with and without university hospitals.\n The results of the survey give cause for concern as the majority of interviewed citizens have medium or low trust/confidence in patient safety. Furthermore, more than two-thirds of Austrian citizens revealed that detailed explanation of treatment, information on associated risk factors, information about patient safety measures to predict medical errors and information about patient safety measures which are in place in a hospital are very important. The study showed that patient safety is an important topic for Austrian citizens and they want to be informed and involved. The study also indicated the need to promote patient safety aspects and to decrease the number of people who are not confident concerning patient safety in Austrian hospitals.\n\nBerghold, Andrea\n\nBrunner, Gernot\n\nHoffmann, Magdalena\n\nKamolz, Lars-Peter\n\nPregartner, Gudrun\n\nSendlhofer, Gerald\n\nSmolle, Christian\n\n\n"
},
{
"text": "\n159319\nDiagnosis and Therapy of Female Pelvic Organ Prolapse. Guideline of the DGGG, SGGG and OEGGG (S2e-Level, AWMF Registry Number 015/006, April 2016).\n\nBaeßler, K\n\nAigmüller, T\n\nAlbrich, S\n\nAnthuber, C\n\nFinas, D\n\nFink, T\n\nFünfgeld, C\n\nGabriel, B\n\nHenscher, U\n\nHetzer, FH\n\nHübner, M\n\nJunginger, B\n\nJundt, K\n\nKropshofer, S\n\nKuhn, A\n\nLogé, L\n\nNauman, G\n\nPeschers, U\n\nPfiffer, T\n\nSchwandner, O\n\nStrauss, A\n\nTunn, R\n\nViereck, V\n\nBeiträge in Fachzeitschriften\nISI:000393055700029\n28042167.0\n10.1055/s-0042-119648\nPMC5193153\nAims: The aim was to establish an official interdisciplinary guideline, published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). The guideline was developed for use in German-speaking countries. In addition to the Germany Society of Gynecology and Obstetrics, the guideline has also been approved by the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). This is a guideline published and coordinated by the DGGG. The aim is to provide evidence-based recommendations obtained by evaluating the relevant literature for the diagnostic, conservative and surgical treatment of women with female pelvic organ prolapse with or without stress incontinence. Methods: We conducted a systematic review together with a synthesis of data and meta-analyses, where feasible. MEDLINE, Embase, Cinahl, Pedro and the Cochrane Register were searched for relevant articles. Reference lists were hand-searched, as were the abstracts of the Annual Meetings of the International Continence Society and the International Urogynecological Association. We included only abstracts of randomized controlled trials that were presented and discussed in podium sessions. We assessed original data on surgical procedures published since 2008 with a minimum follow-up time of at least 12 months. If the studies included descriptions of perioperative complications, this minimum follow-up period did not apply. Recommendations: The guideline encompasses recommendations for the diagnosis and treatment of female pelvic organ prolapse. Recommendations for anterior, posterior and apical pelvic organ prolapse with or without concomitant stress urinary incontinence, uterine preservation options, and the pros and cons of mesh placements during surgery for pelvic organ prolapse are presented. The recommendations are based on an extensive and systematic review and evaluation of the current literature and include the experiences and specific conditions in Germany, Austria and Switzerland.\n\nAigmüller, Thomas\n\nHübner, Margit\n\n\n"
},
{
"text": "\n160447\nRecommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016.\n\nLugli, A\n\nKirsch, R\n\nAjioka, Y\n\nBosman, F\n\nCathomas, G\n\nDawson, H\n\nEl Zimaity, H\n\nFléjou, JF\n\nHansen, TP\n\nHartmann, A\n\nKakar, S\n\nLangner, C\n\nNagtegaal, I\n\nPuppa, G\n\nRiddell, R\n\nRistimäki, A\n\nSheahan, K\n\nSmyrk, T\n\nSugihara, K\n\nTerris, B\n\nUeno, H\n\nVieth, M\n\nZlobec, I\n\nQuirke, P\n\nBeiträge in Fachzeitschriften\nISI:000408774900011\n28548122.0\n10.1038/modpathol.2017.46\nNone\nTumor budding is a well-established independent prognostic factor in colorectal cancer but a standardized method for its assessment has been lacking. The primary aim of the International Tumor Budding Consensus Conference (ITBCC) was to reach agreement on an international, evidence-based standardized scoring system for tumor budding in colorectal cancer. The ITBCC included nine sessions with presentations, a pre-meeting survey and an e-book covering the key publications on tumor budding in colorectal cancer. The 'Grading of Recommendation Assessment, Development and Evaluation' method was used to determine the strength of recommendations and quality of evidence. The following 10 statements achieved consensus: tumor budding is defined as a single tumor cell or a cell cluster consisting of four tumor cells or less (22/22, 100%). Tumor budding is an independent predictor of lymph node metastases in pT1 colorectal cancer (23/23, 100%). Tumor budding is an independent predictor of survival in stage II colorectal cancer (23/23, 100%). Tumor budding should be taken into account along with other clinicopathological features in a multidisciplinary setting (23/23, 100%). Tumor budding is counted on H&E (19/22, 86%). Intratumoral budding exists in colorectal cancer and has been shown to be related to lymph node metastasis (22/22, 100%). Tumor budding is assessed in one hotspot (in a field measuring 0.785 mm2) at the invasive front (22/22, 100%). A three-tier system should be used along with the budding count in order to facilitate risk stratification in colorectal cancer (23/23, 100%). Tumor budding and tumor grade are not the same (23/23, 100%). Tumor budding should be included in guidelines/protocols for colorectal cancer reporting (23/23, 100%). Members of the ITBCC were able to reach strong consensus on a single international, evidence-based method for tumor budding assessment and reporting. It is proposed that this method be incorporated into colorectal cancer guidelines/protocols and staging systems.\n\nLangner, Cord\n\n\n"
},
{
"text": "\n161585\nHuman Placental Hofbauer Cells Maintain an Anti-inflammatory M2 Phenotype despite the Presence of Gestational Diabetes Mellitus.\n\nSchliefsteiner, C\n\nPeinhaupt, M\n\nKopp, S\n\nLögl, J\n\nLang-Olip, I\n\nHiden, U\n\nHeinemann, A\n\nDesoye, G\n\nWadsack, C\n\nBeiträge in Fachzeitschriften\nISI:000406478500001\n28824621.0\n10.3389/fimmu.2017.00888\nPMC5534476\nHofbauer cells (HBCs) are macrophages of the feto-placental unit. Despite the general view that these cells have an anti-inflammatory M2 phenotype, recent studies have claimed that pregnancy pathologies-e.g., gestational diabetes mellitus (GDM)-cause a switch from an M2 to an M1 pro-inflammatory phenotype in HBCs. The pilot-study presented here challenges this claim, showing that HBCs maintain anti-inflammatory properties in spite of the hyperglycemic, low-grade inflammatory environment of GDM.\n HBCs were isolated from placentae of healthy women (N = 5) and women with GDM (N = 6) diagnosed in the second trimester. FACS was used to measure surface markers associated with either M1 or M2 phenotype on the cells. In addition, placental tissue sections were subjected to immune histochemical imaging to assess the phenotype within the tissue context. Supernatant from control and GDM HBCs was collected at defined time points and used in a multiplex ELISA-on-beads approach to assess secretion of cytokines, chemokines, and growth factors. The effect of HBC cell culture supernatant on placental endothelial activation was investigated.\n FACS and immune staining showed that, indeed, M2 markers, such as CD206 and CD209, are increased in HBCs isolated from GDM placentae. Also, the M1 marker CD86 was increased, but only by trend. Secretion of numerous cytokines, chemokines and growth factors was not changed; pro-inflammatory interleukin (IL)-1β and IL-6 release form GDM HBC was increased but not significant. Exposure to GDM HBC supernatant did not induce cell adhesion molecules (VCAM-1, selectins, vascular endothelial-cadherin) in placental endothelial cells compared to supernatant from control HBCs, an induction of intracellular adhesion molecule 1 was observed however.\n Our study-although performed in a small set of patients-shows that placental macrophages maintain their anti-inflammatory, tissue remodeling M2 phenotype even in pregnancies affected by gestational diabetes. This consistent phenotype might be important for propagation of maternal tolerance toward the fetus and for protection of the fetus from a low-grade inflammatory environment.\n\nDesoye, Gernot\n\nHeinemann, Akos\n\nHiden, Ursula\n\nLang-Olip, Ingrid\n\nSchliefsteiner, Carolin\n\nWadsack, Christian\n\n\n"
},
{
"text": "\n161678\nDoes increased sunlight exposure work as a strategy to improve vitamin D status in the elderly: a cluster randomised controlled trial.\n\nSambrook, PN\n\nCameron, ID\n\nChen, JS\n\nCumming, RG\n\nDurvasula, S\n\nHerrmann, M\n\nKok, C\n\nLord, SR\n\nMacara, M\n\nMarch, LM\n\nMason, RS\n\nSeibel, MJ\n\nWilson, N\n\nSimpson, JM\n\nBeiträge in Fachzeitschriften\nISI:000299306300022\n21369788.0\n10.1007/s00198-011-1590-5\nNone\nSunlight exposure by improving vitamin D status could be a simple public health strategy in reducing falls among frail elder people. In a randomised controlled trial, adherence to sunlight exposure was low (median adherence, 26%) and no effect of increased UV exposure on falls risk was observed (incidence rate ratio (IRR) 1.06, P = 0.73).\n This study aimed to determine whether increased sunlight exposure was effective to improve vitamin D status and reduce falls in the elderly.\n In a cluster randomised controlled trial (NCT00322166 at ClinicalTrials.gov), 602 residents aged 70 or more (mean age, 86.4 years; 71% female) were recruited from 51 aged care facilities in Northern Sydney, Australia. Participants were randomised by facility to receive either increased sunlight exposure (additional 30-40 min/day in the early morning) with (UV+) or without (UV) calcium supplementation (600 mg/day) or neither (control) for a year. The co-primary endpoints were change in serum 25 hydroxy vitamin D (25OHD) and falls incidence after 12 months.\n Adherence to sunlight exposure was low (median adherence, 26%; IQR, 7%-45%). Serum 25OHD levels were low at baseline (median, 32.9 nmol/L) and increased only slightly depending on the number of sunlight sessions attended over 12 months (P = 0.04). During the study, 327 falls occurred in 111 (54%) subjects in the control group, 326 falls in 111 (58%) subjects in the UV only group and 335 falls in 108 (52%) subjects in the UV+ group. By intention-to-treat analysis, there was no significant effect of increased UV exposure on falls risk (IRR, 1.06; 95% CI, 0.76-1.48; P = 0.73). However, in 66 participants who attended ≥130 sessions per year (adherence, ≥50% of 260 sessions-five per week), falls were significantly reduced (IRR, 0.52; 95% CI, 0.31-0.88; P = 0.01) compared with the control group.\n Increased sunlight exposure did not reduce vitamin D deficiency or falls risk in frail older people. This public health strategy was not effective most likely due to poor adherence to the intervention.\n\nHerrmann, Markus\n\n\n"
},
{
"text": "\n169667\nIncreased hospital costs are associated with low skeletal muscle mass in patients undergoing elective open aortic surgery.\n\nKoter, S\n\nCohnert, TU\n\nHindermayr, KB\n\nLindenmann, J\n\nBrückner, M\n\nOswald, WK\n\nWerkgartner, G\n\nWagner, D\n\nBeiträge in Fachzeitschriften\nISI:000461898800035\n30292610.0\n10.1016/j.jvs.2018.06.224\nNone\nLow psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the United States. We sought to evaluate this effect on hospital expenditure for patients undergoing vascular repair in a health care system with universal access.\n Skeletal muscle mass was assessed on preoperative abdominal computed tomography scans of patients undergoing open aortic aneurysm repair in a retrospective fashion. The skeletal muscle index (SMI) was used to define low muscle mass. Health care costs were obtained for all patients and the relationship between a low SMI and higher costs was explored using linear regression and cross-sectional analysis.\n We included 156 patients (81.5% male) with a median age of 72 years undergoing elective surgery for infrarenal abdominal aortic aneurysm in this analysis. The median SMI for patients with low skeletal muscle mass was 53.21 cm2/kg and for patients without, 70.07 cm2/kg. Hospital duration of stay was 2 days longer in patients with low skeletal muscle mass as compared with patients with normal (14 days vs 11 days; P = .001), as was duration of intensive care stay (3 days vs 1 day; P = .01). The median overall hospital costs were €10, 60 higher for patients with a low SMI as compared with patients with a normal physical constitution (€53, 39 [interquartile range, €45, 07-€62, 71] vs €43, 79 [interquartile range, €39, 09-€47, 49]; P = .001). After confounder adjustment, a low SMI was associated with a 14.68% cost increase in overall hospital costs, for a cost increase of €6521.\n Low skeletal muscle mass is independently associated with higher hospital as well as intensive care costs in patients undergoing elective aortic aneurysm repair. Strategies to reduce this risk factor are warranted for these patients.\n Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.\n\nCohnert, Tina Ulrike\n\nKoter, Stephan Herwig\n\nLindenmann, Jörg\n\nOswald, Wolfgang Kurt\n\nWagner, Doris\n\nWerkgartner, Georg\n\n\n"
},
{
"text": "\n185210\nThe Global State of Hematopoietic Cell Transplantation for Multiple Myeloma: An Analysis of the Worldwide Network of Blood and Marrow Transplantation Database and the Global Burden of Disease Study.\n\nCowan, AJ\n\nBaldomero, H\n\nAtsuta, Y\n\nMikhael, J\n\nAljurf, M\n\nSeber, A\n\nGreinix, H\n\nKoh, M\n\nWorel, N\n\nLibby, EN\n\nPasquini, M\n\nGaleano, S\n\nSaber, W\n\nIida, M\n\nJaimovich, G\n\nRolon, JM\n\nKodera, Y\n\nBenakli, M\n\nNosa, BG\n\nElhaddad, A\n\nSzer, J\n\nPassweg, J\n\nKroeger, N\n\nWeisdorf, D\n\nNiederwieser, D\n\nBeiträge in Fachzeitschriften\nISI:000594542200038\n32846200.0\n10.1016/j.bbmt.2020.08.018\nPMC7767639\nMultiple myeloma (MM) is a plasma cell neoplasm characterized by destructive bony lesions, anemia, and renal impairment. Access to effective therapy is limited globally. We report the rates and utilization of hematopoietic cell transplantation (HCT) globally from 2006-2015 to better characterize access to HCT for patients with MM. This was an analysis of a retrospective survey of Worldwide Network of Blood and Marrow Transplant sites, conducted annually between 2006-2015. Incidence estimates were from the Global Burden of Disease study. Outcome measures included total number of autologous and allogeneic HCTs by world regions, and percentage of newly diagnosed MM patients who underwent HCT, calculated by the number of transplants per region in calendar year/gross annual incidence of MM per region. From 2006 to 2015, the number of autologous HCT performed worldwide for MM increased by 107%. Utilization of autologous HCT was highest in Northern America and European regions, increasing from 13% to 24% in Northern America, and an increase from 15% to 22% in Europe. In contrast, the utilization of autologous HCT was lower in the Africa/Mediterranean region, with utilization only changing from 1.8% in 2006 to 4% in 2015. The number of first allogeneic HCT performed globally for MM declined after a peak in 2012 by -3% since 2006. Autologous HCT utilization for MM has increased worldwide in high-income regions but remains poorly utilized in Africa and the East Mediterranean. More work is needed to improve access to HCT for MM patients, especially in low to middle income countries. © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.\n Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.\n\nGreinix, Hildegard\n\n\n"
},
{
"text": "\n186808\nOptimization of contrast material delivery for dual-energy computed tomography pulmonary angiography in patients with suspected pulmonary embolism.\n\nNance, JW\n\nHenzler, T\n\nMeyer, M\n\nApfaltrer, P\n\nBraunagel, M\n\nKrissak, R\n\nSchoepf, UJ\n\nSchoenberg, SO\n\nFink, C\n\nBeiträge in Fachzeitschriften\nNone\n21577132.0\n10.1097/RLI.0b013e31821a2142\nNone\nTo prospectively compare subjective and objective measures of image quality using 4 different contrast material injection protocols in dual-energy computed tomography pulmonary angiography (CTPA) studies of patients with suspected pulmonary embolism.\n A total of 100 consecutive patients referred for CTPA for the exclusion of pulmonary embolism were randomized into 1 of 4 contrast material injection protocols manipulating iodine concentration and iodine delivery rate (IDR, expressed as grams of iodine per second): Iomeprol 400 at 3 mL/s (IDR = 1.2 gI/s), iomeprol 400 at 4 mL/s (IDR = 1.6 gI/s), iomeprol 300 at 5.4 mL/s (IDR = 1.6 gI/s), or iomeprol 300 at 4 mL/s (IDR = 1.2 gI/s). Total iodine delivery was held constant. Dual-energy CTPA of the lungs were acquired and used to calculate virtual 120 kV CTPA images as well as iodine perfusion maps. Attenuation values in the thoracic vasculature and image quality of virtual 120 kV CTPAs were compared between groups. Iodine perfusion maps were also compared by identifying differences in the extent of beam-hardening artifacts and subjective image quality.\n Protocols with an IDR of 1.6 gI/s provided the best attenuation profiles. CTPA image quality was greatest in the high concentration, high IDR (1.6 gI/s) protocol (P < 0.05 for all group comparisons) with no differences between the other groups (all P ≥ 0.05). Extent of beam-hardening artifacts and perfusion map image quality was significantly better using the high concentration, high IDR protocol as compared with all groups (P < 0.05 for all comparisons) and significantly worse using the low concentration, low IDR protocol as compared with all groups (all P ≥ 0.05); no difference was found between the high concentration, low IDR protocol and the low concentration, high IDR protocol (P = 0.73 for comparison of beam-hardening artifacts; P = 0.50 for comparison of perfusion map image quality).\n High iodine concentration and high IDR contrast material delivery protocols provide the best image quality of both CTPA and perfusion map images of the lung through high attenuation in the pulmonary arteries and minimization of beam-hardening artifacts.\n\nApfaltrer, Paul\n\n\n"
}
]
}