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"text": "\n17527\nEarly enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction.\n\nGabor, S\n\nRenner, H\n\nMatzi, V\n\nRatzenhofer, B\n\nLindenmann, J\n\nSankin, O\n\nPinter, H\n\nMaier, A\n\nSmolle, J\n\nSmolle-Jüttner, FM\n\nBeiträge in Fachzeitschriften\nISI:000229679200013\n15946413.0\n10.1079/BJN20041383\nNone\nAfter resective and reconstructive surgery in the gastrointestinal tract, oral feeding is traditionally avoided in order to minimize strain to the anastomoses and to reduce the inherent risks of the postoperatively impaired gastrointestinal motility. However, studies have given evidence that the small bowel recovers its ability to absorb nutrients almost immediately following surgery, even in the absence of peristalsis, and that early enteral feeding would preserve both the integrity of gut mucosa and its immunological function. The aim of this study was to investigate the impact of early enteral feeding on the postoperative course following oesophagectomy or oesophagogastrectomy, and reconstruction. Between May 1999 and November 2002, forty-four consecutive patients (thirty-eight males and six females; mean age 62, range 30-82) with oesophageal carcinoma (stages I-III), who had undergone radical resection and reconstruction, entered this study (early enteral feeding group; EEF). A historical group of forty-four patients (thirty-seven males and seven females; mean age 64, range 41-79; stages I-III) resected between January 1997 and March 1999 served as control (parenteral feeding group; PF). The duration of both postoperative stay in the Intensive Care Unit (ICU) and the total hospital stay, perioperative complications and the overall mortality were compared. Early enteral feeding was administered over the jejunal line of a Dobhoff tube. It started 6 h postoperatively at a rate of 10 ml/h for 6 h with stepwise increase until total enteral nutrition was achieved on day 6. In the controls oral enteral feeding was begun on day 7. If compared to the PF group, EEF patients recovered faster considering the duration of both stay in the ICU and in the hospital. There was a significant difference in the interval until the first bowel movements. No difference in overall 30 d mortality was identified. A poor nutritional status was a significant prognostic factor for an increased mortality. Early enteral feeding significantly reduces the duration of ICU treatment and total hospital stay in patients who undergo oesophagectomy or oesophagogastrectomy for oesophageal carcinoma. The mortality rate is not affected.\n\nLindenmann, Jörg\n\nMaier, Alfred\n\nMatzi, Veronika\n\nSankin, Oliver\n\nSmolle, Josef\n\nSmolle-Juettner, Freyja-Maria\n\n\n"
},
{
"text": "\n79956\nNeoangiogenesis after combined transplantation of skeletal myoblasts and angiopoietic progenitors leads to increased cell engraftment and lower apoptosis rates in ischemic heart failure.\n\nBonaros, N\n\nRauf, R\n\nWerner, E\n\nSchlechta, B\n\nRohde, E\n\nKocher, A\n\nBonatti, J\n\nLaufer, G\n\nBeiträge in Fachzeitschriften\nNone\n17925321.0\n10.1510/icvts.2007.162917\nNone\nOBJECTIVES: We previously reported that combined transplantation of skeletal myoblasts and AC-133+ cells leads to improved left ventricular function, reduced infarct size and myocardial apoptosis in a model of chronic ischemia. The aim of this study is to elucidate on the possible mechanisms and to assess new implications in increasing cell therapy efficacy in chronic ischemia. METHODS: Heart failure was induced by LAD-ligation in nude rats. (a) Homologous skeletal myoblasts (SM), (b) human derived AC-133+ cells (SC), (c) combination of both cells (Comb) and (d) culture medium (CM) were injected in the infarct and peri-infarct area, respectively, four weeks after infarction. Cell engraftment was detected by fluorescence microscopy and confirmed by immunohistochemical techniques. Cardiac gene expression levels of VEFG-A, cardiac troponin, ACTA2, SDF-1, TGF-beta-1, were assessed by RT-PCR. RESULTS: Both cell types were detected in the injection areas four weeks after cell transplantation. Double cell therapy led to increased cell engraftment (SM: 52+/-13/mm(2), SC: 45+/-8 in the combination group vs. SM: 31+/-9 and 23+/-7 in the monotherapy groups, P=0.007). This effect was confirmed using PCR. Apoptotic index among engrafted cells was significantly lower in the Comb group (Comb: 0.53+/-0.12 for myoblasts and 0.34+/-0.09 for SC, vs. SM: 0.76+/-0.19 and SC: 0.63+/-0.16, P=0.013). Expression of cardiac troponin was higher in the combination group in the peri-infarct area. Evaluation of capillary density revealed increased angiogenesis in the combination group (Comb: 12.3+/-2.3, SM: 5.2+/-1.2, SC: 8.3+/-1.8, P=0.002). Neoangiogenesis was associated with higher levels of VEGF-A and TGF-beta in the injection areas as detected by RT-PCR. The higher SDF-1 expression in the injected areas implies an increased secretion of chemoattractants by the injected cells, which suggests that the effect of combined cell transplantation is mainly associated with paracrine mechanisms. CONCLUSIONS: The mechanism of functional improvement after combined transplantation of skeletal myoblasts and AC-133+ progenitors in ischemic heart failure is mainly associated with increased angiogenesis based on paracrine factors, which leads to improved survival and lower apoptosis rates of the injected cells.\n\n\n"
},
{
"text": "\n142876\nUpregulation of fibroblast growth factor receptor 2 and 3 in the late stages of fetal lung development in the nitrofen rat model.\n\nFriedmacher, F\n\nDoi, T\n\nGosemann, JH\n\nFujiwara, N\n\nKutasy, B\n\nPuri, P\n\nBeiträge in Fachzeitschriften\nISI:000300679700012\n21994076.0\n10.1007/s00383-011-2985-2\nNone\nNitrofen model of congenital diaphragmatic hernia (CDH) has been widely used to investigate the pathogenesis of pulmonary hypoplasia (PH). Fibroblast growth factor (FGF) signaling pathway plays a fundamental role in fetal lung development. FGF7 and FGF10, which are critical for lung morphogenesis, have been reported to be downregulated in nitrofen-induced PH. FGF signaling is mediated by a family of four single transmembrane receptors, FGFR1-4. FGFR2 and FGFR3 have been shown to be expressed predominantly in the late stages of developing lungs. In addition, the upregulation of FGFR2 gene expression has been associated with severe defects in lung development and resulted in arrested alveologenesis similar to PH seen in the nitrofen model. Furthermore, FGFR3(-/-)FGFR4(-/-) double mutants showed thinner mesenchyme and larger air spaces. We designed this study to test the hypothesis that FGFR gene expression is upregulated in the late stages of lung development in the nitrofen CDH model.\n Pregnant rats were exposed to either olive oil or nitrofen on day 9 of gestation (D9). Cesarean section was performed and fetuses were harvested on D18 and D21. Fetal lungs were divided into three groups: control, nitrofen without CDH [CDH(-)], and nitrofen with CDH [CDH(+)] (n = 24 at each time-point). Pulmonary gene expression levels of FGFR1-4 were analyzed by real-time RT-PCR. Immunohistochemistry was also performed to evaluate protein expression/distribution at each time-point.\n The relative messenger RNA expression levels of pulmonary FGFR2 and FGFR3 on D21 were significantly increased in CDH(-) (6.38 ± 1.93 and 7.84 ± 2.86, respectively) and CDH(+) (7.09 ± 2.50 and 7.25 ± 3.43, respectively) compared to controls (P < 0.05 and P < 0.01, respectively), whereas no significant alteration was observed on D18. There were no differences in FGFR1 and FGFR4 expression at both time-points. Increased immunoreactivity of FGFR2 and FGFR3, mainly in the distal epithelium and mesenchyme, was observed in the nitrofen-induced hypoplastic lungs on D21 compared to controls.\n Upregulation of FGFR2 and FGFR3 pulmonary gene expression in the late stages of fetal lung development may disrupt FGFR-mediated alveologenesis resulting in PH in the CDH model.\n\n\n"
},
{
"text": "\n154203\nAnalysis of Plasminogen Genetic Variants in Multiple Sclerosis Patients.\n\nSadovnick, AD\n\nTraboulsee, AL\n\nBernales, CQ\n\nRoss, JP\n\nForwell, AL\n\nYee, IM\n\nGuillot-Noel, L\n\nFontaine, B\n\nCournu-Rebeix, I\n\nAlcina, A\n\nFedetz, M\n\nIzquierdo, G\n\nMatesanz, F\n\nHilven, K\n\nDubois, B\n\nGoris, A\n\nAstobiza, I\n\nAlloza, I\n\nAntigüedad, A\n\nVandenbroeck, K\n\nAkkad, DA\n\nAktas, O\n\nBlaschke, P\n\nButtmann, M\n\nChan, A\n\nEpplen, JT\n\nGerdes, LA\n\nKroner, A\n\nKubisch, C\n\nKümpfel, T\n\nLohse, P\n\nRieckmann, P\n\nZettl, UK\n\nZipp, F\n\nBertram, L\n\nLill, CM\n\nFernandez, O\n\nUrbaneja, P\n\nLeyva, L\n\nAlvarez-Cermeño, JC\n\nArroyo, R\n\nGaragorri, AM\n\nGarcía-Martínez, A\n\nVillar, LM\n\nUrcelay, E\n\nMalhotra, S\n\nMontalban, X\n\nComabella, M\n\nBerger, T\n\nFazekas, F\n\nReindl, M\n\nSchmied, MC\n\nZimprich, A\n\nVilariño-Güell, C\n\nBeiträge in Fachzeitschriften\nISI:000379590200027\n27194806.0\n10.1534/g3.116.030841\nPMC4938660\nMultiple sclerosis (MS) is a prevalent neurological disease of complex etiology. Here, we describe the characterization of a multi-incident MS family that nominated a rare missense variant (p.G420D) in plasminogen (PLG) as a putative genetic risk factor for MS. Genotyping of PLG p.G420D (rs139071351) in 2160 MS patients, and 886 controls from Canada, identified 10 additional probands, two sporadic patients and one control with the variant. Segregation in families harboring the rs139071351 variant, identified p.G420D in 26 out of 30 family members diagnosed with MS, 14 unaffected parents, and 12 out of 30 family members not diagnosed with disease. Despite considerably reduced penetrance, linkage analysis supports cosegregation of PLG p.G420D and disease. Genotyping of PLG p.G420D in 14446 patients, and 8797 controls from Canada, France, Spain, Germany, Belgium, and Austria failed to identify significant association with disease (P = 0.117), despite an overall higher prevalence in patients (OR = 1.32; 95% CI = 0.93-1.87). To assess whether additional rare variants have an effect on MS risk, we sequenced PLG in 293 probands, and genotyped all rare variants in cases and controls. This analysis identified nine rare missense variants, and although three of them were exclusively observed in MS patients, segregation does not support pathogenicity. PLG is a plausible biological candidate for MS owing to its involvement in immune system response, blood-brain barrier permeability, and myelin degradation. Moreover, components of its activation cascade have been shown to present increased activity or expression in MS patients compared to controls; further studies are needed to clarify whether PLG is involved in MS susceptibility.\n Copyright © 2016 Sadovnick et al.\n\nFazekas, Franz\n\n\n"
},
{
"text": "\n156469\nNo Association of Coronary Artery Disease with X-Chromosomal Variants in Comprehensive International Meta-Analysis.\n\nLoley, C\n\nAlver, M\n\nAssimes, TL\n\nBjonnes, A\n\nGoel, A\n\nGustafsson, S\n\nHernesniemi, J\n\nHopewell, JC\n\nKanoni, S\n\nKleber, ME\n\nLau, KW\n\nLu, Y\n\nLyytikäinen, LP\n\nNelson, CP\n\nNikpay, M\n\nQu, L\n\nSalfati, E\n\nScholz, M\n\nTukiainen, T\n\nWillenborg, C\n\nWon, HH\n\nZeng, L\n\nZhang, W\n\nAnand, SS\n\nBeutner, F\n\nBottinger, EP\n\nClarke, R\n\nDedoussis, G\n\nDo, R\n\nEsko, T\n\nEskola, M\n\nFarrall, M\n\nGauguier, D\n\nGiedraitis, V\n\nGranger, CB\n\nHall, AS\n\nHamsten, A\n\nHazen, SL\n\nHuang, J\n\nKähönen, M\n\nKyriakou, T\n\nLaaksonen, R\n\nLind, L\n\nLindgren, C\n\nMagnusson, PK\n\nMarouli, E\n\nMihailov, E\n\nMorris, AP\n\nNikus, K\n\nPedersen, N\n\nRallidis, L\n\nSalomaa, V\n\nShah, SH\n\nStewart, AF\n\nThompson, JR\n\nZalloua, PA\n\nChambers, JC\n\nCollins, R\n\nIngelsson, E\n\nIribarren, C\n\nKarhunen, PJ\n\nKooner, JS\n\nLehtimäki, T\n\nLoos, RJ\n\nMärz, W\n\nMcPherson, R\n\nMetspalu, A\n\nReilly, MP\n\nRipatti, S\n\nSanghera, DK\n\nThiery, J\n\nWatkins, H\n\nDeloukas, P\n\nKathiresan, S\n\nSamani, NJ\n\nSchunkert, H\n\nErdmann, J\n\nKönig, IR\n\nBeiträge in Fachzeitschriften\nISI:000385004200001\n27731410.0\n10.1038/srep35278\nPMC5059659\nIn recent years, genome-wide association studies have identified 58 independent risk loci for coronary artery disease (CAD) on the autosome. However, due to the sex-specific data structure of the X chromosome, it has been excluded from most of these analyses. While females have 2 copies of chromosome X, males have only one. Also, one of the female X chromosomes may be inactivated. Therefore, special test statistics and quality control procedures are required. Thus, little is known about the role of X-chromosomal variants in CAD. To fill this gap, we conducted a comprehensive X-chromosome-wide meta-analysis including more than 43, 00 CAD cases and 58, 00 controls from 35 international study cohorts. For quality control, sex-specific filters were used to adequately take the special structure of X-chromosomal data into account. For single study analyses, several logistic regression models were calculated allowing for inactivation of one female X-chromosome, adjusting for sex and investigating interactions between sex and genetic variants. Then, meta-analyses including all 35 studies were conducted using random effects models. None of the investigated models revealed genome-wide significant associations for any variant. Although we analyzed the largest-to-date sample, currently available methods were not able to detect any associations of X-chromosomal variants with CAD.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n159131\nColorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.\n\nFerlitsch, M\n\nMoss, A\n\nHassan, C\n\nBhandari, P\n\nDumonceau, JM\n\nPaspatis, G\n\nJover, R\n\nLangner, C\n\nBronzwaer, M\n\nNalankilli, K\n\nFockens, P\n\nHazzan, R\n\nGralnek, IM\n\nGschwantler, M\n\nWaldmann, E\n\nJeschek, P\n\nPenz, D\n\nHeresbach, D\n\nMoons, L\n\nLemmers, A\n\nParaskeva, K\n\nPohl, J\n\nPonchon, T\n\nRegula, J\n\nRepici, A\n\nRutter, MD\n\nBurgess, NG\n\nBourke, MJ\n\nBeiträge in Fachzeitschriften\nISI:000429421900001\n28212588.0\n10.1055/s-0043-102569\nNone\n1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation.) 3 ESGE suggests HSP (with or without submucosal injection) for removal of sessile polyps 10 - 19 mm in size. In most cases deep thermal injury is a potential risk and thus submucosal injection prior to HSP should be considered. (Low quality evidence, strong recommendation.) 4 ESGE recommends HSP for pedunculated polyps. To prevent bleeding in pedunculated colorectal polyps with head ≥ 20 mm or a stalk ≥ 10 mm in diameter, ESGE recommends pretreatment of the stalk with injection of dilute adrenaline and/or mechanical hemostasis. (Moderate quality evidence, strong recommendation.) 5 ESGE recommends that the goals of endoscopic mucosal resection (EMR) are to achieve a completely snare-resected lesion in the safest minimum number of pieces, with adequate margins and without need for adjunctive ablative techniques. (Low quality evidence; strong recommendation.) 6 ESGE recommends careful lesion assessment prior to EMR to identify features suggestive of poor outcome. Features associated with incomplete resection or recurrence include lesion size > 40 mm, ileocecal valve location, prior failed attempts at resection, and size, morphology, site, and access (SMSA) level 4. (Moderate quality evidence; strong recommendation.) 7 For intraprocedural bleeding, ESGE recommends endoscopic coagulation (snare-tip soft coagulation or coagulating forceps) or mechanical therapy, with or without the combined use of dilute adrenaline injection. (Low quality evidence, strong recommendation.)An algorithm of polypectomy recommendations according to shape and size of polyps is given (Fig. 1).\n © Georg Thieme Verlag KG Stuttgart · New York.\n\nLangner, Cord\n\n\n"
},
{
"text": "\n160457\nN-BLR, a primate-specific non-coding transcript leads to colorectal cancer invasion and migration.\n\nRigoutsos, I\n\nLee, SK\n\nNam, SY\n\nAnfossi, S\n\nPasculli, B\n\nPichler, M\n\nJing, Y\n\nRodriguez-Aguayo, C\n\nTelonis, AG\n\nRossi, S\n\nIvan, C\n\nCatela Ivkovic, T\n\nFabris, L\n\nClark, PM\n\nLing, H\n\nShimizu, M\n\nRedis, RS\n\nShah, MY\n\nZhang, X\n\nOkugawa, Y\n\nJung, EJ\n\nTsirigos, A\n\nHuang, L\n\nFerdin, J\n\nGafà, R\n\nSpizzo, R\n\nNicoloso, MS\n\nParanjape, AN\n\nShariati, M\n\nTiron, A\n\nYeh, JJ\n\nTeruel-Montoya, R\n\nXiao, L\n\nMelo, SA\n\nMenter, D\n\nJiang, ZQ\n\nFlores, ER\n\nNegrini, M\n\nGoel, A\n\nBar-Eli, M\n\nMani, SA\n\nLiu, CG\n\nLopez-Berestein, G\n\nBerindan-Neagoe, I\n\nEsteller, M\n\nKopetz, S\n\nLanza, G\n\nCalin, GA\n\nBeiträge in Fachzeitschriften\nISI:000401794000001\n28535802.0\n10.1186/s13059-017-1224-0\nPMC5442648\nNon-coding RNAs have been drawing increasing attention in recent years as functional data suggest that they play important roles in key cellular processes. N-BLR is a primate-specific long non-coding RNA that modulates the epithelial-to-mesenchymal transition, facilitates cell migration, and increases colorectal cancer invasion.\n We performed multivariate analyses of data from two independent cohorts of colorectal cancer patients and show that the abundance of N-BLR is associated with tumor stage, invasion potential, and overall patient survival. Through in vitro and in vivo experiments we found that N-BLR facilitates migration primarily via crosstalk with E-cadherin and ZEB1. We showed that this crosstalk is mediated by a pyknon, a short ~20 nucleotide-long DNA motif contained in the N-BLR transcript and is targeted by members of the miR-200 family. In light of these findings, we used a microarray to investigate the expression patterns of other pyknon-containing genomic loci. We found multiple such loci that are differentially transcribed between healthy and diseased tissues in colorectal cancer and chronic lymphocytic leukemia. Moreover, we identified several new loci whose expression correlates with the colorectal cancer patients' overall survival.\n The primate-specific N-BLR is a novel molecular contributor to the complex mechanisms that underlie metastasis in colorectal cancer and a potential novel biomarker for this disease. The presence of a functional pyknon within N-BLR and the related finding that many more pyknon-containing genomic loci in the human genome exhibit tissue-specific and disease-specific expression suggests the possibility of an alternative class of biomarkers and therapeutic targets that are primate-specific.\n\nPichler, Martin\n\n\n"
},
{
"text": "\n166109\nPredictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians.\n\nStrzelczyk, A\n\nZschebek, G\n\nBauer, S\n\nBaumgartner, C\n\nGrond, M\n\nHermsen, A\n\nKieslich, M\n\nKrämer, G\n\nKurlemann, G\n\nMay, TW\n\nMayer, T\n\nNeubauer, BA\n\nPfäfflin, M\n\nPlecko, B\n\nRyvlin, P\n\nSchubert-Bast, S\n\nStefan, H\n\nTrinka, E\n\nKnake, S\n\nSeifart, C\n\nRosenow, F\n\nBeiträge in Fachzeitschriften\nISI:000373800800013\n26899504.0\n10.1111/epi.13337\nNone\nTo examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP.\n Questionnaires were sent to approximately 5, 00 neurologists and neuropediatricians in 2014 regarding respondents' demographics, their working environments, and how often they discussed SUDEP, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities.\n In total, 519 surveys were completed (respondents' mean age: 45.5 years, 41.6% female, 66.9% adult neurologists, 31.0% neuropediatricians). A minority of 2.7% reported that they counseled all of their patients on SUDEP, 8.7% counseled most of the time (50-90%), 20.8% sometimes (10-49%), 44.5% rarely (1-9%), and 23.3% reported not counseling about SUDEP at all. In contrast, 92.9% reported that they counseled all patients about driving restrictions and 81.5% about risks in daily life activities. Suicidal ideations were discussed in 59.0% for some and in 3.3% for all patients, whereas 35.1% of respondents reported never discussing suicidal ideations. Independent predictors of not discussing SUDEP were no additional epilepsy training, no or uncertain SUDEP cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in SUDEP prevention. The opinion that SUDEP is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on SUDEP.\n Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to SUDEP or suicidality. Both are not discussed at all by a substantial proportion of neurologists and neuropediatricians. This is in contrast to ubiquitous education about driving restrictions. Dissemination of knowledge among physicians about potential preventive strategies might increase the likelihood of discussion. Clinical practice guidelines are welcomed by the majority of physicians in this process.\n Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.\n\nPlecko, Barbara\n\n\n"
},
{
"text": "\n172254\nHome Use of Day-and-Night Hybrid Closed-Loop Insulin Delivery in Very Young Children: A Multicenter, 3-Week, Randomized Trial.\n\nTauschmann, M\n\nAllen, JM\n\nNagl, K\n\nFritsch, M\n\nYong, J\n\nMetcalfe, E\n\nSchaeffer, D\n\nFichelle, M\n\nSchierloh, U\n\nThiele, AG\n\nAbt, D\n\nKojzar, H\n\nMader, JK\n\nSlegtenhorst, S\n\nBarber, N\n\nWilinska, ME\n\nBoughton, C\n\nMusolino, G\n\nSibayan, J\n\nCohen, N\n\nKollman, C\n\nHofer, SE\n\nFröhlich-Reiterer, E\n\nKapellen, TM\n\nAcerini, CL\n\nde Beaufort, C\n\nCampbell, F\n\nRami-Merhar, B\n\nHovorka, R\n\nKidsAP Consortium\n\nBeiträge in Fachzeitschriften\nISI:000461816500025\n30692242.0\n10.2337/dc18-1881\nNone\nWe aimed to assess the feasibility and safety of hybrid closed-loop insulin delivery in children with type 1 diabetes aged 1-7 years as well as evaluate the role of diluted insulin on glucose control.\n In an open-label, multicenter, multinational, randomized crossover study, 24 children with type 1 diabetes on insulin pump therapy (median age 5 years [interquartile range 3-6] and mean ± SD HbA1c 7.4 ± 0.7% [57 ± 8 mmol/mol] and total insulin 13.2 ± 4.8 units/day) underwent two 21-day periods of unrestricted living and we compared hybrid closed-loop with diluted insulin (U20) and hybrid closed-loop with standard strength insulin (U100) in random order. During both interventions, the Cambridge model predictive control algorithm was used.\n The proportion of time that sensor glucose was in the target range between 3.9 and 10 mmol/L (primary end point) was not different between interventions (mean ± SD 72 ± 8% vs. 70 ± 7% for closed-loop with diluted insulin vs. closed-loop with standard insulin, respectively; P = 0.16). There was no difference in mean glucose levels (8.0 ± 0.8 vs. 8.2 ± 0.6 mmol/L; P = 0.14), glucose variability (SD of sensor glucose 3.1 ± 0.5 vs. 3.2 ± 0.4 mmol/L; P = 0.16), or the proportion of time spent with sensor glucose <3.9 mmol/L (4.5 ± 1.7% vs. 4.7 ± 1.4%; P = 0.47) or <2.8 mmol/L (0.6 ± 0.5% vs. 0.6 ± 0.4%; P > 0.99). Total daily insulin delivery did not differ (17.3 ± 5.6 vs. 18.9 ± 6.9 units/day; P = 0.07). No closed-loop-related severe hypoglycemia or ketoacidosis occurred.\n Unrestricted home use of day-and-night closed-loop in very young children with type 1 diabetes is feasible and safe. The use of diluted insulin during closed-loop does not provide additional benefits compared with standard strength insulin.\n © 2019 by the American Diabetes Association.\n\nFritsch, Maria\n\nFröhlich-Reiterer, Elke\n\nKojzar, Harald\n\nMader, Julia\n\n\n"
},
{
"text": "\n177826\nCompartmentalised expression of Delta-like 1 in epithelial somites is required for the formation of intervertebral joints.\n\nTeppner, I\n\nBecker, S\n\nde Angelis, MH\n\nGossler, A\n\nBeckers, J\n\nBeiträge in Fachzeitschriften\nISI:000248126100001\n17572911.0\n10.1186/1471-213X-7-68\nPMC1924847\nExpression of the mouse Delta-like 1 (Dll1) gene in the presomitic mesoderm and in the caudal halves of somites of the developing embryo is required for the formation of epithelial somites and for the maintenance of caudal somite identity, respectively. The rostro-caudal polarity of somites is initiated early on within the presomitic mesoderm in nascent somites. Here we have investigated the requirement of restricted Dll1 expression in caudal somite compartments for the maintenance of rostro-caudal somite polarity and the morphogenesis of the axial skeleton. We did this by overexpressing a functional copy of the Dll1 gene throughout the paraxial mesoderm, in particular in anterior somite compartments, during somitogenesis in transgenic mice.\n Epithelial somites were generated normally and appeared histologically normal in embryos of two independent Dll1 over-expressing transgenic lines. Gene expression analyses of rostro-caudal marker genes suggested that over-expression of Dll1 without restriction to caudal compartments was not sufficient to confer caudal identity to rostral somite halves in transgenic embryos. Nevertheless, Dll1 over-expression caused dysmorphologies of the axial skeleton, in particular, in morphological structures that derive from the articular joint forming compartment of vertebrae. Accordingly, transgenic animals exhibited missing or reduced intervertebral discs, rostral and caudal articular processes as well as costal heads of ribs. In addition, the midline of the vertebral column did not develop normally. Transgenic mice had open neural arches and split vertebral bodies with ectopic pseudo-growth plates. Endochondral bone formation and ossification in the developing vertebrae were delayed.\n The mice overexpressing Dll1 exhibit skeletal dysmorphologies that are also evident in several mutant mice with defects in somite compartmentalisation. The Dll1 transgenic mice demonstrate that vertebral dysmorphologies such as bony fusions of vertebrae and midline vertebral defects can occur without apparent changes in somitic rostro-caudal marker gene expression. Also, we demonstrate that the over-expression of the Dll1 gene in rostral epithelial somites is not sufficient to confer caudal identity to rostral compartments. Our data suggest that the restricted Dll1 expression in caudal epithelial somites may be particularly required for the proper development of the intervertebral joint forming compartment.\n\nKlymiuk, Ingeborg\n\n\n"
},
{
"text": "\n182848\nThree-Year Sustained Clinical Efficacy of Drug-Coated Balloon Angioplasty in a Real-World Femoropopliteal Cohort.\n\nTorsello, G\n\nStavroulakis, K\n\nBrodmann, M\n\nMicari, A\n\nTepe, G\n\nVeroux, P\n\nBenko, A\n\nChoi, D\n\nVermassen, FEG\n\nJaff, MR\n\nGuo, J\n\nDobranszki, R\n\nZeller, T\n\nIN.PACT Global Investigators\n\nBeiträge in Fachzeitschriften\nISI:000543434000001\n32583749.0\n10.1177/1526602820931477\nPMC7545651\nPurpose: To report the 36-month outcomes from the prospective, multicenter, single-arm IN.PACT Global Study (ClinicalTrials.gov identifier NCT01609296) evaluating the performance of the IN.PACT Admiral drug-coated balloon (DCB) in real-world patients with femoropopliteal occlusive disease. Materials and Methods: The IN.PACT Global Study was conducted at 64 international sites and enrolled 1535 patients with complex lesions, which included bilateral disease, multiple lesions, de novo in-stent restenosis, long lesions, and chronic total occlusions. The predefined full clinical cohort included 1406 patients (mean age 68.6 years; 67.8% men) with claudication or rest pain treated with the study DCB. Mean lesion length was 12.09±9.54 cm; 18.0% had in-stent restenosis, 35.5% were totally occluded, and 68.7% were calcified. Freedom from clinically-driven target lesion revascularization (CD-TLR) was evaluated through 36 months. The safety composite endpoint was freedom from device- and procedure-related death through 30 days and freedom from major target limb amputation and clinically-driven target vessel revascularization within 36 months. All safety and revascularization events were reviewed by an independent clinical events committee. Results: The Kaplan-Meier estimate of freedom from CD-TLR through 36 months was 76.9%. The composite safety endpoint was achieved in 75.6% of patients. The 36-month all-cause mortality rate was 11.6%, and the major target limb amputation rate was 1.0%. The Kaplan-Meier estimate of freedom from CD-TLR through 36 months was significantly lower in patients with chronic limb-threatening ischemia (CLTI) compared with claudicants (67.6% vs 78.0%; p=0.003). Lesions affecting both the superficial femoral artery (SFA) and popliteal artery had lower Kaplan-Meier freedom from CD-TLR through 36 months (69.2%) than either isolated SFA (79.7%) or popliteal artery lesions (76.5%; log- rank p<0.001). Predictors of CD-TLR through 36 months included increased lesion length, reference vessel diameter ≤4.5 mm, in-stent restenosis, bilateral disease, CLTI, and hyperlipidemia. Conclusion: DCB angioplasty with the IN.PACT Admiral DCB for femoropopliteal disease in a diverse and complex real-world population is associated with sustained clinical efficacy and low rates of reinterventions at 3 years after the initial procedure.\n\nBrodmann, Marianne\n\n\n"
},
{
"text": "\n185841\nA novel human ex-vivo burn model and the local cooling effect of a bacterial nanocellulose-based wound dressing.\n\nHolzer, JCJ\n\nTiffner, K\n\nKainz, S\n\nReisenegger, P\n\nde Mattos, IB\n\nFunk, M\n\nLemarchand, T\n\nLaaff, H\n\nBal, A\n\nBirngruber, T\n\nKotzbeck, P\n\nKamolz, LP\n\nBeiträge in Fachzeitschriften\nISI:000603578000023\n32660829.0\n10.1016/j.burns.2020.06.024\nNone\nBurn wound progression is a significant problem as burns initially thought to be superficial can actually become full thickness over time. Cooling is an efficient method to reduce burn wound conversion. However, if the cooling agent is below room temperature, depending on the wound size the patient is at risk of hypothermia. Additionally, tissue perfusion is reduced leading to an aggravation of burn wound progression. We investigated if wound dressings based on non-pre-cooled bacterial nanocellulose (BNC) with a high water content cool a burn just by evaporation and reduce the intradermal damages in the skin.\n In a human ex-vivo model, skin explants underwent contact burns using a 100 °C hot steel block. The burned areas were divided into two groups of which one was cooled with a BNC-based wound dressing. Intradermal temperature probes measured temperature in cooled and uncooled burn sites over 24 h. For histological assessments of the burned areas biopsies were taken at different time points. High mobility group box-1 (HMBG1) staining served as marker for cell vitality and necrosis in the different skin layers.\n Intradermal temperature measurement showed that application of the BNC-based wound dressing reduced temperature significantly in burned skin. This cooling effect resulted in a maximum temperature difference of 6.4 ± 1.9 °C and a significant mean reduction of the area under the curve in the first hour after burn of 62% (p < 0.0001). The histological results showed less necrosis and less dermal-epidermal separation in the cooled areas. The HMGB1 staining revealed more vital cells in the cooled group than in the uncooled group.\n Based on our results, BNC-based wound dressings cool a burn. Intradermal temperature as well as thermal damage of the tissue was reduced. The tested BNC-based wound dressing can be used without pre-cooling to cool a burn as well as to reduce the burn BNC-based wound progression through its evaporation cooling effect.\n Copyright © 2020 Elsevier Ltd and ISBI. All rights reserved.\n\nGeißler, Judith Christine Julie\n\nKamolz, Lars-Peter\n\nKotzbeck, Petra\n\n\n"
},
{
"text": "\n187291\nGoogle Trends for Pain Search Terms in the World's Most Populated Regions Before and After the First Recorded COVID-19 Case: Infodemiological Study.\n\nSzilagyi, IS\n\nUllrich, T\n\nLang-Illievich, K\n\nKlivinyi, C\n\nSchittek, GA\n\nSimonis, H\n\nBornemann-Cimenti, H\n\nBeiträge in Fachzeitschriften\nISI:000642264700008\n33844638.0\n10.2196/27214\nPMC8064706\nWeb-based analysis of search queries has become a very useful method in various academic fields for understanding timely and regional differences in the public interest in certain terms and concepts. Particularly in health and medical research, Google Trends has been increasingly used over the last decade.\n This study aimed to assess the search activity of pain-related parameters on Google Trends from among the most populated regions worldwide over a 3-year period from before the report of the first confirmed COVID-19 cases in these regions (January 2018) until December 2020.\n Search terms from the following regions were used for the analysis: India, China, Europe, the United States, Brazil, Pakistan, and Indonesia. In total, 24 expressions of pain location were assessed. Search terms were extracted using the local language of the respective country. Python scripts were used for data mining. All statistical calculations were performed through exploratory data analysis and nonparametric Mann-Whitney U tests.\n Although the overall search activity for pain-related terms increased, apart from pain entities such as headache, chest pain, and sore throat, we observed discordant search activity. Among the most populous regions, pain-related search parameters for shoulder, abdominal, and chest pain, headache, and toothache differed significantly before and after the first officially confirmed COVID-19 cases (for all, P<.001). In addition, we observed a heterogenous, marked increase or reduction in pain-related search parameters among the most populated regions.\n As internet searches are a surrogate for public interest, we assume that our data are indicative of an increased incidence of pain after the onset of the COVID-19 pandemic. However, as these increased incidences vary across geographical and anatomical locations, our findings could potentially facilitate the development of specific strategies to support the most affected groups.\n ©Istvan-Szilard Szilagyi, Torsten Ullrich, Kordula Lang-Illievich, Christoph Klivinyi, Gregor Alexander Schittek, Holger Simonis, Helmar Bornemann-Cimenti. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.04.2021.\n\nBornemann-Cimenti, Helmar\n\nKlivinyi, Christoph\n\nLang-Illievich, Kordula\n\nSchittek, Gregor Alexander\n\nSimonis, Holger\n\nSzilagyi, Istvan - Szilard\n\n\n"
},
{
"text": "\n187840\nEfficient and safe glycaemic control with basal-bolus insulin therapy during fasting periods in hospitalised patients with type 2 diabetes using decision support technology: a post-hoc analysis.\n\nHochfellner, DA\n\nRainer, R\n\nZiko, H\n\nAberer, F\n\nSimic, A\n\nLichtenegger, KM\n\nBeck, P\n\nDonsa, K\n\nPieber, TR\n\nFruhwald, FM\n\nRosenkranz, AR\n\nKamolz, LP\n\nBaumann, PM\n\nMader, JK\n\nPlank, J\n\nBeiträge in Fachzeitschriften\nNone\n34081386.0\n10.1111/dom.14458\nNone\nFasting periods represent a significant challenge for glycaemic control in hospitalised patients. The study aims to evaluate the efficacy and safety of basal-bolus insulin therapy in managing glycaemia during fasting periods in hospitalised patients with type 2 diabetes.\n We performed a post-hoc analysis of two prospective, uncontrolled interventional trials that applied electronic decision support system guided basal-bolus (meal-related and correction) insulin therapy. We searched for fasting periods (invasive or diagnostic procedures, medical condition) during inpatient stays. In a mixed-model analysis, patients' glucose levels and insulin doses on days with regular food intake were compared to days with fasting periods.\n Out of 249 patients, 115 patients (33.9% female, age 68.3±10.3 years, diabetes duration 15.1±10.9 years, BMI 30.1±5.4 kg/m2 , HbA1c 69±20 mmol/mol) had 194 days with fasting periods. Mean daily blood glucose was lower (Modelled difference (ModDiff): -0.5±0.2 mmol/L, p=0.006), and the proportion of glucose values within the target range (3.9-10.0 mmol/L) increased on days with fasting periods compared to days with regular food intake (ModDiff: +0.06±0.02, p=0.005). Glycaemic control on fasting days was driven by a reduction in daily bolus insulin doses (ModDiff: -11.0±0.9 IU, p<0.001), while basal insulin was similar (ModDiff: -1.1±0.6 IU, p=0.082) as compared to non-fasting days. Regarding hypoglycaemic events (BG <3.9 mmol/L), there was no difference between fasting and non-fasting days (χ2 0.9% vs. 1.7%, p=0.174).\n When using well titrated basal-bolus insulin therapy in hospitalised patients with type 2 diabetes, the basal insulin dose does not require adjustment during fasting periods to achieve safe glycaemic control, provided meal-related bolus insulin is omitted and correction bolus insulin is tailored to glucose levels. This article is protected by copyright. All rights reserved.\n This article is protected by copyright. All rights reserved.\n\nAberer, Felix\n\nBaumann, Petra Martina\n\nFruhwald, Friedrich\n\nHochfellner, Daniel\n\nKamolz, Lars-Peter\n\nLichtenegger, Katharina\n\nMader, Julia\n\nPieber, Thomas\n\nRosenkranz, Alexander\n\nSimic, Amra\n\nZiko, Haris\n\n\n"
},
{
"text": "\n1153\nGranulocyte colony-stimulating factor as an adjunct to induction chemotherapy for adult acute lymphoblastic leukemia--a randomized phase-III study.\n\nGeissler, K\n\nKoller, E\n\nHubmann, E\n\nNiederwieser, D\n\nHinterberger, W\n\nGeissler, D\n\nKyrle, P\n\nKnöbl, P\n\nPabinger, I\n\nThalhammer, R\n\nSchwarzinger, I\n\nMannhalter, C\n\nJaeger, U\n\nHeinz, R\n\nLinkesch, W\n\nLechner, K\n\nBeiträge in Fachzeitschriften\nISI:A1997XL77400011\n9226158.0\n10.1182/blood.V90.2.590.590_590_596\nNone\nBecause of the recommendation to avoid the concomitant administration of growth factors and chemotherapy, there is only limited information on colony-stimulating factor (CSF) therapy in acute lymphoblastic leukemia (ALL) induction protocols, in which cytotoxic drugs are administered in divided doses over a prolonged period of time, thus requiring a simultaneous administration of growth factors and chemotherapy. We conducted a prospective, randomized, controlled study to determine the safety and efficacy of granulocyte colony-stimulating factor (G-CSF; filgrastim) as an adjunct to phase I of induction chemotherapy for adult ALL. Patients (n = 53) were randomized to receive no growth factor or G-CSF (5 microg/kg/d subcutaneously) starting on day 2 of chemotherapy consisting of daunorubicin (45 mg/m2) and vincristine (1.5 mg/m2) on days 1, 8, 15, and 22; L-asparaginase (2500 U/m2) on days 1 through 14; and prednisone (60 mg/m2) on days 1 through 28. A total of 25 patients in the G-CSF group and 26 patients in the control arm fulfilled the inclusion criteria of the study. G-CSF markedly ameliorated neutropenia because the median proportion of days with neutropenia less than 1, 00/microL was 29% in the G-CSF group as compared with 84% in the control arm (P < .00005). The median time to reach absolute neutrophil counts (ANC) > or = 1, 00/microL was 16 days in G-CSF patients and 26 days in controls (P < .001). More importantly, G-CSF significantly reduced the incidence of febrile neutropenia (12% v 42% in controls, P < .05) and documented infections (40% v 77%, P < .05). No significant differences were found with regard to requirements for red blood cell transfusions and platelet concentrates. A total of 24 of 25 (96%) patients in the G-CSF group and 20 of 25 (80%) evaluable control patients had complete remission after phase I of induction therapy. We conclude that G-CSF can be safely administered as an adjunct to induction therapy of ALL and is clinically beneficial by ameliorating neutropenia and reducing infectious complications.\n\n\n"
},
{
"text": "\n7963\nOn the mechanism of contraction and desensitization induced by substance P in the intestinal muscle of the guinea-pig.\n\nHolzer, P\n\nPetsche, U\n\nBeiträge in Fachzeitschriften\nISI:A1983RH33900034\n6195332.0\n10.1113/jphysiol.1983.sp014868\nPMC1193976\nThe contractile effect of substance P on the longitudinal muscle of the isolated guinea-pig small intestine and the desensitization of the muscle which occurs on prolonged exposure to the peptide have been investigated. All experiments were performed in the presence of atropine. The response to a substance P concentration which produced a nearly maximal effect was not sustained but faded rapidly. It was found that not elimination of substance P from the bath, but desensitization of the muscle to substance P was the main cause for the fading of contraction. Desensitization of the muscle to substance P only developed if the muscle was exposed to the peptide for a certain time. The degree of and the time needed for recovery from desensitization were directly related to concentration of substance P and contact time. Tetraethylammonium (3 mM), which reduces the membrane conductance for K+, enhanced the potency of substance P in contracting the muscle and reduced the fading of contraction. Noradrenaline (295 nM), which increases the K+ conductance, produced opposite effects. Lowering the extracellular Ca2+ concentration to one-tenth decreased the potency of substance P in contracting the muscle, accelerated the fading of contraction, and reduced the ability of the muscle to respond to a second addition of substance P after the response to the first addition had faded away. Concentrations of substance P (22 nM) and tetraethylammonium (30 mM), which produced nearly maximal contractions, slightly enhanced the efflux of 86Rb from pre-loaded muscle strips. Both substances, however, caused a sustained reduction of 86Rb efflux from strips depolarized by high [K+], the effect of substance P being smaller than that of tetraethylammonium. The effect of substance P and tetraethylammonium on 86Rb efflux appeared independent of the extracellular [Ca2+]. On exposure of the muscle to substance P (22 nM) for 8 min the intracellular uptake of 45Ca was first decreased and then increased while the 45Ca influx was instantly enhanced by tetraethylammonium (30 mM) or K+ (108 mM). The delayed increase in 45Ca influx caused by substance P was also observed in muscle strips depolarized with high [K+].(ABSTRACT TRUNCATED AT 400 WORDS)\n\nHolzer, Peter\n\nHolzer, Ulrike\n\n\n"
},
{
"text": "\n34315\nA new reading chart for simultaneous determination of reading vision and reading speed\n\nRadner, W\n\nWillinger, U\n\nObermayer, W\n\nMudrich, C\n\nVelikay-Parel, M\n\nEisenwort, B\n\nBeiträge in Fachzeitschriften\nISI:000076292900012\n9793916.0\n10.1055/s-2008-1034969\nNone\nBACKGROUND: Reading acuity as well as reading speed are good predictors of everyday visual function. As visual acuity tests are poor predictors of the real-world function, performance-based tests, e.g., reading speed measurements, can be used for the determination of visual function. Thus, a German reading chart was developed in order to evaluate reading acuity as well as reading speed. METHODS: Print size is defined as the height of a lower case x and progresses logarithmically from one phrase to another (factor: 1.25). Reading acuity is determined in LogRAD (Reading Acuity Determination). 32 short German phrases were created, comparable concerning grammatical difficulty as well as in number (n = 14), length and position of words. The reading speed parameters measured with a stop-watch in 160 persons (aged: Phi = 21a +/- 3.8a) were calculated in words per minute (w/min). Out of the 32 phrases the 24 most similar ones were selected statistically and used for the reading charts (Radner Reading Charts). With these reading charts a reading acuity score (LogRAD-score) can be calculated considering reading errors in words of different length. Reading speed can be determined at the same time. Reading acuity (LogRAD-Score) was measured in 32 normal eyes of 16 students and compared to the angular visual acuity (LogMAR). RESULTS: The mean reading speed of the test persons was 211.8 +/- 34.1 w/min. 24 phrases fulfilled the test item criteria for the reading chart: mean +/- 0.25 x SD. The reliability analyses yielded an overall Cronbach's alpha coefficient of 0.98! The mean visual acuity measured in 32 eyes was -0.115 +/- 0.097 LogMAR and the mean reading acuity score was +0.026 +/- 0.091 LogRAD. The mean difference was +0.104 +/- 0.066 and the correlation between LogMAR and LogRAD was good (r = 0.59). CONCLUSIONS: With these reading charts it is for the first time possible to simultaneously determine reading acuity as well as reading speed in German. The high reliability of the 24 phrases and the high correlation between LogMAR and LogRAD leads us to expect a good reproducibility of the reading acuity evaluations. For the "Radner Reading Charts" we have shown that print size is the main reason for changes of reading speed.\n\n\n"
},
{
"text": "\n89943\nGraz Endocrine Causes of Hypertension (GECOH) study: a diagnostic accuracy study of aldosterone to active renin ratio in screening for primary aldosteronism.\n\nPilz, S\n\nTomaschitz, A\n\nStepan, V\n\nObermayer-Pietsch, B\n\nFahrleitner-Pammer, A\n\nSchweighofer, N\n\nPortugaller, HR\n\nSourij, H\n\nDobnig, H\n\nMeinitzer, A\n\nPieber, TR\n\nBeiträge in Fachzeitschriften\nISI:000208119200011\n19351411.0\n10.1186/1472-6823-9-11\nPMC2671510\nBackground: Primary aldosteronism (PA) affects approximately 5 to 10% of all patients with arterial hypertension and is associated with an excess rate of cardiovascular complications that can be significantly reduced by a targeted treatment. There exists a general consensus that the aldosterone to renin ratio should be used as a screening tool but valid data about the accuracy of the aldosterone to renin ratio in screening for PA are sparse. In the Graz endocrine causes of hypertension (GECOH) study we aim to prospectively evaluate diagnostic procedures for PA. Methods and design: In this single center, diagnostic accuracy study we will enrol 400 patients that are routinely referred to our tertiary care center for screening for endocrine hypertension. We will determine the aldosterone to active renin ratio (AARR) as a screening test. In addition, all study participants will have a second determination of the AARR and will undergo a saline infusion test (SIT) as a confirmatory test. PA will be diagnosed in patients with at least one AARR of >= 5.7 ng/dL/ng/L (including an aldosterone concentration of >= 9 ng/dL) who have an aldosterone level of >= 10 ng/dL after the saline infusion test. As a primary outcome we will calculate the receiver operating characteristic curve of the AARR in diagnosing PA. Secondary outcomes include the test characteristics of the saline infusion test involving a comparison with 24 hours urine aldosterone levels and the accuracy of the aldosterone to renin activity ratio in diagnosing PA. In addition we will evaluate whether the use of beta-blockers significantly alters the accuracy of the AARR and we will validate our laboratory methods for aldosterone and renin. Conclusion: Screening for PA with subsequent targeted treatment is of great potential benefit for hypertensive patients. In the GECOH study we will evaluate a standardised procedure for screening and diagnosing of this disease.\n\nFahrleitner-Pammer, Astrid\n\nMeinitzer, Andreas\n\nObermayer-Pietsch, Barbara\n\nPieber, Thomas\n\nPilz, Stefan\n\nPortugaller, Rupert\n\nSchweighofer, Natascha\n\nSourij, Harald\n\nStepan, Vinzenz\n\n\n"
},
{
"text": "\n113416\nTreatment algorithm for complex injuries of the foot in paediatric patients.\n\nEberl, R\n\nRuttenstock, EM\n\nSinger, G\n\nBrader, P\n\nHoellwarth, ME\n\nBeiträge in Fachzeitschriften\nISI:000294539800036\n22081809.0\n10.1016/j.injury.2009.08.005\nNone\nComplex injuries of the foot in the paediatric population present difficult treatment challenges. While standardised protocols exist for the adult population to achieve an optimal result in the treatment of such injuries, therapy in paediatric patientsmust be managed without a firm treatment algorithm.\n Medical records of all patients with a complex trauma of the foot treated at our Department over a period of 13 years were evaluated. A complex trauma of the foot was defined using the scoring system developed by Zwipp et al. (1997).24 Treatment and outcome were analysed. Additionally, our treatment algorithm of complex injuries of the foot in paediatric patients is presented.\n Twenty-nine patients were included in the study (79%m; 21% f, average age 12.1 years, ranging 2–16 years). Traffic accidents were the most common mechanism (n = 14; 48.3%), followed by a fall from a height in five patients (17.2%). Lawnmower injuries were found in another 3 patients (10.3%) and other mechanisms of injury in 7 patients (24.2%). The mean score according to Zwipp et al. (1997)24 was 5.8 points (range 5–8 points). While closed fractures were diagnosed in 20 (69%) patients, 9 patients (31%) presented open fractures. Operative intervention was necessary in 24 patients (82.8%). Fracture stabilisation could be realised using K-wires in 13 cases (54.2%), screws in 3 cases (12.5%) and plate fixation in 1 case (4.2%). Combined techniques including external fixation were applied in another 7 (29.1%) cases. The mean time between injury and latest follow-up examination was 5.7 years (range 13 months to 13 years). The mean functional outcome was 47.6 (29–56) points for the OAFQ, 15.1 (0–69) points for the FFI and 82.3 (59–100) points for the AOFAS Score.\n To regard the maxims in treating complex injuries and open fractures in the growing skeleton we developed a simple treatment algorithm for complex foot injuries in order to provide preservation of the soft tissue envelope, avoidance of infection, restoration of the axis and the articular surface.\n A complex trauma of the paediatric foot is a rare and challenging injury. Avoidance of infection, preservation of the soft tissue envelope and fracture healing will provide good functional outcome despite the severity of trauma. Long time follow-up is essential to detect complications.\n\nHöllwarth, Michael\n\nSinger, Georg\n\n\n"
},
{
"text": "\n146639\nSexual dysfunction related to drugs: a critical review. Part IV: cardiovascular drugs.\n\nLa Torre, A\n\nGiupponi, G\n\nDuffy, D\n\nConca, A\n\nCatanzariti, D\n\nBeiträge in Fachzeitschriften\nISI:000347718700001\n25405774.0\n10.1055/s-0034-1395515\nNone\nSexual dysfunction is a potential side effect of cardiovascular drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, other methodological flaws limit greatly the conclusions of these studies. Most studies relate to male populations and only a few have been conducted on women. Also, the majority of studies on sexual dysfunction induced by cardiovascular drugs relate to antihypertensive drugs. While there is evidence to suggest that older antihypertensive drugs (diuretics, beta-blockers, centrally acting agents) have a negative impact on erectile function, newer agents seem to have either neutral (ACE inhibitors, calcium antagonists) or beneficial effects (i. e., angiotensin receptor blockers, nebivolol). Other cardiovascular drugs analyzed in this review also appear to have an inhibitory action on sexual function. For men, there is some weak evidence supporting the use of specific treatment strategies for sexual dysfunction associated with these drugs.\n This study was conducted in 2014 using the paper and electronic resources of the library of the "Azienda Provinciale per i Servizi Sanitari (APSS)" in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793 or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words "cardiovascular", "adrenergic beta antagonist", "α1-adrenoceptor antagonist", "angiotensin converting enzyme inhibitor", "angiotensin receptor antagonist", "angiotensin receptor blocker", "beta blocker", "beta receptor antagonist", "calcium channel blocker", "diuretic", "antihypertensive", "sexual dysfunction", "sexual side effects", "treatment-emergent sexual dysfunction". All resulting listed articles were reviewed.\n The review includes studies that investigated the relationship between these drug treatments and sexual dysfunction. The purpose was to identify possible intervention strategies for sexual dysfunction related to these drugs.\n © Georg Thieme Verlag KG Stuttgart · New York.\n\n\n"
}
]
}