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"text": "\n187175\nImpact of a clinical decision rule on antibiotic prescription for children with suspected lower respiratory tract infections presenting to European emergency departments: a simulation study based on routine data.\n\nHagedoorn, NN\n\nWagenaar, JHL\n\nNieboer, D\n\nBath, D\n\nVon Both, U\n\nCarrol, ED\n\nEleftheriou, I\n\nEmonts, M\n\nVan Der Flier, M\n\nDe Groot, R\n\nHerberg, J\n\nKohlmaier, B\n\nLevin, M\n\nLim, E\n\nMaconochie, I\n\nMartinon-Torres, F\n\nNijman, R\n\nPokorn, M\n\nRivero Calle, I\n\nTsolia, M\n\nYeung, S\n\nZavadska, D\n\nZenz, W\n\nVermont, CL\n\nOostenbrink, R\n\nMoll, HA\n\nPERFORM consortium\n\nBeiträge in Fachzeitschriften\nISI:000648949700032\n33564871.0\n10.1093/jac/dkab023\nNone\nDiscriminating viral from bacterial lower respiratory tract infections (LRTIs) in children is challenging thus commonly resulting in antibiotic overuse. The Feverkidstool, a validated clinical decision rule including clinical symptoms and C-reactive protein, safely reduced antibiotic use in children at low/intermediate risk for bacterial LRTIs in a multicentre trial at emergency departments (EDs) in the Netherlands.\n Using routine data from an observational study, we simulated the impact of the Feverkidstool on antibiotic prescriptions compared with observed antibiotic prescriptions in children with suspected LRTIs at 12 EDs in eight European countries.\n We selected febrile children aged 1 month to 5 years with respiratory symptoms and excluded upper respiratory tract infections. Using the Feverkidstool, we calculated individual risks for bacterial LRTI retrospectively. We simulated antibiotic prescription rates under different scenarios: (1) applying effect estimates on antibiotic prescription from the trial; and (2) varying both usage (50%-100%) and compliance (70%-100%) with the Feverkidstool's advice to withhold antibiotics in children at low/intermediate risk for bacterial LRTI (≤10%).\n Of 4938 children, 4209 (85.2%) were at low/intermediate risk for bacterial LRTI. Applying effect estimates from the trial, the Feverkidstool reduced antibiotic prescription from 33.5% to 24.1% [pooled risk difference: 9.4% (95% CI: 5.7%-13.1%)]. Simulating 50%-100% usage with 90% compliance resulted in risk differences ranging from 8.3% to 15.8%. Our simulations suggest that antibiotic prescriptions would be reduced in EDs with high baseline antibiotic prescription rates or predominantly (>85%) low/intermediate-risk children.\n Implementation of the Feverkidstool could reduce antibiotic prescriptions in children with suspected LRTIs in European EDs.\n © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.\n\nKohlmaier, Benno\n\nZenz, Werner\n\n\n"
},
{
"text": "\n3035\nCharacterization of a novel 21-kb deletion, CFTRdele2,3(21 kb), in the CFTR gene: a cystic fibrosis mutation of Slavic origin common in Central and East Europe.\n\nDörk, T\n\nMacek, M\n\nMekus, F\n\nTümmler, B\n\nTzountzouris, J\n\nCasals, T\n\nKrebsová, A\n\nKoudová, M\n\nSakmaryová, I\n\nMacek, M\n\nVávrová, V\n\nZemková, D\n\nGinter, E\n\nPetrova, NV\n\nIvaschenko, T\n\nBaranov, V\n\nWitt, M\n\nPogorzelski, A\n\nBal, J\n\nZékanowsky, C\n\nWagner, K\n\nStuhrmann, M\n\nBauer, I\n\nSeydewitz, HH\n\nNeumann, T\n\nJakubiczka, S\n\nBeiträge in Fachzeitschriften\nISI:000086661100001\n10798353.0\n10.1007%2Fs004390000246\nNone\nWe report a large genomic deletion of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, viz., a deletion that is frequently observed in Central and Eastern Europe. The mutation, termed CFTRdele2, (21 kb), deletes 21, 80 bp spanning introns 1-3 of the CFTR gene. Transcript analyses have revealed that this deletion results in the loss of exons 2 and 3 in epithelial CFTR mRNA, thereby producing a premature termination signal within exon 4. In order to develop a simple polymerase chain reaction assay for this allele, we defined the end-points of the deletion at the DNA sequence level. We next screened for this mutation in a representative set of European and European-derived populations. Some 197 CF patients, including seven homozygotes, bearing this mutation have been identified during the course of our study. Clinical evaluation of CFTRdele2, (21 kb) homozygotes and a comparison of compound heterozygotes for deltaF508/CFTRdele2, (21 kb) with pairwise-matched deltaF508 homozygotes indicate that this deletion represents a severe mutation associated with pancreatic insufficiency and early age at diagnosis. Current data show that the mutation is particularly common in Czech (6.4% of all CF chromosomes), Russian (5.2%), Belorussian (3.3%), Austrian (2.6%), German (1.5%), Polish (1.5%), Slovenian (1.5%), Ukrainian (1.2%), and Slovak patients (1.1%). It has also been found in Lithuania, Latvia, Macedonia and Greece and has sporadically been observed in Canada, USA, France, Spain, Turkey, and UK, but not in CF patients from Bulgaria, Croatia, Romania or Serbia. Haplotype analysis has identified the same extragenic CF-haplotype XV-2c/KM. 19 "A" and the same infrequent intragenic microsatellite haplotype 16-33-13 (IVS8CA-IVS 17bTA-IVS 17bCA) in all examined CFTRdele2, (21 kb) chromosomes, suggesting a common origin for this deletion. We conclude that the 21-kb deletion is a frequent and severe CF mutation in populations of Eastern- and Western-Slavic descent.\n\nWagner, Klaus\n\n\n"
},
{
"text": "\n3989\nTreatment of acute aortic type B dissection with stent-grafts.\n\nHausegger, KA\n\nTiesenhausen, K\n\nSchedlbauer, P\n\nOberwalder, P\n\nTauss, J\n\nRigler, B\n\nBeiträge in Fachzeitschriften\nISI:000172214200004\n11815835.0\n10.1007/s00270-001-0048-0\nNone\nPurpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One of the latter also had an unstable dissection flap, compromising the ostium. of the superior mesenteric artery. The distance from the intimal tear to the left subclavian artery was <0.5 cm. in four patients, who had typical type B dissections., In one patient with an atypical dissection the distance from the primary tear to the left subclavian artery was 4 cm. This patient had no re-entry tear. Talent tube Grafts (World Medical Manufacturing Cooperation, Sunrise, FL, USA) were used in all patients.Results: Stent-graft insertion with sealing of the primary tear was successful in all patients. The proximal covered portion of the stent-graft was placed across the left subclavian artery in four patients (1 X transposition of the left subclavian artery). Left arm perfusion was preserved via a subclavian steal phenomenon in the patients in whom the stent-graft covered the orifice of the left subclavian artery. The only procedural complication we observed was an asymptomatic segmental renal infarction in one patient. In the thoracic aorta thrombosis of the false aortic, lumen occurred in all patients. In one patient the false lumen of the abdominal aorta thrombosed after 4 weeks; in the other three patients the status of the abdominal aorta remained unchanged compared with the situation prior, to stent-graft insertion. As a late complication formation of a secondary aneurysm of the thoracic aorta was observed at the distal end, of the stent-graft 3 months after the primary intervention. This aneurysm was treated by coaxial insertion of an additional stent-graft without complications.Conclusion: Endoluminal treatment of acute type B aortic dissections seems to be an attractive alternative treatment to surgical repair. Thrombosis of the false lumen of the thoracic aorta can be induced if the primary tear is sealed with a stent-graft. This could protect the dissected thoracic aorta from delayed rupture.\n\nHausegger, Klaus\n\nOberwalder, Peter\n\nTiesenhausen, Kurt\n\n\n"
},
{
"text": "\n181087\nAcute and midterm outcomes of the post-approval MELODY Registry: a multicentre registry of transcatheter pulmonary valve implantation.\n\nNordmeyer, J\n\nEwert, P\n\nGewillig, M\n\nAlJufan, M\n\nCarminati, M\n\nKretschmar, O\n\nUebing, A\n\nDähnert, I\n\nRöhle, R\n\nSchneider, H\n\nWitsenburg, M\n\nBenson, L\n\nGitter, R\n\nBökenkamp, R\n\nMahadevan, V\n\nBerger, F\n\nBeiträge in Fachzeitschriften\nISI:000490141900021\n31005985.0\n10.1093/eurheartj/ehz201\nNone\nThe post-approval MELODY Registry aimed to obtain multicentre registry data after transcatheter pulmonary valve implantation (TPVI) with the Melody™ valve (Medtronic plc.) in a large-scale cohort of patients with congenital heart disease (CHD).\n Retrospective analysis of multicentre registry data after TPVI with the Melody™ valve. Eight hundred and forty-five patients (mean age: 21.0 ± 11.1 years) underwent TPVI in 42 centres between December 2006 and September 2013 and were followed-up for a median of 5.9 years (range: 0-11.0 years). The composite endpoint of TPVI-related events during follow-up (i.e. death, reoperation, or reintervention >48 h after TPVI) showed an incidence rate of 4.2% per person per year [95% confidence interval (CI) 3.7-4.9]. Transcatheter pulmonary valve implantation infective endocarditis (I.E.) showed an incidence rate of 2.3% per person per year (95% CI 1.9-2.8) and resulted in significant morbidity and in nine deaths. In multivariable Cox proportional hazard models, the invasively measured residual right ventricle (RV)-to-pulmonary artery (PA) pressure gradient (per 5 mmHg) was associated with the risk of the composite endpoint (adjusted hazard ratio: 1.21, 95% CI 1.12-1.30; P < 0.0001) and the risk of TPVI I.E. (adjusted hazard ratio: 1.19, 95% CI 1.07-1.32; P = 0.002). Major procedural complications (death, surgical, or interventional treatment requirement) occurred in 0.5%, 1.2%, and 2.0%, respectively. Acutely, the RV-to-PA pressure gradient and the percentage of patients with pulmonary regurgitation grade >2 improved significantly from 36 [interquartile range (IQR) 24-47] to 12 (IQR 7-17) mmHg and 47 to 1%, respectively (P < 0.001 for each).\n The post-approval MELODY Registry confirms the efficacy of TPVI with the Melody™ valve in a large-scale cohort of CHD patients. The residual invasively measured RV-to-PA pressure gradient may serve as a target for further improvement in the composite endpoint and TPVI I.E. However, TPVI I.E. remains a significant concern causing significant morbidity and mortality.\n Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.\n\nGamillscheg, Andreas\n\n\n"
},
{
"text": "\n182211\nExtending the Minimum Information About BIobank Data Sharing Terminology to Describe Samples, Sample Donors, and Events.\n\nEklund, N\n\nAndrianarisoa, NH\n\nvan Enckevort, E\n\nAnton, G\n\nDebucquoy, A\n\nMüller, H\n\nZaharenko, L\n\nEngels, C\n\nEbert, L\n\nNeumann, M\n\nGeeraert, J\n\nT'Joen, V\n\nDemski, H\n\nCaboux, É\n\nProynova, R\n\nParodi, B\n\nMate, S\n\nvan Iperen, E\n\nMerino-Martinez, R\n\nQuinlan, PR\n\nHolub, P\n\nSilander, K\n\nBeiträge in Fachzeitschriften\nISI:000526667100001\n32302498.0\n10.1089/bio.2019.0129\nPMC7310316\n\nIntroduction:\n The Minimum Information About BIobank data Sharing (MIABIS) was initiated in 2012. MIABIS aims to create a common biobank terminology to facilitate data sharing in biobanks and sample collections. The MIABIS Core terminology consists of three components describing biobanks, sample collections, and studies, in which information on samples and sample donors is provided at aggregated form. However, there is also a need to describe samples and sample donors at an individual level to allow more elaborate queries on available biobank samples and data. Therefore the MIABIS terminology has now been extended with components describing samples and sample donors at an individual level. \nMaterials and Methods:\n The components were defined according to specific scope and use cases by a large group of experts, and through several cycles of reviews, according to the new MIABIS governance model of BBMRI-ERIC (Biobanking and Biomolecular Resources Research Infrastructure-European Research Infrastructure Consortium). The guiding principles applied in developing these components included the following terms: model should consider only samples of human origin, model should be applicable to all types of samples and all sample donors, and model should describe the current status of samples stored in a given biobank. \nResults:\n A minimal set of standard attributes for defining samples and sample donors is presented here. We added an "event" component to describe attributes that are not directly describing samples or sample donors but are tightly related to them. To better utilize the generic data model, we suggest a procedure by which interoperability can be promoted, using specific MIABIS profiles. \nDiscussion:\n The MIABIS sample and donor component extensions and the new generic data model complement the existing MIABIS Core 2.0 components, and substantially increase the potential usability of this terminology for better describing biobank samples and sample donors. They also support the use of individual level data about samples and sample donors to obtain accurate and detailed biobank availability queries.\n\nMüller, Heimo\n\n\n"
},
{
"text": "\n184720\nHSD17B13 truncated variant is associated with a mild hepatic phenotype in Wilson's Disease.\n\nFerenci, P\n\nPfeiffenberger, J\n\nStättermayer, AF\n\nStauber, RE\n\nWillheim, C\n\nWeiss, KH\n\nMunda-Steindl, P\n\nTrauner, M\n\nSchilsky, M\n\nZoller, H\n\nBeiträge in Fachzeitschriften\nNone\n32039348.0\n10.1016/j.jhepr.2019.02.007\nPMC7001574\nHSD17B13 encodes hydroxysteroid 17-β dehydrogenase 13, a novel liver lipid-droplet associated protein that is involved in the regulation of lipid biosynthetic processes. A protein-truncating HSD17B13 variant (rs72613567) was shown to protect individuals from alcoholic and non-alcoholic liver disease. Since steatosis is a common feature in Wilson's disease (WD), we aimed to assess whether the HSD17B13 variant modulates the phenotypic presentation and progression of WD.\n The HSD17B13:TA (rs72613567) variant was determined by allelic discrimination real-time PCR in 586 patients. The HSD17B13 genotype was correlated with the phenotypic presentation. The age of onset and the type of symptoms at presentation were used as markers of the WD phenotype.\n The overall HSD17B13:TA allele frequency in patients with WD was 23.3% (273/1, 72), not significantly different from the reported minor allele frequency. There was a significantly lower HSD17B13:TA allele frequency in patients with fulminant WD compared to all other phenotypic WD groups (11.0% vs. 24.0%, p < 0.01). Among the patients with fulminant WD there was a trend for a gender effect; none of the male patients carried the HSD17B13:TA allele. HSD17B13:TA allele frequency was more common in patients with minimal or no fibrosis (49 [31.1%] had simple steatosis and 20 minimal changes at biopsy) than in patients with cirrhosis or advanced fibrosis (22.3%, p = 0.025).\n The HSD17B13:TA allele modulates the phenotype and outcome of WD. This allele likely ameliorates hepatic fibrosis and reduces the transition from copper induced hemolysis to fulminant disease in patients with WD.\n Wilson's disease is a hereditary disease caused by accumulation of copper in the liver and other tissues. It presents with a variety of clinical symptoms. In this study we explored the role of a recently described gene mutation (HSD17B13:TA) which apparently protects the liver against toxins like alcohol. The results indicate that this mutation plays a role in the evolution of liver disease. Patients with Wilson's disease who carry this mutation are more likely to have mild disease, while the absence of the mutation is associated with the most severe form - fulminant Wilson's disease.\n © 2019 The Author(s).\n\nStauber, Rudolf\n\n\n"
},
{
"text": "\n184735\nPharyngeal electrical stimulation for neurogenic dysphagia following stroke, traumatic brain injury or other causes: Main results from the PHADER cohort study.\n\nBath, PM\n\nWoodhouse, LJ\n\nSuntrup-Krueger, S\n\nLikar, R\n\nKoestenberger, M\n\nWarusevitane, A\n\nHerzog, J\n\nSchuttler, M\n\nRagab, S\n\nEverton, L\n\nLedl, C\n\nWalther, E\n\nSaltuari, L\n\nPucks-Faes, E\n\nBocksrucker, C\n\nVosko, M\n\nde Broux, J\n\nHaase, CG\n\nRaginis-Zborowska, A\n\nMistry, S\n\nHamdy, S\n\nDziewas, R\n\nfor PHADER Investigators\n\nBeiträge in Fachzeitschriften\nNone\n33294818.0\n10.1016/j.eclinm.2020.100608\nPMC7700977\nNeurogenic dysphagia is common and has no definitive treatment. We assessed whether pharyngeal electrical stimulation (PES) is associated with reduced dysphagia.\n The PHAryngeal electrical stimulation for treatment of neurogenic Dysphagia European Registry (PHADER) was a prospective single-arm observational cohort study. Participants were recruited with neurogenic dysphagia (comprising five groups - stroke not needing ventilation; stroke needing ventilation; ventilation acquired; traumatic brain injury; other neurological causes). PES was administered once daily for three days. The primary outcome was the validated dysphagia severity rating scale (DSRS, score best-worst 0-12) at 3 months.\n Of 255 enrolled patients from 14 centres in Austria, Germany and UK, 10 failed screening. At baseline, mean (standard deviation) or median [interquartile range]: age 68 (14) years, male 71%, DSRS 11·4 (1·7), time from onset to treatment 32 [44] days; age, time and DSRS differed between diagnostic groups. Insertion of PES catheters was successfully inserted in 239/245 (98%) participants, and was typically easy taking 11·8 min. 9 participants withdrew before the end of treatment. DSRS improved significantly in all dysphagia groups, difference in means (95% confidence intervals, CI) from 0 to 3 months: stroke (n = 79) -6·7 (-7·8, -5·5), ventilated stroke (n = 98) -6·5 (-7·6, -5·5); ventilation acquired (n = 35) -6·6 (-8·4, -4·8); traumatic brain injury (n = 24) -4·5 (-6·6, -2·4). The results for DSRS were mirrored for instrumentally assessed penetration aspiration scale scores. DSRS improved in both supratentorial and infratentorial stroke, with no difference between them (p = 0·32). In previously ventilated participants with tracheotomy, DSRS improved more in participants who could be decannulated (n = 66) -7·5 (-8·6, -6·5) versus not decannulated (n = 33) -2·1 (-3·2, -1·0) (p<0·001). 74 serious adverse events (SAE) occurred in 60 participants with pneumonia (9·2%) the most frequent SAE.\n In patients with neurogenic dysphagia, PES was safe and associated with reduced measures of dysphagia and penetration/aspiration.\n Phagenesis Ltd.\n © 2020 The Author(s).\n\nKöstenberger, Markus\n\n\n"
},
{
"text": "\n187614\nDysbalance of ACE2 levels - a possible cause for severe COVID-19 outcome in COPD.\n\nFließer, E\n\nBirnhuber, A\n\nMarsh, LM\n\nGschwandtner, E\n\nKlepetko, W\n\nOlschewski, H\n\nKwapiszewska, G\n\nBeiträge in Fachzeitschriften\nISI:000649394500001\n33978304.0\n10.1002/cjp2.224\nNone\nSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a serious threat to healthcare systems worldwide. Binding of the virus to angiotensin-converting enzyme 2 (ACE2) is an important step in the infection mechanism. However, it is unknown if ACE2 expression in patients with chronic lung diseases (CLDs), such as chronic obstructive pulmonary disease (COPD), idiopathic pulmonary arterial hypertension (IPAH), or pulmonary fibrosis (PF), is changed as compared to controls. We used lung samples from patients with COPD (n = 28), IPAH (n = 10), and PF (n = 10) as well as healthy control donor (n = 10) tissue samples to investigate the expression of ACE2 and related cofactors that might influence the course of SARS-CoV-2 infection. Expression levels of the ACE2 receptor, the putative receptor CD147/BSG, and the viral entry cofactors TMPRSS2 (transmembrane serine protease 2), EZR, and FURIN were determined by quantitative PCR and in open-access RNA sequencing datasets. Immunohistochemical and single-cell RNA sequencing (scRNAseq) analyses were used for localization and coexpression, respectively. Soluble ACE2 (sACE2) plasma levels were analyzed by enzyme-linked immunosorbent assay. In COPD as compared to donor, IPAH, and PF lung tissue, gene expression of ACE2, TMPRSS2, and EZR was significantly elevated, but circulating sACE2 levels were significantly reduced in COPD and PF plasma compared to healthy control and IPAH plasma samples. Lung tissue expressions of FURIN and CD147/BSG were downregulated in COPD. None of these changes were associated with changes in pulmonary hemodynamics. Histological analysis revealed coexpression of ACE2, TMPRSS2, and Ezrin in bronchial regions and epithelial cells. This was confirmed by scRNAseq analysis. There were no significant expression changes of the analyzed molecules in the lung tissue of IPAH and idiopathic PF as compared to control. In conclusion, we reveal increased ACE2 and TMPRSS2 expression in lung tissue with a concomitant decrease of protective sACE2 in COPD patients. These changes represent the possible risk factors for an increased susceptibility of COPD patients to SARS-CoV-2 infection.\n © 2021 The Authors. The Journal of Pathology: Clinical Research published by The Pathological Society of Great Britain and Ireland & John Wiley & Sons, Ltd.\n\nBirnhuber, Anna\n\nFließer, Elisabeth\n\nKwapiszewska-Marsh, Grazyna\n\nMarsh, Leigh\n\nOlschewski, Horst\n\n\n"
},
{
"text": "\n35983\nAge-related prevalence of dermoscopy patterns in acquired melanocytic naevi.\n\nZalaudek, I\n\nGrinschgl, S\n\nArgenziano, G\n\nMarghoob, AA\n\nBlum, A\n\nRichtig, E\n\nWolf, IH\n\nFink-Puches, R\n\nKerl, H\n\nSoyer, HP\n\nHofmann-Wellenhof, R\n\nBeiträge in Fachzeitschriften\nISI:000234699400015\n16433800.0\n10.1111/j.1365-2133.2005.06973.x\nNone\nBased on the dermoscopic classification of acquired melanocytic naevi, six different dermoscopic types can be distinguished by morphology (globular, globular-reticular, globular-homogeneous, reticular, reticular-homogeneous, homogeneous) and by pigment distribution (uniform, central hyperpigmentation, central hypopigmentation, peripheral hyperpigmentation, peripheral hypopigmentation, multifocal hyper/hypopigmentation). It has been suggested that most individuals harbour one predominant dermoscopic type among their naevi.\n To evaluate whether the age of the patient influences the predominant naevus pattern observed in individuals with multiple acquired melanocytic naevi.\n Individuals were recruited from the pigmented skin lesion clinic in Graz between July 2000 and February 2001. Individuals with at least 10 melanocytic naevi were selected consecutively until a total of 10 individuals in each of five age groups was obtained. Age groups were: 0-15 years, 16-30 years, 31-45 years, 46-60 years and > 60 years. Digitized images of acquired melanocytic naevi, defined as benign melanocytic proliferations having a diameter of at least 5 mm with a macular component and which were not apparent within the first year of life, were evaluated by dermoscopic criteria. The associations of dermoscopic features as a function of patient age were analysed. We calculated absolute numbers and frequencies, given as percentages, as well as predominance of the dermoscopic types of naevi in the different age groups.\n Analysis of 1268 naevi revealed that the globular pattern predominated in the youngest age group. By contrast, the reticular and/or homogeneous patterns were increasingly exhibited in naevi from older individuals (older than 15 years). Uniform pigmentation was most common in melanocytic naevi in the youngest age group, while central hyperpigmentation was predominantly seen in the group of individuals aged 16-30 years.\n The predominance of dermoscopic types of melanocytic naevi varies according to the individual's age. Awareness of the age-related dermoscopic predominance of melanocytic naevi might allow more accurate recognition of dermoscopic patterns of melanocytic skin lesions that are unusual with respect to the individual's age. This observation may help in the early recognition of some 'banal'-appearing melanomas. Furthermore, the observations made in this study raise interesting questions regarding naevus evolution.\n\nFink-Puches, Regina\n\nHofmann-Wellenhof, Rainer\n\nKerl, Helmut\n\nRichtig, Erika\n\nWolf, Ingrid\n\nZalaudek, Iris\n\n\n"
},
{
"text": "\n127369\nThe impact of blepharospasm and cervical dystonia on health-related quality of life and depression\n\nMuller, J\n\nKemmler, G\n\nWissel, J\n\nSchneider, A\n\nVoller, B\n\nGrossmann, J\n\nDiez, J\n\nHomann, N\n\nWenning, GK\n\nSchnider, P\n\nPoewe, W\n\nBeiträge in Fachzeitschriften\nISI:000177159700009\n12140667.0\n10.1007/s00415-002-0733-1\nNone\nThe aim of the study was to evaluate and compare health-related quality of life (HR-QoL) and depression in essential blepharospasm (BSP) and idiopathic cervical dystonia (CD), to identify the clinical and demographic factors associated with poor HR-QoL in both disorders and to analyse the effect of Botulinum Toxin A (BtxA) therapy. Two hundred-twenty consecutive patients with BSP (N = 89, 62 % women, mean age 64 years, mean disease duration 7 years) and CD (N = 131, 64 % women, mean age 53 years, mean disease duration 8 years) recruited from routine referrals to eight Austrian dystonia clinics were included. HR-QoL was measured by the Short Form 36 (SF-36) and depression by the Beck Depression Inventory (BDI). At baseline, patients with CD and BSP scored significantly worse in all eight SF-36 domains compared with an age-matched community sample. In addition, 47 % of patients with CD and 37 % of those with BSP were depressed. Women with BSP scored significantly lower in all SF-36 domains and were more depressed than male patients. In contrast, there was no significant effect of gender on HR-QoL and depression in CD. Neck pain had a significant impact on all SF-36 domains and represented the main determinant of depression in CD. Although BtxA therapy resulted in a significant improvement of clinical symptoms in BSP and CD, HR-QoL did not improve in BSP and only two of the eight SF-36 domains improved significantly in patients with CD. The present study for the first time demonstrated that BSP has a substantial impact on health status emphasizing the need for psychological support with interventions aimed at treating depression in these patients. Our results provide further evidence for the profound impact of CD on HR-QoL and indicate the importance of an adequate management of neck pain in addition to reducing the severity of dystonia in CD. The mismatch between objective BtxA derived improvement of dystonia and lack of change of HR-QoL as determined by the SF-36 illustrates the need for optimized disease specific quality of life rating scales in patients with craniocervical dystonia.\n\nHomann, Carl\n\n\n"
},
{
"text": "\n155877\nCharacterization of hepatic parenchymous perfusion heterogeneity and regional flow kinetics after porcine liver transplantation.\n\nMehrabi, A\n\nGolling, M\n\nJahnke, C\n\nZapletal, Ch\n\nBusch, Ch\n\nSchemmer, P\n\nGebhard, MM\n\nBüchler, MW\n\nKlar, E\n\nKraus, T\n\nBeiträge in Fachzeitschriften\nISI:000182447300002\n12686165.0\n10.1016/S0026-2862(02)00008-0\nNone\nIn clinical practice, a heterogeneous hepatic tissue microperfusion (MC) is often observed after liver resection or transplantation (LTx). Nevertheless this hepatic perfusion phenomenon has never been really quantified with respect to its anatomic distribution and time course in detail. The aim of the study was to characterize liver perfusion heterogeneity and local flow kinetics both in the physiological situation and after standardized ischemia and reperfusion using an established model of porcine LTx.\n Regional distribution of hepatic MC in healthy native porcine livers (control group; n = 8) was analyzed in comparison with data derived 60 min, 24 h, and 72 h after porcine LTx (transplantation group; n = 8 each subgroup; cold ischemia time: 5.7 +/- 1.2 h). MC was measured with implanted thermal diffusion electrodes (TD). Flow in hepatic artery and portal vein was continuously detected by ultrasonic probes. For standardization of measurement localizations, porcine liver lobes were divided anatomically into three horizontal layers (cranial, medial, caudal), defining 12 distinct hepatic measurement regions.\n In the control group, a homogenous liver MC with a mean flow of 81.6 +/- 13.9 ml/100 g/min was detected in all regions. After LTx, a marked MC heterogeneity was noted 60 min after reperfusion. MC rehomogenization was first documented within horizontal liver planes 24 h later. Comparison of MC between planes showed persisting heterogeneity with a significant intralober drop of mean MC in the cranio-caudal direction. Complete MC rehomogenization (both between horizontal and vertical liver planes) was detected 72 h after reperfusion. Still, an overall reduction of mean liver perfusion by about 15% was existent.\n A homogenous tissue perfusion was observed in healthy porcine livers. In contrast, marked heterogeneity of hepatic MC was detected after LTx. Heterogeneity presents as a very dynamic and temporary phenomenon. Early horizontal flow rehomogenization and reconstitution of normal blood flow, particularly primarily in the cranial liver layers, appear to be characteristic features during early flow reconstitution after postischemic reperfusion. Due to heterogeneity and time-dependent flow dynamics, measurement of MC volumes at single hepatic regions may not always allow a valid characterization of liver perfusion quality during the first 24 h after postischemic reperfusion.\n\nSchemmer, Peter\n\n\n"
},
{
"text": "\n185328\nInnervation of the hip joint capsular complex: A systematic review of histological and immunohistochemical studies and their clinical implications for contemporary treatment strategies in total hip arthroplasty.\n\nTomlinson, J\n\nZwirner, J\n\nOndruschka, B\n\nPrietzel, T\n\nHammer, N\n\nBeiträge in Fachzeitschriften\nISI:000535233700017\n32101545.0\n10.1371/journal.pone.0229128\nPMC7043757\nThe hip joint capsule contributes to the stability of the hip joint and lower extremity, yet this structure is incised and often removed during total hip arthroplasty (THA). Increasing incidence of osteoarthritis is accompanied by a dramatic rise in THAs over the last few decades. Consequently, to improve this treatment, THA with capsular repair has evolved. This partial restoration of physiological hip stability has resulted in a substantial reduction in post-operative dislocation rates compared to conventional THA without capsular repair. A further reason for the success of this procedure is thought to be the preservation of the innervation of the capsule. A systematic review of studies investigating the innervation of the hip joint capsular complex and pseudocapsule with histological techniques was performed, as this is not well established. The literature was sought from databases Amed, Embase and Medline via OVID, PubMed, ScienceDirect, Scopus and Web of Science; excluding articles without a histological component and those involving animals. A total of 21 articles on the topic were identified. The literature indicates two primary outcomes and potential clinical implications of the innervation of the capsule. Firstly, a role in the mechanics of the hip joint, as mechanoreceptors may be present in the capsule. However, the nomenclature used to describe the distribution of the innervation is inconsistent. Furthermore, the current literature is unable to reliably confirm the proprioceptive role of the capsule, as no immunohistochemical study to date has reported type I-III mechanoreceptors in the capsule. Secondly, the capsule may play a role in pain perception, as the density of innervation appears to be altered in painful individuals. Also, increasing age may indicate requirements for different strategies to surgically manage the hip capsule. However, this requires further study, as well as the role of innervation according to sex, specific pathology and other morphometric variables. Increased understanding may highlight the requirement for capsular repair following THA, how this technique may be developed and the contribution of the capsule to joint function and stability.\n\nHammer, Niels\n\n\n"
},
{
"text": "\n5246\nSnoring as an sign of sleep disorders in 11- to 15-year-old school children--initial results of a Vienna epidemiologic study\n\nTörök, K\n\nFatemi, A\n\nWerner, I\n\nKerbl, R\n\nSchwarz, B\n\nIpsiroglu, OS\n\nBeiträge in Fachzeitschriften\nISI:000188366100005\n14768531.0\nNone\nNone\nINTRODUCTION: The prevalence of snoring was evaluated in school children between 11 and 15 years of age. In addition to items reported by parents, children were asked to answer a questionnaire in order to receive information about the children's potential complaints, life style and school performance. METHOD: The study was performed in 21 randomly selected schools in the Vienna area. 1434 school children were interviewed by a questionnaire (mean age 12.5 years, median 13 years, 676 girls vs. 699 boys). The questionnaire consisted of 45 multiple-choice questions about the socioeconomic status, possible sleep disorders and signs or symptoms of obstructive sleep apneas (OSA). The questionnaire completed by parents was also used to calculate the Brouillette-Score from the items snoring, obstructed breaths and apneas. RESULTS: 5.2% (74/1434) of children and 6.9% (86/1259) of parents or caregivers reported about snoring (frequently or very frequently). There were no sex differences for the children's and the parents' questionnaire. None of the children had a clearly positive result (hint of OSA) from the Brouillette-Score whereas "suspicious OSA" was observed in 3.2% (40/1259). When frequent and very frequent snorers were compared with the other children, more mouth breathing during sleep (p < 0.00001), mouth dryness (p < 0.00005), headache (p < 0.0005), cigarette exposition at home (p < 0.001), smoking (p < 0.005), daytime naps (p < 0.005), crying out of sleep (p < 0.01), daytime tiredness (p < 0.05) und a higher body mass index (p < 0.05) could be observed in this group, in addition to the items reported by the parents. CONCLUSION: The prevalence of snoring is lower in our study than in other studies. No statistically significant sex differences were observed, both in the parents' and the children's questionnaire. In our study snoring seems to be a sign or symptom of different sleep disorders, and not only of OSA. A statistically significant correlation between snoring and anamnestic hints of sleep disorders underlines the need to ask concerned children themselves for observations potentially associated with sleep disorders. Results of the Brouillette-Score could not be used to identify sleep disorders in our study.\n\nKerbl, Reinhold\n\n\n"
},
{
"text": "\n17906\nAn inter-laboratory comparison study of image quality of PET scanners using the NEMA NU 2-2001 procedure for assessment of image quality.\n\nBergmann, H\n\nDobrozemsky, G\n\nMinear, G\n\nNicoletti, R\n\nSamal, M\n\nBeiträge in Fachzeitschriften\nISI:000229866100001\n15876661.0\n10.1088/0031-9155/50/10/001\nNone\nAn inter-laboratory comparison study was conducted to assess the image quality of PET scanners in Austria. The survey included both dedicated PET scanners (D-PET, n = 8) and coincidence cameras (GC-PET, n = 7). Measurement of image quality was based on the NEMA (National Electrical Manufacturers Association) NU 2-2001 protocol and the IEC (International Electrotechnical Commission) body phantom. The latter contains six fillable spheres ranging in diameter from 37 mm down to 10 mm and a 'lung' insert. The two largest lesions L1-2 simulate cold lesions, the four smaller ones (L3-6) are filled with 18F and activity concentration ratios relative to background of 8:1 and 4:1, respectively. Acquisition and reconstruction in the study employed the participating institutes' standard oncological processing protocol. Calculation of contrast of the spheres was performed with a fully automated procedure. Contrast quality indices (CQIs) reflecting global performance were obtained by summing individual contrast values. Other image quality parameters calculated according to the NEMA protocol were background variability and relative error for correction of attenuation and scatter. Contrast values obtained were 61 +/- 16 and 37 +/- 14 for L1 (per cent contrast +/- SD for D-PET and GC-PET, respectively), 57 +/- 16 and 29 +/- 16 for L2, 46 +/- 10 and 26 +/- 6.3 for L3, 37 +/- 10 and 15 +/- 4.3 for L4, 26 +/- 11.5 and 6.1 +/- 2.5 for L5, 14 +/- 7.1 and 2.6 +/- 2.6 for L6, with D-PET systems consistently being superior to GC-PET systems. CQIs permitted ranking of the scanners, also demonstrating a clear distinction between D-PET and GC-PET systems. Background variability was largest for GC-PET systems; the relative error of attenuation and scatter correction was significantly correlated with image quality for D-PET systems only. The study demonstrated considerable differences in image quality not only between GC-PET and D-PET systems but also between individual D-PET systems with possible consequences for clinical interpretation of images and measurement of quantitative indices such as the standardized uptake value. The study provided valuable feedback to the participants as well as baseline data for improving interchangeability of PET images and of quantitative indices between different laboratories.\n\n\n"
},
{
"text": "\n64245\nAnalysis of the human VH gene repertoire. Differential effects of selection and somatic hypermutation on human peripheral CD5(+)/IgM+ and CD5(-)/IgM+ B cells.\n\nBrezinschek, HP\n\nFoster, SJ\n\nBrezinschek, RI\n\nDörner, T\n\nDomiati-Saad, R\n\nLipsky, PE\n\nBeiträge in Fachzeitschriften\nISI:A1997XB22600029\n9153293.0\n10.1172/JCI119433\nPMC508090\nTo analyze the immunoglobulin repertoire of human IgM+ B cells and the CD5(+) and CD5(-) subsets, individual CD19(+)/ IgM+/CD5(+) or CD5(-) B cells were sorted and non-productive as well as productive VH gene rearrangements were amplified from genomic DNA and sequenced. In both subsets, the VH3 family was overrepresented largely as a result of preferential usage of a small number of specific individual family members. In the CD5(+) B cell subset, all other VH families were found at a frequency expected from random usage, whereas in the CD5(-) population, VH4 appeared to be overrepresented in the nonproductive repertoire, and also negatively selected since it was found significantly less often in the productive compared to the nonproductive repertoire; the VH1 family was significantly diminished in the productive rearrangements of CD5(-) B cells. 3-23/DP-47 was the most frequently used VH gene segment and was found significantly more often than expected from random usage in productive rearrangements of both CD5(+) and CD5(-) B cells. Evidence for selection based on the D segment and the JH gene usage was noted in CD5(+) B cells. No differences were found between the B cell subsets in CDR3 length, the number of N-nucleotides or evidence of exonuclease activity. Somatically hypermutated VHDJH rearrangements were significantly more frequent and extensive in CD5(-) compared to CD5(+) IgM+ B cells, indicating that IgM+ memory B cells were more frequent in the CD5(-) B cell population. Of note, the frequency of specific VH genes in the mutated population differed from that in the nonmutated population, suggesting that antigen stimulation imposed additional biases on the repertoire of IgM+ B cells. These results indicate that the expressed repertoire of IgM+ B cell subsets is shaped by recombinational bias, as well as selection before and after antigen exposure. Moreover, the influences on the repertoires of CD5(+) and CD5(-) B cells are significantly different, suggesting that human peripheral blood CD5(+) and CD5(-) B cells represent different B cell lineages, with similarities to murine B-1a and B-2 subsets, respectively.\n\nBrezinsek, Hans-Peter\n\n\n"
},
{
"text": "\n68026\nSmall bowel carcinoid (enterochromaffin cell) neoplasia exhibits transforming growth factor-beta1-mediated regulatory abnormalities including up-regulation of C-Myc and MTA1.\n\nKidd, M\n\nModlin, IM\n\nPfragner, R\n\nEick, GN\n\nChampaneria, MC\n\nChan, AK\n\nCamp, RL\n\nMane, SM\n\nBeiträge in Fachzeitschriften\nISI:000247113500005\n17469181.0\n10.1002/cncr.22725\nNone\nBACKGROUND: Although it is known that small intestinal carcinoids are derived from enterochromaffin (EC) cells, these cells remain poorly characterized and little is known of the growth regulatory mechanisms of these neuroendocrine cells. Down-regulation or loss of the transforming growth factor-beta1 (TGFbeta1) cytostatic program and activation of TGFbeta-mediated transcriptional networks is associated with uncontrolled growth and metastasis in other neural tumors, glioblastomas. Whether this phenomenon is common to small intestinal carcinoid tumors was investigated. METHODS: The effects of TGFbeta1 on cultured normal EC cells (isolated by FACS sorting) and the neoplastic EC cell line, KRJ-I, was assessed using the MTT assay. The TGFbetaRII transcript and protein were identified in tumor cells and the effects of TGFbeta1 on SMAD2 phosphorylation and nuclear translocation quantified. The time-dependent response of SMAD4, SMAD7, c-Myc, and P21(WAF1/CIP1) protein expression and c-Myc and p21(WAF1/CIP1) transcript was measured in response to TGFbeta1 and the transcript expression of candidate downstream targets, MTA1 and E-cadherin, were assessed. RESULTS: TGFbeta1 inhibited normal EC cell proliferation (IC(50) = 17 pM) but stimulated neoplastic EC cell proliferation (EC(50) = 22 pM). In tumor cells, significantly decreased transcript (P < .01) of TGFbetaRII was identified, but no receptor mutations were identified and protein expression was evident. TGFbeta1 (1 ng/mL) resulted in SMAD2 phosphorylation and <7% nuclear expression compared with 93% in normal EC cells. In neoplastic cells, TGFbeta1 (1 ng/mL) caused a decrease in SMAD4 (>16%, P < .05), whereas SMAD7 and c-Myc transcript and protein were respectively increased >21% (P < .05) and approximately 40% (P < .002). TGFbeta1 (1 ng/mL) also decreased p21(WAF1/CIP1) transcript by 60% (P < .001) and protein that was undetectable at 24 hours. Expression of the downstream targets of the c-Myc pathway, MTA1, was increased (20%) and E-cadherin decreased (30%). CONCLUSIONS: The neoplastic EC cell is characterized by loss of TGFbeta-1-mediated growth inhibition and, similar to glioblastomas, utilizes the TGFbeta system to induce gene responses associated with growth promotion (c-Myc and the ERK pathway), invasion (E-cadherin), and metastasis (MTA1).\n\n\n"
},
{
"text": "\n84973\nReticulate phylogeny of gastropod-shell-breeding cichlids from Lake Tanganyika--the result of repeated introgressive hybridization.\n\nKoblmüller, S\n\nDuftner, N\n\nSefc, KM\n\nAibara, M\n\nStipacek, M\n\nBlanc, M\n\nEgger, B\n\nSturmbauer, C\n\nBeiträge in Fachzeitschriften\nISI:000244053300001\n17254340.0\n10.1186/1471-2148-7-7\nPMC1790888\nBACKGROUND: The tribe Lamprologini is the major substrate breeding lineage of Lake Tanganyika's cichlid species flock. Among several different life history strategies found in lamprologines, the adaptation to live and breed in empty gastropod shells is probably the most peculiar. Although shell-breeding arose several times in the evolutionary history of the lamprologines, all obligatory and most facultative shell-breeders belong to the so called "ossified group", a monophyletic lineage within the lamprologine cichlids. Since their distinctive life style enables these species to live and breed in closest vicinity, we hypothesized that these cichlids might be particularly prone to accidental hybridization, and that introgression might have affected the evolutionary history of this cichlid lineage. RESULTS: Our analyses revealed discrepancies between phylogenetic hypotheses based on mitochondrial and nuclear (AFLP) data. While the nuclear phylogeny was congruent with morphological, behavioral and ecological characteristics, several species--usually highly specialized shell-breeders--were placed at contradicting positions in the mitochondrial phylogeny. The discordant phylogenies strongly suggest repeated incidents of introgressive hybridization between several distantly related shell-breeding species, which reticulated the phylogeny of this group of cichlids. Long interior branches and high bootstrap support for many interior nodes in the mitochondrial phylogeny argue against a major effect of ancient incomplete lineage sorting on the phylogenetic reconstruction. Moreover, we provide morphological and genetic (mtDNA and microsatellites) evidence for ongoing hybridization among distantly related shell-breeders. In these cases, the territorial males of the inferred paternal species are too large to enter the shells of their mate, such that they have to release their sperm over the entrance of the shell to fertilize the eggs. With sperm dispersal by water currents and wave action, trans-specific fertilization of clutches in neighboring shells seem inevitable, when post-zygotic isolation is incomplete. CONCLUSION: From the direct observation of hybrids we conclude that hybridization between distantly related gastropod-shell-breeding cichlids of Lake Tanganyika follows inevitably from their ecological specialization. Moreover, the observed incongruence between mtDNA and nuclear multilocus phylogeny suggests that repeated hybridization events among quite distantly related taxa affected the diversification of this group, and introduced reticulation into their phylogeny.\n\n\n"
},
{
"text": "\n154527\nAdjuvant treatment with pegylated interferon α-2a versus low-dose interferon α-2a in patients with high-risk melanoma: a randomized phase III DeCOG trial.\n\nEigentler, TK\n\nGutzmer, R\n\nHauschild, A\n\nHeinzerling, L\n\nSchadendorf, D\n\nNashan, D\n\nHölzle, E\n\nKiecker, F\n\nBecker, J\n\nSunderkötter, C\n\nMoll, I\n\nRichtig, E\n\nPönitzsch, I\n\nPehamberger, H\n\nKaufmann, R\n\nPföhler, C\n\nVogt, T\n\nBerking, C\n\nPraxmarer, M\n\nGarbe, C\n\nDermatologic Cooperative Oncology Group (DeCOG)\n\nBeiträge in Fachzeitschriften\nISI:000383182800035\n27287206.0\n10.1093/annonc/mdw225\nNone\nAdjuvant treatment with interferon (IFN)-α-2a improved disease-free survival (DFS) and showed a trend for improving overall survival (OS) in melanoma. This trial was designed to examine whether PEG-IFN is superior to IFN with regard to distant metastasis-free survival (DMFS), DFS and OS.\n In this multicenter, open-label, prospective randomized phase III trial, patients with resected cutaneous melanoma stage IIA(T3a)-IIIB (AJCC 2002) were randomized to receive PEG-IFN (180 μg subcutaneously 1×/week; 24 months) or IFN α-2a (3MIU subcutaneously 3×/week; 24 months). Randomization was stratified for stage, number of metastatic nodes, age and previous IFN treatment. The primary end point was DMFS; secondary end points were OS, DFS, quality of life (QoL) and tolerability.\n A total of 909 patients were enrolled (451 PEG-IFN versus 458 IFN). Neither 5-year DMFS [PEG-IFN 61.0% versus IFN 67.3%; hazard ratio (HR) 1.16, P = 0.21] nor 5-year OS (PEG-IFN 73.2% versus IFN 75.2%; HR 1.05, P = 0.70) nor 5-year DFS (PEG-IFN 57.3% versus IFN 60.9%; HR 1.09, P = 0.40) showed significant differences. Subgroup analyses in patients ± ulcerated primaries and of different tumor stages did not find differences in DMFS, OS or DFS between the treatment groups. One hundred and eighteen patients (26.2%) in the PEG-IFN and 61 patients (13.3%) in the IFN population did not receive the full dosage and length of treatment due to adverse events (P < 0.001). Leukopenia and elevation of liver enzymes were more common in the PEG-IFN arm (56% versus 23.5% LCP; 19.1% versus 9.4% AST; 33.0% versus 16.5% ALT). QoL was identical for nearly all domains.\n PEG-IFN did not improve the outcome over IFN. A higher percentage of patients under PEG-IFN discontinued treatment due to toxicity.\n NCT00204529.\n © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.\n\nRichtig, Erika\n\n\n"
},
{
"text": "\n159895\nPrognostic and discriminative power of the 7th TNM classification for patients with surgically treated papillary renal cell carcinoma: results of a multi-institutional validation study (CORONA subtype project).\n\nMay, M\n\nSurcel, C\n\nCapitanio, U\n\nDell'Oglio, P\n\nKlatte, T\n\nShariat, S\n\nEcke, T\n\nWolff, I\n\nVergho, D\n\nWagener, N\n\nHuck, N\n\nPahernik, S\n\nZastrow, S\n\nWirth, M\n\nBorgmann, H\n\nHaferkamp, A\n\nMusquera, M\n\nKrabbe, LM\n\nHerrmann, E\n\nScavuzzo, A\n\nMirvald, C\n\nHutterer, G\n\nZigeuner, R\n\nStief, CG\n\nWaidelich, R\n\nCindolo, L\n\nKalusova, K\n\nBrookman-May, SD\n\nCollaborative Research On Renal Neoplasms Association (CORONA) and European Association of Urology (EAU) Young Academic Urologists (YAU) Kidney Cancer Group\n\nBeiträge in Fachzeitschriften\nISI:000405483400007\n28399699.0\n10.1080/21681805.2017.1300187\nNone\nStudies on the prognostic reliability of the Union for International Cancer Control tumor, node, metastasis (TNM) staging system for renal cell carcinoma (RCC) predominantly focus on clear-cell RCC. Therefore, the aim of this study was to investigate whether the oncological prognosis of surgically treated papillary RCC (papRCC) patients is reliably given by the current TNM system, by analyzing the largest database reported to date.\n Data on 2325 papRCC patients who underwent surgical treatment in 1984- 2015 were collated from 17 international centers (median follow-up 47 months). Tumor stage was adapted to the 7th edition of the TNM system. Multivariable, bootstrap-corrected Cox regression models were applied to assess the independent impact of the TNM system on cancer-specific mortality (CSM) and all-cause mortality (ACM).\n The median age at diagnosis was 63 years (interquartile range 54-70 years) and 77% of patients were male. Nephron-sparing surgery was performed in 42%, and 82% were with symptom free at diagnosis. In 6.7% (n = 156), organ metastasis (stage M1) was present at the time of surgery. On multivariable analysis, the TNM system and Fuhrman grade had an independent impact on both CSM and ACM, while patient age affected ACM only. The discriminative ability of the pT classification was significant for both endpoints: 5 year CSM rates were 5%, 17%, 36% and 56% for stages pT1, pT2, pT3 and pT4, respectively (each p < 0.001). The pT classification contributed significantly to the predictive accuracy of the CSM and ACM models by 6.3% and 2.5%, respectively (each p < 0.001).\n The 2010 TNM staging system can be reliably applied to papRCC patients and allows certain prognostic discrimination.\n\nHutterer, Georg\n\nZigeuner, Richard\n\n\n"
},
{
"text": "\n163363\nMicrobial Community and Biochemical Dynamics of Biological Soil Crusts across a Gradient of Surface Coverage in the Central Mojave Desert.\n\nMogul, R\n\nVaishampayan, P\n\nBashir, M\n\nMcKay, CP\n\nSchubert, K\n\nBornaccorsi, R\n\nGomez, E\n\nTharayil, S\n\nPayton, G\n\nCapra, J\n\nAndaya, J\n\nBacon, L\n\nBargoma, E\n\nBlack, D\n\nBoos, K\n\nBrant, M\n\nChabot, M\n\nChau, D\n\nCisneros, J\n\nChu, G\n\nCurnutt, J\n\nDiMizio, J\n\nEngelbrecht, C\n\nGott, C\n\nHarnoto, R\n\nHovanesian, R\n\nJohnson, S\n\nLavergne, B\n\nMartinez, G\n\nMans, P\n\nMorales, E\n\nOei, A\n\nPeplow, G\n\nPiaget, R\n\nPonce, N\n\nRenteria, E\n\nRodriguez, V\n\nRodriguez, J\n\nSantander, M\n\nSarmiento, K\n\nScheppelmann, A\n\nSchroter, G\n\nSexton, D\n\nStephenson, J\n\nSymer, K\n\nRusso-Tait, T\n\nWeigel, B\n\nWilhelm, MB\n\nBeiträge in Fachzeitschriften\nISI:000413413700001\n29109701.0\n10.3389/fmicb.2017.01974\nPMC5660283\nIn this study, we expand upon the biogeography of biological soil crusts (BSCs) and provide molecular insights into the microbial community and biochemical dynamics along the vertical BSC column structure, and across a transect of increasing BSC surface coverage in the central Mojave Desert, CA, United States. Next generation sequencing reveals a bacterial community profile that is distinct among BSCs in the southwestern United States. Distribution of major phyla in the BSC topsoils included Cyanobacteria (33 ± 8%), Proteobacteria (26 ± 6%), and Chloroflexi (12 ± 4%), with Phormidium being the numerically dominant genus. Furthermore, BSC subsurfaces contained Proteobacteria (23 ± 5%), Actinobacteria (20 ± 5%), and Chloroflexi (18 ± 3%), with an unidentified genus from Chloroflexi (AKIW781, order) being numerically dominant. Across the transect, changes in distribution at the phylum (p < 0.0439) and genus (p < 0.006) levels, including multiple biochemical and geochemical trends (p < 0.05), positively correlated with increasing BSC surface coverage. This included increases in (a) Chloroflexi abundance, (b) abundance and diversity of Cyanobacteria, (b) OTU-level diversity in the topsoil, (c) OTU-level differentiation between the topsoil and subsurface, (d) intracellular ATP abundances and catalase activities, and (e) enrichments in clay, silt, and varying elements, including S, Mn, Co, As, and Pb, in the BSC topsoils. In sum, these studies suggest that BSCs from regions of differing surface coverage represent early successional stages, which exhibit increasing bacterial diversity, metabolic activities, and capacity to restructure the soil. Further, these trends suggest that BSC successional maturation and colonization across the transect are inhibited by metals/metalloids such as B, Ca, Ti, Mn, Co, Ni, Mo, and Pb.\n\n\n"
}
]
}