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"text": "\n181917\nThe AST/ALT (De Ritis) ratio predicts clinical outcome in patients with pancreatic cancer treated with first-line nab-paclitaxel and gemcitabine: <i>post hoc</i> analysis of an Austrian multicenter, noninterventional study.\n\nRiedl, JM\n\nPosch, F\n\nPrager, G\n\nEisterer, W\n\nOehler, L\n\nSliwa, T\n\nWilthoner, K\n\nPetzer, A\n\nPichler, P\n\nHubmann, E\n\nWinder, T\n\nBurgstaller, S\n\nKorger, M\n\nAndel, J\n\nGreil, R\n\nNeumann, HJ\n\nPecherstorfer, M\n\nPhilipp-Abbrederis, K\n\nDjanani, A\n\nGruenberger, B\n\nLaengle, F\n\nWöll, E\n\nGerger, A\n\nBeiträge in Fachzeitschriften\nISI:000528550300001\n32313566.0\n10.1177/1758835919900872\nPMC7153180\nThe pretreatment De Ritis ratio [aspartate transaminase (AST)/alanine transaminase (ALT)] has been shown to be an adverse prognostic marker in various cancer entities. However, its relevance to advanced pancreatic ductal adenocarcinoma (PDAC) has not yet been studied. In the present study we investigated the AST/ALT ratio as a possible predictor of treatment response and disease outcome in patients with advanced PDAC treated with first-line gemcitabine/nab-paclitaxel.\n A post hoc analysis of a prospective, multicenter, noninterventional study was performed. A total of 202 patients with advanced PDAC treated with first-line gemcitabine/nab-paclitaxel for whom the AST/ALT ratio was measured were included in this analysis.\n Median and 1-year progression-free survival estimates were 4.8 months and 5.1%, respectively in patients with an AST/ALT ratio above the 75th percentile of its distribution, and 6.0 months and 18.7%, respectively in patients with an AST/ALT ratio less than or equal to this cutoff, respectively (log-rank p = 0.004). In univariable Cox regression, a doubling of the AST/ALT ratio was associated with a 1.4-fold higher relative risk of progression or death [hazard ratio = 1.38, 95% confidence interval (CI): 1.06-1.80, p = 0.017]. The prognostic association was also found in multivariable analysis adjusting for Eastern Cooperative Oncology Group performance status and lung metastases (hazard ratio per AST/ALT ratio doubling = 1.32, 95% CI: 1.00-1.75, p = 0.047). In treatment response analysis, a doubling of the AST/ALT ratio was associated with a 0.5-fold lower odds of objective response (odds ratio = 0.54, 95% CI: 0.31-0.94, p = 0.020).\n The pretreatment serum AST/ALT ratio predicts poor disease outcome and response rate in patients with advanced PDAC treated with gemcitabine/nab-paclitaxel and might represent a novel and inexpensive marker for individual risk assessment in the treatment of pancreatic cancer.\n © The Author(s), 2020.\n\nGerger, Armin\n\nPosch, Florian\n\nRiedl, Jakob\n\n\n"
},
{
"text": "\n7138\nThe influence of an anterior-posterior gliding mobile bearing on range of motion after total knee arthroplasty. A prospective, randomized, double-blinded study.\n\nAigner, C\n\nWindhager, R\n\nPechmann, M\n\nRehak, P\n\nEngeleke, K\n\nBeiträge in Fachzeitschriften\nISI:000224463800018\n15466736.0\n10.2106/00004623-200410000-00018\nNone\nBACKGROUND: Range of motion is a crucial measure of outcome after total knee arthroplasty. In order for maximum flexion to occur, the femur must progressively shift posteriorly on the tibia, a movement that is known as femoral rollback. Mobile bearings with free anterior-posterior translation could improve knee flexion by allowing such motion. The purpose of the present study was to determine the influence of an anterior-posterior gliding mobile bearing on the postoperative range of knee motion in patients with an intact posterior cruciate ligament. METHODS: We performed a prospective, randomized clinical trial of fifty consecutive total knee arthroplasties that were performed with use of the LCS-Universal prosthesis. Participants were randomized to receive either a deep-dish rotating platform or a mobile bearing that allowed additional anterior-posterior translation, the latter of which requires an intact posterior cruciate ligament. The ranges of motion of the knees were assessed to detect a 15 degrees difference in the active non-weight-bearing range of motion with a power (1 - beta) of 20% and with the level of significance (alpha) set at 0.05. The translation of the mobile bearing was measured with use of a standardized ultrasound technique and was correlated with maximum knee flexion. The participants and the assessor were blinded throughout the study. RESULTS: At the time of the one-year follow-up evaluation, forty-eight knees were available for an intention-to-treat analysis. The mean active non-weight-bearing range of motion at one year was 113 degrees (95% confidence interval, 108 degrees to 118 degrees ) in the twenty-six knees that had received a rotating platform and 111 degrees (95% confidence interval, 115 degrees to 125 degrees ) in the twenty-two knees that had received an anterior-posterior gliding bearing (p = 0.57). In the latter group, a continuous rollback occurred in two knees. There was no significant correlation between knee flexion and anterior-posterior translation (r(2) = 0.015). CONCLUSIONS: The use of a mobile bearing that allowed free anterior-posterior translation did not regularly restore femoral rollback and did not improve range of motion after total knee arthroplasty compared with the findings seen in association with the use of a rotating platform.\n\n\n"
},
{
"text": "\n92165\nLong-term effects of weight-reducing drugs in hypertensive patients.\n\nSiebenhofer, A\n\nHorvath, K\n\nJeitler, K\n\nBerghold, A\n\nStich, AK\n\nMatyas, E\n\nPignitter, N\n\nSiering, U\n\nBeiträge in Fachzeitschriften\nISI:000268037800002\n19588440.0\n10.1002/14651858.CD007654.pub2\nNone\nBACKGROUND: All major guidelines for antihypertensive therapy recommend weight loss; anti-obesity drugs might be a helpful option. OBJECTIVES: Primary objectives:To assess the long-term effects of pharmacologically induced reduction in body weight with orlistat, sibutramine or rimonabant on:- all cause mortality - cardiovascular morbidity - adverse eventsSecondary objectives: - changes in systolic and/or diastolic blood pressure - body weight reduction SEARCH STRATEGY: Studies were obtained from computerised searches of Ovid MEDLINE, EMBASE, CENTRAL and from hand searches in reference lists and systematic reviews. SELECTION CRITERIA: Randomized controlled trials in adult hypertensive patients with a study duration of at least 24 weeks comparing pharmacologic interventions (orlistat, sibutramine, rimonabant) for weight loss with placebo. DATA COLLECTION AND ANALYSIS: Two authors independently assessed risk of bias and extracted data. Studies were pooled using fixed-effect meta-analysis in the absence of significant heterogeneity between studies (p>0.1). Otherwise, we used the random effects method and investigated the cause of heterogeneity. MAIN RESULTS: Eight studies comparing orlistat or sibutramine to placebo fulfilled our inclusion criteria. No relevant studies investigating rimonabant for weight loss were identified. No study included mortality and cardiovascular morbidity as a pre-defined outcome. Incidence of gastrointestinal side effects was consistently higher in orlistat treated vs. placebo treated patients. Most frequent side effects with sibutramine were dry mouth, constipation and headache. Patients assigned to weight loss diets, orlistat or sibutramine reduced their body weight more effectively than patients in the usual care/placebo groups. Blood pressure reduction in patients treated with orlistat was for systolic blood pressure (SBP): weighted mean difference (WMD): -2.5 mm Hg; 95% CI, -4.0 to -0.9 mm Hg and for diastolic blood pressure (DBP): WMD -1.9 mm Hg; 95% CI, -3.0 to -0.9 mm Hg. Meta-analysis showed DBP increase under therapy with sibutramine: WMD +3.2 mm Hg; 95%CI +1.4 to +4.9 mm Hg. AUTHORS' CONCLUSIONS: In patients with elevated blood pressure, orlistat and sibutramine reduced body weight to a similar degree. In the same trials, orlistat reduced blood pressure and sibutramine increased blood pressure. No trials investigating rimonabant in people with elevated blood pressure could be included. Long-term trials assessing the effect of orlistat, sibutramine and rimonabant on mortality and morbidity are needed.\n\nBerghold, Andrea\n\nHorvath, Karl\n\nJeitler, Klaus\n\nNagele, Eva Helene\n\nPosch, Nicole\n\nSiebenhofer-Kroitzsch, Andrea\n\n\n"
},
{
"text": "\n116202\nThe evidence on the degradation processes in the midgut epithelial cells of the larval antlion Euroleon nostras (Geoffroy in Fourcroy, 1785) (Myrmeleontidae, Neuroptera).\n\nLipovsek, S\n\nLetofsky-Papst, I\n\nHofer, F\n\nLeitinger, G\n\nDevetak, D\n\nBeiträge in Fachzeitschriften\nISI:000302673600011\n22236559.0\n10.1016/j.micron.2011.11.012\nNone\nWe analysed structural differences between midgut epithelial cells of fed instar antlions' larvae Euroleon nostras and starved ones. In starved larvae the presence of autophagolysosome-like structures was observed, which are characteristic structures associated with autophagy. The results presented here provide insight supporting the role of autophagy as a cell survival mechanism for the periods of food deprivation. Additional structural changes in the cytoplasm were seen in the spherites. The ultrastructure and chemical composition of spherites in the midgut epithelial cells of first, second and third instar larvae were observed with light microscopy and transmission electron microscopy (TEM). A detailed characterization of the elemental composition of the spherites was studied using analytical electron microscopy; a combination of energy dispersive X-ray spectroscopy (EDXS), electron energy-loss spectroscopy (EELS) and energy filtering TEM (EFTEM) was applied. The structure and elemental composition of the spherites changed during the period of larval life. Moreover, changes in chemical composition were found between spherites from fed and starved E. nostras. In fed first instar larvae, the spherites contained an organic matrix, composed of C, N and O. In this matrix, P, Cl, Ca and Fe were detected. In starved first instar larvae, only C, N and P were present. The spherites of fed second instar larvae were rich in organic and inorganic elements and were composed of C, N, O, Na, Mg, P, S, Cl, K, Ca, Mn, Fe and Zn. In starved second instar larvae, the chemical elements N, O, P, Ca and Fe were found. In fed third instar larvae, the spherites contained C, N, O, Na, Mg, P, Cl, K, Ca, Mn, Fe, Co and Zn. In starved third larvae, C, O, Si, Ca, and Fe were detected. Generally, the spherites are exploited in starved larvae. These results suggest that the elemental supply of spherites may provide crucial support for physiological processes during starvation periods amongst E. nostras instar larvae. In some cases in fed second and fed third instar larvae, spherites were seen in the lumen of the midgut. Such spherites could serve as reservoirs for nontoxic waste material that cannot be metabolized.\n\nLeitinger, Gerd\n\n\n"
},
{
"text": "\n123985\nCombined Proteomic and Metabolomic Profiling of Serum Reveals Association of the Complement System with Obesity and Identifies Novel Markers of Body Fat Mass Changes.\n\nOberbach, A\n\nBluher, M\n\nWirth, H\n\nTill, H\n\nKovacs, P\n\nKullnick, Y\n\nSchlichting, N\n\nTomm, JM\n\nRolle-Kampczyk, U\n\nMurugaiyan, J\n\nBinder, H\n\nDietrich, A\n\nvon Bergen, M\n\n\n\nBeiträge in Fachzeitschriften\nISI:000295602700035\n21823675.0\n10.1021/pr2005555\nNone\nObesity is associated with multiple adverse health effects and a high risk of developing metabolic and cardiovascular diseases. Therefore, there is a great need to identify circulating parameters that link changes in body fat mass with obesity. This study combines proteomic and metabolomic approaches to identify circulating molecules that discriminate healthy lean from healthy obese individuals in an exploratory study design. To correct for variations in physical activity, study participants performed a one hour exercise bout to exhaustion. Subsequently, circulating factors differing between lean and obese individuals, independent of physical activity, were identified. The DIGE approach yielded 126 differentially abundant spots representing 39 unique proteins. Differential abundance of proteins was confirmed by ELISA for antithrombin-III, clusterin, complement C3 and complement C3b, pigment epithelium-derived factor (PEDF), retinol binding protein 4 (RBP4), serum amyloid P (SAP), and vitamin-D binding protein (VDBP). Targeted serum metabolomics of 163 metabolites identified 12 metabolites significantly related to obesity. Among those, glycine (GLY), glutamine (GLN), and glycero-phosphatidylcholine 42:0 (PCaa 42:0) serum concentrations were higher, whereas PCaa 32:0, PCaa 32:1, and PCaa 40:5 were decreased in obese compared to lean individuals. The integrated bioinformatic evaluation of proteome and metabolome data yielded an improved group separation score of 2.65 in contrast to 2.02 and 2.16 for the single-type use of proteomic or metabolomics data, respectively. The identified circulating parameters were further investigated in an extended set of 30 volunteers and in the context of two intervention studies. Those included 14 obese patients who had undergone sleeve gastrectomy and 12 patients on a hypocaloric diet. For determining the long-term adaptation process the samples were taken six months after the treatment. In multivariate regression analyses, SAP, CLU, RBP4, PEDF, GLN, and C18:2 showed the strongest correlation to changes in body fat mass. The combined serum proteomic and metabolomic profiling reveals a link between the complement system and obesity and identifies both novel (C3b, CLU, VDBP, and all metabolites) and confirms previously discovered markers (PEDF, RBP4, C3, ATIII, and SAP) of body fat mass changes.\n\nTill, Holger\n\n\n"
},
{
"text": "\n142816\nPrenatal administration of all-trans retinoic acid upregulates leptin signaling in hypoplastic rat lungs with experimental congenital diaphragmatic hernia.\n\nFriedmacher, F\n\nHofmann, AD\n\nTakahashi, T\n\nTakahashi, H\n\nKutasy, B\n\nPuri, P\n\nBeiträge in Fachzeitschriften\nISI:000345072200002\n25330951.0\n10.1007/s00383-014-3605-8\nNone\nPulmonary hypoplasia (PH), characterized by alveolar immaturity, is one of the leading causes of respiratory insufficiency in newborns with congenital diaphragmatic hernia (CDH). Leptin (Lep) and its receptor (Lep-R) play an important role in fetal lung growth by stimulating alveolar differentiation and maturation. Lep and Lep-R are strongly expressed by alveolar cells during the saccular stage of fetal lung development. Lep-deficient mice exhibit decreased alveolarization with reduced pulmonary surfactant phospholipid synthesis, similar to human and nitrofen-induced PH. Prenatal administration of all-trans retinoic acid (ATRA) has been shown to stimulate alveolarization in nitrofen-induced PH. Recent studies have demonstrated that Lep and Lep-R expression in developing lungs is regulated by ATRA. We hypothesized that prenatal treatment with ATRA increases pulmonary Lep and Lep-R expression in the nitrofen model of CDH-associated PH.\n Time-mated rats received either 100 mg nitrofen or vehicle via oral-gastric lavage on embryonic day 9.5 (E9.5). Control and nitrofen-exposed dams were randomly assigned to either intraperitoneal ATRA (5 mg/kg/d) or placebo administration on E18.5, E19.5 and E20.5. Fetal lungs were harvested on E21.5, and divided into Control+Placebo, Control+ATRA, Nitrofen+Placebo and Nitrofen+ATRA. Alveolarization was assessed using stereo- and morphometric analysis techniques. Surfactant phospholipid synthesis was analyzed by labeling for surfactant protein B (SP-B). Pulmonary gene expression levels of Lep and Lep-R were determined using quantitative real-time polymerase chain reaction. Immunohistochemical staining for Lep and Lep-R was performed to evaluate alveolar protein expression and localization.\n In vivo administration of ATRA resulted in significantly increased lung-to-body weight ratio with enhanced radial alveolar count and decreased mean linear intercept compared to placebo treatment. Immunofluorescence analysis demonstrated markedly increased pulmonary SP-B expression in Nitrofen+ATRA compared to Nitrofen+Placebo. Relative mRNA expression of Lep and Lep-R was significantly increased in Nitrofen+ATRA compared to Nitrofen+Placebo. Lep and Lep-R immunoreactivity was markedly increased in interstitial and alveolar epithelial cells of Nitrofen+ATRA compared to Nitrofen+Placebo.\n Increased Lep and Lep-R expression after prenatal administration of ATRA in nitrofen-induced PH suggests that ATRA may have therapeutic potential in attenuating CDH-associated PH by stimulating alveolarization and de novo surfactant production.\n\n\n"
},
{
"text": "\n2054\nPreoperative myocardial cell damage in patients with unstable angina undergoing coronary artery bypass graft surgery.\n\nMächler, H\n\nMetzler, H\n\nSabin, K\n\nAnelli-Monti, M\n\nRehak, P\n\nRigler, B\n\nGombotz, H\n\nBeiträge in Fachzeitschriften\nISI:A1994PV98200005\n7992899.0\nNone\nNone\nTroponin-T is one of the contractile proteins of the myocardium. Its release into the circulation indicates various degrees of myocardial cell damage. Troponin-T may be measured in serum with a recently developed enzyme immunoassay. This immunoassay was used to evaluate the preoperative myocardial cell damage in patients with stable and unstable angina undergoing elective coronary artery bypass graft surgery, and it was compared with conventional assays of creatine kinase (CK) MB isoenzyme activity and mass.\n Twenty-one patients with unstable angina and 31 with stable angina were studied. Troponin-T, CK-MB activity, and CK-MB mass were measured 24 h before anesthesia and surgery, immediately before induction of anesthesia, before and after cardiopulmonary bypass, at the end of surgery, and 24 h afterward.\n In 90% (19 of 21) of the patients with unstable angina, troponin-T was increased 24 h before anesthesia (median 0.33 microgram/l, range 0.15-5.2 micrograms/l), whereas only 3% (1 of 31) of the patients with stable angina had increased values (median 0.0 microgram/l, range 0.0-0.53 microgram/l). The difference was statistically significant (P < 0.001). The same profile was found in patients with and without unstable angina immediately before induction of anesthesia (86% [18 of 21] and 0%, respectively) and before cardiopulmonary bypass (62% [13 of 21] and 0%, respectively). In contrast to troponin-T, CK-MB activity was increased in only 0-14% of patients with unstable angina, and CK-MB mass was increased in only 9-24%. After bypass troponin-T increased in both groups (P < 0.01), but there was no longer a statistically significant difference between the groups. Twelve percent (4 of 31) of the patients in the stable angina group and 28% (6 of 21) in the unstable group had major cardiac events (P not significant).\n The study data suggest that many patients with unstable angina undergoing elective coronary artery bypass graft surgery have already increased troponin-T levels preoperatively, although conventional biochemical markers such as CK-MB activity and mass are at a normal range. Increased troponin-T and normal CK-MB concentrations may reflect some degree of ischemic myocardial cell damage. Because of the small number of patients in the study, the influence of preoperative myocardial injury on perioperative outcome could not be clarified.\n\nAnelli-Monti, Michael\n\nMächler, Heinrich\n\nMetzler, Helfried\n\n\n"
},
{
"text": "\n26417\nRemarkably high frequency of EGFR expression in breast carcinomas with squamous differentiation.\n\nBossuyt, V\n\nFadare, O\n\nMartel, M\n\nOcal, IT\n\nBurtness, B\n\nMoinfar, F\n\nLeibl, S\n\nTavassoli, FA\n\nBeiträge in Fachzeitschriften\nISI:000233122000003\n16273187.0\n10.1177/106689690501300403\nNone\nThe human epidermal growth factor receptor (EGFR) is reportedly overexpressed in 15-20% of breast carcinomas. EGFR overexpression is associated with reduced survival and is inversely correlated with expression of estrogen receptor (ER). This study assessed EGFR expression in breast carcinomas with squamous differentiation. The immunohistochemical (IHC) expression of EGFR was evaluated in 39 breast carcinomas with squamous differentiation (30 pure squamous, 6 adenosquamous, 3 carcinosarcomas) by use of the pharmDx assay (clone 2-18C9, DakoCytomation). Cases were considered positive if at least 10% of the cells showed 1+ positivity in the squamous component. Squamous differentiation was confirmed with IHC for CK5-6 (clone D5/16B4, DakoCytomation). ER, PR, and HER2 status as well as clinical information regarding treatment and outcome were correlated. As a control, a tissue microarray comprising 280 lymph node positive breast carcinomas was evaluated with the same EGFR assay. The 39 patients ranged in age from 33 to 77 years (mean 52). The tumors measured 1.3-30 cm (mean 4.8). Sentinel or full axillary lymph node dissection was performed in 28 patients. Fourteen patients had positive lymph nodes. At the time of initial diagnosis, 3 patients had distant metastasis. Follow-up was available for 16 patients (mean 45 months). Disease-free survival at 3 years was 70%. Among the 39 tumors 87% (34) were positive for EGFR (p<0.0001). Sixty-nine percent (27 of 39) showed >50% 2+ EGFR staining. EGFR-positive tumor cells (showing squamous morphology) were also found in 1 bone, 1 lung, and 8 of 11 lymph node metastases available for evaluation. All 11 lymph nodes showed squamous differentiation. All but 1 of the EGFR+ tumors examined were ER and PR negative. Six EGFR-positive tumors were HER2 positive. No statistically significant differences in HER2 status, size, lymph node status and disease-free survival were observed between EGFR+ and EGFR- cases, but the number of EGFR-negative tumors was quite small. Nine of 280 (3%) of lymph node-positive invasive carcinomas on the tissue microarray were EGFR+; review of the initial diagnostic slides failed to reveal squamous features in all but 1 of the 9 EGFR+ tumors. Breast carcinomas with squamous differentiation are a distinct subgroup of breast tumors with a very high frequency of EGFR positivity. Breast carcinomas of this type would be ideal candidates for a trial with EGFR inhibitors.\n\nMoinfar, Farid\n\n\n"
},
{
"text": "\n159120\nVitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium.\n\nGaksch, M\n\nJorde, R\n\nGrimnes, G\n\nJoakimsen, R\n\nSchirmer, H\n\nWilsgaard, T\n\nMathiesen, EB\n\nNjølstad, I\n\nLøchen, ML\n\nMärz, W\n\nKleber, ME\n\nTomaschitz, A\n\nGrübler, M\n\nEiriksdottir, G\n\nGudmundsson, EF\n\nHarris, TB\n\nCotch, MF\n\nAspelund, T\n\nGudnason, V\n\nRutters, F\n\nBeulens, JW\n\nvan 't Riet, E\n\nNijpels, G\n\nDekker, JM\n\nGrove-Laugesen, D\n\nRejnmark, L\n\nBusch, MA\n\nMensink, GB\n\nScheidt-Nave, C\n\nThamm, M\n\nSwart, KM\n\nBrouwer, IA\n\nLips, P\n\nvan Schoor, NM\n\nSempos, CT\n\nDurazo-Arvizu, RA\n\nŠkrabáková, Z\n\nDowling, KG\n\nCashman, KD\n\nKiely, M\n\nPilz, S\n\nBeiträge in Fachzeitschriften\nISI:000394424500013\n28207791.0\n10.1371/journal.pone.0170791\nPMC5312926\nVitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality.\n In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488.\n We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/L were 1.15 (1.00-1.29), 1.33 (1.16-1.51), and 1.67 (1.44-1.89), respectively. We observed similar results for cardiovascular mortality, but there was no significant linear association between 25(OH)D and cancer mortality. There was also no significantly increased mortality risk at high 25(OH)D levels up to 125 nmol/L.\n In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths.\n\nMärz, Winfried\n\nPilz, Stefan\n\n\n"
},
{
"text": "\n4882\nControlled, double-blind, multicentre clinical trial to investigate long-term tolerability and efficacy of trospium chloride in patients with detrusor instability.\n\nHalaska, M\n\nRalph, G\n\nWiedemann, A\n\nPrimus, G\n\nBallering-Brühl, B\n\nHöfner, K\n\nJonas, U\n\nBeiträge in Fachzeitschriften\nISI:000183194200014\n12811500.0\n10.1007/s00345-003-0321-8\nNone\nOur objectives were to ascertain the tolerability and efficacy of trospium chloride in doses of 20 mg twice daily for long-term therapy (52 weeks) in patients with urge syndrome. The trial comprised a total of 358 patients with urge syndrome or urge incontinence. After randomisation in the ratio of 3:1, participants were treated continuously for 52 weeks with either trospium chloride (20 mg twice daily) or oxybutynin (5 mg twice daily). At intervals of 4-8 weeks, patients were physically examined with measurements of blood pressure and pulse rate, were questioned about any adverse events, checked for compliance and underwent relevant laboratory tests. As an additional safety measure, an ECG was made at 26 and 52 weeks. Urodynamic measurements were performed at the beginning, and at 26 and 52 weeks to determine the maximal cystometric bladder capacity. Among others things, the frequencies of micturition, incontinence and number of urgency events were recorded in patient diary protocols in weeks 0, 2, 26 and 52. The evaluation of vital parameters, laboratory results and ECGs did not show any relevant changes attributable to the action of the anticholinergics. Analysis of the micturition diary clearly indicated a reduction of the micturition frequency, incontinence frequency, and a reduction of the number of urgencies in both treatment groups. Mean maximum cystometric bladder capacity increased during treatment with trospium chloride by 92 ml after 26 weeks and 115 ml after 52 weeks (P=0.001). Further comparison with oxybutynin did not reveal any statistically significant differences in urodynamic variables between the drugs. Adverse events occurred in 64.8% of the patients treated with trospium chloride and 76.7% of those treated with oxybutynin. The main symptom encountered in both treatment group was dryness of the mouth. For patients on trospium chloride, the estimated risk of an unexpected adverse event was 0.027 per patient per week for all adverse events and 0.009 for dryness of the mouth, resulting in a considerably lower risk during treatment given with trospium chloride than with oxybutynin (0.045 and 0.021, respectively). An overall assessment for each of the drugs reveals a comparable efficacy level and a better benefit-risk ratio for trospium chloride than for oxybutynin due to better tolerability.\n\n\n"
},
{
"text": "\n80006\nSkeletal response to dietary zinc in adult female mice.\n\nDimai, HP\n\nHall, SL\n\nStilt-Coffing, B\n\nFarley, JR\n\nBeiträge in Fachzeitschriften\nISI:000072518300007\n9504955.0\n10.1007/s002239900437\nNone\nThe current studies were intended to assess dose- and time-dependent effects of dietary zinc (Zn) on alkaline phosphatase (ALP) activity and tartrate-resistant acid phosphatase (TRAP) activity in adult female mice. In the first study, mice were given 0, 1x, 2x, 3x, or 4x normal dietary Zn for 2 weeks, 4 weeks, or 6 weeks. In the second study, mice were given 0, 1x, 2x, 3x, 4x, and 5x normal dietary Zn for 4 weeks. Sera were collected for measurements of ALP and (in the second study) osteocalcin. Tibiae and calvaria were extracted for measurements of ALP, protein, and TRAP. The first study showed positive correlations between dietary Zn and serum ALP (4 and 6 weeks, P < 0.001), Zn and tibial ALP (2, 4, and 6 weeks, P < 0.03), and Zn and tibial protein (2, 4, and 6 weeks, P < 0.001), as well as a negative correlation between dietary Zn and tibial TRAP (2, 4, and 6 weeks, P < 0.001). Covariant analyses showed that serum ALP, tibial ALP, tibial protein, and tibial TRAP were affected by the dose of Zn (P < 0.005) and by the treatment time (P < 0.03). Supplemental studies showed that (1) the dose-dependent effect of dietary Zn on serum ALP (at 6 weeks) was proportional to the effects on tibial ALP and calvarial ALP, but not to the effects of Zn on renal, hepatic, or intestinal ALP; (2) 6 weeks of dietary Zn caused dose-dependent increases in ALP specific activity in the tibia, calvaria, and liver, but not kidneys or intestines; and (3) Zn increased ALP activity and cell layer protein and decreased TRAP activity in monolayer cultures of the murine osteoblastic cell line, MC3T3-E1. The second dietary study confirmed the results of the first: 4 weeks of treatment with Zn caused significant increases in serum ALP, calvarial ALP, and tibial ALP activities, and a significant decrease in tibial TRAP (P < 0.05-0.005 for each). This study also revealed an effect of Zn to increase serum osteocalcin (P < 0.03 at 2x normal Zn). Together, these data indicate that incremental increases in dietary Zn are associated with increases in ALP activity in serum and in bone. The effect of Zn to decrease TRAP activity in osteoblast-line cells precludes the interpretation of a Zn-dependent decrease in tibial TRAP activity as evidence of decreased bone resorption.\n\nDimai, Hans\n\n\n"
},
{
"text": "\n114366\nInterferon α therapy in patients with chronic hepatitis C infection: biopsychosocial consequences].\n\nBaranyi, A\n\nMeinitzer, A\n\nStepan, A\n\nMatejka, J\n\nStauber, R\n\nKapfhammer, HP\n\nRothenhäusler, HB\n\nBeiträge in Fachzeitschriften\nISI:000308539800009\n22033579.0\n10.1007/s00115-011-3302-y\nNone\nInterferon alpha (IFN-alpha) is widely used in the treatment of viral infections, including hepatitis C. Unfortunately depression is a common side effect of IFN-alpha therapy. The presence of depressive symptoms is important because they have an adverse effect on the course of the illness and reduce the quality of life and the treatment adherence. The current prospective study examines the effects of IFN-alpha on the development of depressive disorders, on cognitive functioning and on quality of life. A total of 25 patients with chronic hepatitis C infection were investigated. All patients were treated in the Department of Gastroenterology and Hepatology, University of Medicine of Graz, Austria. Psychometric observer rating and self-rating scales were administered 1 month and 3 months after the beginning of the antiviral treatment to evaluate depressive symptoms [Beck Depression Inventory (BDI); Hamilton Depression Scale]. The data on life satisfaction before therapy and health-related quality of life were obtained from the Fragebogen zur Lebenszufriedenheit (FLZ) and the SF-36 (Health Status Questionnaire). Cognitive function was based on the SKT (Syndrom Kurztest). All patients completed the Social Support Questionnaire (SSS), a multidimensional self-report measure of social support. Three months after the initial IFN-alpha administration in the whole sample significant impairments in health-related quality of life were found in the health-related domains aEurophysical functioning", aEurorole physical", aEurorole emotional", aEurosocial functioning" and aEurovitality". The whole sample showed cognitive impairments. No changes in social support were recorded. Three months after the first INF-alpha administration, 48% (n=12) of the sample suffered from moderate clinical depression. In comparison to patients without pathological affective findings, patients with INF-alpha-induced clinical depression showed decreased life satisfaction before the initial antiviral therapy. Impairments in health-related quality of life (SF-36) were found in the sample with clinical depression in the health-related domains aEurogeneral health", aEurosocial functioning", aEurorole emotional", aEurovitality" and aEuromental health". Hepatitis C is associated with an increased prevalence of psychiatric disorders, particularly depression. INF-alpha patients having low levels of life satisfaction in the domains aEuroself-concept" (skills, appearance, self-confidence, vitality aEuro broken vertical bar), aEuroemployment" and aEurophysical health and constitution" seem to face a major risk of depression.\n\nBaranyi, Andreas\n\nKapfhammer, Hans-Peter\n\nMeinitzer, Andreas\n\nRothenhäusler, Hans-Bernd\n\nStauber, Rudolf\n\n\n"
},
{
"text": "\n137012\nHistorical epidemiology of hepatitis C virus (HCV) in selected countries.\n\nBruggmann, P\n\nBerg, T\n\nØvrehus, AL\n\nMoreno, C\n\nBrandão Mello, CE\n\nRoudot-Thoraval, F\n\nMarinho, RT\n\nSherman, M\n\nRyder, SD\n\nSperl, J\n\nAkarca, U\n\nBalık, I\n\nBihl, F\n\nBilodeau, M\n\nBlasco, AJ\n\nButi, M\n\nCalinas, F\n\nCalleja, JL\n\nCheinquer, H\n\nChristensen, PB\n\nClausen, M\n\nCoelho, HS\n\nCornberg, M\n\nCramp, ME\n\nDore, GJ\n\nDoss, W\n\nDuberg, AS\n\nEl-Sayed, MH\n\nErgör, G\n\nEsmat, G\n\nEstes, C\n\nFalconer, K\n\nFélix, J\n\nFerraz, ML\n\nFerreira, PR\n\nFrankova, S\n\nGarcía-Samaniego, J\n\nGerstoft, J\n\nGiria, JA\n\nGonçales, FL\n\nGower, E\n\nGschwantler, M\n\nGuimarães Pessôa, M\n\nHézode, C\n\nHofer, H\n\nHusa, P\n\nIdilman, R\n\nKåberg, M\n\nKaita, KD\n\nKautz, A\n\nKaymakoglu, S\n\nKrajden, M\n\nKrarup, H\n\nLaleman, W\n\nLavanchy, D\n\nLázaro, P\n\nMarotta, P\n\nMauss, S\n\nMendes Correa, MC\n\nMüllhaupt, B\n\nMyers, RP\n\nNegro, F\n\nNemecek, V\n\nÖrmeci, N\n\nParkes, J\n\nPeltekian, KM\n\nRamji, A\n\nRazavi, H\n\nReis, N\n\nRoberts, SK\n\nRosenberg, WM\n\nSarmento-Castro, R\n\nSarrazin, C\n\nSemela, D\n\nShiha, GE\n\nSievert, W\n\nStärkel, P\n\nStauber, RE\n\nThompson, AJ\n\nUrbanek, P\n\nvan Thiel, I\n\nVan Vlierberghe, H\n\nVandijck, D\n\nVogel, W\n\nWaked, I\n\nWedemeyer, H\n\nWeis, N\n\nWiegand, J\n\nYosry, A\n\nZekry, A\n\nVan Damme, P\n\nAleman, S\n\nHindman, SJ\n\nBeiträge in Fachzeitschriften\nISI:000333893200002\n24713004.0\n10.1111/jvh.12247\nNone\nChronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. For some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. The largest viremic populations were in Egypt, with 6, 58, 00 cases in 2008 and Brazil with 2, 06, 00 cases in 2007. The age distribution of cases differed between countries. In most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.\n © 2014 John Wiley & Sons Ltd.\n\nStauber, Rudolf\n\n\n"
},
{
"text": "\n160720\nLevosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery.\n\nMehta, RH\n\nLeimberger, JD\n\nvan Diepen, S\n\nMeza, J\n\nWang, A\n\nJankowich, R\n\nHarrison, RW\n\nHay, D\n\nFremes, S\n\nDuncan, A\n\nSoltesz, EG\n\nLuber, J\n\nPark, S\n\nArgenziano, M\n\nMurphy, E\n\nMarcel, R\n\nKalavrouziotis, D\n\nNagpal, D\n\nBozinovski, J\n\nToller, W\n\nHeringlake, M\n\nGoodman, SG\n\nLevy, JH\n\nHarrington, RA\n\nAnstrom, KJ\n\nAlexander, JH\n\nLEVO-CTS Investigators\n\nBeiträge in Fachzeitschriften\nISI:000401959600006\n28316276.0\n10.1056/NEJMoa1616218\nNone\nLevosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery.\n In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35% or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients were randomly assigned to receive either intravenous levosimendan (at a dose of 0.2 μg per kilogram of body weight per minute for 1 hour, followed by a dose of 0.1 μg per kilogram per minute for 23 hours) or placebo, with the infusion started before surgery. The two primary end points were a four-component composite of death through day 30, renal-replacement therapy through day 30, perioperative myocardial infarction through day 5, or use of a mechanical cardiac assist device through day 5; and a two-component composite of death through day 30 or use of a mechanical cardiac assist device through day 5.\n A total of 882 patients underwent randomization, 849 of whom received levosimendan or placebo and were included in the modified intention-to-treat population. The four-component primary end point occurred in 105 of 428 patients (24.5%) assigned to receive levosimendan and in 103 of 421 (24.5%) assigned to receive placebo (adjusted odds ratio, 1.00; 99% confidence interval [CI], 0.66 to 1.54; P=0.98). The two-component primary end point occurred in 56 patients (13.1%) assigned to receive levosimendan and in 48 (11.4%) assigned to receive placebo (adjusted odds ratio, 1.18; 96% CI, 0.76 to 1.82; P=0.45). The rate of adverse events did not differ significantly between the two groups.\n Prophylactic levosimendan did not result in a rate of the short-term composite end point of death, renal-replacement therapy, perioperative myocardial infarction, or use of a mechanical cardiac assist device that was lower than the rate with placebo among patients with a reduced left ventricular ejection fraction who were undergoing cardiac surgery with the use of cardiopulmonary bypass. (Funded by Tenax Therapeutics; LEVO-CTS ClinicalTrials.gov number, NCT02025621 .).\n\nToller, Wolfgang\n\n\n"
},
{
"text": "\n166242\nAvoiding Arterial Hypotension in Preterm Neonates (AHIP)-A Single Center Randomised Controlled Study Investigating Simultaneous Near Infrared Spectroscopy Measurements of Cerebral and Peripheral Regional Tissue Oxygenation and Dedicated Interventions.\n\nPichler, G\n\nHöller, N\n\nBaik-Schneditz, N\n\nSchwaberger, B\n\nMileder, L\n\nStadler, J\n\nAvian, A\n\nPansy, J\n\nUrlesberger, B\n\nBeiträge in Fachzeitschriften\nISI:000423820300001\n29450194.0\n10.3389/fped.2018.00015\nPMC5799241\nUp to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates.\n Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study. Blood pressure was measured non-invasively or invasively. In the NIRS group, simultaneous cTOI and pTOI monitoring was used starting within 6 h after birth for 24 h to calculate changes in cTOI/pTOI ratio over time. Depending on these changes, interventions including echocardiography, administration of volume or patent ductus arteriosus treatment were performed. In the control group, only routine monitoring and treatment were performed and NIRS signals were not visible. The primary outcome was burden of hypotension within 48 h after initiation of NIRS monitoring.\n 49 preterm neonates were included in each group: NIRS group 33.1 (32.0-34.0) (median: 25-75 centile) weeks of gestation and control group 33.4 (32.3-34.3) weeks of gestation. In the NIRS group, echocardiography was performed in 17 preterm neonates due to NIRS measurements, whereby six neonates received further treatment. Percentage of neonates with any hypotensive episode during the 48-h observational period was 32.6% in the NIRS group and 44.9% in the control group (p = 0.214). Burden of hypotension (i.e., %mmHg of mean arterial pressure < gestational age) was 0.0 (0.0-2.1) mmHg h in the NIRS group and 0.4 (0.0-3.3) mmHg h in the control group (p = 0.313), with observed burden of hypotension being low in both groups. No severe adverse reactions were observed.\n In preterm neonates using simultaneous peripheral and cerebral NIRS measurements for early detection of centralization followed by predefined interventions led to a non-significant reduction in burden of arterial hypotension.\n www.ClinicalTrials.gov, identifier: NCT01910467.\n\nAvian, Alexander\n\nBaik-Schneditz, Nariae\n\nHöller, Nina\n\nMileder, Lukas Peter\n\nPansy, Jasmin\n\nPichler, Gerhard\n\nSchwaberger, Bernhard Christian\n\nStadler, Jasmin\n\nUrlesberger, Berndt\n\n\n"
},
{
"text": "\n178112\nProgression of Stargardt Disease as Determined by Fundus Autofluorescence Over a 12-Month Period: ProgStar Report No. 11.\n\nStrauss, RW\n\nKong, X\n\nHo, A\n\nJha, A\n\nWest, S\n\nIp, M\n\nBernstein, PS\n\nBirch, DG\n\nCideciyan, AV\n\nMichaelides, M\n\nSahel, JA\n\nSunness, JS\n\nTraboulsi, EI\n\nZrenner, E\n\nPitetta, S\n\nJenkins, D\n\nHariri, AH\n\nSadda, S\n\nScholl, HPN\n\nProgStar Study Group\n\nBeiträge in Fachzeitschriften\nISI:000492028900007\n31369039.0\n10.1001/jamaophthalmol.2019.2885\nPMC6681653\nSensitive outcome measures for disease progression are needed for treatment trials of Stargardt disease.\n To estimate the progression rate of atrophic lesions in the prospective Natural History of the Progression of Atrophy Secondary to Stargardt Disease (ProgStar) study over a 12-month period.\n This multicenter prospective cohort study was conducted in an international selection of tertiary referral centers from October 21, 2013, to February 15, 2017. Patients who were affected by Stargardt disease, aged 6 years and older at baseline, and harboring disease-causing variants of the ABCA4 gene were enrolled at 9 centers in the United States, United Kingdom, and continental Europe. Data analysis occurred from November 2016 to January 2017.\n Autofluorescence images obtained with a standard protocol were sent to a central reading center, and areas of definitely decreased autofluorescence, questionably decreased autofluorescence, and the total combined area of decreased autofluorescence were outlined and quantified. Progression rates were estimated from linear mixed models with time as the independent variable.\n Yearly rate of progression, using the growth of atrophic lesions measured by autofluorescence imaging.\n A total of 259 study participants (488 eyes; 230 individuals [88.8%] were examined in both eyes) were enrolled (mean [SD] age at first visit, 33.3 [15.1] years; 118 [54.4%] female). Gradable images were available for evaluation for 480 eyes at baseline and 454 eyes after 12 months. At baseline, definitely decreased autofluorescence was present in 306 eyes, and the mean (SD) lesion size was 3.93 (4.37) mm2. The mean total area of decreased autofluorescence at baseline was 4.07 (4.04) mm2. The estimated progression of definitely decreased autofluorescence was 0.76 (95% CI, 0.54-0.97) mm2 per year (P < .001), and the total area of both questionably and definitely decreased autofluorescence was 0.64 (95% CI, 0.50-0.78) mm2 per year (P < .001). Both progression rates depended on initial lesion size.\n In Stargardt disease, autofluorescence imaging may serve as a monitoring tool and definitely decreased autofluorescence and total area as outcome measures for interventional clinical trials that aim to slow disease progression. Rates of progression depended mainly on initial lesion size.\n\nStrauß, Rupert\n\n\n"
},
{
"text": "\n181348\nA new concordant partial AUC and partial c statistic for imbalanced data in the evaluation of machine learning algorithms.\n\nCarrington, AM\n\nFieguth, PW\n\nQazi, H\n\nHolzinger, A\n\nChen, HLH\n\nMayr, F\n\nManuel, DG\n\nBeiträge in Fachzeitschriften\nISI:000512626100003\nNone\n10.1186/s12911-019-1014-6\nNone\nBackground In classification and diagnostic testing, the receiver-operator characteristic (ROC) plot and the area under the ROC curve (AUC) describe how an adjustable threshold causes changes in two types of error: false positives and false negatives. Only part of the ROC curve and AUC are informative however when they are used with imbalanced data. Hence, alternatives to the AUC have been proposed, such as the partial AUC and the area under the precision-recall curve. However, these alternatives cannot be as fully interpreted as the AUC, in part because they ignore some information about actual negatives. Methods We derive and propose a new concordant partial AUC and a new partial c statistic for ROC data-as foundational measures and methods to help understand and explain parts of the ROC plot and AUC. Our partial measures are continuous and discrete versions of the same measure, are derived from the AUC and c statistic respectively, are validated as equal to each other, and validated as equal in summation to whole measures where expected. Our partial measures are tested for validity on a classic ROC example from Fawcett, a variation thereof, and two real-life benchmark data sets in breast cancer: the Wisconsin and Ljubljana data sets. Interpretation of an example is then provided. Results Results show the expected equalities between our new partial measures and the existing whole measures. The example interpretation illustrates the need for our newly derived partial measures. Conclusions The concordant partial area under the ROC curve was proposed and unlike previous partial measure alternatives, it maintains the characteristics of the AUC. The first partial c statistic for ROC plots was also proposed as an unbiased interpretation for part of an ROC curve. The expected equalities among and between our newly derived partial measures and their existing full measure counterparts are confirmed. These measures may be used with any data set but this paper focuses on imbalanced data with low prevalence. Future work Future work with our proposed measures may: demonstrate their value for imbalanced data with high prevalence, compare them to other measures not based on areas; and combine them with other ROC measures and techniques.\n\nHolzinger, Andreas\n\n\n"
},
{
"text": "\n17123\nOptimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients.\n\nHofer, A\n\nHassan, AS\n\nLegat, FJ\n\nKerl, H\n\nWolf, P\n\nBeiträge in Fachzeitschriften\nISI:000229013600020\n15888156.0\n10.1111/j.1365-2133.2004.06321.x\nNone\nRecently the beneficial effect of excimer laser treatment has been reported for patients with vitiligo. The influence of treatment frequency on this effect is not clear.\n To determine the optimal frequency of 308-nm excimer laser therapy for vitiligo.\n In this prospective, university-based hospital study over 12 weeks we enrolled 14 patients. Each had at least three stable vitiligo lesions in the same body area. The three stable vitiligo lesions in each subject were randomly assigned to receive excimer laser treatment once (1 x), twice (2 x) and three times (3 x) weekly, respectively. The initial ultraviolet (UV) dose was 50 mJ cm(-2) less than the 308-nm minimal erythematous dose in vitiligo skin. The UV dose was increased at each treatment session according to the erythematous response to the previous treatment.\n Thirteen subjects were treated for at least 6 weeks; seven were treated for all 12 weeks. At 6 weeks, the repigmentation rates for treated lesions were 8% (1/13) after 1 x weekly treatment, 23% (3/13) after 2 x weekly treatment and 62% (8/13) after 3 x weekly treatment (P = 0.0134; 3 x vs. 1 x weekly); at 12 weeks, these rates were 46% (6/13), 62% (8/13) and 69% (9/13), respectively (P = NS; 3 x vs. 1 x weekly). Repigmentation initiation correlated with treatment number, regardless of frequency (P = NS). As shown by Kaplan-Meier analysis, repigmentation occurred earliest in the most frequently treated lesions (P = 0.0336). At 12 weeks, the projected repigmentation rates for 1 x, 2 x and 3 x weekly treatment approached each other (60%, 79% and 82%, respectively); the mean repigmentation grades (on a scale of 0-5) for 1 x, 2 x and 3 x weekly treatment were 1.7, 2.4 and 3.3, respectively (P = 0.018; 3 x vs. 1 x weekly). Laser-induced repigmentation persisted in most cases over the entire follow-up of 12 months after the end of treatment.\n 308-nm excimer laser therapy is effective against vitiligo. Although repigmentation occurs fastest with 3 x weekly treatment, the ultimate repigmentation initiation seems to depend entirely on the total number of treatments, not their frequency. However, treatment periods of more than 12 weeks may be necessary to obtain a satisfactory clinical repigmentation, particularly when vitiligo lesions are treated only 1 x or 2 x compared with 3 x weekly.\n\nHofer, Angelika\n\nKerl, Helmut\n\nLegat, Franz\n\nWolf, Peter\n\n\n"
},
{
"text": "\n17996\nEvaluation of spinal fusion using autologous anterior strut grafts and posterior instrumentation for thoracic/thoracolumbar kyphosis.\n\nSaraph, VJ\n\nBach, CM\n\nKrismer, M\n\nWimmer, C\n\nBeiträge in Fachzeitschriften\nISI:000230517700005\n16025027.0\n10.1097/01.brs.0000170299.48246.28\nNone\nSTUDY DESIGN: A retrospective cohort study. OBJECTIVE: To evaluate anterior strut grafts in spinal fusion for thoracic/thoracolumbar kyphosis. SUMMARY AND BACKGROUND DATA: Autologous strut grafts harvested from the fibula, iliac crest, and rib are frequently used for treating severe kyphosis and kyphoscoliosis. However, a majority of the studies have presented mixed patient populations kyphosis and/or scoliosis, treated either with anterior or anteroposterior fusion. Very few reports have presented an evaluation of autologous strut grafts for anterior fusion with posterior instrumentation for the treatment of kyphotic deformities. METHODS: A total of 23 patients comprised the study. Diagnosis was granulomatous infection (9 patients), congenital (6), posttraumatic (4), neurofibromatosis (1), ankylosing spondylitis (1), Scheuermann disease (1), and plasmacytoma of the vertebral body with pathologic fracture (1). Average age at surgery was 41 years (range 6-77). Indication for surgery was pain with or without progression in 15 patients and additional progressive neurologic deficit in the other 8. Anterior strut grafts consisted of the autologous fibula (9 patients), iliac (10), fibula and ribs (2), fibula and iliac (1), and fibula, iliac, and ribs (1). The fusion areas were thoracic (11 patients), thoracolumbar (11), and cervicothoracic (1). Anterior decompression was performed in 8 patients because of the presence of neurologic symptoms caused by cord compression. Dorsal fusion was performed in all patients with third-generation systems. RESULTS: Average 4.2 vertebrae were fused anteriorly. Mean follow-up bracing time was 9.7 months. Average kyphosis measured 50.9 degrees before surgery and 32.5 at a mean follow-up of 4.5 years (P < 0.0001). No graft breakages were noted at final follow-up. Solid fusion was achieved in all patients. No donor site complications were observed. Of the 8 patients presenting with neurologic deficits, 4 had full recovery, 3 had partial recoveries, and 1 had no improvement. Loss of postoperative correction > 5 degrees was observed in 3 patients. At final follow-up, 3 patients complained of occasional pain, and 1 complained of pain when lying on the back, particularly on hard surfaces. CONCLUSION: Adequate correction was maintained throughout an average follow-up of 4.5 years, and solid fusion was obtained in all patients. Anterior strut grafts, supplemented with posterior fusion with instrumentation provide a good treatment alternative for the treatment of kyphosis deformity of the spine as a result of various etiologies.\n\n\n"
},
{
"text": "\n86643\nThree-dimensional computational modeling of subject-specific cerebrospinal fluid flow in the subarachnoid space.\n\nGupta, S\n\nSoellinger, M\n\nBoesiger, P\n\nPoulikakos, D\n\nKurtcuoglu, V\n\nBeiträge in Fachzeitschriften\nISI:000261891400010\n19102569.0\n10.1115/1.3005171\nNone\nThis study aims at investigating three-dimensional subject-specific cerebrospinal fluid (CSF) dynamics in the inferior cranial space, the superior spinal subarachnoid space (SAS), and the fourth cerebral ventricle using a combination of a finite-volume computational fluid dynamics (CFD) approach and magnetic resonance imaging (MRI) experiments. An anatomically accurate 3D model of the entire SAS of a healthy volunteer was reconstructed from high resolution T2 weighted MRI data. Subject-specific pulsatile velocity boundary conditions were imposed at planes in the pontine cistern, cerebellomedullary cistern, and in the spinal subarachnoid space. Velocimetric MRI was used to measure the velocity field at these boundaries. A constant pressure boundary condition was imposed at the interface between the aqueduct of Sylvius and the fourth ventricle. The morphology of the SAS with its complex trabecula structures was taken into account through a novel porous media model with anisotropic permeability. The governing equations were solved using finite-volume CFD. We observed a total pressure variation from -42 Pa to 40 Pa within one cardiac cycle in the investigated domain. Maximum CSF velocities of about 15 cms occurred in the inferior section of the aqueduct, 14 cms in the left foramen of Luschka, and 9 cms in the foramen of Magendie. Flow velocities in the right foramen of Luschka were found to be significantly lower than in the left, indicating three-dimensional brain asymmetries. The flow in the cerebellomedullary cistern was found to be relatively diffusive with a peak Reynolds number (Re)=72, while the flow in the pontine cistern was primarily convective with a peak Re=386. The net volumetric flow rate in the spinal canal was found to be negligible despite CSF oscillation with substantial amplitude with a maximum volumetric flow rate of 109 mlmin. The observed transient flow patterns indicate a compliant behavior of the cranial subarachnoid space. Still, the estimated deformations were small owing to the large parenchymal surface. We have integrated anatomic and velocimetric MRI data with computational fluid dynamics incorporating the porous SAS morphology for the subject-specific reconstruction of cerebrospinal fluid flow in the subarachnoid space. This model can be used as a basis for the development of computational tools, e.g., for the optimization of intrathecal drug delivery and computer-aided evaluation of cerebral pathologies such as syrinx development in syringomelia.\n\n\n"
}
]
}