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"text": "\n154309\nOncologic Outcomes of Kidney-sparing Surgery Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review by the EAU Non-muscle Invasive Bladder Cancer Guidelines Panel.\n\nSeisen, T\n\nPeyronnet, B\n\nDominguez-Escrig, JL\n\nBruins, HM\n\nYuan, CY\n\nBabjuk, M\n\nBöhle, A\n\nBurger, M\n\nCompérat, EM\n\nCowan, NC\n\nKaasinen, E\n\nPalou, J\n\nvan Rhijn, BW\n\nSylvester, RJ\n\nZigeuner, R\n\nShariat, SF\n\nRouprêt, M\n\nBeiträge in Fachzeitschriften\nISI:000390563100040\n27477528.0\n10.1016/j.eururo.2016.07.014\nNone\nThere is uncertainty regarding the oncologic effectiveness of kidney-sparing surgery (KSS) compared with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).\n To systematically review the current literature comparing oncologic outcomes of KSS versus RNU for UTUC.\n A computerised bibliographic search of the Medline, Embase, and Cochrane databases was performed for all studies reporting comparative oncologic outcomes of KSS versus RNU. Approaches considered for KSS were segmental ureterectomy (SU) and ureteroscopic (URS) or percutaneous (PC) management. Using the methodology recommended by the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, we identified 22 nonrandomised comparative retrospective studies published between 1999 and 2015 that were eligible for inclusion in this systematic review. A narrative review and risk-of-bias (RoB) assessment were performed using cancer-specific survival (CSS) as the primary end point.\n Seven studies compared KSS overall (n=547) versus RNU (n=1376). Information on the comparison of SU (n=586) versus RNU (n=3692), URS (n=162) versus RNU (n=367), and PC (n=66) versus RNU (n=114) was available in 10, 5, and 2 studies, respectively. No significant difference was found between SU and RNU in terms of CSS or any other oncologic outcomes. Only patients with low-grade and noninvasive tumours experienced similar CSS after URS or PC when compared with RNU, despite an increased risk of local recurrence following endoscopic management of UTUC. The RoB assessment revealed, however, that the analyses were subject to a selection bias favouring KSS.\n Our systematic review suggests similar survival after KSS versus RNU only for low-grade and noninvasive UTUC when using URS or PC. However, selected patients with high-grade and invasive UTUC could safely benefit from SU when feasible. These results should be interpreted with caution due to the risk of selection bias.\n We reviewed the studies that compared kidney-sparing surgery versus radical nephroureterectomy for upper tract urothelial carcinoma. We found similar oncologic outcomes for favourable tumours when using ureteroscopic or percutaneous management, whereas indications for segmental ureterectomy could be extended to selected cases of aggressive tumours.\n Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.\n\nZigeuner, Richard\n\n\n"
},
{
"text": "\n158494\nThe potential of isotopically enriched magnesium to study bone implant degradation in vivo.\n\nDraxler, J\n\nMartinelli, E\n\nWeinberg, AM\n\nZitek, A\n\nIrrgeher, J\n\nMeischel, M\n\nStanzl-Tschegg, SE\n\nMingler, B\n\nProhaska, T\n\nBeiträge in Fachzeitschriften\nISI:000398014000042\n28111338.0\n10.1016/j.actbio.2017.01.054\nNone\nThis pilot study highlights the substantial potential of using isotopically enriched (non-radioactive) metals to study the fate of biodegradable metal implants. It was possible to show that magnesium (Mg) release can be observed by combining isotopic mass spectrometry and isotopic pattern deconvolution for data reduction, even at low amounts of Mg released a from slowly degrading 26Mg enriched (>99%) Mg metal. Following implantation into rats, structural in vivo changes were monitored by μCT. Results showed that the applied Mg had an average degradation rate of 16±5μmyear-1, which corresponds with the degradation rate of pure Mg. Bone and tissue extraction was performed 4, 24, and 52weeks after implantation. Bone cross sections were analyzed by laser ablation inductively coupled plasma mass spectrometry (ICP-MS) to determine the lateral 26Mg distribution. The 26Mg/24Mg ratios in digested tissue and excretion samples were analyzed by multi collector ICP-MS. Isotope pattern deconvolution in combination with ICP-MS enabled detection of Mg pin material in amounts as low as 200ppm in bone tissues and 20ppm in tissues up to two fold increased Mg levels with a contribution of pin-derived Mg of up to 75% (4weeks) and 30% (24weeks) were found adjacent to the implant. After complete degradation, no visual bone disturbance or residual pin-Mg could be detected in cortical bone. In organs, increased Δ26Mg/24Mg values up to 16‰ were determined compared to control samples. Increased Δ26Mg/24Mg values were detected in serum samples at a constant total Mg level. In contrast to urine, feces did not show a shift in the 26Mg/24Mg ratios. This investigation showed that the organism is capable of handling excess Mg well and that bones fully recover after degradation.\n Magnesium alloys as bone implants have faced increasing attention over the past years. In vivo degradation and metabolism studies of these implant materials have shown the promising application in orthopaedic trauma surgery. With advance in Mg research it has become increasingly important to monitor the fate of the implant material in the organism. For the first time, the indispensible potential of isotopically enriched materials is documented by applying 26Mg enriched Mg implants in an animal model. Therefore, the spatial distribution of pin-Mg in bone and the pin-Mg migration and excretion in the organism could be monitored to better understand metal degradation as well as Mg turn over and excretion.\n Copyright © 2017. Published by Elsevier Ltd.\n\nWeinberg, Annelie-Martina\n\n\n"
},
{
"text": "\n170870\nDynamization at the near cortex in locking plate osteosynthesis by means of dynamic locking screws: an experimental study of transverse tibial osteotomies in sheep.\n\nRichter, H\n\nPlecko, M\n\nAndermatt, D\n\nFrigg, R\n\nKronen, PW\n\nKlein, K\n\nNuss, K\n\nFerguson, SJ\n\nStöckle, U\n\nvon Rechenberg, B\n\nBeiträge in Fachzeitschriften\nISI:000349395000014\n25653321.0\n10.2106/JBJS.M.00529\nNone\nLocking plates are widely used in fracture fixation, mainly for meta-diaphyseal fractures, comminuted fractures, fractures with a critical-size bone defect, periprosthetic fractures, osteotomies, and fractures in osteoporotic bone. The aim of this animal study was to evaluate the effect on bone-healing of dynamization of locking plate constructs by means of new 5.0-mm dynamic locking screws (in the DLS group), which allow near-cortex micromotion, compared with a more rigid construct utilizing standard bicortical locking-head screws (in the LS group). Use of dynamic locking screws allows modulation of the stiffness of existing locking compression plate systems via parallel interfragmentary micromotion.\n A standardized diaphyseal tibial osteotomy (90°, 3-mm fracture gap) was performed and stabilized with a six-hole large-fragment locking compression plate in twelve female sheep (six in each group). Radiographs were made postoperatively and then weekly from week three until sacrifice at nine weeks. Macroscopic, biomechanical, histologic, and radiographic assessments and microcomputed tomography were performed.\n The callus in the tested specimens in the DLS group had better biomechanical stability, with a significantly greater maximum failure moment (mean and standard deviation [SD] as a percentage of intact, 55.15 ± 20.65 compared with 26.80 ± 14.96 in the LS group; p = 0.021). The DLS group also had greater periosteal callus volume at the near cortex (mean volume and SD as a percentage of the tibial shaft volume, 36.21% ± 10.08% compared with 18.98% ± 8.61% in the LS group; p = 0.026) and in the intercortical region (mean volume and SD as a percentage of the bone volume of the tibial shaft, 3.56% ± 0.52% compared with 2.64% ± 0.98% in the LS group; p = 0.045), as shown by microcomputed tomography. The DLS group also had significantly greater torsional stiffness (mean and SD as a percentage of intact, 84.88 ± 13.51 compared with 58.89 ± 20.61 in the LS group; p = 0.027).\n Controlled micromotion and nearly homogeneous interfragmentary strain at the fracture site, together with the stable bicortical fixation achieved by the new dynamic locking screw, led to more uniform callus formation, significantly more callus formation at the near cortex, and biomechanically more competent bone-healing compared with use of rigid locking plate constructs with locking-head screws.\n Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.\n\nPlecko, Michael\n\n\n"
},
{
"text": "\n22649\nOrgan- and treatment-specific local response rates to systemic and local treatment modalities in stage IV melanoma.\n\nRichtig, E\n\nLudwig, R\n\nKerl, H\n\nSmolle, J\n\nBeiträge in Fachzeitschriften\nISI:000232492600009\n16225601.0\n10.1111/j.1365-2133.2005.06796.x\nNone\nBACKGROUND: Metastatic melanoma shows different local response rates in organs to systemic or local treatment modalities. Whereas skin, soft tissue, lymph node and lung metastases seem to have better local response rates, the local response of metastases localized in the liver, brain and bone seems to be low. OBJECTIVES: The organ-specific response rate, local response rate of each therapeutic measure and survival of 68 patients with stage IV disease were evaluated. METHODS: Four hundred and ten treatment periods (1-18 per patient) in 17 different organs of 43 men and 25 women (mean age 55 years, range 19-79) with measurable, widespread, surgically incurable disease were analysed. Chemotherapy was given in 405 of 410 treatment periods with dacarbazine, fotemustine, vindesine, carboplatin and temozolomide in different schedules. Local treatment modalities comprising radiotherapy, gamma knife radiosurgery and local hyperthermia were given in 71 of 410 treatment periods. RESULTS: Local response (complete or partial local remission) was achieved in 52 treatment periods (12.7%). When local treatment modalities, either combined with systemic therapy or not, were compared with systemic therapeutic modalities alone, a local response of 24% was achieved with local measures, compared with 10% in systemic treatment only (P = 0.003). When a spontaneous remission rate of less than 5% is considered, however, local as well as systemic treatments had a significant effect (P < 0.001). Organ-specific response rates to local therapies showed no statistically significant differences between the various organs involved. When systemic treatments without local measures were taken into account, lung metastases, cutaneous/subcutaneous metastases and adrenal metastases performed significantly better than liver metastases. When different treatment modalities were considered, there was no significant difference between the three local measures applied (radiotherapy, gamma knife radiosurgery and hyperthermia). Among the systemic therapies, dacarbazine high dose and carboplatin monochemotherapy were superior to combined regimens using fotemustine. A local response, irrespective of the mode of therapy, was significantly associated with longer survival (median 16 months) compared with no local response or local progressive disease (median 7 months; P < 0.0001). When the first treatment period of each patient was considered, local response was no longer a significant predictor. CONCLUSIONS: The study shows that local therapeutic measures are superior in inducing a local response than systemic therapies alone. Induction of remission may be associated with longer survival. Chemotherapy, despite limited local response rates, is still statistically superior to an estimated spontaneous remission rate.\n\nKerl, Helmut\n\nRichtig, Erika\n\nSmolle, Josef\n\n\n"
},
{
"text": "\n102743\nClinical review: Practical recommendations on the management of perioperative heart failure in cardiac surgery\n\nMebazaa, A\n\nPitsis, AA\n\nRudiger, A\n\nToller, W\n\nLongrois, D\n\nRicksten, SE\n\nBobek, I\n\nDe Hert, S\n\nWieselthaler, G\n\nSchirmer, U\n\nvon Segesser, LK\n\nSander, M\n\nPoldermans, D\n\nRanucci, M\n\nKarpati, PCJ\n\nWouters, P\n\nSeeberger, M\n\nSchmid, ER\n\nWeder, W\n\nFollath, F\n\nBeiträge in Fachzeitschriften\nISI:000278816800075\n20497611.0\n10.1186/cc8153\nPMC2887098\nAcute cardiovascular dysfunction occurs perioperatively in more than 20% of cardiosurgical patients, yet current acute heart failure (HF) classification is not applicable to this period. Indicators of major perioperative risk include unstable coronary syndromes, decompensated HF, significant arrhythmias and valvular disease. Clinical risk factors include history of heart disease, compensated HF, cerebrovascular disease, presence of diabetes mellitus, renal insufficiency and high-risk surgery. EuroSCORE reliably predicts perioperative cardiovascular alteration in patients aged less than 80 years. Preoperative B-type natriuretic peptide level is an additional risk stratification factor. Aggressively preserving heart function during cardiosurgery is a major goal. Volatile anaesthetics and levosimendan seem to be promising cardioprotective agents, but large trials are still needed to assess the best cardioprotective agent(s) and optimal protocol(s). The aim of monitoring is early detection and assessment of mechanisms of perioperative cardiovascular dysfunction. Ideally, volume status should be assessed by 'dynamic' measurement of haemodynamic parameters. Assess heart function first by echocardiography, then using a pulmonary artery catheter (especially in right heart dysfunction). If volaemia and heart function are in the normal range, cardiovascular dysfunction is very likely related to vascular dysfunction. In treating myocardial dysfunction, consider the following options, either alone or in combination: low-to-moderate doses of dobutamine and epinephrine, milrinone or levosimendan. In vasoplegia-induced hypotension, use norepinephrine to maintain adequate perfusion pressure. Exclude hypovolaemia in patients under vasopressors, through repeated volume assessments. Optimal perioperative use of inotropes/vasopressors in cardiosurgery remains controversial, and further large multinational studies are needed. Cardiosurgical perioperative classification of cardiac impairment should be based on time of occurrence (precardiotomy, failure to wean, postcardiotomy) and haemodynamic severity of the patient's condition (crash and burn, deteriorating fast, stable but inotrope dependent). In heart dysfunction with suspected coronary hypoperfusion, an intra-aortic balloon pump is highly recommended. A ventricular assist device should be considered before end organ dysfunction becomes evident. Extra-corporeal membrane oxygenation is an elegant solution as a bridge to recovery and/or decision making. This paper offers practical recommendations for management of perioperative HF in cardiosurgery based on European experts' opinion. It also emphasizes the need for large surveys and studies to assess the optimal way to manage perioperative HF in cardiac surgery.\n\nToller, Wolfgang\n\n\n"
},
{
"text": "\n118416\nClear-cell differentiation and lymphatic invasion, but not the revised TNM classification, predict lymph node metastases in pT1 penile cancer: a clinicopathologic study of 76 patients from a low incidence area.\n\nMannweiler, S\n\nSygulla, S\n\nTsybrovskyy, O\n\nRazmara, Y\n\nPummer, K\n\nRegauer, S\n\nBeiträge in Fachzeitschriften\nISI:000325664300059\n22421354.0\n10.1016/j.urolonc.2012.01.017\nNone\nObjective: Prediction of lymph node (LN) metastases in penile invasive cancer relies on clinical features and histologic characteristics of the primary tumor. Correct prediction, however, is difficult, as only 50% patients undergoing lymphadenectomies will have LN metastases. In 2009, the tumor, nodes, metastases (TNM) classification for staging of early penile cancers was revised. We tested the predictive accuracy of the revised TNM classification in a low incidence area for penile carcinoma. Materials and methods: The presence of LN metastases in 76 men with pT1 penile cancers was correlated with the 2009 TNM subclassification, which is based on a combined evaluation of tumor grade and lymphatic invasion, but also with individual parameters, such as histologic grade, lymphatic invasion, perineural invasion, invasion depth, growth pattern and human papilloma virus (HPV) status. Results: 76pT1 penile cancers were reclassified into 31pT1a squamous cell carcinomas (SCC) and 45pT1b (41 SCC; 4 clear-cell carcinomas); 12/22 men (55%; 8 SCC, 4 clear-cell carcinomas) undergoing lymphadenectomy for enlarged inguinal lymph nodes had metastases, 54 patients without enlarged LN and lymphadenectomies had no LN metastases during follow-up of median 47 months. Statistically, clear cell differentiation of the primary carcinoma was highly associated with metastases (100% clear-cell carcinomas vs. 11% SCC) and poor survival (50% vs. 5.5%). Among conventional SCC, only lymphatic invasion showed a highly significant association with metastases with 100% specificity. The 2009 TNM classification, tumor grade alone, perineural invasion, growth pattern, invasion depth or HPV status could not predict LN status. Lymphadenectomy for enlarged LN resulted in 100% sensitivity and 42% predictive probability for identifying metastases and a 16% false positive rate. Statistically, survival correlated significantly with clear-cell differentiation and with lymphatic invasion in both clear-cell carcinomas and conventional SCC. Conclusions: Penile clear-cell carcinomas are more aggressive cancers than SCC. Our observation suggests a benefit of a prophylactic lymphadenectomy for patients with clear-cell carcinomas. Among conventional SCC, only lymphatic invasion predicted LN metastases. Neither tumor grade alone nor perineural invasion, growth pattern, depth of invasion, and subgrouping according to the revised TNM classification correlated with metastases. Clinical evaluation of the LN status was superior to histologic risk stratification. (C) 2013 Elsevier Inc. All rights reserved.\n\nMannweiler, Sebastian\n\nPummer, Karl\n\nRegauer, Sigrid\n\nSygulla, Stephan\n\nTsybrovskyy, Oleksiy\n\n\n"
},
{
"text": "\n159638\nDermoscopic Clues for Diagnosing Melanomas That Resemble Seborrheic Keratosis.\n\nCarrera, C\n\nSegura, S\n\nAguilera, P\n\nScalvenzi, M\n\nLongo, C\n\nBarreiro, A\n\nBroganelli, P\n\nCavicchini, S\n\nLlambrich, A\n\nZaballos, P\n\nThomas, L\n\nMalvehy, J\n\nPuig, S\n\nZalaudek, I\n\nBeiträge in Fachzeitschriften\nISI:000403484800008\n28355453.0\n10.1001/jamadermatol.2017.0129\nPMC5540029\nMelanomas that clinically mimic seborrheic keratosis (SK) can delay diagnosis and adequate treatment. However, little is known about the value of dermoscopy in recognizing these difficult-to-diagnose melanomas.\n To describe the dermoscopic features of SK-like melanomas to understand their clinical morphology.\n This observational retrospective study used 134 clinical and dermoscopic images of histopathologically proven melanomas in 134 patients treated in 9 skin cancer centers in Spain, France, Italy, and Austria. Without knowledge that the definite diagnosis for all the lesions was melanoma, 2 dermoscopy-trained observers evaluated the clinical descriptions and 48 dermoscopic features (including all melanocytic and nonmelanocytic criteria) of all 134 images and classified each dermoscopically as SK or not SK. The total dermoscopy score and the 7-point checklist score were assessed. Images of the lesions and patient data were collected from July 15, 2013, through July 31, 2014.\n Frequencies of specific morphologic patterns of (clinically and dermoscopically) SK-like melanomas, patient demographics, and interobserver agreement of criteria were evaluated.\n Of the 134 cases collected from 72 men and 61 women, all of whom were white and who had a mean (SD) age of 55.6 (17.5) years, 110 (82.1%) revealed dermoscopic features suggestive of melanoma, including pigment network (74 [55.2%]), blue-white veil (72 [53.7%]), globules and dots (68 [50.7%]), pseudopods or streaks (47 [35.1%]), and blue-black sign (43 [32.3%]). The remaining 24 cases (17.9%) were considered likely SKs, even by dermoscopy. Overall, lesions showed a scaly and hyperkeratotic surface (45 [33.6%]), yellowish keratin (42 [31.3%]), comedo-like openings (41 [30.5%]), and milia-like cysts (30 [22.4%]). The entire sample achieved a mean (SD) total dermoscopy score of 4.7 (1.6) and a 7-point checklist score of 4.4 (2.3), while dermoscopically SK-like melanomas achieved a total dermoscopy score of only 4.2 (1.3) and a 7-point checklist score of 2.0 (1.9), both in the range of benignity. The most helpful criteria in correctly diagnosing SK-like melanomas were the presence of blue-white veil, pseudopods or streaks, and pigment network. Multivariate analysis found only the blue-black sign to be significantly associated with a correct diagnosis, while hyperkeratosis and fissures and ridges were independent risk markers of dermoscopically SK-like melanomas.\n Seborrheic keratosis-like melanomas can be dermoscopically challenging, but the presence of the blue-black sign, pigment network, pseudopods or streaks, and/or blue-white veil, despite the presence of other SK features, allows the correct diagnosis of most of the difficult melanoma cases.\n\nZalaudek, Iris\n\n\n"
},
{
"text": "\n168170\nLife-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study.\n\nMartinón-Torres, F\n\nSalas, A\n\nRivero-Calle, I\n\nCebey-López, M\n\nPardo-Seco, J\n\nHerberg, JA\n\nBoeddha, NP\n\nKlobassa, DS\n\nSecka, F\n\nPaulus, S\n\nde Groot, R\n\nSchlapbach, LJ\n\nDriessen, GJ\n\nAnderson, ST\n\nEmonts, M\n\nZenz, W\n\nCarrol, ED\n\nVan der Flier, M\n\nLevin, M\n\nEUCLIDS Consortium\n\nBeiträge in Fachzeitschriften\nISI:000434769800018\n30169282.0\n10.1016/S2352-4642(18)30113-5\nNone\nSepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe.\n The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures.\n 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4-93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0-80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8-100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis.\n Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients.\n European Union's Seventh Framework programme.\n Copyright © 2018 Elsevier Ltd. All rights reserved.\n\nEber, Ernst\n\nKohlfürst, Daniela\n\nZenz, Werner\n\n\n"
},
{
"text": "\n182400\nGenetic Variation in HSD17B13 Reduces the Risk of Developing Cirrhosis and Hepatocellular Carcinoma in Alcohol Misusers.\n\nStickel, F\n\nLutz, P\n\nBuch, S\n\nNischalke, HD\n\nSilva, I\n\nRausch, V\n\nFischer, J\n\nWeiss, KH\n\nGotthardt, D\n\nRosendahl, J\n\nMarot, A\n\nElamly, M\n\nKrawczyk, M\n\nCasper, M\n\nLammert, F\n\nBuckley, TWM\n\nMcQuillin, A\n\nSpengler, U\n\nEyer, F\n\nVogel, A\n\nMarhenke, S\n\nvon Felden, J\n\nWege, H\n\nSharma, R\n\nAtkinson, S\n\nFranke, A\n\nNehring, S\n\nMoser, V\n\nSchafmayer, C\n\nSpahr, L\n\nLackner, C\n\nStauber, RE\n\nCanbay, A\n\nLink, A\n\nValenti, L\n\nGrove, JI\n\nAithal, GP\n\nMarquardt, JU\n\nFateen, W\n\nZopf, S\n\nDufour, JF\n\nTrebicka, J\n\nDatz, C\n\nDeltenre, P\n\nMueller, S\n\nBerg, T\n\nHampe, J\n\nMorgan, MY\n\nBeiträge in Fachzeitschriften\nISI:000534080400001\n31630428.0\n10.1002/hep.30996\nNone\nCarriage of rs738409:G in patatin-like phospholipase domain containing 3 (PNPLA3) is associated with an increased risk for developing alcohol-related cirrhosis and hepatocellular carcinoma (HCC). Recently, rs72613567:TA in hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13) was shown to be associated with a reduced risk for developing alcohol-related liver disease and to attenuate the risk associated with carriage of PNPLA3 rs738409:G. This study explores the risk associations between these two genetic variants and the development of alcohol-related cirrhosis and HCC.\n Variants in HSD17B13 and PNPLA3 were genotyped in 6, 71 participants, including 1, 31 with alcohol-related cirrhosis and HCC, 1, 53 with alcohol-related cirrhosis without HCC, 2, 88 alcohol misusers with no liver disease, and 899 healthy controls. Genetic associations with the risks for developing alcohol-related cirrhosis and HCC were determined using logistic regression analysis. Carriage of HSD17B13 rs72613567:TA was associated with a lower risk for developing both cirrhosis (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.72-0.88; P = 8.13 × 10-6 ) and HCC (OR, 0.77; 95% CI, 0.68-0.89; P = 2.27 × 10-4 ), whereas carriage of PNPLA3 rs738409:G was associated with an increased risk for developing cirrhosis (OR, 1.70; 95% CI, 1.54-1.88; P = 1.52 × 10-26 ) and HCC (OR, 1.77; 95% CI, 1.58-1.98; P = 2.31 × 10-23 ). These associations remained significant after adjusting for age, sex, body mass index, type 2 diabetes, and country. Carriage of HSD17B13 rs72613567:TA attenuated the risk for developing cirrhosis associated with PNPLA3 rs738409:G in both men and women, but the protective effect against the subsequent development of HCC was only observed in men (ORallelic , 0.75; 95% CI, 0.64-0.87; P = 1.72 × 10-4 ).\n Carriage of variants in PNPLA3 and HSD17B13 differentially affect the risk for developing advanced alcohol-related liver disease. A genotypic/phenotypic risk score might facilitate earlier diagnosis of HCC in this population.\n © 2019 by the American Association for the Study of Liver Diseases.\n\nLackner, Karoline\n\nStauber, Rudolf\n\n\n"
},
{
"text": "\n1372\nInsulin binding to trophoblast plasma membranes and placental glycogen content in well-controlled gestational diabetic women treated with diet or insulin, in well-controlled overt diabetic patients and in healthy control subjects.\n\nDesoye, G\n\nHofmann, HH\n\nWeiss, PA\n\nBeiträge in Fachzeitschriften\nISI:A1992GY99400008\n1541381.0\n10.1007/BF00400851\nNone\nInsulin binding to trophoblast plasma membranes and the placental glycogen content were measured in twelve healthy women, in eleven well-controlled gestational diabetic women who were treated either with diet alone (n = 4) or with insulin (n = 7) and in 18 women with well-controlled overt diabetes mellitus (six White B; four White C; eight White D). The competitive binding assay was carried out with 22 concentrations of unlabelled insulin. Binding data were analysed by a non-linear direct model fitting procedure assuming one non-cooperative binding site. Maximum specific binding was unchanged in the total collective of gestational diabetic women, but was decreased by 30% in those treated with diet (6.2 +/- 2.2%) and increased by 90% in insulin-treated women (16.4 +/- 10.2%) as compared to the control subjects (8.7 +/- 2.5%). The diet-treated women had only 40% as many and those treated with insulin had more than twice as many receptors compared to control subjects on a per mg protein basis and if expressed per total placenta. In patients with overt diabetes mellitus maximum specific binding (18.5 +/- 10.6%) was higher (p less than 0.05) due to more receptors compared to control subjects but was similar to the insulin-treated gestational diabetic patients. Maximum specific binding and receptor concentrations did not correlate linearly with maternal plasma insulin levels. Receptor affinities were virtually similar in all groups (1.8 x 10(9) l/mol). The placental glycogen content was reduced (p less than 0.05) to about 80% of that of control subjects in the diet-treated collective, whereas it was unchanged compared to control subjects in the insulin-treated gestational diabetic women despite a 40% increase (p less than 0.001) of the maternal-to-cord serum glucose ratio. In overt diabetic patients the maternal-to-cord serum glucose ratio and the placental glycogen content were higher (p less than 0.05) than in the control subjects. We conclude that trophoblast plasma membranes from gestational diabetic women treated with diet alone express less and those from women treated with insulin express more insulin receptors than those from a healthy control group in vitro. These differences could not have been disclosed without consideration of the mode of treatment. Trophoblast plasma membranes from overt diabetic women have more insulin receptors than those from healthy control subjects.\n\nDesoye, Gernot\n\n\n"
},
{
"text": "\n103463\nIs there a place for FET PET in the initial evaluation of brain lesions with unknown significance?\n\nPichler, R\n\nDunzinger, A\n\nWurm, G\n\nPichler, J\n\nWeis, S\n\nNussbaumer, K\n\nTopakian, R\n\nAigner, RM\n\nBeiträge in Fachzeitschriften\nISI:000280639400011\n20396883.0\n10.1007/s00259-010-1457-6\nNone\nThe aim of this study was to evaluate the clinical value of the use of O-(2-[(18)F]fluoroethyl)-l-tyrosine (FET) positron emission tomography (PET)/computed tomography (CT) in patients of a neurological clinic for evaluation of brain lesions newly diagnosed by magnetic resonance imaging (MRI). We evaluated 88 patients (44 women and 44 men) with a mean age of 50 +/- 19 years who were sent consecutively for evaluation of an intracerebral mass or lesion observed by MRI from 2006 to 2008. Hospitalization was necessary due to neurological clinical symptoms. Images were obtained by PET/CT 30 min after i.v. injection of 185 MBq FET. Coregistration with MRI was done by HERMES workstation. FET uptake above the cortical level was observed in 60 patients. Neurosurgery was performed in 60 patients (51 with FET-positive imaging); 36 high-grade and 19 low-grade tumours were verified histologically. The sensitivity of FET PET for high-grade tumours (WHO III-IV) was 94% in this setting. Among the low-grade brain tumours (WHO I-II) 13 of 19 were FET positive, which indicates a sensitivity of 68%. Five of ten (50%) astrocytomas I and II could not be visualized by FET. Histological data were not provided for 28 of 88 patients, so the diagnostic approach is based upon longitudinal observation. Radiological and/or clinical control was done at a median of 7 months later. Three patients (all FET positive) died a few months after the examination because of rapid progression of the malignant brain tumour. A malignant entity could be excluded in the other 25 patients. Considering the whole cohort of 88 patients, 43 patients with malignant tumour could be identified, including high-grade glioma, intracerebral lymphoma (n = 1) and metastasis (n = 3). The sensitivity of FET PET for detecting a malignant tumour entity was 93%. We observed two false-positive cases with postischaemic lesions. Remarkably, the two patients with cerebral gliomatosis were false-negative on FET PET imaging. The negative predictive value for a malignant entity was calculated to be 89%. Our results indicate a high sensitivity of FET PET for detecting high-grade glioma in patients with neurological symptoms and recently observed brain lesions by MRI. In the setting of evaluating new brain lesions of unknown significance via FET PET a negative image can encourage a wait and see strategy-of course in accordance with the clinical picture and morphological imaging.\n\nAigner, Reingard\n\n\n"
},
{
"text": "\n139777\nA genome-wide association study identifies LIPA as a susceptibility gene for coronary artery disease.\n\nWild, PS\n\nZeller, T\n\nSchillert, A\n\nSzymczak, S\n\nSinning, CR\n\nDeiseroth, A\n\nSchnabel, RB\n\nLubos, E\n\nKeller, T\n\nEleftheriadis, MS\n\nBickel, C\n\nRupprecht, HJ\n\nWilde, S\n\nRossmann, H\n\nDiemert, P\n\nCupples, LA\n\nPerret, C\n\nErdmann, J\n\nStark, K\n\nKleber, ME\n\nEpstein, SE\n\nVoight, BF\n\nKuulasmaa, K\n\nLi, M\n\nSchäfer, AS\n\nKlopp, N\n\nBraund, PS\n\nSager, HB\n\nDemissie, S\n\nProust, C\n\nKönig, IR\n\nWichmann, HE\n\nReinhard, W\n\nHoffmann, MM\n\nVirtamo, J\n\nBurnett, MS\n\nSiscovick, D\n\nWiklund, PG\n\nQu, L\n\nEl Mokthari, NE\n\nThompson, JR\n\nPeters, A\n\nSmith, AV\n\nYon, E\n\nBaumert, J\n\nHengstenberg, C\n\nMärz, W\n\nAmouyel, P\n\nDevaney, J\n\nSchwartz, SM\n\nSaarela, O\n\nMehta, NN\n\nRubin, D\n\nSilander, K\n\nHall, AS\n\nFerrieres, J\n\nHarris, TB\n\nMelander, O\n\nKee, F\n\nHakonarson, H\n\nSchrezenmeir, J\n\nGudnason, V\n\nElosua, R\n\nArveiler, D\n\nEvans, A\n\nRader, DJ\n\nIllig, T\n\nSchreiber, S\n\nBis, JC\n\nAltshuler, D\n\nKavousi, M\n\nWitteman, JC\n\nUitterlinden, AG\n\nHofman, A\n\nFolsom, AR\n\nBarbalic, M\n\nBoerwinkle, E\n\nKathiresan, S\n\nReilly, MP\n\nO'Donnell, CJ\n\nSamani, NJ\n\nSchunkert, H\n\nCambien, F\n\nLackner, KJ\n\nTiret, L\n\nSalomaa, V\n\nMunzel, T\n\nZiegler, A\n\nBlankenberg, S\n\nBeiträge in Fachzeitschriften\nISI:000293901300014\n21606135.0\n10.1161/CIRCGENETICS.110.958728\nPMC3157552\neQTL analyses are important to improve the understanding of genetic association results. We performed a genome-wide association and global gene expression study to identify functionally relevant variants affecting the risk of coronary artery disease (CAD).\n In a genome-wide association analysis of 2078 CAD cases and 2953 control subjects, we identified 950 single-nucleotide polymorphisms (SNPs) that were associated with CAD at P<10(-3). Subsequent in silico and wet-laboratory replication stages and a final meta-analysis of 21 428 CAD cases and 38 361 control subjects revealed a novel association signal at chromosome 10q23.31 within the LIPA (lysosomal acid lipase A) gene (P=3.7×10(-8); odds ratio, 1.1; 95% confidence interval, 1.07 to 1.14). The association of this locus with global gene expression was assessed by genome-wide expression analyses in the monocyte transcriptome of 1494 individuals. The results showed a strong association of this locus with expression of the LIPA transcript (P=1.3×10(-96)). An assessment of LIPA SNPs and transcript with cardiovascular phenotypes revealed an association of LIPA transcript levels with impaired endothelial function (P=4.4×10(-3)).\n The use of data on genetic variants and the addition of data on global monocytic gene expression led to the identification of the novel functional CAD susceptibility locus LIPA, located on chromosome 10q23.31. The respective eSNPs associated with CAD strongly affect LIPA gene expression level, which was related to endothelial dysfunction, a precursor of CAD.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n174557\n2019 ARIA Care pathways for allergen immunotherapy.\n\nBousquet, J\n\nPfaar, O\n\nTogias, A\n\nSchünemann, HJ\n\nAnsotegui, I\n\nPapadopoulos, NG\n\nTsiligianni, I\n\nAgache, I\n\nAnto, JM\n\nBachert, C\n\nBedbrook, A\n\nBergmann, KC\n\nBosnic-Anticevich, S\n\nBosse, I\n\nBrozek, J\n\nCalderon, M\n\nCanonica, GW\n\nCaraballo, L\n\nCardona, V\n\nCasale, T\n\nCecchi, L\n\nChu, DK\n\nCosta, E\n\nCruz, AA\n\nCzarlewski, W\n\nDurham, SR\n\nDu Toit, G\n\nDykewicz, M\n\nEbisawa, M\n\nFauquert, JL\n\nFernandez-Rivas, M\n\nFokkens, WJ\n\nFonseca, J\n\nFontaine, JF\n\nvan Wijk, RG\n\nHaahtela, T\n\nHalken, S\n\nHellings, PW\n\nIerodiakonou, D\n\nIinuma, T\n\nIvancevich, JC\n\nJacobsen, L\n\nJutel, M\n\nKaidashev, I\n\nKhaitov, M\n\nKalayci, O\n\nKleine Tebbe, J\n\nKlimek, L\n\nKowalski, ML\n\nKuna, P\n\nKvedariene, V\n\nLa Grutta, S\n\nLarenas-Linemann, D\n\nLau, S\n\nLaune, D\n\nLe, L\n\nCarlsen, KL\n\nLourenço, O\n\nMalling, HJ\n\nMarien, G\n\nMenditto, E\n\nMercier, G\n\nMullol, J\n\nMuraro, A\n\nO'Hehir, R\n\nOkamoto, Y\n\nPajno, GB\n\nPark, HS\n\nPanzner, P\n\nPassalacqua, G\n\nPham-Thi, N\n\nRoberts, G\n\nRolland, C\n\nRosario, N\n\nRyan, D\n\nSamolinski, B\n\nSanchez-Borges, M\n\nScadding, G\n\nShamji, MH\n\nSheikh, A\n\nSturm, GJ\n\nTodo Bom, A\n\nToppila-Salmi, S\n\nValentin-Rostan, M\n\nValiulis, A\n\nValovirta, E\n\nVentura, MT\n\nWahn, U\n\nWalker, S\n\nWallace, D\n\nWaserman, S\n\nYorgancioglu, A\n\nZuberbier, T\n\nARIA Working Group\n\nBeiträge in Fachzeitschriften\nISI:000476168500001\n30955224.0\n10.1111/all.13805\nNone\nAllergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as on the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow up of patients. This article is protected by copyright. All rights reserved.\n This article is protected by copyright. All rights reserved.\n\nSturm, Gunter\n\n\n"
},
{
"text": "\n175460\nHuman myeloperoxidase (hMPO) is expressed in neurons in the substantia nigra in Parkinson's disease and in the hMPO-α-synuclein-A53T mouse model, correlating with increased nitration and aggregation of α-synuclein and exacerbation of motor impairment.\n\nMaki, RA\n\nHolzer, M\n\nMotamedchaboki, K\n\nMalle, E\n\nMasliah, E\n\nMarsche, G\n\nReynolds, WF\n\nBeiträge in Fachzeitschriften\nISI:000483920100011\n31175983.0\n10.1016/j.freeradbiomed.2019.05.033\nPMC6774439\nα-Synuclein (αSyn) is central to the neuropathology of Parkinson's disease (PD) due to its propensity for misfolding and aggregation into neurotoxic oligomers. Nitration/oxidation of αSyn leads to dityrosine crosslinking and aggregation. Myeloperoxidase (MPO) is an oxidant-generating enzyme implicated in neurodegenerative diseases. In the present work we have examined the impact of MPO in PD through analysis of postmortem PD brain and in a novel animal model in which we crossed a transgenic mouse expressing the human MPO (hMPO) gene to a mouse expressing human αSyn-A53T mutant (A53T) (hMPO-A53T). Surprisingly, our results show that in PD substantia nigra, the hMPO gene is expressed in neurons containing aggregates of nitrated αSyn as well as MPO-generated HOCl-modified epitopes. In our hMPO-A53T mouse model, we also saw hMPO expression in neurons but not mouse MPO. In the mouse model, hMPO was expressed in neurons colocalizing with nitrated αSyn, carbamylated lysine, nitrotyrosine, as well as HOCl-modified epitopes/proteins. RNAscope in situ hybridization confirmed hMPO mRNA expression in neurons. Interestingly, the hMPO protein expressed in hMPO-A53T brain is primarily the precursor proMPO, which enters the secretory pathway potentially resulting in interneuronal transmission of MPO and oxidative species. Importantly, the hMPO-A53T mouse model, when compared to the A53T model, exhibited significant exacerbation of motor impairment on rotating rods, balance beams, and wire hang tests. Further, hMPO expression in the A53T model resulted in earlier onset of end stage paralysis. Interestingly, there was a high concentration of αSyn aggregates in the stratum lacunosum moleculare of hippocampal CA2 region, which has been associated in humans with accumulation of αSyn pathology and neural atrophy in dementia with Lewy bodies. This accumulation of αSyn aggregates in CA2 was associated with markers of endoplasmic reticulum (ER) stress and the unfolded protein response with expression of activating transcription factor 4 (ATF4), C/EBP homologous protein (CHOP), MPO, and cleaved caspase-3. Together these findings suggest that MPO plays an important role in nitrative and oxidative damage that contributes to αSyn pathology in synucleinopathies.\n Copyright © 2019 Elsevier Inc. All rights reserved.\n\nHolzer, Michael\n\nMalle, Ernst\n\nMarsche, Gunther\n\n\n"
},
{
"text": "\n177298\nA preliminary technical study on sodium dodecyl sulfate-induced changes of the nano-structural and macro-mechanical properties in human iliotibial tract specimens.\n\nHammer, N\n\nHuster, D\n\nBoldt, A\n\nHädrich, C\n\nKoch, H\n\nMöbius, R\n\nSchulze-Tanzil, G\n\nScheidt, HA\n\nBeiträge in Fachzeitschriften\nISI:000380080400016\n26866452.0\n10.1016/j.jmbbm.2016.01.018\nNone\nAcellular scaffolds are frequently used for the surgical repair of ligaments and tendons. Even though data on the macro-mechanical properties related to the acellularization process exist, corresponding data on the nano-structural properties are still lacking. Such data would help identify target proteins of the formed extracellular matrix that are chemically altered by the acellularization. In this study we examined the altered structure by comparing molecular properties of collagens from native and acellular iliotibial tract samples to the macroscopic stress-strain behavior of tract samples.\n Matched pairs of five human iliotibial tract samples were obtained from five donors (mean age 28.2±4.7 years). One of each pair was acellularized using 1vol% sodium dodecyl sulfate (SDS) for 7 days. (13)C magic angle spinning nuclear magnetic resonance spectroscopy ((13)C CP MAS NMR) was utilized to compare the collagen overall secondary structure and internal dynamics of collagen-typical amino acid proteins. The resulting data was compared to age-matched stress-strain data of tract samples obtained in an uniaxial tensile setup and histologically.\n Typical and nearly identical collagen (13)C CP MAS NMR spectra were found in the tract samples before and after acellularization with SDS. The characteristic collagen backbone remained intact in the native and acellular samples. Collagen molecular composition was largely unaltered in both conditions. Furthermore, a similar dynamic behavior was found for the amino acids Hyp γ, Pro α/Hyp α, Ala α, Gly α and Ala β. These minute alterations in the collagens' molecular properties related to acellularization with SDS were in line with the similarly minute changes in the macro-mechanical tensile behavior, such as the elastic modulus and ultimate stress. Histology showed intact type I collagens, minute amounts of elastins before and after acellularization and evidence for acellularization-induced reductions of proteoglycans.\n Nano-structural properties of collagens are minutely affected by SDS treatment for acellularization, indicated by the molecular composition and dynamics. The lacking acellularization-related changes in the molecular structure properties of collagens in iliotibial tract samples are in line with the small alterations in their macro-mechanical tensile behavior. Though the given setup approaches soft tissue mechanics from both scaling extremes of mechanical testing, further structural analyzes are needed in a larger sample size to substantiate these findings.\n Copyright © 2016 Elsevier Ltd. All rights reserved.\n\nHammer, Niels\n\n\n"
},
{
"text": "\n184983\nPsychometric properties of instruments used to measure the cultural competence of nurses: A systematic review.\n\nOsmancevic, S\n\nSchoberer, D\n\nLohrmann, C\n\nGroßschädl, F\n\nBeiträge in Fachzeitschriften\nISI:000600703200018\n33212330.0\n10.1016/j.ijnurstu.2020.103789\nNone\nCultural competence is a key component of culturally congruent nursing care. In order to reduce healthcare inequalities and to identify potentials for improvement in nursing practice, researchers need to be able to assess cultural competence properly. Although many instruments for the assessment of cultural competence have been developed, their measurement properties have not yet been reviewed systematically. Such an overview of existing instruments, however, would allow researchers to identify the most valid and reliable instrument for nursing practice.\n The purpose of conducting this review is to identify and critically appraise the psychometric properties of instruments used to measure the cultural competence of nurses.\n A systematic literature search was performed in November 2019 in the following electronic databases: Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO and PubMed. Studies that were conducted to assess any measurement property of instruments used to measure the cultural competence of nurses were included. Two reviewers independently screened the articles and assessed the risk of bias using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The quality of included instruments was assessed on the basis of the updated criteria for good measurement properties, and the quality of the summarised results was graded based on the principles of Grading of Recommendations Assessment, Development and Evaluation.\n In total, 44 studies describing 21 instruments were included in this study. We found that most instruments were tested for at least some forms of validity, but seldom for reliability. The quality of the psychometric properties was evaluated using the criteria for good measurement properties for the following: content validity, structural validity, internal consistency, reliability, measurement error and construct validity. No studies were found in which cross-cultural validity, criterion validity, or the responsiveness of the included instruments were evaluated. The Transcultural Self-Efficacy Tool, the Cultural Competence Assessment, and the Cultural Competence Health Practitioner Assessment showed sufficient levels of quality for psychometric properties and can be recommended for the assessment of cultural competence in nurses.\n Given the broad availability of self-administered instruments to assess cultural competence, the development of new instrument is not recommended. A particular need was identified to conduct further psychometric evaluation studies on existing instruments and to adapt them accordingly, and especially on less frequently evaluated properties, such as reliability, measurement error and responsiveness.\n Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.\n\nGroßschädl, Franziska\n\nLohrmann, Christa\n\nOsmancevic, Selvedina\n\nSchoberer, Daniela\n\n\n"
},
{
"text": "\n2452\nSulfoconjugated and free plasma catecholamine levels at rest and during exercise in patients with idiopathic dilated cardiomyopathy.\n\nDobnig, H\n\nLeb, G\n\nLipp, R\n\nPorta, S\n\nDusleag, J\n\nEber, B\n\nKlein, W\n\nKrejs, GJ\n\nBeiträge in Fachzeitschriften\nISI:A1995QF61800009\n7858737.0\n10.1530/eje.0.1320181\nNone\nPlasma levels of sulfoconjugated (sc) catecholamines (CA) have been shown to be increased with activation of the sympathoadrenal system in a number of clinical settings. We evaluated the relation between scCA and clinical or hemodynamic parameters of patients with idiopathic dilated cardiomyopathy (IDC) at rest and during incremental exercise testing. Eleven healthy subjects, nine patients in New York Heart Association (NYHA) functional class I (IDC-A group) and 11 in NYHA functional class II and III (IDC-B group) performed a symptom-limited, graded bicycle exercise test. Resting, peak and various postexercise levels of plasma free and scCA were determined by high-pressure liquid chromatography. Resting CA levels obtained in the supine position were remarkable for elevations of free norepinephrine (NE) in IDC-B patients (355 +/- 157 ng/l) as compared to IDC-A patients (177 +/- 54, p = 0.006) or healthy controls (193 +/- 74, p = 0.007). Similarly, scNE was highest in IDC-B patients with 1856 +/- 1089 ng/l, followed by IDC-A (1028 +/- 187, p = 0.025) and control subjects (1109 +/- 440, p = 0.025). There was a highly significant correlation between free and scNE (r = 0.76, p < 0.0005). Whereas resting free dopamine (DA) levels were comparable in all three groups, scDA was found to be elevated clearly in IDC-B patients (8772 +/- 2097 ng/l) and significantly different to IDC-A (5786 +/- 2481, p = 0.01) or control subjects (4892 +/- 1575, p = 0.0005). The NYHA functional class and maximum exercise performance correlated best with resting scDA (r = 0.68, p = 0.001 and r = 0.56, p = 0.005, respectively). At peak exercise, IDC-B patients exhibited a significant decrease in scNE and sc epinephrine (E) (from 1856 +/- 1089 to 1495 +/- 932 ng/l, p < 0.005 and from 491 +/- 173 to 282 +/- 143 ng/l, p < 0.01) compared to controls (from 1109 +/- 444 to 1094 +/- 548 ng/l and from 379 +/- 200 to 329 +/- 134 ng/l). In IDC-B patients this decrease in scNE and scE at peak exercise was related inversely to the rise in free NE and E (r = -0.81, p < 0.005 and r = -0.68, p < 0.05). Resting hemodynamic indices generally were reflected better by some free CA rather than by conjugated forms or by parameters of clinical performance. These findings suggest that in addition to free or scNE levels, resting scDA is elevated in symptomatic patients with IDC.(ABSTRACT TRUNCATED AT 400 WORDS)\n\nKrejs, Günter Josef\n\nLeb, Georg\n\nLipp, Rainer\n\n\n"
},
{
"text": "\n187899\nPsychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation\n\nDalkner, N\n\nWagner-Skacel, J\n\nRatzenhofer, M\n\nFellendorf, F\n\nLenger, M\n\nMaget, A\n\nTmava-Berisha, A\n\nPilz, R\n\nQueissner, R\n\nHamm, C\n\nBengesser, S\n\nPlatzer, M\n\nBirner, A\n\nReininghaus, E\n\nBeiträge in Fachzeitschriften\nISI:000656450800001\n34059980.0\n10.1186/s40345-021-00222-8\nNone\nBackground The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group. Methods An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 +/- 15.6 years) and 20 healthy controls (mean age = 32.7 +/- 9.6 years). A 2 x 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2). Results At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients. Conclusions There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.\n\nBengesser, Susanne\n\nBirner, Armin\n\nDalkner, Nina\n\nFellendorf, Frederike\n\nHamm, Carlo\n\nLenger, Melanie\n\nMaget, Alexander\n\nPilz, Rene\n\nPlatzer, Martina\n\nQueissner, Robert\n\nRatzenhofer, Michaela\n\nReininghaus, Eva\n\nTmava-Berisha, Adelina\n\nWagner-Skacel, Jolana\n\n\n"
},
{
"text": "\n2335\nSerum cytokines in juvenile rheumatoid arthritis. Correlation with conventional inflammation parameters and clinical subtypes.\n\nMangge, H\n\nKenzian, H\n\nGallistl, S\n\nNeuwirth, G\n\nLiebmann, P\n\nKaulfersch, W\n\nBeaufort, F\n\nMuntean, W\n\nSchauenstein, K\n\nBeiträge in Fachzeitschriften\nISI:A1995QF43300008\n7848311.0\n10.1002/art.1780380209\nNone\nObjective. To examine the usefulness of determining extended serum cytokine profiles in patients with juvenile rheumatoid arthritis (JRA), for the purpose of improving differential diagnosis and monitoring disease activity. Methods. In a 2-year prospective study, serum levels of interleukin-1 beta (IL-1 beta), soluble IL-2 receptor (sIL-2R), IL-6, IL-8, tumor necrosis factor alpha (TNF alpha), and the p55 soluble TNF receptor (sTNFR) were repeatedly determined by enzyme-linked immunosorbent assay in 40 patients with JRA, 13 patients with postinfectious arthropathies, and 30 healthy controls. The data were compared with conventional parameters of inflammation, such as C-reactive protein (CRP), iron and hemoglobin levels, erythrocyte sedimentation rate (ESR), white blood cell (WBC) counts, and platelet counts. WBC subsets were analyzed by flow cytofluorometry. Results. At the first visit and at the peak of inflammatory activity according to CRP levels and/or ESR, serum levels of sIL-2R, IL-6, and sTNFR in JRA patients correlated significantly with conventional inflammation indicators, whereas IL-1 beta, IL-8, and TNF alpha did not. No changes in leukocyte subset distribution were noted. Among the different clinical subtypes of JRA, sIL-2R, IL-6, and sTNFR values at the time of the initial visit showed a pattern similar to CRP, whereby patients with systemic disease exhibited by far the highest values. TNF alpha and IL-1 beta were variably elevated in certain JRA subtypes. Patients with postinfectious arthropathies showed elevated levels of CRP, sIL-2R, TNF alpha, and sTNFR, which did not differ significantly from levels in the various JRA subtypes with the exception of systemic disease. Detailed analysis of types I and II pauciarticular JRA revealed that levels of CRP, IL-1 beta, and TNF alpha were elevated in patients with type I disease. While these parameters were invariably normal in patients with type II disease, sTNFR and sIL-2R were still found to be significantly elevated. Followup studies suggested that persistently high sTNFR values are a better indicator of JRA activity than are measurements of other cytokines or CIP. Conclusion. JRA is associated with significant and consistent changes in serum levels of inflammatory cytokines and soluble receptors. For the clinical monitoring of JRA, determination of levels of sTNFR, and to some extent sIL-2R, may be particularly useful, since these determinations yield information about subtype and/or activity of disease that is not available from conventional parameters of inflammation.\n\nGallistl, Siegfried\n\nMangge, Harald\n\nMuntean, Eugen\n\n\n"
},
{
"text": "\n119251\nLiver segmentation in contrast enhanced CT data using graph cuts and interactive 3D segmentation refinement methods.\n\nBeichel, R\n\nBornik, A\n\nBauer, C\n\nSorantin, E\n\nBeiträge in Fachzeitschriften\nISI:000301503400024\n22380370.0\n10.1118/1.3682171\nPMC4109564\nPurpose: Liver segmentation is an important prerequisite for the assessment of liver cancer treatment options like tumor resection, image-guided radiation therapy (IGRT), radiofrequency ablation, etc. The purpose of this work was to evaluate a new approach for liver segmentation. Methods: A graph cuts segmentation method was combined with a three-dimensional virtual reality based segmentation refinement approach. The developed interactive segmentation system allowed the user to manipulate volume chunks and/or surfaces instead of 2D contours in cross-sectional images (i.e, slice-by-slice). The method was evaluated on twenty routinely acquired portal-phase contrast enhanced multislice computed tomography (CT) data sets. An independent reference was generated by utilizing a currently clinically utilized slice-by-slice segmentation method. After 1 h of introduction to the developed segmentation system, three experts were asked to segment all twenty data sets with the proposed method. Results: Compared to the independent standard, the relative volumetric segmentation overlap error averaged over all three experts and all twenty data sets was 3.74%. Liver segmentation required on average 16 min of user interaction per case. The calculated relative volumetric overlap errors were not found to be significantly different [analysis of variance (ANOVA) test, p = 0.82] between experts who utilized the proposed 3D system. In contrast, the time required by each expert for segmentation was found to be significantly different (ANOVA test, p = 0.0009). Major differences between generated segmentations and independent references were observed in areas were vessels enter or leave the liver and no accepted criteria for defining liver boundaries exist. In comparison, slice-by-slice based generation of the independent standard utilizing a live wire tool took 70.1 min on average. A standard 2D segmentation refinement approach applied to all twenty data sets required on average 38.2 min of user interaction and resulted in statistically not significantly different segmentation error indices (ANOVA test, significance level of 0.05). Conclusions: All three experts were able to produce liver segmentations with low error rates. User interaction time savings of up to 71% compared to a 2D refinement approach demonstrate the utility and potential of our approach. The system offers a range of different tools to manipulate segmentation results, and some users might benefit from a longer learning phase to develop efficient segmentation refinement strategies. The presented approach represents a generally applicable segmentation approach that can be applied to many medical image segmentation problems. (C) 2012 American Association of Physicists in Medicine. [DOI: 10.1118/1.3682171]\n\nSorantin, Erich\n\n\n"
}
]
}