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"text": "\n111789\nThe influence of age at single-event multilevel surgery on outcome in children with cerebral palsy who walk with flexed knee gait.\n\nSvehlík, M\n\nSteinwender, G\n\nKraus, T\n\nSaraph, V\n\nLehmann, T\n\nLinhart, WE\n\nZwick, EB\n\nBeiträge in Fachzeitschriften\nISI:000292464100018\n21711455.0\n10.1111/j.1469-8749.2011.03995.x\nNone\nAIM Information on the timing and long-term outcome of single-event multilevel surgery in children with bilateral spastic cerebral palsy (CP) walking with flexed knee gait is limited. Based on our clinical experience, we hypothesized that older children with bilateral spastic CP would benefit more from single-event multilevel surgery than younger children. Moreover, any improvement in older children could be maintained with fewer additional surgery events. METHOD We performed a retrospective analysis of the long-term outcomes of single-event multilevel surgery. Thirty-two children (17 males, 15 females) who had received single-event multilevel surgery between 1995 and 2000 with a mean age at the time of surgery of 10 years 6 months (range 5y 8mo-15y 6mo; SD 3y 1mo) and in Gross Motor Function Classification System level II (n=12) or III (n=20) were included in the study. The inclusion criteria required that all children were ambulatory with spastic bilateral CP, had a flexed knee gait, had a full set of data for single-event multilevel surgery preoperatively and at 1 year and 10 years postoperatively, had not had previous surgery on their lower limbs, had not had any treatment with botulinum toxin A before gait assessment, and had not received intrathecal baclofen medication. The follow-up time lasted for over 10 years until the participants reached adulthood (mean age at the last follow-up 21 years 4 months, SD 3y 4mo). Data were collected on six separate occasions: preoperatively, at 1 year, at 2 to 3 years, at 5 years, at 7 to 8 years, and at 10 or more years postoperatively. The primary outcome was the Gait Deviation Index, and the secondary outcomes were the number and type of initial and additional surgeries. A linear mixed model and Spearman's rank correlation coefficient were used to prove the hypothesis. RESULTS The older the child was at the time of the surgery, the better the long-term result ((beta) over cap (Age, Time)=0.15; p=0.03). We did not find any correlation between age at the time of surgery and the number of bony or soft-tissue procedures performed initially as well as during the 10 years of follow-up. INTERPRETATION Children with CP who require single-event multilevel surgery at an older age fare better in the long term than those who are younger at the time of surgery. The pubertal growth spurt is discussed as a contributing factor to gait deterioration.\n\nKraus, Tanja\n\nLinhart, Wolfgang\n\n\n"
},
{
"text": "\n129872\n[Postoperative prognosis of chromophobic renal cell carcinoma: comparative analysis of the multinational CORONA database].\n\nMay, M\n\nZigeuner, R\n\nAziz, A\n\nCindolo, L\n\nGilfrich, C\n\nSchips, L\n\nDe Cobelli, O\n\nRocco, B\n\nDe Nunzio, C\n\nTubaro, A\n\nComan, I\n\nFeciche, B\n\nTruss, M\n\nHoschke, B\n\nDalpiaz, O\n\nStoltze, A\n\nFenske, F\n\nFritsche, HM\n\nChromecki, T\n\nLebentrau, S\n\nFigenshau, RS\n\nMadison, K\n\nSánchez-Chapado, M\n\nDel Carmen Santiago Martin, M\n\nSalzano, L\n\nLotrecchiano, G\n\nJoniau, S\n\nWaidelich, R\n\nStief, CG\n\nBrookman-May, S\n\nMitglieder des "\n\nCORONA projects"\n\n\n\nProjektgruppe "\n\nYoung Academic Urologists Renal Cancer Group"\n\nder European Association of Urology (EAU)\n\nBeiträge in Fachzeitschriften\nISI:000331705500010\n23836364.0\n10.1007/s00120-013-3237-y\nNone\nThe chromophobe subtype represents the third most common histological subtype of renal cell carcinoma (chRCC). Due to the rarity of this subtype only one publication regarding the specific analysis of clinical and histopathological criteria as well as survival analysis of more than 200 patients with chRCC is known to date.\n A total of 6, 34 RCC patients from 11 centres who were treated by (partial) nephrectomy are contained in the database of this multinational study. Of the patients 259 were diagnosed with chRCC (4.2 %) and thus formed the study group for this retrospective investigation. These subjects were compared to 4, 94 patients with a clear cell subtype (80.1 %) with respect to clinical and histopathological criteria. The independent influence of the chromophobe subtype regarding tumor-specific survival and overall survival was determined using analysis by Cox proportional hazards regression models. The median follow-up was 59 months (interquartile range 29-106 months).\n The chRCC patients were significantly younger (60 vs. 63.2 years, p < 0.001), more often female (50 vs. 41 %, p = 0.005) and showed simultaneous distant metastases to a lesser extent (3.5 vs. 7.1 %, p = 0.023) compared to patients with a clear cell subtype. Despite a comparable median tumor size a ≥ pT3 tumor stage was diagnosed in only 24.7 % of the patients compared to of 30.5 % in patients with a clear cell subtype (p = 0.047). In addition to the clinical criteria of age, sex and distant metastases, the histological variables pTN stage, grade and tumor size showed a significant influence on tumor-specific and overall survival. However, in the multivariable Cox regression analysis no independent effect on tumor-specific mortality (HR 0.88, p = 0.515) and overall mortality (HR 1.00, p = 0.998) due to the histological subtype was found (c-index 0.86 and 0.77, respectively).\n Patients with chRCC and clear cell RCC differ significantly concerning the distribution of clinical and histopathological criteria. Patients with chRCC present with less advanced tumors which leads to better tumor-specific survival rates in general; however, this advantage could not be verified after adjustment for the established risk factors.\n\nDalpiaz, Orietta\n\nZigeuner, Richard\n\n\n"
},
{
"text": "\n178247\nGender differences in albumin and ascorbic acid in the vitreous antioxidant system.\n\nSchwab, C\n\nPaar, M\n\nFengler, VH\n\nIvastinovic, D\n\nHaas, A\n\nSeidel, G\n\nGlatz, W\n\nMalle, EM\n\nWeger, M\n\nVelikay-Parel, M\n\nFaustmann, G\n\nWedrich, A\n\nReibnegger, G\n\nWinklhofer-Roob, B\n\nOettl, K\n\nBeiträge in Fachzeitschriften\nISI:000504866900021\n31705958.0\n10.1016/j.freeradbiomed.2019.11.008\nNone\nAscorbic acid is present at high concentrations in the vitreous and plays a central role in vitreous redox chemistry. Albumin is the main protein in the vitreous with antioxidant properties and occurs in different oxidation states, which can be used as redox indicators, but have not been studied in the vitreous. This study, therefore, addressed the vitreous redox state of cysteine-34 of albumin in relation to the ascorbic acid content, which has been suggested to exert a main function in detoxifying reactive oxygen in the vitreous. A total of 58 vitreous samples obtained from patients undergoing vitrectomy were analyzed for (i) human mercaptalbumin (HMA), the reduced thiol form; (ii) human non-mercaptalbumin1 (HNA1), a reversible oxidative modification with a disulfide at cysteine-34; and (iii) human non-mercaptalbumin2 (HNA2), a non-reversibly (highly) oxidized form of albumin; as well as (iv) ascorbic acid concentrations, to study possible relations. In addition, blood samples were taken to compare albumin redox state between plasma and the vitreous. Vitreous albumin showed greater variability in the redox state of cysteine-34 and a shift to the oxidized fractions compared to plasma albumin (P < 0.001). A strong positive relation was observed between the vitreous ascorbic acid concentrations and the reversibly oxidized form, HNA1 (P < 0.001), and a negative relation with the reduced form, HMA. Positive relations between ascorbic acid and HNA1 in the vitreous were stronger in men than in women. In contrast to HMA and HNA1, there was a distinct gender difference noted for the irreversibly oxidized form, HNA2. While males showed a positive relation between the vitreous ascorbic acid concentrations and HNA2, there was no correlation found with HNA2 in females. Our results support the view that ascorbic acid, by decreasing either directly or indirectly the concentrations of molecular oxygen, generates hydrogen peroxide, and that thiols, including HMA, are acting as antioxidants. This study for the first time provides evidence that vitreous albumin can be used as a marker molecule for the appearance of reactive oxygen species in the vitreous of patients undergoing vitrectomy. Moreover, it can be shown that there are gender differences in vitreous ascorbic acid and albumin concentrations as well as in oxidation state of vitreous albumin.\n Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.\n\nGlatz, Wilfried\n\nHaas, Anton\n\nIvastinovic, Domagoj\n\nMalle, Eva Maria Birgit\n\nÖttl, Karl\n\nPaar, Margret\n\nReibnegger, Gilbert\n\nSchwab, Christoph\n\nSeidel, Gerald\n\nWedrich, Andreas\n\nWeger, Martin\n\n\n"
},
{
"text": "\n185110\nElectrospun PCL/PLA Scaffolds Are More Suitable Carriers of Placental Mesenchymal Stromal Cells Than Collagen/Elastin Scaffolds and Prevent Wound Contraction in a Mouse Model of Wound Healing.\n\nVonbrunn, E\n\nMueller, M\n\nPichlsberger, M\n\nSundl, M\n\nHelmer, A\n\nWallner, SA\n\nRinner, B\n\nTuca, AC\n\nKamolz, LP\n\nBrislinger, D\n\nGlasmacher, B\n\nLang-Olip, I\n\nBeiträge in Fachzeitschriften\nISI:000603389300001\n33425870.0\n10.3389/fbioe.2020.604123\nPMC7793771\nMesenchymal stem/stromal cells (MSCs) exert beneficial effects during wound healing, and cell-seeded scaffolds are a promising method of application. Here, we compared the suitability of a clinically used collagen/elastin scaffold (Matriderm) with an electrospun Poly(ε-caprolactone)/poly(l-lactide) (PCL/PLA) scaffold as carriers for human amnion-derived MSCs (hAMSCs). We created an epidermal-like PCL/PLA scaffold and evaluated its microstructural, mechanical, and functional properties. Sequential spinning of different PCL/PLA concentrations resulted in a wide-meshed layer designed for cell-seeding and a dense-meshed layer for apical protection. The Matriderm and PCL/PLA scaffolds then were seeded with hAMSCs, with or without Matrigel coating. The quantity and quality of the adherent cells were evaluated in vitro. The results showed that hAMSCs adhered to and infiltrated both scaffold types but on day 3, more cells were observed on PCL/PLA than on Matriderm. Apoptosis and proliferation rates were similar for all carriers except the coated Matriderm, where apoptotic cells were significantly enhanced. On day 8, the number of cells decreased on all carrier types except the coated Matriderm, which had consistently low cell numbers. Uncoated Matriderm had the highest percentage of proliferative cells and lowest apoptosis rate of all carrier types. Each carrier also was topically applied to skin wound sites in a mouse model and analyzed in vivo over 14 days via optical imaging and histological methods, which showed detectable hAMSCs on all carrier types on day 8. On day 14, all wounds exhibited newly formed epidermis, and all carriers were well-integrated into the underlying dermis and showing signs of degradation. However, only wounds treated with uncoated PCL/PLA maintained a round appearance with minimal contraction. Overall, the results support a 3-day in vitro culture of scaffolds with hAMSCs before wound application. The PCL/PLA scaffold showed higher cell adherence than Matriderm, and the effect of the Matrigel coating was negligible, as all carrier types maintained sufficient numbers of transplanted cells in the wound area. The anti-contractive effects of the PCL/PLA scaffold offer potential new therapeutic approaches to wound care.\n Copyright © 2020 Vonbrunn, Mueller, Pichlsberger, Sundl, Helmer, Wallner, Rinner, Tuca, Kamolz, Brislinger, Glasmacher and Lang-Olip.\n\nBrislinger, Dagmar\n\nKamolz, Lars-Peter\n\nLang-Olip, Ingrid\n\nPichlsberger, Melanie\n\nRinner, Beate\n\nSundl, Monika\n\nTuca, Alexandru\n\nWallner, Stefanie Angela\n\n\n"
},
{
"text": "\n65132\nBrain metabolite changes in cortical grey and normal-appearing white matter in clinically early relapsing-remitting multiple sclerosis.\n\nChard, DT\n\nGriffin, CM\n\nMcLean, MA\n\nKapeller, P\n\nKapoor, R\n\nThompson, AJ\n\nMiller, DH\n\nBeiträge in Fachzeitschriften\nISI:000178613700016\n12244090.0\n10.1093/brain/awf240\nNone\nWhile much work has concentrated on focal white matter (WM) lesions in multiple sclerosis, there is growing evidence to suggest that normal-appearing WM (NAWM) and grey matter (GM) are also involved in the disease process. This study investigated multiple sclerosis disease effects on NAWM and cortical GM (CGM) metabolite concentrations, and the relationships between these metabolite concentrations and clinical impairment. Proton magnetic resonance spectroscopic imaging ((1)H-MRSI) data acquired using point resolved spectroscopic (PRESS) localization (echo time 30 ms, repetition time 3000 ms, nominal voxel volume 2.3 ml) from 27 relapsing-remitting multiple sclerosis and 29 normal control (NC) subjects were processed using LCModel to estimate metabolite concentrations in millimoles per litre. (1)H-MRSI voxel tissue contents were estimated using SPM99 tissue and semi-automatic lesion segmentations of three-dimensional fast spoiled gradient recall scans acquired during the same scanning session. NAWM and CGM metabolite concentrations estimated were: choline-containing compounds (Cho); creatine and phosphocreatine (Cr); myo-inositol (Ins); N-acetyl-aspartate plus N-acetyl-aspartyl-glutamate (tNAA); and glutamate plus glutamine (Glx). CGM data came from 24 of the multiple sclerosis (mean age 35.2 years, mean disease duration 1.7 years) and 25 of the NC (mean age 34.9 years) subjects. NAWM data came from 25 of the multiple sclerosis (mean age 35.0 years, mean disease duration 1.7 years) and 28 of the NC (mean age 36.7 years) subjects. Metabolite concentrations were compared between multiple sclerosis and NC subjects using multiple (linear) regression models allowing for age, gender, (1)H-MRSI voxel tissue and CSF contents, and brain parenchymal volume. At a significance level of P < 0.05, CGM Cho, CGM and NAWM tNAA, and CGM Glx were all significantly reduced, and NAWM Ins was significantly elevated. Spearman correlations of multiple sclerosis functional composite scores with tissue metabolite concentrations were significant for the following: CGM Cr (r(s) = 0.524, P = 0.009), CGM Glx (r(s) = 0.580, P = 0.003) and NAWM Ins (r(s) = -0.559, P = 0.004). These results indicate that metabolite changes in NAWM and CGM can be detected early in the clinical course of multiple sclerosis, and that some of these changes relate to clinical status. The correlation of clinical impairment with CGM Cr and Glx but not tNAA suggests that it is more closely associated with neuronal metabolic dysfunction rather than loss in clinically early relapsing-remitting multiple sclerosis. The correlation of clinical impairment with a raised NAWM Ins may indicate that glial proliferation also relates to function at this stage of the disease.\n\nKapeller, Peter\n\n\n"
},
{
"text": "\n65922\nGlucagon-like peptide 1 increases secretory burst mass of pulsatile insulin secretion in patients with type 2 diabetes and impaired glucose tolerance.\n\nRitzel, R\n\nSchulte, M\n\nPørksen, N\n\nNauck, MS\n\nHolst, JJ\n\nJuhl, C\n\nMärz, W\n\nSchmitz, O\n\nSchmiegel, WH\n\nNauck, MA\n\nBeiträge in Fachzeitschriften\nISI:000167719600011\n11289042.0\n10.2337/diabetes.50.4.776\nNone\nThe insulinotropic gut hormone glucagon-like peptide (GLP)-1 increases secretory burst mass and the amplitude of pulsatile insulin secretion in healthy volunteers without affecting burst frequency. Effects of GLP-1 on secretory mechanisms in type 2 diabetic patients and subjects with impaired glucose tolerance (IGT) known to have impaired pulsatile release of insulin have not yet been studied. Eight type 2 diabetic patients (64+/-9 years, BMI 28.9+/-7.2 kg/m2, HbA1c 7.7+/-1.3%) and eight subjects with IGT (63+/-10 years, BMI 31.7+/-6.4 kg/m2, HbA1c 5.7+/-0.4) were studied on separate occasions in the fasting state during the continued administration of exogenous GLP-1 (1.2 pmol x kg(-1) x min(-1), started at 10:00 P.M. the evening before) or placebo. For comparison, eight healthy volunteers (62+/-7 years, BMI 27.7+/-4.8 kg/m2, HbA1c 5.4+/-0.5) were studied only with placebo. Blood was sampled continuously over 60 min (roller-pump) in 1-min fractions for the measurement of plasma glucose and insulin. Pulsatile insulin secretion was characterized by deconvolution, autocorrelation, and spectral analysis and by estimating the degree of randomness (approximate entropy). In type 2 diabetic patients, exogenous GLP-1 at approximately 90 pmol/l improved plasma glucose concentrations (6.4+/-2.1 mmol/l vs. placebo 9.8+/-4.1 mmol/l, P = 0.0005) and significantly increased mean insulin burst mass (by 68%, P = 0.007) and amplitude (by 59%, P = 0.006; deconvolution analysis). In IGT subjects, burst mass was increased by 45% (P = 0.019) and amplitude by 38% (P = 0.02). By deconvolution analysis, insulin secretory burst frequency was not affected by GLP-1 in either type 2 diabetic patients (P = 0.15) or IGT subjects (P = 0.76). However, by both autocorrelation and spectral analysis, GLP-1 prolonged the period (lag time) between subsequent maxima of insulin concentrations significantly from approximately 9 to approximately 13 min in both type 2 diabetic patients and IGT subjects. Under placebo conditions, parameters of pulsatile insulin secretion were similar in normal subjects, type 2 diabetic patients, and IGT subjects based on all methodological approaches (P > 0.05). In conclusion, intravenous GLP-1 reduces plasma glucose in type 2 diabetic patients and improves the oscillatory secretion pattern by amplifying insulin secretory burst mass, whereas the oscillatory period determined by autocorrelation and spectral analysis is significantly prolonged. This was not the case for the interpulse interval determined by deconvolution. Together, these results suggest a normalization of the pulsatile pattern of insulin secretion by GLP-1, which supports the future therapeutic use of GLP-1-derived agents.\n\nMärz, Winfried\n\n\n"
},
{
"text": "\n145444\nUtilisation of blood components in cardiac surgery: a single-centre retrospective analysis with regard to diagnosis-related procedures.\n\nGeissler, RG\n\nRotering, H\n\nBuddendick, H\n\nFranz, D\n\nBunzemeier, H\n\nRoeder, N\n\nKwiecien, R\n\nSibrowski, W\n\nScheld, HH\n\nMartens, S\n\nSchlenke, P\n\nBeiträge in Fachzeitschriften\nISI:000353433300002\n26019702.0\n10.1159/000377691\nPMC4439773\nMore blood components are required in cardiac surgery than in most other medical disciplines. The overall blood demand may increase as a function of the total number of cardiothoracic and vascular surgical interventions and their level of complexity, and also when considering the demographic ageing. Awareness has grown with respect to adverse events, such as transfusion-related immunomodulation by allogeneic blood supply, which can contribute to morbidity and mortality. Therefore, programmes of patient blood management (PBM) have been implemented to avoid unnecessary blood transfusions and to standardise the indication of blood transfusions more strictly with aim to improve patients' overall outcomes.\n A comprehensive retrospective analysis of the utilisation of blood components in the Department of Cardiac Surgery at the University Hospital of Münster (UKM) was performed over a 4-year period. Based on a medical reporting system of all medical disciplines, which was established as part of a PBM initiative, all transfused patients in cardiac surgery and their blood components were identified in a diagnosis- and medical procedure-related system, which allows the precise allocation of blood consumption to interventional procedures in cardiac surgery, such as coronary or valve surgery.\n This retrospective single centre study included all in-patients in cardiac surgery at the UKM from 2009 to 2012, corresponding to a total of 1, 05-1, 44 cases per year. A blood supply was provided for 55.6-61.9% of the cardiac surgery patients, whereas approximately 9% of all in-patients at the UKM required blood transfusions. Most of the blood units were applied during cardiac valve surgery and during coronary surgery. Further surgical activities with considerable use of blood components included thoracic surgery, aortic surgery, heart transplantations and the use of artificial hearts. Under the measures of PBM in 2012 a noticeable decrease in the number of transfused cases was observed compared to the period from 2009 to 2011 before implementation of the PBM initiative (red blood cells p < 0.002; fresh frozen plasma p < 0.0006; platelets p < 0.00006).\n Until now, cardiac surgery comes along with a significant blood supply. By using a case-related data evaluation programme, the consumption of each blood component can be linked to clinical performance groups and, if necessary, to individual patients. Based on the results obtained from this retrospective analysis, prospective studies are underway to begin conducting target / actual performance comparisons to better understand the individual decision-making by the attending physicians with respect to transfusions.\n\nSchlenke, Peter\n\n\n"
},
{
"text": "\n164811\nDeep gray matter volume loss drives disability worsening in multiple sclerosis.\n\nEshaghi, A\n\nPrados, F\n\nBrownlee, WJ\n\nAltmann, DR\n\nTur, C\n\nCardoso, MJ\n\nDe Angelis, F\n\nvan de Pavert, SH\n\nCawley, N\n\nDe Stefano, N\n\nStromillo, ML\n\nBattaglini, M\n\nRuggieri, S\n\nGasperini, C\n\nFilippi, M\n\nRocca, MA\n\nRovira, A\n\nSastre-Garriga, J\n\nVrenken, H\n\nLeurs, CE\n\nKillestein, J\n\nPirpamer, L\n\nEnzinger, C\n\nOurselin, S\n\nWheeler-Kingshott, CAMG\n\nChard, D\n\nThompson, AJ\n\nAlexander, DC\n\nBarkhof, F\n\nCiccarelli, O\n\nMAGNIMS study group\n\nBeiträge in Fachzeitschriften\nISI:000425624500003\n29331092.0\n10.1002/ana.25145\nPMC5838522\nGray matter (GM) atrophy occurs in all multiple sclerosis (MS) phenotypes. We investigated whether there is a spatiotemporal pattern of GM atrophy that is associated with faster disability accumulation in MS.\n We analyzed 3, 04 brain high-resolution T1-weighted magnetic resonance imaging scans from 1, 17 participants: 1, 14 MS patients (253 clinically isolated syndrome [CIS], 708 relapsing-remitting [RRMS], 128 secondary-progressive [SPMS], and 125 primary-progressive [PPMS]), over an average follow-up of 2.41 years (standard deviation [SD] = 1.97), and 203 healthy controls (HCs; average follow-up = 1.83 year; SD = 1.77), attending seven European centers. Disability was assessed with the Expanded Disability Status Scale (EDSS). We obtained volumes of the deep GM (DGM), temporal, frontal, parietal, occipital and cerebellar GM, brainstem, and cerebral white matter. Hierarchical mixed models assessed annual percentage rate of regional tissue loss and identified regional volumes associated with time-to-EDSS progression.\n SPMS showed the lowest baseline volumes of cortical GM and DGM. Of all baseline regional volumes, only that of the DGM predicted time-to-EDSS progression (hazard ratio = 0.73; 95% confidence interval, 0.65, 0.82; p < 0.001): for every standard deviation decrease in baseline DGM volume, the risk of presenting a shorter time to EDSS worsening during follow-up increased by 27%. Of all longitudinal measures, DGM showed the fastest annual rate of atrophy, which was faster in SPMS (-1.45%), PPMS (-1.66%), and RRMS (-1.34%) than CIS (-0.88%) and HCs (-0.94%; p < 0.01). The rate of temporal GM atrophy in SPMS (-1.21%) was significantly faster than RRMS (-0.76%), CIS (-0.75%), and HCs (-0.51%). Similarly, the rate of parietal GM atrophy in SPMS (-1.24-%) was faster than CIS (-0.63%) and HCs (-0.23%; all p values <0.05). Only the atrophy rate in DGM in patients was significantly associated with disability accumulation (beta = 0.04; p < 0.001).\n This large, multicenter and longitudinal study shows that DGM volume loss drives disability accumulation in MS, and that temporal cortical GM shows accelerated atrophy in SPMS than RRMS. The difference in regional GM atrophy development between phenotypes needs to be taken into account when evaluating treatment effect of therapeutic interventions. Ann Neurol 2018;83:210-222.\n © 2018 The Authors Annals of Neurology published by Wiley Periodicals, Inc. on behalf of American Neurological Association.\n\nEnzinger, Christian\n\nPirpamer, Lukas\n\n\n"
},
{
"text": "\n166893\nThe use of PIPAC (pressurized intraperitoneal aerosol chemotherapy) in gynecological oncology: a statement by the German "Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR)", the Swiss and Austrian AGO, and the North-Eastern German Society of Gynaecologic Oncology.\n\nDueckelmann, AM\n\nFink, D\n\nHarter, P\n\nHeinzelmann, V\n\nMarth, C\n\nMueller, M\n\nReinthaller, A\n\nTamussino, K\n\nWimberger, P\n\nSehouli, J\n\nBeiträge in Fachzeitschriften\nISI:000427466800004\n29356953.0\n10.1007/s00404-018-4673-0\nNone\nOvarian, tubal, and peritoneal carcinomas primarily affect the peritoneal cavity, and they are typically diagnosed at an advanced tumor stage (Foley, Rauh-Hain, del Carmen in Oncology (Williston Park) 27:288-294, 2013). In the course of primary surgery, postoperative tumor residuals are, apart from the tumor stage, the strongest independent factors of prognosis (du Bois, Reuss, Pujade-Lauraine, Harter, Ray-Coquard, Pfisterer in Cancer 115:1234-1244, 2009). Due to improved surgical techniques, including the use of multi-visceral procedures, macroscopic tumor clearance can be achieved in oncological centers, in most cases (Harter, Muallem, Buhrmann et al in Gynecol Oncol 121:615-619, 2011). However, to date, it has not been shown that peritoneal carcinomatosis is, per se, an independent factor of prognosis or that it excludes the achievement of tumor clearance. Several studies have shown that a preceding drug therapy in peritoneal carcinomatosis could positively influence the overall prognosis (Trimbos, Trimbos, Vergote et al in J Natl Cancer Inst 95:105-112, 2003). In relapses of ovarian carcinoma, studies have shown that peritoneal carcinomatosis is a negative predictor of complete tumor resection; however, when it is possible to resect the tumor completely, peritoneal carcinomatosis does not play a role in the prognosis (Harter, Hahmann, Lueck et al in Ann Surg Oncol 16:1324-1330, 2009).\n PIPAC is a highly experimental method for treating patients with ovarian, tubal, and peritoneal cancer. To date, only three studies have investigated a total of 184 patients with peritoneal carcinomatosis (Grass, Vuagniaux, Teixeira-Farinha, Lehmann, Demartines, Hubner in Br J Surg 104:669-678, 2017). Only some of those studies were phase I/II studies that included PIPAC for patients with different indications and different cancer entities. It is important to keep in mind that the PIPAC approach is associated with relatively high toxicity. To date, no systematic dose-finding studies have been reported. Moreover, no studies have reported improvements in progression-free or overall survival associated with PIPAC therapy.\n Randomized phase III studies are required to evaluate the effect of this therapy compared to other standard treatments (sequential or simultaneous applications with systemic chemotherapy). In cases of ovarian, tubal, and peritoneal cancer, PIPAC should not be performed outside the framework of prospective, controlled studies.\n\nTamussino, Karl\n\n\n"
},
{
"text": "\n182009\nCOVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon.\n\nHirschmann, MT\n\nHart, A\n\nHenckel, J\n\nSadoghi, P\n\nSeil, R\n\nMouton, C\n\nBeiträge in Fachzeitschriften\nISI:000528963300001\n32342138.0\n10.1007/s00167-020-06022-4\nPMC7184806\nWith the COVID-19 crisis, recommendations for personal protective equipment (PPE) are necessary for protection in orthopaedics and traumatology. The primary purpose of this study is to review and present current evidence and recommendations for personal protective equipment and safety recommendations for orthopaedic surgeons and trauma surgeons.\n A systematic review of the available literature was performed using the keyword terms "COVID-19", "Coronavirus", "surgeon", "health-care workers", "protection", "masks", "gloves", "gowns", "helmets", and "aerosol" in several combinations. The following databases were assessed: Pubmed, Cochrane Reviews, Google Scholar. Due to the paucity of available data, it was decided to present it in a narrative manner. In addition, participating doctors were asked to provide their guidelines for PPE in their countries (Austria, Luxembourg, Switzerland, Germany, UK) for consideration in the presented practice recommendations.\n World Health Organization guidance for respiratory aerosol-generating procedures (AGPs) such as intubation in a COVID19 environment was clear and included the use of an FFP3 (filtering face piece level 3) mask and face protection. However, the recommendation for surgical AGPs, such as the use of high-speed power tools in the operating theatre, was not clear until the UK Public Health England (PHE) guidance of 27 March 2020. This guidance included FFP3 masks and face protection, which UK surgeons quickly adopted. The recommended PPE for orthopaedic surgeons, working in a COVID19 environment, should consist of level 4 surgical gowns, face shields or goggles, double gloves, FFP2-3 or N95-99 respirator masks. An alternative to the mask, face shield and goggles is a powered air-purifying respirator, particularly if the surgeons fail the mask fit test or are required to undertake a long procedure. However, there is a high cost and limited availabilty of these devices at present. Currently available surgical helmets and toga systems may not be the solution due to a permeable top for air intake. During the current COVID-19 crisis, it appeared that telemedicine can be considered as an electronic personal protective equipment by reducing the number of physical contacts and risk contamination.\n Orthopaedic and trauma surgery using power tools, pulsatile lavage and electrocautery are surgical aerosol-generating procedures and all body fluids contain virus particles. Raising awareness of these issues will help avoid occupational transmission of COVID-19 to the surgical team by aerosolization of blood or other body fluids and hence adequate PPE should be available and used during orthopaedic surgery. In addition, efforts have to be made to improve the current evidence in this regard.\n IV.\n\nSadoghi, Patrick\n\n\n"
},
{
"text": "\n70928\nContribution of cAMP-phosphodiesterase inhibition and sensitization of the contractile proteins for calcium to the inotropic effect of pimobendan in the failing human myocardium.\n\nBöhm, M\n\nMorano, I\n\nPieske, B\n\nRüegg, JC\n\nWankerl, M\n\nZimmermann, R\n\nErdmann, E\n\nBeiträge in Fachzeitschriften\nISI:A1991FT47500008\n1660359.0\n10.1161/01.RES.68.3.689\nNone\nPrevious studies have shown reduced effects of cAMP-dependent positive inotropic agents in the failing human myocardium; thus other cAMP-independent mechanisms of action may be useful to increase force of contraction in this condition. The purpose of this investigation was to determine whether a positive inotropic effect of the cAMP-phosphodiesterase (PDE) inhibitor pimobendan is observed in the failing human myocardium and to study whether other factors, such as an increase in the Ca2+ sensitivity of myofilaments, play a functional role in the increase in force of contraction. Pimobendan produced a positive inotropic effect in isolated preparations from nonfailing donor hearts; however, in moderately (New York Heart Association class II-III, NYHA II-III) and severely (NYHA IV) failing myocardium, this effect was reduced. In addition, in NYHA IV specimens pimobendan inhibited the crude cAMP-PDE (crude PDE) and the isoenzymes I-III (PDE I-III) in a concentration-dependent way. As judged from the IC50 values found in this tissue for the inhibition of PDE III and of crude PDE, the potency of the compound was 18.1 times greater on PDE III. Consistent with a cAMP-PDE-dependent mechanism of action, the positive inotropic effect was potentiated by isoproterenol and inhibited by adenosine in failing myocardium. In failing myocardium, pimobendan also increased the sensitivity of skinned cardiac fibers to Ca2+ and shifted the Ca(2+)-tension relation to the left. This sensitizing effect began at 0.01 mumol/l in NYHA II-III and NYHA IV and rose to about 200% at 300 mumol/l in both groups. In contrast, the demethylated metabolite UD-CG 212 Cl failed to produce positive inotropic effects in failing myocardium alone, but in the presence of isoproterenol, it exerted an increase in force of contraction. The potency of UD-CG 212 Cl for PDE III inhibition in NYHA IV was greater than that of pimobendan. The metabolite pronouncedly decreased the sensitivity of skinned cardiac fibers to Ca2+ at 30-300 mumol/l in NYHA II-III and NYHA IV. It is concluded that in the failing human heart pimobendan inhibited PDE III and sensitized contractile proteins for Ca2+. Both effects appear to be involved in the positive inotropic effect of the compound, because its metabolite, UD-CG 212 Cl, had no effect on force of contraction and on the Ca2+ sensitivity of skinned cardiac fibers but inhibited PDE III even more potently than pimobendan.(ABSTRACT TRUNCATED AT 400 WORDS)\n\n\n"
},
{
"text": "\n119248\nHealth-Related Quality of Life in EORTC clinical trials-30 years of progress from methodological developments to making a real impact on oncology practice\n\nVelikova, G\n\nCoens, C\n\nEfficace, F\n\nGreimel, E\n\nGroenvold, M\n\nJohnson, C\n\nSinger, S\n\nvan de Poll-Franse, L\n\nYoung, T\n\nBottomley, A\n\nBeiträge in Fachzeitschriften\nISI:000302130800021\nNone\nNone\nNone\nThe impact of cancer on patients' lives can be measured using self-reported questionnaires, known as Health-Related Quality of Life (HRQOL) measures. HRQOL is defined as a multi-dimensional construct covering disease and treatment-related symptoms, physical, psychological, and social functioning. The EORTC Quality of Life Group (QLG) was created in 1984 with the mission to develop measures of HRQOL and to promote and coordinate clinical studies concerning the quality of life of cancer patients. The EORTC Quality of Life Department (QL Department) was founded in 1993 with the support of an EU grant to provide administrative, practical and scientific support to co-operative groups conducting clinical trials with HRQOL outcomes. We are proud to report significant scientific achievements that have made us international leaders in HRQOL research and have led to real changes to cancer patient treatments. We developed a modular system for HRQOL measurement consisting of the EORTC QLQ-C30, a core cancer quality of life questionnaire and supplementary questionnaire modules. The EORTC-QLQ-C30 has been one of the most widely used cancer questionnaires in randomized trials in oncology as demonstrated by systematic reviews. To date, the EORTC QLQ-C30 has been translated and linguistically validated into more than 60 languages. HRQOL outcome measures have been an integral part of EORTC clinical trials for the last 30 years. We present examples of significant, practice-changing clinical trials evaluating HRQOL in several cancer sites, such as brain tumors, breast and ovarian cancers, and malignant melanoma. In a series of systematic reviews, we examined the quality of reporting HRQOL in international cancer clinical trials, and the impact of the results on oncology practice that led to a recommendation to improve CONSORT (Consolidated Standards of Reporting Trials) with regard to reporting of HRQOL. The QLG is an international leader in methodological research in the measurement of HRQOL in oncology and pursues research in several key areas, such as cross-cultural differences between populations in HRQOL assessment, Computer-Adaptive Testing, electronic administration of EORTC QLQ-C30, and summary scores for EORTC QLQ-C30. In summary, the QLG and QL Department have been international leaders in the field. Our questionnaires have brought HRQOL assessment to the fore in many international trials that have changed oncology practice and brought the patient's perspective into cancer research. (C) 2012 European Organisation for Research and Treatment of Cancer. All rights reserved.\n\nGreimel, Elfriede Renate\n\n\n"
},
{
"text": "\n172972\nAcute and 30-Day Safety and Effectiveness Evaluation of Eximo Medical's B-Laser™, a Novel Atherectomy Device, in Subjects Affected With Infrainguinal Peripheral Arterial Disease: Results of the EX-PAD-03 Trial.\n\nShammas, NW\n\nChandra, P\n\nBrodmann, M\n\nWeinstock, B\n\nSedillo, G\n\nCawich, I\n\nMicari, A\n\nLee, A\n\nMetzger, C\n\nPalena, LM\n\nRundback, J\n\nEX-PAD-03 Investigators\n\nBeiträge in Fachzeitschriften\nISI:000513939400017\n30559030.0\n10.1016/j.carrev.2018.11.022\nNone\nB-Laser™ is a novel atherectomy device that uses a solid-state third harmonic pulsed Nd:YAG laser with an output of 355 nm. Early data showed that the B-Laser™ is safe in treating a broad range of infrainguinal arterial lesions. We present the results of the EX-PAD-03 U.S. pivotal trial of the EXIMO B-Laser™.\n EX-PAD-03 is a prospective, single-arm, multi-center, international, open-label, clinical study. The study enrolled patients in the United States and Europe. The primary efficacy endpoint was the average reduction in residual diameter stenosis of >20% from baseline prior to any adjunctive therapy achieved by the B-Laser™ catheter alone. The primary safety endpoint was freedom from major adverse events (MAEs) defined as: unplanned target limb amputation above the ankle, clinically driven target lesion revascularization (CD-TLR) and cardiovascular related death.\n A total of 97 subjects (107 lesions) were enrolled. Mean age was 70.5 years and 51% were males. Diabetes mellitus was present in 42.3%. Mean lesion length was 53.96 ± 43.18 mm and 26.2% had severe calcification. Lesions were de novo (79.4%), followed by in-stent restenosis (ISR) (15.9%) and non in-stent restenosis (4.7%). The mean percent stenosis at the target lesion as assessed by the Core lab was 85.7% ± 12.2 (femoro-popliteal 85.6 ± 12.8%; tibials 86.0 ± 9.6%). Post B-Laser™ and prior to adjunctive therapy, the mean percent stenosis at the target lesion was 52.1%. This resulted in a mean reduction from baseline to post B-Laser™ of 33.6% ± 14.2% meeting the primary efficacy endpoint goal. The freedom from MAE through the 30-day follow-up period after intervention was 98.9%. Per Core lab, there was no device-related distal embolization, dissections that required additional therapy, perforation, or pseudoaneurysm. Bailout stenting was 0.9%. A significant improvement from baseline in ABI (0.24 ± 0.18), Rutherford category (-1.79 ± 1.22) and WIQ (0.26 ± 0.28) were noted at 1 month. There was no target lesion revascularization and the patency was 96.8% by duplex ultrasound criteria at 30-day follow up.\n The Eximo B-Laser™ is effective and safe in ablating atherosclerotic and restenotic tissue for both above and below the knee obstructive arterial disease. The device has a high safety profile including a low risk of distal embolization.\n Copyright © 2018 Elsevier Inc. All rights reserved.\n\nBrodmann, Marianne\n\n\n"
},
{
"text": "\n178873\nHow is the outcome of the Limb Preservation System™ for reconstruction of hip and knee?\n\nSmolle, MA\n\nFriesenbichler, J\n\nBergovec, M\n\nGilg, M\n\nMaurer-Ertl, W\n\nLeithner, A\n\nBeiträge in Fachzeitschriften\nISI:000539660200005\n31864962.0\n10.1016/j.otsr.2019.09.030\nNone\nDespite tremendous advantages in the development and application of megaprostheses in tumour and revision surgery, complications are still not infrequently observed. Only two studies investigating the outcome of the LPS™ system in the proximal femur and distal femur/proximal tibia have been published thus far. Herein, mid-term implant survival rates one of the largest cohort of patients treated with the LPS™-system are presented aiming tp answer: 1) How is the outcome of the LPS™ system in the proximal femur and distal femur/proximal tibia? 2) Which factors are associated with altered implant survival? 3) What is the cumulative risk of complications according to Henderson?\n The LPS™-system is associated with high complication rates that depend on implant site, with infections being most common.\n Fifty-seven patients who received the LPS™-system at the proximal femur (n=31), distal femur (n=21) and proximal tibia (n=5) between 2004 and 2010 for oncological (n=40) or non-oncological (n=17) causes, were retrospectively included. Median follow-up was 5.0 years (range, 0-12.4 years). Complications were classified according to Henderson into instability/soft tissue failure (type 1), aseptic loosening (type 2), structural failure (type 3), periprosthetic infection (type 4), tumour progression (type 5). Competing-risk-analyses were applied to estimate implant survival with death as the competing event.\n Twenty-six patients (45.6%) developed a complication, of whom 9 (29.0%) had a proximal femoral and 17 (65.4%) a distal femoral/proximal tibial implant. Type 4 complications were most common (n=11), followed by type 3 (n=6, including 2 yoke-fractures), type 1 and 2 (n=4 each), and type 5 (n=1). The only factor associated with the development of complications in the multivariate model was a distal femoral/proximal tibial implant (hazard-ratio: 7.418, 95% confidence-interval: 2.193-26.096, p=0.001), irrespective of reason for reconstruction and use of muscular flaps. The cumulative-incidence of failure including all complications was 34.3%, 40.7% and 67.1% at 3, 5 and 10 years, respectively.\n The LPS™-system may be used for proximal femoral reconstructions both in the oncological and non-oncological setting. Rates of complications are higher in our cohort than reported in literature for other, comparable, megaprosthesis systems. Especially in the distal femur/proximal tibia, complication rates were high, partially attributable to the former implant design leading to fractures of the yoke-mechanism. As the implant has been remodelled after these issues became evident, there is no objection to use this megaprosthesis system today.\n IV, Observational Study.\n Copyright © 2019 Elsevier Masson SAS. All rights reserved.\n\nBergovec, Marko\n\nFriesenbichler, Jörg\n\nGilg, Magdalena Maria\n\nLeithner, Andreas\n\nMaurer-Ertl, Werner\n\nSmolle, Maria Anna\n\n\n"
},
{
"text": "\n166009\nIncidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe.\n\nHabre, W\n\nDisma, N\n\nVirag, K\n\nBecke, K\n\nHansen, TG\n\nJöhr, M\n\nLeva, B\n\nMorton, NS\n\nVermeulen, PM\n\nZielinska, M\n\nBoda, K\n\nVeyckemans, F\n\nAPRICOT Group of the European Society of Anaesthesiology Clinical Trial Network\n\nBeiträge in Fachzeitschriften\nISI:000402090600027\n28363725.0\n10.1016/S2213-2600(17)30116-9\nNone\nLittle is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors.\n The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760.\n Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0-5·5) with an incidence of respiratory critical events of 3·1% (2·9-3·3). Cardiovascular instability occurred in 1·9% (1·7-2·1), with an immediate poor outcome in 5·4% (3·7-7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86-0·90; p<0·0001), medical history, and physical condition (1·60, 1·40-1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981-0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97-0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers.\n This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia.\n European Society of Anaesthesiology.\n Copyright © 2017 Elsevier Ltd. All rights reserved.\n\nMesserer, Brigitte\n\nVittinghoff, Maria\n\n\n"
},
{
"text": "\n183838\nSurvival Outcomes Associated With 3 Years vs 1 Year of Adjuvant Imatinib for Patients With High-Risk Gastrointestinal Stromal Tumors: An Analysis of a Randomized Clinical Trial After 10-Year Follow-up.\n\nJoensuu, H\n\nEriksson, M\n\nSundby Hall, K\n\nReichardt, A\n\nHermes, B\n\nSchütte, J\n\nCameron, S\n\nHohenberger, P\n\nJost, PJ\n\nAl-Batran, SE\n\nLindner, LH\n\nBauer, S\n\nWardelmann, E\n\nNilsson, B\n\nKallio, R\n\nJaakkola, P\n\nJunnila, J\n\nAlvegård, T\n\nReichardt, P\n\nBeiträge in Fachzeitschriften\nISI:000562846800012\n32469385.0\n10.1001/jamaoncol.2020.2091\nPMC7260691\nAdjuvant imatinib is associated with improved recurrence-free survival (RFS) when administered after surgery to patients with operable gastrointestinal stromal tumor (GIST), but its influence on overall survival (OS) has remained uncertain.\n To evaluate the effect of adjuvant imatinib on OS of patients who have a high estimated risk for GIST recurrence after macroscopically complete surgery.\n In this open-label, randomized (1:1), multicenter phase 3 clinical trial conducted in Finland, Germany, Norway, and Sweden, 400 patients who had undergone macroscopically complete surgery for GIST with a high estimated risk for recurrence according to the modified National Institutes of Health Consensus Criteria were enrolled between February 2004 and September 2008. Data for this follow-up analysis were analyzed from September to November, 2019.\n Imatinib 400 mg/d administered orally for either 12 months or 36 months after surgery.\n The primary end point was RFS; the secondary objectives included OS and treatment safety.\n The intention-to-treat cohort consisted of 397 patients (12-month group, 199; 36-month group, 198; 201 men and 196 women; median [IQR] age, 62 (51-69) years and 60 (51-67) years, during a median follow-up time of 119 months after the date of randomization, 194 RFS events and 96 OS events were recorded in the intention-to-treat population. Five-year and 10-year RFS was 71.4% and 52.5%, respectively, in the 36-month group and 53.0% and 41.8% in the 12-month group (hazard ratio [HR], 0.66; 95% CI, 0.49-0.87; P = .003). In the 36-month group, 5-year OS and 10-year OS rates were 92.0% and 79.0%, respectively, and in the 12-month group 85.5% and 65.3% (HR, 0.55; 95% CI, 0.37-0.83; P = .004). The results were similar in the efficacy population, from which 15 patients who did not have GIST in central pathology review and 24 patients who had intra-abdominal metastases removed at surgery were excluded (36-month group, 10-year OS 81.6%; 12-month group, 66.8%; HR, 0.50; 95% CI, 0.32-0.80; P = .003). No new safety signals were detected.\n Three years of adjuvant imatinib is superior in efficacy compared with 1 year of imatinib. Approximately 50% of deaths may be avoided during the first 10 years of follow-up after surgery with longer adjuvant imatinib treatment.\n ClinicalTrials.gov Identifier: NCT00116935.\n\nJost, Philipp\n\n\n"
},
{
"text": "\n184516\nSexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis.\n\nHämmerli, S\n\nKohl-Schwartz, A\n\nImesch, P\n\nRauchfuss, M\n\nWölfler, MM\n\nHäberlin, F\n\nvon Orelli, S\n\nLeeners, B\n\nBeiträge in Fachzeitschriften\nNone\n33032958.0\n10.1016/j.jsxm.2020.09.001\nNone\nDyspareunia, one of the main symptoms of the chronic gynecological pelvic pain disorder endometriosis, may interfere with the likelihood of reaching an orgasm, yet for women with dyspareunia, no data on orgasm rates in different sexual activities are available.\n The aim of this study was to evaluate the ability to reach an orgasm and its association with sexual satisfaction during different sexual activities in women with a chronic pelvic pain disorder and in healthy control women.\n A set of questionnaires including the brief index of sexual functioning and global sexual functioning was used to evaluate sexuality in women affected with endometriosis (n = 434) and a nonaffected control group (n = 434) recruited in German-speaking countries.\n The primary outcome measure of this study was the orgasm rate during different types of sexual activities.\n Only the ability to have an orgasm during sexual intercourse (P = .002) but not during masturbation (P = .509) or partnered noncoital sexual activities (P = .229) is affected by endometriosis. Dyspareunia was associated with a reduced ability to experience an orgasm during intercourse for endometriosis patients (P = .020) and control women (P = .006). The ability to orgasm during noncoital sexual activities (P = .006) and sexual intercourse (P = .038) was associated with a higher sexual satisfaction in women with endometriosis. For controls, only the ability to achieve an orgasm with sexual intercourse was associated with sexual satisfaction (P = .038).\n Sexual counselling as part of medical support could help couples living with chronic pelvic pain of the female partner integrate noncoital sexual activities in their sex lives, leading to fewer sex-related problems and higher sexual desire and satisfaction.\n This study is the first to examine different ways of achieving an orgasm and sexual satisfaction in a large group of women with endometriosis and a matched control group. The breadth of the questionnaire allowed a differentiated analysis of factors influencing the likelihood of achieving an orgasm and overall sexual satisfaction. The one limitation is that the length and the intimate nature of the questionnaire possibly resulted in reluctance to answer this part of the questionnaire.\n Partnered noncoital sexual activities may represent an alternative to reach orgasm for women with endometriosis-related chronic pelvic pain or anorgasmia during sexual intercourse. Hämmerli S, Kohl-Schwartz A, Imesch P, et al. Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis. J Sex Med 2020;17:2417-2426.\n Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.\n\nWölfler, Monika Martina\n\n\n"
},
{
"text": "\n6027\nHuman low density lipoprotein as a target of hypochlorite generated by myeloperoxidase.\n\nJerlich, A\n\nFabjan, JS\n\nTschabuschnig, S\n\nSmirnova, AV\n\nHorakova, L\n\nHayn, M\n\nAuer, H\n\nGuttenberger, H\n\nLeis, HJ\n\nTatzber, F\n\nWaeg, G\n\nSchaur, RJ\n\nBeiträge in Fachzeitschriften\nISI:000073801200010\n9626568.0\n10.1016/S0891-5849(97)00439-5\nNone\nThe aim of this study was to further clarify which part of human low density lipoprotein (LDL) is attacked by the MPO/H2O2/Cl- -system and which reactive oxygen species is responsible for the attack. Therefore the influence of this system on the modification of the lipid and protein moiety of LDL was studied in vitro. Using the monochlorodimedone assay it was found that HOCl is produced in micromolar quantities in the absence of LDL and is rapidly consumed by LDL in a concentration dependent manner. The consumption of HOCl was reflected in the formation of HOCl-specific epitopes on apo B-100 as determined by an antibody raised against HOCl-modified LDL. The absorbency at 234 nm was applied to measure continuously the extent of modification of LDL. The general kinetic pattern of the absorbency measurement consisted of a lag phase where no LDL modification was observed, followed by a rapid increase of absorbency and a plateau phase. Finally the absorbency decreased due to LDL precipitation. Time dependent absorption spectra indicated that this kinetic pattern is mainly caused by light scattering due to particle aggregation rather than by a specific absorption at 234 nm due to conjugated diene formation. In agreement with this finding a low rate of thiobarbituric acid reactive substances (TBArS) formation was observed after a lag phase. The aggregation of LDL occurs most likely by modification of apo B-100, which was determined fluorimetrically in terms of LDL-tryptophan destruction in presence of the MPO/H2O2/Cl(-)-system. The kinetic course of tryptophan fluorescence generally consisted of a rapid decrease leveling off into a low plateau phase. Gas chromatographic determinations of linoleic acid in LDL in presence of the MPO system showed that this polyunsaturated fatty acid (PUFA) is easily attacked by HOCl. Consistent with this finding NMR spectra of HOCl modified LDL indicated a complete disappearance of bis-allylic methylene groups. Since lipid peroxidation products only partially account for this loss of PUFAs, other reactions of HOCl with unsaturated lipids--probably chlorohydrin formation--must be involved. Summarizing, although the rate of lipid peroxidation is low, both the lipid and the protein moiety of LDL are readily modified by the MPO system. It appears that the immediate consequence of apo B-100 modification is its aggregation. It is concluded that MPO, which has been detected in atherosclerotic lesions, is able to contribute to the modification of LDL into a form recognizable for uncontrolled uptake by macrophages.\n\nLeis, Hans-Joerg\n\nTatzber, Franz\n\n\n"
},
{
"text": "\n50078\nInvasive meningococcal disease in Austria 2002: assessment of completeness of notification by comparison of two independent data sources.\n\nBerghold, C\n\nBerghold, A\n\nFülöp, G\n\nHeuberger, S\n\nStrauss, R\n\nZenz, W\n\nBeiträge in Fachzeitschriften\nISI:000236572700008\n16489523.0\n10.1007/s00508-005-0502-0\nNone\nAIM OF THE STUDY: The notified incidence of meningococcal disease in European countries varies from <1 case per 100, 00 inhabitants to approximately 7 cases per 100, 00. Assessing the true burden of disease is important for setting priorities in health services and for estimating the benefit of interventions such as vaccination. Completeness and timeliness of reporting is also essential for the early recognition of outbreaks. The objective of this study was to assess the completeness of surveillance data on invasive meningococcal disease in Austria at the National Reference Center for Meningococci for the year 2002. METHODS: The data stored at the reference center was compared with an independent database containing the main diagnosis documented in the obligatory hospital discharge dataset of all Austrian hospitals (coded in ICD-10 since 2001). All mismatches were reviewed in order to exclude possible errors and identify true cases of meningococcal disease that had not been reported to the reference center. The number of cases not recorded by either data source was estimated using the capture-recapture method. RESULTS: The first comparison of the two data sources identified 50 cases not registered at the national reference center. Screening of the ICD codes from these 50 patients through the hospitals reduced the number of under-reported cases to 10, of which 6 showed symptoms compatible with meningococcal disease, although microbiological confirmation was missing. Re-evaluation of the case histories of these 6 patients by a clinical expert for meningococcal disease identified them as probable cases. The main reason for correction of the diagnosis in 27 cases was an obvious coding error: these patients had been treated in hospitals for illnesses not related to meningococcal disease. In 72 cases, the two databases were in agreement. Eleven cases of meningococcal disease were notified solely to the national reference center. Addition of the newly recognized cases of invasive meningococcal disease increased the total number of cases from 83 (incidence, 1.03/100, 00) to 93 (incidence, 1.16/100, 00). Estimation of the "true" number of cases of meningococcal disease, using the capture-recapture method, gave a final total of 95 cases (95% CI, 93-98) and an incidence of 1.18/100, 00. The completeness (sensitivity) of the original notification at the national reference center was therefore 87.4% (83 of 95 cases). CONCLUSION: All probable cases of meningococcal disease, even those (still) lacking microbiological confirmation, should be reported to the public health authorities as soon as possible, in order to ensure the necessary prompt prophylactic action (e.g., chemoprophylaxis).\n\nBerghold, Andrea\n\nZenz, Werner\n\n\n"
},
{
"text": "\n80008\nAlkaline phosphatase levels and osteoprogenitor cell numbers suggest bone formation may contribute to peak bone density differences between two inbred strains of mice.\n\nDimai, HP\n\nLinkhart, TA\n\nLinkhart, SG\n\nDonahue, LR\n\nBeamer, WG\n\nRosen, CJ\n\nFarley, JR\n\nBaylink, DJ\n\nBeiträge in Fachzeitschriften\nISI:000072322800005\n9514213.0\n10.1016/S8756-3282(97)00268-8\nNone\nPrevious studies have shown that C3H/HeJ (C3H) mice have higher peak bone density than C57BL/6J (B6) mice, at least in part because of differences in rates of bone resorption. The current studies were intended to examine the alternative, additional hypothesis that the greater bone density in C3H mice might also be a consequence of increased bone formation. To that end, we measured two presumptive, indirect indices of bone formation and osteoblast number in these inbred strains of mice: alkaline phosphatase (ALP) activity in serum, bones, and bone cells; and the number of ALP-positive colony-forming units (CFU) in bone marrow stromal cell cultures. We found that C3H mice had higher serum levels of ALP activity than B6 mice at 6 (118 vs. 100 U/L, p < 0.03) and 32 weeks of age (22.2 vs. 17.2 U/L, p < 0.001). Tibiae from C3H mice also contained higher levels of ALP activity than tibiae from B6 mice at 6 (417 vs. 254 mU/mg protein, p < 0.02) and 14 weeks of age (132 vs. 79 mU/mg protein, p < 0.001), as did monolayer cultures of bone-derived cells from explants of 7.5-week-old C3H calvariae and femora (8.2 times more, p < 0.02, and 4.6 times more, p < 0.001, respectively). Monolayer cell cultures prepared by collagenase digestion of calvariae from newborn and 6-week-old mice also showed similar strain-dependent differences in ALP-specific activity (p < 0.001 for each). Our studies also showed more ALP-positive CFU in bone marrow stromal cell cultures from 8-week-old C3H mice, compared with B6 mice (72.3 vs. 26.1 ALP-positive CFU/culture dish, p < 0.001). A similar result was seen for ALP-positive CFU production at 6 and 14 weeks of age, and the difference was greatest for the CFU that contained the greatest numbers of ALP-positive cells. Because skeletal ALP activity is a product of osteoblasts and has been shown to correlate with rates of bone formation, and because the number of ALP-positive CFU is believed to reflect the number of osteoprogenitor cells, the current data are consistent with the general hypothesis that bone formation may be greater in C3H than B6 mice because of a difference in osteoblast number. Our data further suggest that peak bone density may be greater in C3H mice than B6 mice due to a combination of decreased bone resorption and increased bone formation.\n\nDimai, Hans\n\n\n"
}
]
}