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Icks A, Haastert B, Arend W, Konein J, Thorand B, Holle R, Laxy M, Schunk M, Neumann A, Wasem J, Chernyak N, Dintsios CM. Patient time costs due to self-management in diabetes may be as high as direct medical costs: results from the population-based KORA survey FF4 in Germany. Diabet Med 2020; 37:895-897. [PMID: 31829456 DOI: 10.1111/dme.14210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Neumann A, Giral P, Weill A, Coste J. Estimation de l’effet de l’arrêt d’un traitement préventif chez les sujets âgés à partir des données médico-administratives : exploration de l’utilisation des modèles structuraux marginaux sur l’exemple des statines. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bischoff M, Howland V, Klinger-König J, Tomczyk S, Schmidt S, Zygmunt M, Heckmann M, van den Berg N, Bethke B, Corleis J, Günther S, Liutkus K, Stentzel U, Neumann A, Penndorf P, Ludwig T, Hammer E, Winter T, Grabe HJ. Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child's health. BMC Psychiatry 2019; 19:371. [PMID: 31775668 PMCID: PMC6880484 DOI: 10.1186/s12888-019-2279-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As early as pregnancy, maternal mental stress impinges on the child's development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child's needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity. METHODS A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child's mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals. DISCUSSION The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child's and mothers' mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner. TRIAL REGISTRATION German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111-1230-9826. Registered 01 April 2019.
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Exertier P, Belli A, Samain E, Meng W, Zhang H, Tang K, Schlicht A, Schreiber U, Hugentobler U, Prochàzka I, Sun X, McGarry JF, Mao D, Neumann A. Time and laser ranging: a window of opportunity for geodesy, navigation and metrology. JOURNAL OF GEODESY 2019; 93:2389-2404. [PMID: 33867691 PMCID: PMC8051204 DOI: 10.1007/s00190-018-1173-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/08/2018] [Indexed: 06/12/2023]
Abstract
Recent progress in the domain of time and frequency (T/F) standards requires important improvements of existing time distribution links. Among these, the accuracy of time transfer is actually an important part of the concerns in order to establish and maintain time & space references from ground and/or space facilities. Several time transfers by laser link projects have been carried out over the past 10 years with numerous scientific and metrological objectives. Satellite Laser ranging (SLR) has proven to be a fundamental tool, offering a straightforward, conceptually simple, highly accurate and unambiguous observable. Depending on the mission, LR is used to transmit time over two-way or one-way distances from 500 to several millions of km. The following missions and their objectives employed this technique: European Laser Timing (ELT) at 450 km, Time Transfer by Laser Link (T2L2) at 1,336 km, Laser Time Transfer (LTT) at 36,000 km, Lunar Reconnaissance Orbiter (LRO) at 350,000 km, and MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) at tens of million km. This article describes the synergy between SLR and T/F technologies developed on the ground and in space and as well as the state of the art of their exploitation. The performance and sources of limitation of such space missions are analyzed. It shows that current and future challenges lie in the improvement of the time accuracy and stability of the time for ground geodetic observatories. The role of the next generation of SLR systems is emphasized both in space and at ground level, from the point of view of GGOS and valuable exploitation of the synergy between time synchronization, ranging and data transfer.
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Icks A, Haastert B, Arend W, Konein J, Thorand B, Holle R, Laxy M, Schunk M, Neumann A, Wasem J, Chernyak N. Time spent on self-management by people with diabetes: results from the population-based KORA survey in Germany. Diabet Med 2019; 36:970-981. [PMID: 30267540 DOI: 10.1111/dme.13832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 11/26/2022]
Abstract
AIMS Time needed for health-related activities in people with diabetes is assumed to be substantial, yet available data are limited. Time spent on self-management and associated factors was analysed using cross-sectional data from people with diagnosed diabetes enrolled in a population-based study. METHODS Mean total time spent on self-management activities was estimated using a questionnaire for all participants with diagnosed diabetes in the KORA FF4 study (n = 227, 57% men, mean age 69.7, sd 9.9 years). Multiple two-part regression models were fitted to evaluate associated factors. Multiple imputation was performed to adjust for bias due to missing values. RESULTS Some 86% of participants reported spending time on self-management activities during the past week. Over the entire sample, a mean of 149 (sd 241) min/week were spent on self-management-activities. People with insulin or oral anti-hyperglycaemic drug treatment, better diabetes education, HbA1c 48 to < 58 mmol/mol (6.5% to < 7.5%) or lower quality of life, spent more time on self-management activities. For example, people without anti-hyperglycaemic medication invested 66 min/week in self-management, whereas those taking insulin and oral anti-hyperglycaemic drugs invested 269 min/week (adjusted ratio 4.34, 95% confidence interval 1.85-10.18). CONCLUSIONS Time spent on self-management activities by people with diabetes was substantial and varied with an individual's characteristics. Because of the small sample size and missing values, the results should be interpreted in an explorative manner. Nevertheless, time needed for self-management activities should be routinely considered because it may affect diabetes self-care and quality of life.
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Neumann A, Sarikouch S, Bobylev D, Meschenmoser L, Breymann T, Westhoff-Bleck M, Scheid M, Tzanavaros I, Bertram H, Beerbaum P, Haverich A, Boethig D, Horke A. Long-term results after repair of anomalous origin of left coronary artery from the pulmonary artery: Takeuchi repair versus coronary transfer. Eur J Cardiothorac Surg 2019; 51:308-315. [PMID: 28186291 DOI: 10.1093/ejcts/ezw268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/28/2016] [Accepted: 07/04/2016] [Indexed: 11/14/2022] Open
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Przybylek B, Boethig D, Neumann A, Borchert-Moerlins B, Daemen K, Keil J, Haverich A, Falk C, Bara C. Novel Cytokine Score and Cardiac Allograft Vasculopathy. Am J Cardiol 2019; 123:1114-1119. [PMID: 30660351 DOI: 10.1016/j.amjcard.2018.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/20/2018] [Accepted: 12/26/2018] [Indexed: 01/05/2023]
Abstract
To date, there are no established noninvasive biomarkers available for prediction of cardiac allograft vasculopathy (CAV) after orthotopic heart transplantation (OHT). Inflammatory processes are supposed to play a central role in the pathogenesis of CAV. Recent studies have suggested that immune mediators could serve as biomarkers for cardiovascular diseases. We hypothesized particular cytokines or a combination thereof may serve as noninvasive biomarkers for CAV. Plasma cytokines were screened from 27 patients with CAV and 27 patients without CAV after OHT. The concentrations of interleukins-4, -6, -10, -21, -23, -31, -33, interferon gamma, tumor necrosis factor alpha, and the soluble activation marker CD40 ligand were determined using Luminex-based multiplex analyses. Although concentrations of all cytokines except interferon gamma were on average higher in the CAV group, there were no significant differences between the groups for any 1 cytokine. Using a binary logistic regression model, we were able to develop a probability score for detecting patients at elevated risk for advanced CAV with a sensitivity of 92.31% and a specificity of 60.71% (receiver-operating characteristic area under the curve 0.799 ± 0.06; p<0.0001). In conclusion, analyzing the concentration of specific inflammatory cytokines could be meaningfully included in evaluation of CAV after OHT.
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Volkmar C, Geile C, Neumann A, Hannemann K. Direct-current current transformer for the measurement of an electric propulsion ion beam. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2019; 90:033303. [PMID: 30927767 DOI: 10.1063/1.5087804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
An important task in the development of electric propulsion devices is ground-based testing. In order to characterize electric thrusters, their generated ion beams are regarded as figures of merit and have to be well-known and understood. We present an approach to measure DC ion beam currents generated by electric thrusters by means of an inductive direct-current current transformer. In contrast to commonly used devices like Faraday cups, this device can measure the beam current non-intrusively by means of magnetic field coupling rather than charge collection. This paper shows the development of a prototype sensor which can measure currents in the typical range for electric thrusters with high resolution and satisfactory accuracy. A detailed SPICE model to assist during hardware development is also introduced and verified by test case measurements. The prototype has been tested and validated with a radio-frequency ion thruster. Its readout shows very good agreement with the output of an analytical model which computes a Gaussian-shaped ion beam in the far-field based on experimental input data.
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Neumann A, Vöhringer L, Fischer J, Mustafi M, Schneider W, Krüger T, Schlensak C. Off-Pump Coronary Artery Bypass Grafting in Acute Coronary Syndrome: Focus on Safety and Completeness of Revascularization. Thorac Cardiovasc Surg 2019; 68:679-686. [DOI: 10.1055/s-0039-1677834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Abstract
Background Emergency coronary artery bypass grafting (CABG) in the setting of acute coronary syndrome (ACS) has been associated with increased morbidity and mortality. Avoiding cardiopulmonary bypass might be advantageous, but the role of off-pump CABG (OPCAB) remains controversial, as it has been associated with incomplete revascularization in several studies. The objective of this study was to evaluate the feasibility, efficacy, and outcome of OPCAB surgery in ACS patients.
Methods We performed a retrospective review of ACS patients who underwent on-pump CABG (ONCAB) or OPCAB, either emergently or delayed, at our institution.
Results Between January 2015 and December 2016, a total of 205 consecutive ACS patients underwent either ONCAB (109 patients, 53.2%) or OPCAB surgery (96 patients, 46.8%). EuroSCORE II levels (5.6 ± 7.2 vs 4.9 ± 6.5, p = 0.226) and demography were comparable between groups.A trend towards lower postoperative mortality was observed in OPCAB patients (2.1 vs 5.5%). The incidence of postoperative stroke and low cardiac output syndrome, as well as the duration of inotropic support and the need for re-sternotomy, was significantly lower in the OPCAB group (p < 0.05).CABG performed instantly in an emergency situation was not associated with increased mortality or morbidity when compared with delayed procedures, and OPCAB surgery in emergency patients was associated with lower postoperative morbidity and shorter stays in the intensive care unit (p < 0.05).There were no differences in completeness of revascularization between groups (median 1 [1–1.33;0.33–1.67] OPCAB versus median 1 (1–1.33;0.67–2) ONCAB, p = 0.617), even in the emergency setting.
Conclusion OPCAB surgery is safe and effective in ACS and may be considered in hemodynamically stable patients in the emergency setting.
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Hohenhorst W, Neumann A. Nachruf Prof. Dr. med. Joachim Heermann. Laryngorhinootologie 2018. [DOI: 10.1055/a-0734-4304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Am 20.07.2018 ist Herr Prof. Dr. med. Joachim Heermann nach langer Krankheit
im Kreise seiner großen Familie in Essen verstorben. Mit Joachim Heermann
verliert die HNO-Gesellschaft eine außergewöhnliche Persönlichkeit, einen
Pionier der Mikrochirurgie des Ohres und der Nase und einen menschlichen
innovativen Geist.
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Viuff AC, Sharp GC, Rai D, Henriksen TB, Pedersen LH, Kyng KJ, Staunstrup NH, Cortes A, Neumann A, Felix JF, Tiemeier H, Jaddoe VWV, Relton CL. Maternal depression during pregnancy and cord blood DNA methylation: findings from the Avon Longitudinal Study of Parents and Children. Transl Psychiatry 2018; 8:244. [PMID: 30405117 PMCID: PMC6221892 DOI: 10.1038/s41398-018-0286-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 08/26/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022] Open
Abstract
Up to 13% of women may experience symptoms of depression during pregnancy or in the postpartum period. Depression during pregnancy has been associated with an increased risk of adverse neurodevelopmental outcomes in the child and epigenetic mechanisms could be one of the biological pathways to explain this association. In 844 mother-child pairs from the Avon Longitudinal Study of Parents and Children, we carried out an epigenome-wide association study (EWAS) to investigate associations between prospectively collected data on maternal depression ascertained by the Edinburgh Postnatal Depression Scale in pregnancy and DNA methylation in the cord blood of newborn offspring. In individual site analysis, we identified two CpG sites associated with maternal depression in the middle part of pregnancy. In our regional analysis, we identified 39 differentially methylated regions (DMRs). Seven DMRs were associated with depression at any time point during pregnancy, 7 associated with depression in mid-pregnancy, 23 were associated with depression in late pregnancy, and 2 DMRs were associated with depression throughout pregnancy. Several of these map to genes associated with psychiatric disease and brain development. We attempted replication in The Generation R Study and could not replicate our results. Although our findings in ALSPAC suggest that maternal depression could be associated with cord blood DNA methylation the results should be viewed as preliminary and hypothesis generating until further replicated in a larger sample.
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Neumann A, Stevens G, Richter Lagha R, Sorkin D, Guerrero L, Patel D, Madanat H. PARTNERSHIPS TO IMPROVE AGING IN CALIFORNIA: PERSPECTIVES FROM HRSA’S GERIATRIC WORKFORCE ENHANCEMENT PROGRAMS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Radcliffe K, Yang J, Neumann A, Myers J, Frazier R, Rivera J, Chodos A. THE ‘FIVE KEYS TO OLDER ADULT HEALTH’ CURRICULUM IMPROVED GERIATRIC KNOWLEDGE IN SAFETY NET PRIMARY CARE TEAMS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Okan O, Jochimsen MA, Hendricks J, Wasm J, Hörster L, Neumann A, Biermann J, Neusser S, Pinheiro P, Bauer U. Synth-HLCA: Health literacy research and knowledge transfer for effective public health strategies. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kerkemeyer L, Lux G, Walendzik A, Wasem J, Neumann A. [Medical care of patients with spasticity following stroke : Evaluation of the treatment situation in Germany with focus on the use of botulinum toxin]. DER NERVENARZT 2018; 88:919-928. [PMID: 28289789 DOI: 10.1007/s00115-017-0312-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Upper limb spasticity is a common complication following stroke. Cohort studies found 19% of post-stroke patients had upper limb spasticity at 3 months and 38% of patients at 12 months. For focal spasticity, intramuscular injections of botulinum toxin are indicated. In Germany, it is assumed that patients with the described indication are undersupplied with botulinum toxin. OBJECTIVE The aim of the present study is to evaluate the medical care of patients with upper limb spasticity post-stroke with the focus on the use of botulinum toxin as one treatment option. METHODS A standardized questionnaire was developed and a postal survey of a representative national random sample of 800 neurologists to capture the actual medical care situation. RESULTS The response rate amounted to 37% (n = 292). 59% of the neurologists surveyed had never used botulinum toxin. In total, 87% of neurologists noticed barriers regarding the use of botulinum toxin, where the amount of the doctor's remuneration in 40% and the lack of reimbursement of costs in off-label use in 60% were the most commonly used answers. The achievement of an advanced training in using botulinum toxin was also stated as a general obstacle for resident neurologists. DISCUSSION Due to a response rate of 37% for the postal survey a selection bias cannot be excluded. Although botulinum toxin is recommended in the national treatment guidelines, many neurologists do not use botulinum toxin. The reasons can be seen from the barriers described.
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Peer A, Kolin M, Rouvinov K, Keizman D, Sarid D, Leibowitz-Amit R, Berger R, Sella A, Rasco A, Rosenbaum E, Maurice-Dror C, Neumann A, Neiman V. Advanced treatment line (ATL) with lenvatinib and everolimus (Len+Eve) for metastatic renal cell carcinoma (mRCC): Analysis of a national early access program (EAP). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Infantes A, Zwick M, Stoll I, Boukis N, Oswald F, Neumann A. Syngas Fermentation at Elevated Pressure. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Neusser S, Seidler E, Trautner A, Willsch K, Buchberger B, Grabein K, Wasem J, Neumann A, Neumann A. Krankheitskosten des Opioid-Abusus in Deutschland – eine systematisches Review der Evidenzlage. DAS GESUNDHEITSWESEN 2018. [DOI: 10.1055/s-0038-1667819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Neusser S, Taubert S, Plomer AS, Neumann A. Workshop Mantelabstract: Präexpositionsprophylaxe zur HIV-Prävention. Eine medikamentöse Präventionsmaßnahme im Spannungsfeld verschiedener Perspektiven. DAS GESUNDHEITSWESEN 2018. [DOI: 10.1055/s-0038-1667685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Neusser S, Willsch K, Biermann J, Wasem J, Rhiem K, Schmutzler R, Neumann A. Die budgetären Auswirkungen der genetischen Risikoklassifikation am Beispiel des hereditären Mammakarzinoms. DAS GESUNDHEITSWESEN 2018. [DOI: 10.1055/s-0038-1667622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rosenberg S, Blitzer G, Ko H, Anderson B, Geye H, Kiltz J, Neumann A, Dailey S, McCulloch T, Wieland A, Hartig G, Bruce J, Witek M, Kimple R, Harari P. Conducting a Free Head and Neck Cancer Screening Clinic at a Major Academic Center. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Beckmann E, Kensah G, Neumann A, Benecke N, Martens A, Martin U, Gruh I, Haverich A. Prolonged myocardial protection during hypothermic storage: potential application for cardiac surgery and myocardial tissue engineering. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aab055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wigger A, Tellhelm B, Zwick M, Klumpp S, Neumann A, Oltersdorf B, Amort K, Failing K, Kramer M, Rau FC. Observer variability and sensitivity of radiographic diagnosis of canine medial coronoid disease. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2018. [DOI: 10.1055/s-0038-1623595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summary
Objective: Medial coronoid disease (MCD) is a very common form of elbow joint disease and it’s radiographic diagnosis can be challenging since it is frequently based on the detection of rather subtle primary or secondary changes than on a large primary lesion. We hypothesized that accuracy of radiographic diagnosis of MCD is highly dependent on training and experience level. Methods: Radiographs of 102 canine elbows were evaluated for MCD by four observers with different levels of training and experience. All elbows underwent CT scans and arthroscopy. Sensitivity and specificity of radiographic and CT interpretation was determined using arthroscopy as a gold standard. Interobserver and intraobserver agreement (reliability and repeatability) were assessed by using Cohen’s Kappa (κ) statistic. Results: The sensitivity (92.4–96.7%) of the two experienced observers was almost comparable to that of CT (100%) and significantly higher than that of the two less experienced observers (77.2–80.4%). Reliability of the radiographic diagnosis of MCD was better between observers with higher experience level (κ = 0.74) than between observers of lower or different experience levels (κ =0.07–0.42). Repeatability was better in experienced (κ = 0.73–0.88) than in less experienced observers (κ = 0.31–0.42). Conclusion: Our results confirm that training and experience play important roles in reaching high sensitivity, reliability and repeatability for the radiographic diagnosis of MCD. Clinical relevance: Although radiography is inferior to CT in imaging of the medial coronoid process itself, sensitivity of radiographic diagnosis MCD can be significantly improved with observer experience almost reaching that of CT. Therefore, it is advised that radiographic screening for MCD should be performed by specialists experienced in the radiographic evaluation of elbow joint disease.
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Neumann A, Žižka Z, Koucký M, Bolcková HT, Calda P. Fetal and neonatal alloimmune thrombocytopenia. CESKA GYNEKOLOGIE 2018; 83:448-451. [PMID: 30848151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This article shows our experience with fetal and neonatal alloimmune thrombocytopenia (FNAIT) on a particular patient and the difficulties we faced during the hospitalization. DESIGN Case report. SETTING Department of Obsterics and Gynecology 1st Faculty of Medicine, Charles University and General Faculty Hospital in Prague. METHODS Our experience with FNAIT therapy. RESULTS According to literature is recommended to use IVIG for FNAIT treatment. Women, who were treated by IVIG have better results, in comparison with women, who had no treatment at all. Our case is not confirming this statement, because first pregnancy of our patient terminated by IUFD, on the other hand second pregnancy was successful and she delivered healthy child. CONCLUSION FNAIT is relatively rare disease, but if it appears, it can be dangerous for a fetus or for a new-born baby. In the worst case FNAIT can result in intracranial bleeding or prenatal death. There are limited preventive steps and available therapy produces uncertain results. The only partially accepted treatment substance is IVIG (intravenous immunoglobulins). Unfortunately, this therapy is very expensive and not accepted by some experts. This article shows our experience with FNAIT on a particular patient and the difficulties we faced during the hospitalization.
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Peer A, Savion K, Rouvinov K, Leibowitz-Amit R, Berger R, Sella A, Neiman V, Rosenbaum E, Mermershtain W, Neumann A, Kolin M, Perets R, Keizman D. Patients (pts) with metastatic non-clear cell renal cell carcinoma (mnccRCC) treated with Nivolumab (Nivo) based immunotherapy as advanced treatment (ATL) line: analysis of a national early access program (EAP). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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