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Wiese M, Stancliffe RJ, Dew A, Balandin S, Howarth G. What is talked about? Community living staff experiences of talking with older people with intellectual disability about dying and death. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:679-690. [PMID: 23870022 DOI: 10.1111/jir.12065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND The aim of this study was to explore what community living staff talked about and did with people with intellectual disability (ID) to assist them to understand dying and death. METHOD Guided by grounded theory methodology, focus groups and one-to-one interviews were conducted with 22 staff who had talked about any topic relating to dying and death with their clients. RESULTS There was little evidence that staff talked with, or did things with clients to assist understanding of the end of life, both prior to and after a death. Prior to death staff assisted clients in a limited way to understand about determining wishes in preparation for death, and what dying looks like by observance of its passage. Following a death staff offered limited assistance to clients to understand the immutability of death, and how the dead can be honoured with ritual, and remembered. CONCLUSIONS The findings have implications for why people with ID have only partial understanding of the end of life, the staff skills required to support clients' understanding, and when conversations about the end of life should occur.
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Wiese M, Pol S, Vassilev K, Deffontaines S, Mazevet D. Spasticity care in the elderly: Retrospective analysis in a physical medicine and rehabilitation department. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wiese M, Pol S, Vassilev K, Deffontaines S, Mazevet D. Prise en charge de la spasticité chez les patients âgés : analyse des pratiques d’un service de MPR. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dawson MA, Gudgin EJ, Horton SJ, Giotopoulos G, Meduri E, Robson S, Cannizzaro E, Osaki H, Wiese M, Putwain S, Fong CY, Grove C, Craig J, Dittmann A, Lugo D, Jeffrey P, Drewes G, Lee K, Bullinger L, Prinjha RK, Kouzarides T, Vassiliou GS, Huntly BJP. Recurrent mutations, including NPM1c, activate a BRD4-dependent core transcriptional program in acute myeloid leukemia. Leukemia 2014; 28:311-20. [PMID: 24220271 PMCID: PMC3918873 DOI: 10.1038/leu.2013.338] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 10/22/2013] [Indexed: 11/25/2022]
Abstract
Recent evidence suggests that inhibition of bromodomain and extra-terminal (BET) epigenetic readers may have clinical utility against acute myeloid leukemia (AML). Here we validate this hypothesis, demonstrating the efficacy of the BET inhibitor I-BET151 across a variety of AML subtypes driven by disparate mutations. We demonstrate that a common 'core' transcriptional program, which is HOX gene independent, is downregulated in AML and underlies sensitivity to I-BET treatment. This program is enriched for genes that contain 'super-enhancers', recently described regulatory elements postulated to control key oncogenic driver genes. Moreover, our program can independently classify AML patients into distinct cytogenetic and molecular subgroups, suggesting that it contains biomarkers of sensitivity and response. We focus AML with mutations of the Nucleophosmin gene (NPM1) and show evidence to suggest that wild-type NPM1 has an inhibitory influence on BRD4 that is relieved upon NPM1c mutation and cytosplasmic dislocation. This leads to the upregulation of the core transcriptional program facilitating leukemia development. This program is abrogated by I-BET therapy and by nuclear restoration of NPM1. Finally, we demonstrate the efficacy of I-BET151 in a unique murine model and in primary patient samples of NPM1c AML. Taken together, our data support the use of BET inhibitors in clinical trials in AML.
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MESH Headings
- Animals
- Benzodiazepines/administration & dosage
- Benzodiazepines/pharmacology
- Cell Cycle Proteins
- Cell Line, Tumor
- Disease Models, Animal
- Drug Evaluation, Preclinical
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic/drug effects
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/mortality
- Mice
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- Nucleophosmin
- Transcription Factors/metabolism
- Transcription, Genetic
- Transcriptional Activation
- Xenograft Model Antitumor Assays
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Wyspiańska BS, Bannister AJ, Barbieri I, Nangalia J, Godfrey A, Calero-Nieto FJ, Robson S, Rioja I, Li J, Wiese M, Cannizzaro E, Dawson MA, Huntly B, Prinjha RK, Green AR, Gottgens B, Kouzarides T. BET protein inhibition shows efficacy against JAK2V617F-driven neoplasms. Leukemia 2014; 28:88-97. [PMID: 23929215 DOI: 10.1038/leu.2013.234] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/06/2013] [Indexed: 12/17/2022]
Abstract
Small molecule inhibition of the BET family of proteins, which bind acetylated lysines within histones, has been shown to have a marked therapeutic benefit in pre-clinical models of mixed lineage leukemia (MLL) fusion protein-driven leukemias. Here, we report that I-BET151, a highly specific BET family bromodomain inhibitor, leads to growth inhibition in a human erythroleukemic (HEL) cell line as well as in erythroid precursors isolated from polycythemia vera patients. One of the genes most highly downregulated by I-BET151 was LMO2, an important oncogenic regulator of hematopoietic stem cell development and erythropoiesis. We previously reported that LMO2 transcription is dependent upon Janus kinase 2 (JAK2) kinase activity in HEL cells. Here, we show that the transcriptional changes induced by a JAK2 inhibitor (TG101209) and I-BET151 in HEL cells are significantly over-lapping, suggesting a common pathway of action. We generated JAK2 inhibitor resistant HEL cells and showed that these retain sensitivity to I-BET151. These data highlight I-BET151 as a potential alternative treatment against myeloproliferative neoplasms driven by constitutively active JAK2 kinase.
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Joanna R, Kedziora-Kornatowska K, Wiese M, Czajkowska-Malinowska M, Kedziora J. EPA-0919 – Imbalance between glucocorticoid-induced tnfr-related protein (gitr) and il-2 in depressed copd patients modulate immunological self-tolerance mediated by treg cells and may explain amplified systemic inflammation. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78244-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Leblebicioglu H, Arama V, Causse X, Marcellin P, Ozaras R, Postawa-Klozinska B, Simon K, Suceveanu AI, Wiese M, Zeuzem S, Klauck I, Morais E, Bjork S, Lescrauwaet B, Kamar D, Zarski JP. Predictors associated with treatment initiation and switch in a real-world chronic hepatitis B population from five European countries. J Viral Hepat 2013; 21:662-70. [PMID: 24329883 DOI: 10.1111/jvh.12202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 09/17/2013] [Indexed: 12/26/2022]
Abstract
In Europe, healthcare systems differ between countries and different factors may influence Chronic hepatitis B (CHB) treatment choices in different counties. This analysis from a prospective, longitudinal, non-interventional study in five EU countries aimed to explore determinants associated with treatment initiation or switch in patients with CHB. A total of 1267 adult patients with compensated CHB in Germany, France, Poland, Romania and Turkey were prospectively followed for up to 2 years (March 2008-December 2010). Determinants of treatment initiation or switch were analysed using multivariate Cox proportional hazards regression. Median time since CHB diagnosis was 2.6 (0-37.7) years. Among 646 treatment-naïve patients, the probability of treatment initiation during follow-up was higher: in Germany (P = 0.0006), Poland (P < 0.0001) and Romania (P = 0.0004) compared with Turkey; in patients with alanine transaminase (ALT) 1-2 × upper limit of normal (ULN) (P = 0.0580) or >2 × ULN (P = 0.0523) compared with ALT ≤ 1 × ULN; and in patients with hepatitis B virus (HBV) DNA ≥ 2000 IU/mL (P < 0.0001) compared with HBV DNA <2000 IU/mL or undetectable. Among 567 treated patients, 87 switched treatment during follow-up. The probability of treatment switch was higher: in France (P = 0.0029), Germany (P = 0.0078) and Poland (P = 0.0329) compared with Turkey; and in patients with HBV DNA <2000 (P < 0.0001) or ≥ 2000 IU/mL (P < 0.0001), compared with undetectable. Viral load and ALT level were identified as the major drivers of treatment initiation. HBV DNA level was also a significant determinant of treatment switch. Results were statistically different across EU countries.
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Wiese M, Dew A, Stancliffe RJ, Howarth G, Balandin S. 'If and when?': the beliefs and experiences of community living staff in supporting older people with intellectual disability to know about dying. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:980-992. [PMID: 22973870 DOI: 10.1111/j.1365-2788.2012.01593.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The aim of this study was to explore the way in which community living staff engaged with people with intellectual disability (ID) about dying and death. METHOD Guided by grounded theory methodology, focus groups and individual interviews were conducted with staff who had either no experience with client death, experience of a client sudden death, or a client death experience which was pre-dated by a period of end-of-life care. RESULTS While in principle, staff unanimously supported the belief that people with ID should know about dying, there was limited in-practice engagement with clients about the topic. Engagement varied according to staff experience, client capacity to understand and the nature of the 'opportunity' to engage. Four 'opportunities' were identified: 'when family die', 'incidental opportunities', 'when clients live with someone who is dying' and 'when a client is dying'. Despite limited engagement by staff, people with ID are regularly exposed to dying and death. CONCLUSIONS People with ID have a fundamental right to know about dying and death. Sophisticated staff skills are required to ensure that people with ID can meaningfully engage with end-of-life issues as opportunities arise.
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Al-Okshi A, Nilsson M, Petersson A, Wiese M, Lindh C. Using GafChromic film to estimate the effective dose from dental cone beam CT and panoramic radiography. Dentomaxillofac Radiol 2013; 42:20120343. [PMID: 23610090 PMCID: PMC3699970 DOI: 10.1259/dmfr.20120343] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To demonstrate the feasibility of GafChromic(®) XR-QA2 (ISP Corp., Wayne, NJ) as a dosemeter when performing measurements of the effective dose from three cone beam CT (CBCT) units and to compare the doses from examinations of three common dental clinical situations. A second aim was to compare the radiation doses for three digital panoramic units with the doses for the CBCT units. METHODS The CBCT units used were Veraviewepocs 3De(®) (J Morita MFG Corp., Kyoto, Japan), ProMax(®) 3D (Planmeca, Helsinki, Finland) and NewTom VGi(®) (Quantitative Radiology, Verona, Italy). GafChromic XR-QA2 films were placed between the selected layers of the head and neck of a tissue-equivalent human skull (RANDO(®) phantom; The Phantom Laboratory, Salem, NY). The exposure parameters were set using the automatic exposure control function of the units. Depending on the availability, medium and smaller field of view (FOV) scanning modes were used. The effective dose was estimated using the 2007 International Commission on Radiological Protection formalism. RESULTS The lowest effective dose of a CBCT unit was observed for ProMax 3D, FOV 4 × 5 cm (10 μSv), the highest for NewTom VGi, FOV 8 × 8 cm-high resolution (129 μSv). The range of effective doses for digital panoramic machines measured was 8-14 μSv. CONCLUSIONS This study demonstrates the feasibility of using radiochromic films for dental CBCT and panoramic dosimetry.
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Herzig S, Klose L, Tenckhoff H, Berg T, Wiese M, Thöne-Otto A, Schroeter ML, Villringer A. Fatigue und Depression bei chronischer Hepatitis C. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schrader H, Wiese M, Ellrichmann M, Belyaev O, Uhl W, Tannapfel A, Schmidt W, Meier J. Diagnostic value of quantitative EUS elastography for malignant pancreatic tumors: relationship with pancreatic fibrosis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2012; 33:E196-E201. [PMID: 21630184 DOI: 10.1055/s-0031-1273256] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE EUS elastography has been used to facilitate the diagnosis of pancreatic cancer, but as yet the interpretation of this procedure has been largely subjective. The present study has been designed to validate a quantitative approach for the analysis of EUS elastography, and to assess its relationship with pancreatic fibrosis. MATERIALS AND METHODS 86 patients with malignant pancreatic masses and 28 control subjects without any evidence of pancreatic diseases were examined by EUS elastography. EUS video sequences were subjected to a quantitative analysis based on mean hue histogram analysis. Pancreatic fibrosis was determined by quantitative morphometry in tissue specimens from 36 patients. RESULTS The mean RGB (red, green, blue) value was significantly higher in the cancer patients compared to the controls (14.0 ± 0.4 vs. 11.5 ± 0.9; p = 0.0085), albeit with significant overlap between the groups. In contrast, a much sharper separation between the groups was obtained based on the individual color values for blue, green and red (p < 0.0001, respectively). By these means, 100 % sensitivity and specificity for the distinction between tumor and normal tissue was obtained for the blue color value, while the red and green color values were less discriminative. The fractional fiber content of the tumors was unrelated to the respective hue histogram color values. CONCLUSION Quantitative EUS elastography allows for clear differentiation between malignant pancreatic tumors and normal tissue. Using this approach, we demonstrated that the stiffness of pancreatic tumors is largely independent of their fiber content.
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Chaudhry T, Hissaria P, Wiese M, Heddle R, Kette F, Smith WB. Oral drug challenges in non-steroidal anti-inflammatory drug-induced urticaria, angioedema and anaphylaxis. Intern Med J 2012; 42:665-71. [DOI: 10.1111/j.1445-5994.2011.02601.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chaudhry T, Hissaria P, Wiese M, Heddle R, Kette F, Smith WB. Oral drug challenges in non-steroidal anti-inflammatory drug-induced urticaria, angioedema and anaphylaxis. Intern Med J 2012. [DOI: 10.1111/j.1445-5994.2011.02601.x 671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wiese M, Eljaszewicz A, Andryszczyk M, Gronek S, Gackowska L, Kubiszewska I, Kaszewski W, Helmin-Basa A, Januszewska M, Motyl I, Wieczynska J, Michalkiewicz J. Immunomodulatory effects of Lactobacillous plantarum and Helicobacter pylori CagA⁺ on the expression of selected superficial molecules on monocyte and lymphocyte and the synthesis of cytokines in whole blood culture. JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY : AN OFFICIAL JOURNAL OF THE POLISH PHYSIOLOGICAL SOCIETY 2012; 63:217-224. [PMID: 22791635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 06/18/2012] [Indexed: 06/01/2023]
Abstract
Helicobacter pylori (H. pylori) infections are usually superficial and clinically asymptomatic, but in approximately 10-20% cases it can be more aggressive and associated with other pathologies. The reason for weak or strong pro-inflammatory responses in gastric mucosa that occur during H. pylori infection is not understood. Combined treatment, including antibiotic therapy with administration of probiotic bacteria along, considerably improves the effectiveness of H. pylori eradication and reduces the relapse rate. Thus, the aim of this study was to analyze the effect of Lactobacillus plantarum (L. plantarum) and/or H. pylori CagA(+) on leucocytes in whole blood cultures. This study revealed how selected strains of H. pylori and L. plantarum modulate expression of chosen membrane markers of monocytes and lymphocytes, and the cytokine synthesis of in vitro cultures. The level of IFN-γ was higher in cultures stimulated with L. plantarum than in combination of this two examinated strains. We also observe the tendency to increase the level of IFN-γ by L. planatrum in relation to cells stimulated by H. pylori. In contrast, both H. pylori alone and in combination with L. plantarum had a strong modulatory effect on the synthesis of interleukin-10. Moreover lymphocytes with higher expression of CD25 and CD58 receptors was observed only in those cultures that were stimulated with L. plantarum strain alone or in combination with H. pylori. Effects exerted on the immune system, both in terms of natural and adaptive response, constitute the only functional criterion of probiotic bacteria. The immunostimulant effects documented in this study suggest that Lactobacillus spp. can restore immune function of mucosal membrane during symptomatic infection with H. pylori.
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Alsaadi M, Italia J, Mullen A, Kumar MR, Candlish A, Williams R, Shaw C, Al Gawhari F, Coombs G, Wiese M, Thomson A, Puig-Sellart M, Wallace J, Sharp A, Wheeler L, Warn P, Carter K. The efficacy of aerosol treatment with non-ionic surfactant vesicles containing amphotericin B in rodent models of leishmaniasis and pulmonary aspergillosis infection. J Control Release 2012; 160:685-91. [DOI: 10.1016/j.jconrel.2012.04.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/23/2012] [Accepted: 04/02/2012] [Indexed: 11/24/2022]
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Griffiths R, Alper J, Beckingsale A, Goldhill D, Heyburn G, Holloway J, Leaper E, Parker M, Ridgway S, White S, Wiese M, Wilson I. Management of proximal femoral fractures 2011: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2012; 67:85-98. [PMID: 22150501 DOI: 10.1111/j.1365-2044.2011.06957.x] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There should be protocol-driven, fast-track admission of patients with hip fractures through the emergency department. Patients with hip fractures require multidisciplinary care, led by orthogeriatricians. Surgery is the best analgesic for hip fractures. Surgical repair of hip fractures should occur within 48 hours of hospital admission. Surgery and anaesthesia must be undertaken by appropriately experienced surgeons and anaesthetists. There must be high-quality communication between clinicians and allied health professionals. Early mobilisation is a key part of the management of patients with hip fractures. Pre-operative management should include consideration of planning for discharge from hospital. Measures should be taken to prevent secondary falls. 10. Continuous audit and targeted research is required in order to inform and improve the management of patients with hip fracture.
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Wiegand J, Brosteanu O, Kullig U, Wiese M, Berr F, Maier M, Tillmann HL, Schiefke I. Quantification of HBsAg and HBV-DNA during therapy with peginterferon alpha-2b plus lamivudine and peginterferon alpha-2b alone in a German chronic hepatitis B cohort. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2011; 49:1463-9. [PMID: 22069045 DOI: 10.1055/s-0031-1281582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Peginterferon alpha-2b (PEG-IFNa2b) and lamivudine are efficient treatment options for chronic hepatitis B virus (HBV) infection. We assumed that a combination therapy of PEG-IFNα-2b plus lamivudine will be more effective than PEG-IFNα-2b alone concerning loss of HBV-DNA, HBeAg seroconversion, and HBsAg reduction. PATIENTS AND METHODS Patients with chronic hepatitis B were randomised to nine months treatment with PEG-IFNα-2b 1.5 µg/kg o. i. w. or PEG- IFNα-2b plus lamivudine 100 mg/d. The study was designed with 60 patients per treatment arm. The primary endpoint was defined as loss of HBV-DNA (< 400 copies/mL) 24 weeks after the end of therapy. HBV-DNA (PCR), HBsAg (Architect, Abbott), and HBeAg (Axsym, Abbott) were determined prior to and at the end of treatment as well as at follow-up. HBV-genotypes were determined by Innolipa (Innogenetics). RESULTS Only 32 patients were randomised to combination therapy and 27 individuals to monotherapy due to low recruitment rates. On treatment reduction of HBV-DNA was significantly higher during combination therapy compared to PEG-IFNa-2b monotherapy (- 4.60 ± 2.71 vs. - 2.41 ± 2.17 log; p = 0.003). However, there was no difference in the number of cases achieving HBV-DNA < 400 copies/mL, ALT normalisation, or HBeAg seroconversion at follow-up. None of the parameters was significantly related to HBV-genotypes. In a post-hoc analysis serum HBsAg levels were analysed as an additional prognostic parameter for treatment response (n = 29). Combination therapy showed a stronger, but not significant HBsAg decline during (- 0.7 ± 1.17 log IU/mL vs. - 0.26 ± 0.61 log IU/mL; p = 0.35) and after therapy (- 0.68 ± 1.29 log IU/mL vs. - 0.24 ± 0.56 log IU/mL; p = 0.82). Two of three cases with a 2-log HBsAg decline to HBsAg levels < 100 IU/mL eliminated HBsAg during long-term follow-up. CONCLUSION The study was underpowered with respect to the primary endpoint due to low recruitment rates. However, in the post-hoc analysis HBsAg decline was over two-fold stronger at the end of treatment and follow-up after combination therapy and did not rebound after lamivudine withdrawal. These results may indicate the usefulness of future combination therapies without discontinuation of nucleos(t)ide analogues.
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Tillmann HL, Wiese M, Braun Y, Wiegand J, Tenckhoff S, Mössner J, Manns MP, Weissenborn K. Quality of life in patients with various liver diseases: patients with HCV show greater mental impairment, while patients with PBC have greater physical impairment. J Viral Hepat 2011; 18:252-61. [PMID: 20337922 DOI: 10.1111/j.1365-2893.2010.01292.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Little is known comparing and contrasting quality of life (QoL) in patients with hepatitis C, compared to patients with other liver diseases. We performed two independent prospective cross-sectional studies including 511 and 284 patients with different forms of liver diseases. SF-36 was used in both studies. Fatigue Impact Score, WHO-BREF and Hospital Anxiety and Depression Scale (HADS) were used in either study only. In both studies, HCV-positive patients scored worse in the mental aspects of health-related QoL compared to other liver diseases, except for HBV in one study. Surprisingly, in both studies, quality of life was also significantly impaired in patients with viral clearance after interferon therapy but not after spontaneous clearance. Furthermore, patients with primary biliary cirrhosis showed significantly better mental health but significantly worse physical well-being. Liver diseases differ in their form of impaired QoL. In HCV, this impairment might not always return to normal after treatment-induced viral clearance. This may suggest that HCV either may not be involved in QoL impairment or may induce a process which persists after viral clearance in some patients.
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Giugliano S, Ruhl M, Neumann-Haefelin C, Wiese M, Thimme R, Roggendorf M, Spengler U, Nattermann J, Timm J. Differences in the source sequence of two HCV genotype 1b outbreaks within immunodominant CD8 epitopes are associated with differential outcome. ZEITSCHRIFT FÜR GASTROENTEROLOGIE 2010. [DOI: 10.1055/s-0029-1246509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wiese M, Krämer J, Becker C, Nentwig V, Theodoridis T, Teske W. Rückenschule heute. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2009; 147:194-8. [DOI: 10.1055/s-2008-1039234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Theodoridis T, Mamarvar R, Krämer J, Wiese M, Teske W. [Angle of needle position for the epidural-perineural injection at the lumbar spine]. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2009; 147:65-8. [PMID: 19263316 DOI: 10.1055/s-2008-1038973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM The aim of this study was to find the correct angle of the needle position for the epidural perineural injection at the lumbar spine without any help by imaging. METHODS In 11 human cadaver lumbar spines besides dura, nerve roots and bones all soft tissue had been removed to allow us to look into the anterior lateral epidural spaces between L3 and S1 in different angles with an operation microscope. The area between the dura (medial), facet joint (lateral) and the laminae (cranial and caudal) were photographed and planimetrically measured. This area is called the width of the injection canal. RESULTS Degenerative lumbar spines show a width of the injection canal of 29.61 mm(2) in L5/S1 with an angle of the needle position of 15 degrees to the midline. The optimal angle position of the needle brought a width of the injection canal in L4/5 only for 7.3 mm(2) and in L3/4 for 3.5 mm(2). In non-degenerative spines the injections canals were much wider. DISCUSSION The epidural-perineural injection into the anterolateral epidural space only makes sense in the segment L5/S1. Here the L5 nerve root is reached as well as the S1 root - the main causes of sciatica. In upper segments the injection canal is far smaller even at optimal injection angles. In case of nerve root compression at L4 and upwards other epidural injection techniques should be used such as the epidural dorsal loss of resistance technique or the transforaminal technique. CONCLUSION With some training it is possible to perform epidural-perineural injection for sciatica without the help of imaging.
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Hintze H, Wiese M, Wenzel A. Comparison of three radiographic methods for detection of morphological temporomandibular joint changes: panoramic, scanographic and tomographic examination. Dentomaxillofac Radiol 2009; 38:134-40. [DOI: 10.1259/dmfr/31066378] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Wiese M, Jansen D, Schlichter A. Verlaufsbeobachtung beim metastasierten Plattenepithelkarzinom des Penis mittels SCC-Bestimmung. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1055613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hintze H, Wiese M, Wenzel A. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. Dentomaxillofac Radiol 2007; 36:192-7. [PMID: 17536085 DOI: 10.1259/dmfr/25523853] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the diagnostic accuracy of cone beam CT images with conventional tomographic images for the detection of morphological temporomandibular joint (TMJ) changes. METHODS 80 dry human skulls were scanned using a NewTom 3G scanner and lateral and frontal reconstructions of the right and the left TMJs were performed. In addition, lateral and frontal cross-sectional tomograms of the skulls' TMJs were obtained in a Cranex Tome unit with Digora storage phosphor plates. Naked-eye inspection of the TMJs performed by three observers served as the gold standard for the true presence of morphological changes. The mandibular fossae were excluded from the study due to few changes in this joint component. The NewTom and the conventional tomographic images were examined by three independent observers using a binary scale for the presence of morphological changes in the condyle (flattening, defects and osteophytes) and the articular tubercle (flattening and defects). The accuracy for the different types of changes in relation to the condyles and the articular tubercles was expressed as sensitivity and specificity values, whereas the diagnostic accuracy for a general assessment including all changes in both joint components was expressed by the sum of cases where the gold standard and the radiographic scores were not identical (absolute difference). Differences between the two radiographic modalities were tested by paired t-test. RESULTS Detection of the various types of morphological changes in relation to the condyle and the articular tubercle assessed separately resulted in no significant differences between the two radiographic modalities, with the exception of bone defects in the articular tubercle examined on frontal views alone where the specificity with tomography was significantly higher than with cone beam CT. Detection of all morphological changes in relation to both the condyle and the articular tubercle showed a significantly higher accuracy with tomography than with cone beam CT using lateral views alone, but there was no significant difference between the two modalities using frontal views alone and lateral and frontal views in combination. CONCLUSION In general, no significant differences in diagnostic accuracy for the detection of bone changes in the condyle and in the articular tubercle were found between cone beam CT images and conventional tomograms.
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Wiese M, Hintze H, Svensson P, Wenzel A. Comparison of diagnostic accuracy of film and digital tomograms for assessment of morphological changes in the TMJ. Dentomaxillofac Radiol 2007; 36:12-7. [PMID: 17329582 DOI: 10.1259/dmfr/78486936] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare diagnostic accuracy of tomograms obtained with film and three digital image receptor modalities for detection of morphological changes in the temporomandibular joint (TMJ). METHODS Lateral and frontal cross-sectional tomograms of 158 TMJs in 80 dry human skulls were obtained with four X-ray receptors: one conventional film (Agfa-Gevaert), two photostimulable phosphor (PSP) plates: VistaScan and Digora PCT and one charge-coupled device (CCD): ProMax. The film and the PSP plate tomograms were exposed in a Cranex Tome X-ray unit and the CCD tomograms in the ProMax X-ray unit. The tomograms were examined by three observers for the presence of morphological changes in the condyle, the mandibular fossa and the articular tubercle. Naked-eye inspection of the articular surfaces of the TMJs performed by the same three observers served as the gold standard for the true presence of morphological changes. RESULTS For examination of TMJ changes using lateral and frontal tomograms in combination and lateral tomograms separately, the ProMax modality obtained a significant lower diagnostic accuracy than the other three modalities, between which no significant differences were found. For morphological changes localized to the condyle in which the highest number of changes were present according to the gold standard, the same result was found. CONCLUSION The ProMax modality was significantly less accurate than the film, VistaScan and Digora PCT modalities for the detection of overall TMJ morphological bone changes as well as condylar bone changes.
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