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Thapa A, Cowell A, Peters A, Noble DJ, James A, Lamb C, Grose D, Vohra S, Schipani S, Mactier K, Mackenzie J, Srinivasan D, Laws K, Moleron R, Niblock P, Soh FY, Paterson C, Wilson C. The UK Divide: Does Having a Pembrolizumab-Chemotherapy Option in Head and Neck Cancer Matter? Real-world Experience of First-line Palliative Pembrolizumab Monotherapy and Pembrolizumab-Chemotherapy Combination in Scotland. Clin Oncol (R Coll Radiol) 2024; 36:287-299. [PMID: 38395634 DOI: 10.1016/j.clon.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
AIMS The Scottish Medical Consortium recently approved first-line pembrolizumab monotherapy or in combination with chemotherapy for head and neck squamous cell carcinoma in the palliative setting, contrasting with the decision made by the National Institute for Health and Care Excellence, who approved monotherapy alone in England and Wales. The aim of this study was to provide real-world performance data for first-line pembrolizumab-containing treatments for head and neck squamous cell carcinoma in the palliative setting in Scotland. MATERIALS AND METHODS We analysed the electronic records of patients who started pembrolizumab-containing treatment between 1 March 2020 and 30 September 2021. Outcomes included overall survival, progression-free survival (PFS), the duration of response and the disease control rate. Data were compared with the KEYNOTE-048 study and clinical factors were evaluated for association with survival. RESULTS Our cohort included 91 patients (median follow-up 10.8 months). Patient characteristics were similar to those in the KEYNOTE-048 study, although our cohort had a higher proportion of patients with newly diagnosed, non-metastatic disease. For patients receiving monotherapy (n = 76), 12- and 24-month overall survival were 45% and 27%, respectively. For patients receiving pembrolizumab-chemotherapy (n = 15), 12-month overall survival was 60% (24-month overall survival had not yet been reached). Experiencing one or more immune-related adverse event (irAE; versus no irAEs), of any grade, was associated with favourable overall survival and PFS for patients receiving monotherapy in both univariable Log-rank analysis (median overall survival 17.4 months versus 8.6 months, respectively, P = 0.0033; median PFS 10.9 months versus 3.0 months, respectively, P < 0.0001) and multivariable analysis (Cox proportional hazards regression: overall survival hazard ratio 0.31, P = 0.0009; PFS hazard ratio 0.17, P < 0.0001). CONCLUSION Our real-world data support the KEYNOTE-048 study findings and the value of combination treatment options. Additionally, our data show that irAEs of any grade, as reported in routine clinical records, are associated with better outcomes in this patient group, adding to the growing body of evidence showing that irAEs are generally a positive marker of programmed death-ligand 1 (PD-L1) inhibitor response.
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Affiliation(s)
- A Thapa
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - A Cowell
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Peters
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D J Noble
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK; Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - A James
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Lamb
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D Grose
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Vohra
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Schipani
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - K Mactier
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - J Mackenzie
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - D Srinivasan
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - K Laws
- Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Moleron
- Aberdeen Royal Infirmary, Aberdeen, UK
| | | | - F-Y Soh
- Raigmore Hospital, Inverness, UK
| | - C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
| | - C Wilson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
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Schepp M, Freuer D, Wawro N, Peters A, Heier M, Teupser D, Meisinger C, Linseisen J. Association of the habitual dietary intake with the fatty liver index and effect modification by metabotypes in the population-based KORA-Fit study. Lipids Health Dis 2024; 23:99. [PMID: 38575962 PMCID: PMC10993479 DOI: 10.1186/s12944-024-02094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is an emerging threat for public health with diet being a major risk factor in disease development and progression. However, the effects of habitual food consumption on fatty liver are still inconclusive as well as the proposed role of the individuals' metabolic profiles. Therefore, the aim of our study is to examine the associations between diet and NAFLD with an emphasis on the influence of specific metabotypes in the general population. METHODS A total of 689 participants (304 men and 385 women) of the KORA-Fit (S4) survey, a follow-up study of the population-based KORA cohort study running in the Region of Augsburg, Germany, were included in this analysis. Dietary information was derived from repeated 24-h food lists and a food frequency questionnaire. The intake of energy and energy-providing nutrients were calculated using the national food composition database. The presence of fatty liver was quantified by the fatty liver index (FLI), and metabotypes were calculated using K-means clustering. Multivariable linear regression models were used for the analysis of habitual food groups and FLI; for the evaluation of macronutrients, energy substitution models were applied. RESULTS A higher consumption of nuts and whole grains, and a better diet quality (according to Alternate Healthy Eating Index and Mediterranean Diet Score) were associated with lower FLI values, while the intake of soft drinks, meat, fish and eggs were associated with a higher FLI. The isocaloric substitution of carbohydrates with polyunsaturated fatty acids was associated with a decreased FLI, while substitution with monounsaturated fatty acids and protein showed increased FLI. Statistically significant interactions with the metabotype were observed for most food groups. CONCLUSION The consumption of plant-based food groups, including nuts and whole grains, and diet quality, were associated with lower FLI values, whereas the intake of soft drinks and products of animal origin (meat, fish, eggs) were associated with a higher FLI. The observed statistically significant interactions with the metabotype for most food groups could help to develop targeted prevention strategies on a population-based level if confirmed in independent prospective studies.
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Affiliation(s)
- M Schepp
- University of Augsburg, University Hospital Augsburg, EpidemiologyAugsburg, Germany.
| | - D Freuer
- University of Augsburg, University Hospital Augsburg, EpidemiologyAugsburg, Germany
| | - N Wawro
- University of Augsburg, University Hospital Augsburg, EpidemiologyAugsburg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - A Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - M Heier
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - D Teupser
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - C Meisinger
- University of Augsburg, University Hospital Augsburg, EpidemiologyAugsburg, Germany
| | - J Linseisen
- University of Augsburg, University Hospital Augsburg, EpidemiologyAugsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
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Fokkens WJ, De Corso E, Backer V, Bernal-Sprekelsen M, Bjermer L, von Buchwald C, Chaker A, Diamant Z, Gevaert P, Han J, Hopkins C, Hox V, Klimek L, Lund VJ, Lee S, Luong A, Mullol J, Peters A, Pfaar O, Reitsma S, Toppila-Salmi S, Scadding GK, Sedaghat AR, Viskens AS, Wagenmann M, Hellings PW. EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP. Rhinology 2024; 0:3150. [PMID: 38217529 DOI: 10.4193/rhin23.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
Severe chronic rhinosinusitis with nasal polyps (CRSwNP), a form of diffuse bilateral (usually type 2) CRS, is a debilitating disease with a significant impact on quality of life (QoL). With novel knowledge and treatment options becoming available, there is a growing need to update or revise key definitions to enable communication across different specialties dealing with CRS, and to agree on novel goals of care in CRSwNP. The European Forum for Research and Education in Allergy and Airway diseases (EUFOREA) and EPOS expert members discussed how to measure treatment responses and set new treatment goals for CRSwNP. In this paper a consensus on a list of definitions related to CRSwNP is provided: control, remission, cure, recurrence/exacerbation, treatable traits, remodeling, progression, and disease modification. By providing these definitions, the involved experts hope to improve communication between all stakeholders involved in CRSwNP treatment for use in routine care, basic and clinical research and international guidelines aimed to harmonize and optimize standard of care of patients with CRSwNP in the future.
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Affiliation(s)
- W J Fokkens
- Department of Otorhinolarynogology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E De Corso
- Otolaryngology, Head and Neck Surgery, Rhinology, A. Gemelli Universitary Hospital Foundation, IRCSS, Rome, Italy
| | - V Backer
- Department of Otorhinolaryngology, Head and Neck surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - M Bernal-Sprekelsen
- Department of Otorhinolaryngology, University of Barcelona, Department of Otorhinolaryngology, Clinic Barcelona, Spain
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, Lund University, Skåne University Hospital, Lund, Sweden
| | - C von Buchwald
- Department of Otorhinolaryngology, Head and Neck surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - A Chaker
- Department of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany
| | - Z Diamant
- Department of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany
- Department of Microbiology Immunology and Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
- Department of Clinical Pharmacy and Pharmacology, UMCG, Groningen, The Netherlands
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skåne University Hospital Lund, Sweden
- D
| | - P Gevaert
- Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
| | - J Han
- Department of Otolaryngology and Head and Neck Surgery at Eastern Virginia Medical School, Norfolk, VI, USA
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - V Hox
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - V J Lund
- Professorial Unit, Ear Institute, University College London, United Kingdom
| | - S Lee
- Division of Rhinology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A Luong
- Department of Otorhinolaryngology, Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES. Barcelona, Catalonia, Spain
| | - A Peters
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - S Reitsma
- Department of Otorhinolarynogology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki , Finland
| | - G K Scadding
- Division of infection and Immunity, University College London, United Kingdom
| | - A R Sedaghat
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - A-S Viskens
- Laboratory of Allergy and Clinical Immunology Research Unit, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - M Wagenmann
- Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany
| | - P W Hellings
- Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, Leuven, Belgium
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Bauke F, Schmitz T, Harmel E, Raake P, Heier M, Linseisen J, Peters A, Meisinger C. Anterior-wall and non-anterior-wall STEMIs do not differ in long-term mortality: results from the augsburg myocardial infarction registry. Front Cardiovasc Med 2024; 10:1306272. [PMID: 38259315 PMCID: PMC10800510 DOI: 10.3389/fcvm.2023.1306272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background Different ST-segment elevation myocardial infarction (STEMI) localizations go along with dissimilarities in the size of the affected myocardium, the causing coronary vessel occlusion, and the right ventricular participation. Therefore, this study aims to clarify if there is any difference in long-term survival between anterior- and non-anterior-wall STEMI. Methods This study included 2,195 incident STEMI cases that occurred between 2009 and 2017, recorded by the population-based Augsburg Myocardial Infarction Registry, Germany. The study population comprised 1.570 men and 625 women aged 25-84 years at acute myocardial infarction. The patients were observed from the day of their first acute event with an average follow-up period of 4.3 years, (standard deviation: 3.0). Survival analyses and multivariable Cox regression analyses were performed to examine the association between infarction localizations and long-term all-cause mortality. Results Of the 2,195 patients, 1,118 had an anterior (AWS)- and 1,077 a non-anterior-wall-STEMI (NAWS). No significant associations of the STEMI localization with long-term mortality were found. When comparing AWS with NAWS, a hazard ratio of 0.91 [95% confidence interval: 0.75-1.10] could be calculated after multivariable adjustment. In contrast to NAWS, AWS was associated with a greater <28 day mortality, less current or former smoking and higher creatine kinase-myocardial band levels (CK-MB) and went along with a higher frequency of impaired left ventricular ejection fraction (<30%). Conclusions Despite pathophysiological differences between AWS and NAWS, and identified differences in multiple clinical characteristics, no significant differences in long-term mortality between both groups were observed.
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Affiliation(s)
- F. Bauke
- Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - T. Schmitz
- Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - E. Harmel
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - P. Raake
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - M. Heier
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute for Epidemiology, Neuherberg, Germany
| | - J. Linseisen
- Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - A. Peters
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute for Epidemiology, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
- German Research Center for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, Munich, Germany
| | - C. Meisinger
- Epidemiology, Medical Faculty, University of Augsburg, Augsburg, Germany
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Hecker K, Banszerus L, Schäpers A, Möller S, Peters A, Icking E, Watanabe K, Taniguchi T, Volk C, Stampfer C. Coherent charge oscillations in a bilayer graphene double quantum dot. Nat Commun 2023; 14:7911. [PMID: 38036517 PMCID: PMC10689829 DOI: 10.1038/s41467-023-43541-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023] Open
Abstract
The coherent dynamics of a quantum mechanical two-level system passing through an anti-crossing of two energy levels can give rise to Landau-Zener-Stückelberg-Majorana (LZSM) interference. LZSM interference spectroscopy has proven to be a fruitful tool to investigate charge noise and charge decoherence in semiconductor quantum dots (QDs). Recently, bilayer graphene has developed as a promising platform to host highly tunable QDs potentially useful for hosting spin and valley qubits. So far, in this system no coherent oscillations have been observed and little is known about charge noise in this material. Here, we report coherent charge oscillations and [Formula: see text] charge decoherence times in a bilayer graphene double QD. The charge decoherence times are measured independently using LZSM interference and photon assisted tunneling. Both techniques yield [Formula: see text] average values in the range of 400-500 ps. The observation of charge coherence allows to study the origin and spectral distribution of charge noise in future experiments.
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Affiliation(s)
- K Hecker
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany.
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany.
| | - L Banszerus
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany
| | - A Schäpers
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
| | - S Möller
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany
| | - A Peters
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
| | - E Icking
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany
| | - K Watanabe
- Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, 305-0044, Japan
| | - T Taniguchi
- International Center for Materials Nanoarchitectonics, National Institute for Materials Science, 1-1 Namiki, Tsukuba, 305-0044, Japan
| | - C Volk
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany
| | - C Stampfer
- JARA-FIT and 2nd Institute of Physics, RWTH Aachen University, 52074, Aachen, Germany
- Peter Grünberg Institute (PGI-9), Forschungszentrum Jülich, 52425, Jülich, Germany
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Cornelissen NV, Mineikaitė R, Erguven M, Muthmann N, Peters A, Bartels A, Rentmeister A. Post-synthetic benzylation of the mRNA 5' cap via enzymatic cascade reactions. Chem Sci 2023; 14:10962-10970. [PMID: 37829022 PMCID: PMC10566477 DOI: 10.1039/d3sc03822j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/28/2023] [Indexed: 10/14/2023] Open
Abstract
mRNAs are emerging modalities for vaccination and protein replacement therapy. Increasing the amount of protein produced by stabilizing the transcript or enhancing translation without eliciting a strong immune response are major steps towards overcoming the present limitations and improving their therapeutic potential. The 5' cap is a hallmark of mRNAs and non-natural modifications can alter the properties of the entire transcript selectively. Here, we developed a versatile enzymatic cascade for regioselective benzylation of various biomolecules and applied it for post-synthetic modification of mRNA at the 5' cap to demonstrate its potential. Starting from six synthetic methionine analogues bearing (hetero-)benzyl groups, S-adenosyl-l-methionine analogues are formed and utilized for N7G-cap modification of mRNAs. This post-synthetic enzymatic modification exclusively modifies mRNAs at the terminal N7G, producing mRNAs with functional 5' caps. It avoids the wrong orientation of the 5' cap-a problem in common co-transcriptional capping. In the case of the 4-chlorobenzyl group, protein production was increased to 139% during in vitro translation and to 128-150% in four different cell lines. This 5' cap modification did not activate cytosolic pathogen recognition receptors TLR3, TLR7 or TLR8 significantly more than control mRNAs, underlining its potential to contribute to the development of future mRNA therapeutics.
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Affiliation(s)
- N V Cornelissen
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
| | - R Mineikaitė
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
| | - M Erguven
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
- University of Münster, Cells in Motion Interfaculty Centre Waldeyerstr. 15 48149 Münster Germany
| | - N Muthmann
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
| | - A Peters
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
| | - A Bartels
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
| | - A Rentmeister
- University of Münster, Department of Chemistry, Institute of Biochemistry Corrensstr. 36 48149 Münster Germany
- University of Münster, Cells in Motion Interfaculty Centre Waldeyerstr. 15 48149 Münster Germany
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Fornacon-Wood I, Banfill K, Ahmad S, Britten A, Carson C, Dorey N, Hatton M, Hiley C, Thippu Jayaprakash K, Jegannathen A, Kidd AC, Koh P, Panakis N, Peedell C, Peters A, Pope A, Powell C, Stilwell C, Thomas B, Toy E, Wicks K, Wood V, Yahya S, Price G, Faivre-Finn C. Impact of the COVID-19 Pandemic on Outcomes for Patients with Lung Cancer Receiving Curative-intent Radiotherapy in the UK. Clin Oncol (R Coll Radiol) 2023; 35:e593-e600. [PMID: 37507280 DOI: 10.1016/j.clon.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
AIMS Previous work found that during the first wave of the COVID-19 pandemic, 34% of patients with lung cancer treated with curative-intent radiotherapy in the UK had a change to their centre's usual standard of care treatment (Banfill et al. Clin Oncol 2022;34:19-27). We present the impact of these changes on patient outcomes. MATERIALS AND METHODS The COVID-RT Lung database was a prospective multicentre UK cohort study including patients with stage I-III lung cancer referred for and/or treated with radical radiotherapy between April and October 2020. Data were collected on patient demographics, radiotherapy and systemic treatments, toxicity, relapse and death. Multivariable Cox and logistic regression were used to assess the impact of having a change to radiotherapy on survival, distant relapse and grade ≥3 acute toxicity. The impact of omitting chemotherapy on survival and relapse was assessed using multivariable Cox regression. RESULTS Patient and follow-up forms were available for 1280 patients. Seven hundred and sixty-five (59.8%) patients were aged over 70 years and 603 (47.1%) were female. The median follow-up was 213 days (119, 376). Patients with stage I-II non-small cell lung cancer (NSCLC) who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.859) or death (P = 0.884); however, they did have increased odds of grade ≥3 acute toxicity (P = 0.0348). Patients with stage III NSCLC who had a change to their radiotherapy had no significant increase in distant relapse (P = 0.216) or death (P = 0.789); however, they did have increased odds of grade ≥3 acute toxicity (P < 0.001). Patients with stage III NSCLC who had their chemotherapy omitted had no significant increase in distant relapse (P = 0.0827) or death (P = 0.0661). CONCLUSION This study suggests that changes to radiotherapy and chemotherapy made in response to the COVID-19 pandemic did not significantly affect distant relapse or survival. Changes to radiotherapy, namely increased hypofractionation, led to increased odds of grade ≥3 acute toxicity. These results are important, as hypofractionated treatments can help to reduce hospital attendances in the context of potential future emergency situations.
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Affiliation(s)
| | - K Banfill
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - S Ahmad
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Britten
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - C Carson
- The Northern Ireland Cancer Centre, Belfast, UK
| | - N Dorey
- Torbay and South Devon NHS Foundation Trust, Torquay, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | - C Hiley
- University College London Hospitals, London, UK
| | - K Thippu Jayaprakash
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Jegannathen
- University Hospitals North Midlands, Stoke on Trent, UK
| | | | - P Koh
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - N Panakis
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - C Peedell
- The James Cook University Hospital, Middlesborough, UK
| | - A Peters
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Pope
- Clatterbridge Cancer Centre, Liverpool, UK
| | - C Powell
- Velindre Cancer Centre, Cardiff, UK
| | | | - B Thomas
- Swansea Bay University Hospital, Swansea, UK
| | - E Toy
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - K Wicks
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - V Wood
- University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - S Yahya
- University Hospitals Birmingham, Birmingham, UK
| | - G Price
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Faivre-Finn
- University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
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Ataollahi F, McGrath S, Friend M, Dutton G, Peters A, Bhanugopan M. Evaluating the effect of calcium, magnesium and sodium supplementation of Merino ewes on their lambs' growth. Aust Vet J 2023; 101:391-396. [PMID: 37503775 DOI: 10.1111/avj.13274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/05/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
Our study aimed to investigate responses to supplementation of calcium (Ca), magnesium (Mg) and sodium (Na) to lactating ewes and lambs grazing barley forage from lamb marking to weaning. A 10-ha paddock sown to barley was subdivided into eight plots as four replicates of two treatments. Merino ewes (n = 104) with lambs at foot were stratified to the eight plots (13 ewes and 21 lambs/plot) based on number of lambs (twin or single) and ewes' weight. Supplemented groups had access to mineral supplements (30 g/ewe/day) supplying 12 g/ewe/day ground limestone, 12 g/ewe/day Causmag® and 6 g/ewe/day coarse salt in a ratio of 2: 2: 1 by weight (as fed) from day 0 (a day before lamb marking) after sample collection. Control groups were not supplemented with minerals. Blood, milk and urine samples from ewes and blood from lambs were collected at different time points, namely, a day prior to lamb marking (day 0), 14 days after the commencement of study (day 14), and 28 days after the commencement of study (day 28). Weight of the lambs was also recorded at each time point. We found that the concentration of the forage minerals (Ca, Mg and potassium (K)) was lower on day 28 than on day 0 (P < 0.025). Liveweight gain was greater in the first 14 days compared with the second weight gain period (P < 0.001). The interaction of time and treatment was significant for liveweight (P < 0.001). Due to the improvement in weight gain of supplemented lambs, we recommend that mineral supplementation during late lactation is beneficial considering the low cost of minerals, even though the mineral content of the forage was not deficient.
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Affiliation(s)
- F Ataollahi
- New South Wales Department of Primary Industries, Wagga Wagga Agricultural Institute, Pine Gully Road, Wagga Wagga, New South Wales, 2650, Australia
| | - S McGrath
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
- Gulbali Institute, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
| | - M Friend
- Gulbali Institute, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
| | - G Dutton
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
| | - A Peters
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
- Gulbali Institute, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
| | - M Bhanugopan
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
- Gulbali Institute, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, 2650, Australia
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9
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Böckler D, Hatzl J, Bischoff MS, Chang DH, Meisenbacher K, Peters A. [Intra-abdominal vascular injuries after blunt abdominal trauma]. Chirurgie (Heidelb) 2023:10.1007/s00104-023-01931-9. [PMID: 37470862 PMCID: PMC10374704 DOI: 10.1007/s00104-023-01931-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
Vascular injuries and hemorrhaging are serious potential complications in the management of patients with blunt abdominal trauma. The treatment depends on the extent and localization and can range from surveillance to endovascular treatment up to open surgery. The keys to success include the focused assessment with sonography for trauma (FAST) management and timely decision making. Abdominal vascular trauma continues to be a difficult problem and open and endovascular techniques continue to evolve in order to address this complex disease process.
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Affiliation(s)
- D Böckler
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.
| | - J Hatzl
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
| | - M S Bischoff
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
| | - De Hua Chang
- Klinik für Radiodiagnostik und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - K Meisenbacher
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
| | - A Peters
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
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10
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Braun S, Thiering E, Standl M, Peters A, Harris C. Fish Consumption And Its Interaction With Fads Gene Variants In Association With Myocardial Infarction. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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11
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Fokkens WJ, Viskens AS, Backer V, Conti D, De Corso E, Gevaert P, Scadding GK, Wagemann M, Bernal-Sprekelsen M, Chaker A, Heffler E, Han JK, Van Staeyen E, Hopkins C, Mullol J, Peters A, Reitsma S, Senior BA, Hellings PW. EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023. Rhinology 2023:3069. [PMID: 36999780 DOI: 10.4193/rhin22.489] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Severe chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating disease with a significant impact on the quality of life (QoL). It is typically characterized by a type 2 inflammatory reaction and by comorbidities such as asthma, allergies and NSAID-Exacerbated Respiratory Disease (N-ERD). Here, the European Forum for Research and Education in Allergy and Airway diseases discusses practical guidelines for patients on biologic treatment. Criteria for the selection of patients who would benefit from biologics were updated. Guidelines are proposed concerning the monitoring of the drug effects that provide recognition of responders to the therapy and, subsequently, the decision about continuation, switching or discontinuation of a biologic. Furthermore, gaps in the current knowledge and unmet needs were discussed.
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Affiliation(s)
- W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), ItalyPersonalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), Italy
| | - A-S Viskens
- Laboratory of Allergy and Clinical Immunology Research Unit, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - V Backer
- Department of ENT, head and neck surgery and audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - D Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - E De Corso
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - P Gevaert
- Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
| | - G K Scadding
- Department of Allergy and Rhinology, Royal National ENT Hospital, London, United Kingdom
| | - M Wagemann
- Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany
| | - M Bernal-Sprekelsen
- Department of Otorhinolaryngology, University of Barcelona, Barcelona, Spain
- Department of Otorhinolaryngology, hospital clinic Barcelona, Spain
| | - A Chaker
- Dept. of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany
| | - E Heffler
- Personalized Medicine, Asthma and Allergy - IRCCS Humanitas Research Hospital - Rozzano (MI), Italy
- Department of Biomedical Sciences - Humanitas University - Pieve Emanuele (MI), Italy
| | - J K Han
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - E Van Staeyen
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, CIBERES. Barcelona, Catalonia, Spain
| | - A Peters
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - S Reitsma
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - B A Senior
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - P W Hellings
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Laboratory of Allergy and Clinical Immunology Research Unit, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
- Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Bel
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Passek K, Ronellenfitsch U, Meisenbacher K, Peters A, Böckler D. [Results of a single center vascular screening program in Germany]. Chirurgie (Heidelb) 2023; 94:342-348. [PMID: 36808496 PMCID: PMC10042912 DOI: 10.1007/s00104-023-01821-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Cardiovascular diseases are the main cause of death in Europe with a relevant socioeconomic burden. A screening program for vascular diseases in asymptomatic persons with a defined risk constellation can lead to an early diagnosis. OBJECTIVE The study examined a screening program for carotid stenosis, peripheral arterial occlusive disease (PAOD) and abdominal aortic aneurysms (AAA) in persons without any known vascular disease with respect to demographic data, risk factors, pre-existing conditions, medication intake, detection of pathological findings and/or findings requiring treatment. MATERIAL AND METHODS Test subjects were invited using various information material and filled in a questionnaire on cardiovascular risk factors. The screening took place with measurement of the ABI and duplex sonography as a monocentric prospective single arm study within 1 year. Endpoints were the prevalence of risk factors and pathological and/or results requiring treatment. RESULTS A total of 391 persons participated, 36% presented with at least 1 cardiovascular risk factor, 35.5% with 2 and 14.4% with 3 or more. The sonography showed results requiring control with a carotid stenosis of < 50-> 75% or occlusion in 9%. An AAA with a diameter of 3.0-4.5 cm was diagnosed in 0.9% and a pathological ABI < 0.9 or > 1.3 in 12.3%. The indications for a pharmacotherapy were found in 17% and no operation was recommended. CONCLUSION The practicability of a screening program for carotid stenosis, PAOD and AAA of a defined risk population was shown. Vascular pathologies that required treatment were hardly found in the catchment area of the hospital. Consequently, the implementation of this screening program in Germany based on the collected data cannot currently be recommended in this form.
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Affiliation(s)
- K Passek
- Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.
| | - U Ronellenfitsch
- Klinik für viszerale, Gefäß- und endokrine Chirurgie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle, Deutschland
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13
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Vogel von Falckenstein J, Freuer D, Peters A, Heier M, Linseisen J, Meisinger C. Sex-specific associations between systolic, diastolic and pulse pressure and hemostatic parameters in the population-based KORA-Fit study: a cross-sectional study. Thromb J 2023; 21:7. [PMID: 36658589 PMCID: PMC9850515 DOI: 10.1186/s12959-023-00451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Several prior studies postulated an effect of hypertension on coagulation factors. However, population-based studies investigating the sex-specific associations between hypertension and hemostatic parameters are scarce. Therefore, we investigated the relationship between blood pressure and parameters of coagulation, namely activated partial thromboplastin time (aPTT), international normalized ratio (INR), fibrinogen, factor VIII, antithrombin III, protein C, protein S, and D-dimer in men and women from the general population. METHODS Based on 803 participants (376 men, 427 women) from the KORA-Fit Study the sex-specific relationship between systolic, diastolic, and pulse pressure and commonly measured coagulation factors were investigated using multivariable-adjusted linear regression models. RESULTS Hypertensive males had significantly higher median fibrinogen levels and factor VIII activity in comparison to normotensive males. There was a statistically significant difference between females with and without hypertension regarding the parameter fibrinogen, D-dimers, Protein S activity, and factor VIII activity. In multivariable linear regression analyses no significant association between systolic blood pressure, diastolic blood pressure, as well as pulse pressure and the investigated hemostatic parameters was found in men. In women, a significant positive association could be observed between systolic blood pressure and D-dimer level [β-estimate per mmHg increase 3.37 (95% CI 0.935-5.804; p = 0.007)] and between pulse pressure and D-dimer level [β-estimate per mmHg increase 5.351 (95% CI 1.772-8.930; p = 0.003)]. CONCLUSIONS It appears that sex differences exist in the association between blood pressure parameters and commonly measured coagulation markers in the general population. Further studies are needed to identify the underlying causes.
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Affiliation(s)
- J. Vogel von Falckenstein
- grid.7307.30000 0001 2108 9006Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, 86156 Augsburg, Germany
| | - D. Freuer
- grid.7307.30000 0001 2108 9006Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, 86156 Augsburg, Germany
| | - A. Peters
- Helmholtz Zentrum München, Institute for Epidemiology, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany ,grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany ,grid.452396.f0000 0004 5937 5237German Center for Cardiovascular Disease (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - M. Heier
- Helmholtz Zentrum München, Institute for Epidemiology, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany ,grid.419801.50000 0000 9312 0220KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - J. Linseisen
- grid.7307.30000 0001 2108 9006Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, 86156 Augsburg, Germany
| | - C. Meisinger
- grid.7307.30000 0001 2108 9006Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, 86156 Augsburg, Germany
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14
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Harrer P, Folberth J, Zhao C, Schormair B, Tilch E, Gieger C, Peters A, Oexle K, Schwaninger M, Winkelmann J. Methylglyoxal – a central metabolic factor in restless legs syndrome? Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Wang M, Flexeder C, Kilanowski A, Kress S, Schikowski T, Peters A, Standl M. Longitudinal associations of insufficient sleep duration and insomnia with obesity from adolescence to young adulthood in the GINIplus and LISA studies. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Desrosiers M, Diamant Z, Castelnuovo P, Hellings P, Han J, Silver J, Gevaert P, Peters A. SUSTAINED CLINICAL BENEFITS IN PATIENTS WITH CHRONIC RHINOSINUSITIS WITH NASAL POLYPS 24 WEEKS POST-MEPOLIZUMAB TREATMENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Bachert C, Khan A, Lee S, Peters A, Nash S, Radwan A, Jacob-Nara J. DUPILUMAB IMPROVES CHRONIC RHINOSINUSITIS WITH NASAL POLYPS DISEASE OUTCOMES IRRESPECTIVE OF TYPE 2 SIGNATURE DEFINITION. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Peters A. TREATMENT OF DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS) WITH MEPOLIZUMAB. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Bali V, Schelfhout J, Sher M, Peters A, Patel G, Mayorga M, Cook T, Romano C. PATIENT-REPORTED SYMPTOMS, IMPACTS, AND TREATMENT PREFERENCES IN REFRACTORY OR UNEXPLAINED CHRONIC COUGH: A QUALITATIVE STUDY. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Dragano N, Reuter M, Peters A, Schmidt B, Bohn B, Berger K. Increase in Mental Disorders During the COVID-19 Pandemic - Role of Occupational & Financial Strains. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Numerous studies reported an increase in mental disorders during the COVID-19 pandemic, but the specific causes for this increase are unclear. We therefore investigate whether pandemic-related occupational and financial changes (e.g., reduced working hours, working from home, financial losses) were associated with increased symptoms of depression and anxiety compared with the situation before the pandemic.
Methods
We analyzed data from the German National Cohort Study (NAKO). Between May and November 2020, 161,849 participants answered questions on their mental state and social circumstances. Responses were compared with data from the baseline survey before the pandemic (2014-2019). Linear fixed-effects models were used to determine whether individual changes in the symptoms of depression (PHQ-9) or anxiety (GAD-7) were associated with occupational/financial changes (controlling for covariates).
Results
A pronounced increase in symptoms was observed among those who became unemployed during the pandemic (+ 1.16 points on the depression scale, 95% confidence interval [0.91; 1.41], range 0-27). Increases were also seen for reduced working hours without short-term working allowance, increased working hours, working from home, insecurity regarding employment, and financial strain. The deterioration in mental health was largely statistically explained by the occupational and financial changes investigated in the model.
Conclusions
Depressive symptoms and anxiety disorders increased in the study population during the first year of the COVID-19 pandemic and occupational and financial difficulties were an essential contributory factor. These strains should be taken into account both in the care of individual patients and in the planning of targeted prevention measures. Results suggest that welfare state benefits such as short-time allowance in times of crises may reduce mental load in affected populations.
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Affiliation(s)
- N Dragano
- Institute of Medical Sociology, University of Düsseldorf , Düsseldorf, Germany
| | - M Reuter
- Institute of Medical Sociology, University of Düsseldorf , Düsseldorf, Germany
| | - A Peters
- Institute for Epidemiology, Helmholtz Center Munich , Munich, Germany
- Medical Faculty, Ludwig-Maximilians-Universität München , Munich, Germany
| | - B Schmidt
- Medical Faculty, University Hospital of Essen , Essen, Germany
| | - B Bohn
- NAKO e.V. , Heidelberg, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Münster , Münster, Germany
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21
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Schmitz T, Harmel E, Heier M, Peters A, Linseisen J, Meisinger C. Inflammatory plasma proteins predict short-term mortality in patients with an acute myocardial infarction. J Transl Med 2022; 20:457. [PMID: 36209229 PMCID: PMC9547640 DOI: 10.1186/s12967-022-03644-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/18/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between inflammatory markers and 28-day mortality in patients with ST-elevation myocardial infarction (STEMI). METHODS In 398 STEMI patients recorded between 2009 and 2013 by the population-based Myocardial Infarction Registry Augsburg, 92 protein biomarkers were measured in admission arterial blood samples using the OLINK inflammatory panel. In multivariable-adjusted logistic regression models, the association between each marker and 28-day mortality was investigated. The values of the biomarkers most significantly associated with mortality were standardized and summarized to obtain a prediction score for 28-day mortality. The predictive ability of this biomarker score was compared to the established GRACE score using ROC analysis. Finally, a combined total score was generated by adding the standardized biomarker score to the standardized GRACE score. RESULTS The markers IL-6, IL-8, IL-10, FGF-21, FGF-23, ST1A1, MCP-1, 4E-BP1, and CST5 were most significantly associated with 28-day mortality, each with FDR-adjusted (false discovery rate adjusted) p-values of < 0.01 in the multivariable logistic regression model. In a ROC analysis, the biomarker score and the GRACE score showed comparable predictive ability for 28-day mortality (biomarker score AUC: 0.7859 [CI: 0.6735-0.89], GRACE score AUC: 0.7961 [CI: 0.6965-0.8802]). By combining the biomarker score and the Grace score, the predictive ability improved with an AUC of 0.8305 [CI: 0.7269-0.9187]. A continuous Net Reclassification Improvement (cNRI) of 0.566 (CI: 0.192-0.94, p-value: 0.003) and an Integrated Discrimination Improvement (IDI) of 0.083 ((CI: 0.016-0.149, p-value: 0.015) confirmed the superiority of the combined score over the GARCE score. CONCLUSIONS Inflammatory biomarkers may play a significant role in the pathophysiology of acute myocardial infarction (AMI) and AMI-related mortality and might be a promising starting point for personalized medicine, which aims to provide each patient with tailored therapy.
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Affiliation(s)
- T. Schmitz
- grid.419801.50000 0000 9312 0220Epidemiology, Medical Faculty, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - E. Harmel
- grid.419801.50000 0000 9312 0220Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - M. Heier
- grid.419801.50000 0000 9312 0220University Hospital of Augsburg, KORA Study Centre, Augsburg, Germany ,Helmholtz Zentrum München, Institute for Epidemiology, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - A. Peters
- Helmholtz Zentrum München, Institute for Epidemiology, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany ,grid.5252.00000 0004 1936 973XChair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany ,grid.452622.5German Center for Diabetes Research (DZD), Neuherberg, Germany ,grid.452396.f0000 0004 5937 5237German Research Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - J. Linseisen
- grid.419801.50000 0000 9312 0220Epidemiology, Medical Faculty, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - C. Meisinger
- grid.419801.50000 0000 9312 0220Epidemiology, Medical Faculty, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
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22
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Bartkowiak J, Peters A, Seitz R, Bernhard B, Praz F, Graeni C, Brugger N, Huber A. Association of heart failure and liver T1 mapping in cardiac magnetic resonance imaging. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure culminates in liver congestion. As the liver can be assessed by cardiac magnetic resonance T1 mapping sequences, it represents a promising imaging biomarker for heart failure.
Objectives
To evaluate the association between heart failure and magnetic resonance liver T1 mapping, as a non-invasive imaging surrogate of liver congestion.
Methods
Patients with cardiac magnetic resonance including T1 mapping sequences on a single 1.5T scanner were consecutively included between 01/2017 and 12/2019. Liver T1 was measured in the left lobe, right lobe and caudate lobe on short axis view and in the liver dome on four chamber view. Echocardiographic and laboratory parameters were analyzed within 90 days of the cardiac magnetic resonance exam. Left ventricular filling pressures were assessed according to the European Association of Cardiovascular Imaging guidelines [1]. Liver T1 and echocardiographic parameters were compared between patients with and without elevated NT-proBNP levels (>125 pg/ml) using a Mann-Whitney U test. A multivariate logistic regression model was used to correct for age, sex, body mass index, left ventricular ejection fraction and the presence of atrial fibrillation.
Results
A total of 397 patients were included (median age 56, 127 females), of whom 138 patients (35%) presented with elevated NT-proBNP levels. Patients with elevated NT-proBNP levels had a larger indexed end-diastolic left ventricular volume (92 vs. 81 ml/m2, p<0.001), lower left ventricular ejection fraction (60 vs. 50%, p<0.001) and a higher E/E' ratio (11 vs. 8, p<0.001). Liver T1 was higher in patients with elevated NT-proBNP in the right liver lobe (670 vs. 596 ms, p<0.001) and the caudate lobe (664 vs. 598 ms, p<0.001), but not in the left liver lobe (571 vs. 568 ms, p=0.068) and in the liver dome (590 vs. 560 ms, p=0.1). Echocardiographic evaluation showed similar results with significant difference in T1 times between patients with elevated and non-elevated left ventricular filling pressures in caudate and right liver lobe. Liver T1 retained its predictive value when corrected for age, left ventricular ejection fraction and the presence of atrial fibrillation, when measured in the caudate lobe (adjusted odds ratio 1.013, 95% confidence interval 1.004–1.023, p=0.005) and in the right lobe (adjusted odds ratio 1.012, 95% confidence interval 1.003–1.021, p=0.009).
Conclusions
Elevated liver T1 in cardiac magnetic resonance imaging is associated with heart failure and represents an independent non-invasive imaging surrogate for liver congestion.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Bartkowiak
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - A Peters
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - R Seitz
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - B Bernhard
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - F Praz
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - C Graeni
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - N Brugger
- Bern University Hospital, Inselspital , Bern , Switzerland
| | - A Huber
- Bern University Hospital, Inselspital , Bern , Switzerland
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Schmitz T, Freuer D, Harmel E, Heier M, Peters A, Linseisen J, Meisinger C. Prognostic value of stress hyperglycemia ratio on short- and long-term mortality after acute myocardial infarction. Acta Diabetol 2022; 59:1019-1029. [PMID: 35532812 PMCID: PMC9242951 DOI: 10.1007/s00592-022-01893-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/09/2022] [Indexed: 01/08/2023]
Abstract
AIMS Prior studies demonstrated an association between hospital admission blood glucose and mortality in acute myocardial infarction (AMI). Because stress hyperglycemia ratio (SHR) has been suggested as a more reliable marker of stress hyperglycemia this study investigated to what extent SHR in comparison with admission blood glucose is associated with short- and long-term mortality in diabetic and non-diabetic AMI patients. METHODS The analysis was based on 2,311 AMI patients aged 25-84 years from the population-based Myocardial Infarction Registry Augsburg (median follow-up time 6.5 years [IQR: 4.9-8.1]). The SHR was calculated as admission glucose (mg/dl)/(28.7 × HbA1c (%)-46.7). Using logistic and COX regression analyses the associations between SHR and admission glucose and mortality were investigated. RESULT Higher admission glucose and higher SHR were significantly and nonlinearly associated with higher 28-day mortality in AMI patients with and without diabetes. In patients without diabetes, the AUC for SHR was significantly lower than for admission glucose (SHR: 0.6912 [95%CI 0.6317-0.7496], admission glucose: 0.716 [95%CI 0.6572-0.7736], p-value: 0.0351). In patients with diabetes the AUCs were similar for SHR and admission glucose. Increasing admission glucose and SHR were significantly nonlinearly associated with higher 5-year all-cause mortality in AMI patients with diabetes but not in non-diabetic patients. AUC values indicated a comparable prediction of 5-year mortality for both measures in diabetic and non-diabetic patients. CONCLUSIONS Stress hyperglycemia in AMI patients plays a significant role mainly with regard to short-term prognosis, but barely so for long-term prognosis, underlining the assumption that it is a transient dynamic disorder that occurs to varying degrees during the acute event, thereby affecting prognosis.
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Affiliation(s)
- T Schmitz
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany.
| | - D Freuer
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - E Harmel
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - M Heier
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
- Institute for Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - A Peters
- Institute for Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - J Linseisen
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - C Meisinger
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
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Lorbeer R, Rospleszcz S, Schlett C, Rado S, Thorand B, Meisinger C, Rathmann W, Heier M, Vasan R, Bamberg F, Peters A, Lieb W. Longitudinal multivariable trajectory risk clusters and sex-specific association with MRI-derived cardiac function and structure in a population-based sample. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Grüneis R, Lamina C, Di Maio S, Schönherr S, Zöscher P, Forer L, Peters A, Gieger C, Köttgen A, Kronenberg F, Coassin S. The effect of the LPA variant P.THR3888PRO on lipoprotein(a) and coronary artery disease is modified by the LPA KIV-2 splice site variant 4925g>A. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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26
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Lonsdale-Eccles E, Peters A, Richfield E. 978 ADVANCED CARE PLANNING IN PATIENTS WITH PARKINSONIAN DISORDERS. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Advanced care planning (ACP) supports individuals to make decisions regarding their future care. Guidelines (NICE, 2017) recommend offering ACP discussions to people with Parkinson’s Disease (PD), but uptake lags behind other countries (Sokol, NPJ Parkinson’s Dis, 2019, 22:5–24). As part of a project to improve ACP in the community we audited ACP practice at North Bristol NHS Trust.
Method
Records for 100 patients with idiopathic PD or atypical Parkinsonian syndromes seen in Movement Disorders clinics from March to October 2021 were scrutinised. ACP was defined as including: Do not attempt cardio-pulmonary resuscitation (DNACPR), Advanced Statement of Wishes, Advanced Decision to Refuse Treatment (ADRT) and Lasting Power of Attorney (LPOA). Disease severity was assessed using Hoehn and Yahr (H&Y) score.
Results
87 records were audited, 13 were excluded due to non-Parkinsonian disorders (11) or unavailable records (2). ACP was completed for 22 (25%) cases, (18 DNACPR and 11 Advanced Statements, 1 LPA, 0 ADRT). Informal ACP, such as documentation of wishes in clinic letters, were present in 5 cases. Of the 22 instances of ACP, 20 were recorded on Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. Preferences included ventilation (10), hospital admission (6), life prolonging treatments (6), preferred place of care (4), nutrition (0). Completed ACP was associated with higher H&Y scores or atypical syndromes.
Conclusion
It is recognised that there is a need to further investigate how ACP is delivered for patients with Parkinsonian Disorders. Three US studies estimated ACP rates ranging from 14.6%–53%. (Nimmons, European Journal of Neurology 2020, 27:1971–1987). We are not aware of any comparable UK data. This is a preliminary audit for a project to improve ACP within our MD Service. We are collecting further data on the views of our community movement disorders team with a view to upskilling in ACP.
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Affiliation(s)
| | - A Peters
- Southmead Hospital, North Bristol NHS Trust
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27
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Knobloch C, Metzner M, Kehrein F, Schömers C, Scheloske S, Brons S, Hermann R, Peters A, Jäkel O, Martišíková M, Gehrke T. Experimental helium-beam radiography with a high-energy beam: Water-equivalent thickness calibration and first image-quality results. Med Phys 2022; 49:5347-5362. [PMID: 35670033 DOI: 10.1002/mp.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE A clinical implementation of ion-beam radiography (iRad) is envisaged to provide a method for on-couch verification of ion-beam treatment plans. The aim of this work is to introduce and evaluate a method for quantitative water-equivalent thickness (WET) measurements for a specific helium-ion imaging system for WETs that are relevant for imaging thicker body parts in the future. METHODS Helium-beam radiographs (αRads) are measured at the Heidelberg Ion-beam Therapy Center (HIT) with an initial beam energy of 239.5 MeV/ u. An imaging system based on three pairs of thin silicon pixel detectors is used for ion path reconstruction and measuring the energy deposition (dE) of each particle behind the object to be imaged. The dE behind homogeneous plastic blocks is related to their well-known WETs between 280.6mm and 312.6 mm with a calibration curve that is created by fitting the measured data points. The quality of the quantitative WET measurements is determined by the uncertainty of the measured WET of a single ion (single-ion WET precision) and the deviation of a measured WET value to the well-known WET (WET accuracy). Subsequently, the fitted calibration curve is applied to an energy deposition radiograph of a phantom with a complex geometry. The spatial resolution (modulation transfer function at 10% (MTF10% )) and WET accuracy (mean absolute percentage difference (MAPD)) of the WET map, are determined. RESULTS In the optimal imaging WET-range from ∼ 280 mm to 300 mm, the fitted calibration curve reached a mean single-ion WET precision of 1.55 ± 0.00%. Applying the calibration to an ion radiograph (iRad) of a more complex WET distribution, the spatial resolution was determined to be MTF10% = 0.49 ± 0.03 lp/mm and the WET accuracy was assessed as MAPD to 0.21%. CONCLUSIONS Using a beam energy of 239.5MeV/ u and the proposed calibration procedure, quantitative αRads of WETs between ∼ 280mm to 300 mm can be measured and show high potential for clinical use. The proposed approach with the resulting image qualities encourages further investigation towards the clinical application of helium-beam radiography. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- C Knobloch
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - M Metzner
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - F Kehrein
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - C Schömers
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - S Scheloske
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - S Brons
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - R Hermann
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany.,Goethe University Frankfurt, Institute of Applied Physics, Frankfurt, Germany
| | - A Peters
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - O Jäkel
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - M Martišíková
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - T Gehrke
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany
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Djupesland PG, Reitsma S, Hopkins C, Sedaghat AR, Peters A, Fokkens WJ. Endoscopic grading systems for nasal polyps: are we comparing apples to oranges? Rhinology 2022; 60:169-176. [PMID: 35403178 DOI: 10.4193/rhin21.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Endoscopic grading of nasal polyps (NP) is typically a coprimary endpoint in clinical trials evaluating treatments for chronic rhinosinusitis with nasal polyps (CRSwNP). However, a consensus on the most effective way to grade nasal polyps has not been reached. Different scales have been used, hampering the interpretation of data across trials. This review compares the characteristics of NP grading systems used in registration trials for approved NP treatments. These fundamental differences in grading systems make quantitative comparison of outcomes between trials inaccurate and potentially misleading. In lieu of a universal grading system, reporting the baseline distribution of polyp grades (unilateral and/or summed/total grades), as well as changes from baseline over time by baseline grade may help improve interpretability of outcomes and reduce inaccuracy when attempting cross-trial comparisons and making therapeutic decisions.
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Affiliation(s)
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - C Hopkins
- Department of Otorhinolaryngology, Guy's Hospital, London, UK
| | - A R Sedaghat
- Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - A Peters
- Division of Allergy and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
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29
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Steinbeisser K, Schwarzkopf L, Grill E, Schwettmann L, Peters A, Seidl H. Gender-linked determinants for utilization of long-term care in community-dwelling adults in Germany. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The number of people using long-term care (LTC) is increasing steadily worldwide. Hence, demand for adequate services is rising. The purpose of this exploratory study was to identify relevant gender-linked determinants for utilization of LTC in community-dwelling older adults.
Methods
We examined 4077 females (52.7%) and males ≥ 65 years old (range: 65-97) between 2011/12 (t1) and 2016 (t2). Data originated from the population-based Cooperative Health Research in the Region of Augsburg (KORA)-Age study in Germany. A descriptive analysis assessed the amount of LTC used. Cross-sectional generalized estimating equation logistic models identified determinants for utilization of (in)formal LTC. Determinants for transition to LTC between t1 and t2 were examined using a longitudinal logistic regression model. Potential determinants were chosen according to Andersen's Behavioral Model of Health Services Use.
Results
At t2, 820 (20.1%) were LTC users with 527 (64.3%) being female. The average amount of informal LTC was higher in males (158.0 minutes/day (m/d) (SD: 270.5) vs. 70.1 m/d (SD: 152.8)), whereas the amount of formal LTC was higher in females (89.7 m/d (SD: 224.7) vs. 28.5 m/d (SD: 23.3)). In both genders, higher age, multimorbidity, and disability were associated with utilization of and transition to LTC. Living alone was significantly associated with utilization of (formal) LTC in both genders, but its effect was almost two times stronger in males (men: OR: 3.48 (CI: 2.05-5.90) vs females: OR: 1.83 (CI: 1.25-2.69)). Thus, ‘living alone' is considered the essential gender-linked determinant.
Conclusions
Gender-linked determinants must be considered when establishing demand-oriented policies. Future health programs should specifically target older individuals, especially males, living alone to improve their capabilities in activities of daily living to allow them to remain living longer and more independently within community settings.
Key messages
Older individuals, especially men, living alone should be targeted in future health programs. Females tend to use a higher amount of formal long-term care than males.
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Affiliation(s)
- K Steinbeisser
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munich, Munich, Germany
- Faculty for Applied Healthcare Sciences, Technical University of Deggendorf, Deggendorf, Germany
| | - L Schwarzkopf
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munich, Munich, Germany
- IFT, Institut für Therapieforschung, Munich, Germany
| | - E Grill
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - L Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munich, Munich, Germany
- Department of Economics, Martin Luther University Halle-Wittenberg, Munich, Germany
| | - A Peters
- Institute of Epidemiology II, Helmholtz Zentrum Munich, Munich, Germany
| | - H Seidl
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munich, Munich, Germany
- Quality Management and Gender Medicine, München Klinik Schwabing, Munich, Germany
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Sinning C, Makarova N, Schnabel R, Ojeda F, Felix SB, Koenig W, Peters A, Rathmann W, Brenner H, Kuulasmaa K, Wilsgaard T, Blankenberg S, Soderberg S, Ferrario MM, Thorand B. Association of glycated haemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE consortium. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Glycated haemoglobin A1c (HbA1c) is used to monitor the quality of diabetes treatment; however, its role in predicting cardiovascular outcomes in the general population remains uncertain.
Purpose
The additional use of glycated haemoglobin A1c (HbA1c) as a biomarker might highlight subjects of the general population with an increased risk for cardiovascular outcomes with cardiovascular disease, cardiovascular mortality or overall-mortality.
Methods
Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analysed. HbA1c was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular diseases (CVD), and overall mortality in the study population, in non-diabetic (N=32,477), and diabetic participants (N=3,703).
Results
Kaplan-Meier curves showed higher event rates with increasing continuous log-transformed HbA1c levels. Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) log-transformed divided by interquartile range and the examined outcomes, with a hazard ratio (HR) of 1.12 (95% confidence interval (CI): 1.04–1.20, p=0.0019) for cardiovascular mortality, 1.10 (95% CI: 1.04–1.16, p<0.001) for CVD, and 1.09 (95% CI: 1.05–1.14, p<0.001) for overall mortality per one unit increase.
An increased risk of CVD was observed in subjects without diabetes with increased HbA1c levels (HR 1.09; 95% CI: 1.01–1.16, p=0.021). An HbA1c cut-off value of 39.89 mmol/mol (5.8%), 36.62 mmol/mol (5.5%), and 38.80 mmol/mol (5.7%) for cardiovascular mortality, CVD, and overall mortality, respectively, was determined for selecting individuals at an increased risk.
Conclusion
HbA1c was demonstrated to be an independent prognostic biomarker for all investigated outcomes in the general European population. An approximately linear relationship was observed between an increase of HbA1c levels and the outcomes. Elevated HbA1c levels were also associated with the outcomes in participants without diabetes (i.e. HbA1c levels <6.5% (<48mmol/mol) which underlines the importance of HbA1c levels in the overall population.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union Seventh Framework ProgrammeEuropean Union FP 7 project CHANCES Kaplan-Meier curves for the outcomesPenalised cubic splines HbA1c/time event
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Affiliation(s)
- C Sinning
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - N Makarova
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - R Schnabel
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - F Ojeda
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - S B Felix
- University Hospital of Greifswald, Department of Internal Medicine B, Greifswald, Germany
| | - W Koenig
- Deutsches Herzzentrum Muenchen Technical University of Munich, Department of Cardiology, Munich, Germany
| | - A Peters
- Helmholtz Center Munich - German Research Center for Environment and Health, Institute of Epidemiology, Munich, Germany
| | - W Rathmann
- German Diabetes Centre Duesseldorf, Department of Epidemiology, Duesseldorf, Germany
| | - H Brenner
- German Cancer Research Center, Division of Clinical Epidemiology and Ageing Research, Heidelberg, Germany
| | - K Kuulasmaa
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - T Wilsgaard
- UiT The Arctic University of Norway, Epidemiology of Chronic Diseases Research Group, Tromso, Norway
| | - S Blankenberg
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - S Soderberg
- Umea University, Department of Public Health and Clinical Medicine, Umea, Sweden
| | - M M Ferrario
- University of Insubria, EPIMED Research Centre, Varese, Italy
| | - B Thorand
- Helmholtz Center Munich - German Research Center for Environment and Health, German Centre for Diabetes Research, Munich, Germany
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Steinbeißer K, Schwarzkopf L, Grill E, Schwettmann L, Peters A, Seidl H. Gender-linked determinants for utilization of long-term care in community-dwelling adults 65+ in Germany: results from the population-based KORA-Age study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Steinbeißer
- Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), IGM
- Faculty for Applied Healthcare Sciences, Technical University of Deggendorf
| | - L Schwarzkopf
- Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), IGM
- Institut für Therapieforschung
| | - E Grill
- Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
| | - L Schwettmann
- Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), IGM
- Department of Economics, Martin Luther University Halle-Wittenberg
| | - A Peters
- Institute of Epidemiology II, Helmholtz Zentrum München
| | - H Seidl
- Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), IGM
- Quality Management and Gender Medicine, München Klinik Schwabing
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Peters A, Völzke H, Pischon T, Löffler M, Schmidt M, Albrecht M, Bohn B, Panreck L, Greiser KH. Die NAKO Gesundheitsstudie – Design, Methoden und Datennutzung für wissenschaftliche Auswertungen. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH)
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich
| | - H Völzke
- Department of Community Medicine, University Medicine Greifswald
| | - T Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association, Molecular Epidemiology Research Group (MDC)
| | - M Löffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University Leipzig
| | - M Schmidt
- German Cancer Research Center (DKFZ)
| | | | | | | | - KH Greiser
- German Cancer Research Center (DKFZ)
- NAKO e.V
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Chemello K, Coassin S, Khantalin I, Gieger C, Peters A, Zschocke J, Lamina C, Lambert G. Genome-wide characterization of a highly penetrant form of hyperlipoprotein(a)emia causatively associated with genetically elevated cardiovascular risk. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moitinho-Silva L, Boraczynski N, Emmert H, Baurecht H, Szymczak S, Schulz H, Haller D, Linseisen J, Gieger C, Peters A, Tittmann L, Lieb W, Bang C, Franke A, Rodriguez E, Weidinger S. Host traits, lifestyle and environment are associated with human skin bacteria. Br J Dermatol 2021; 185:573-584. [PMID: 33733457 DOI: 10.1111/bjd.20072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The human skin offers diverse ecosystems for microbial symbionts. However, the factors shaping skin-microbiome interactions are still insufficiently characterized. This contrasts with the broader knowledge about factors influencing gut microbiota. OBJECTIVES We aimed to investigate major patterns of association of host traits, lifestyle and environmental factors with skin bacteria in two German populations. METHODS This is a cross-sectional study with 647 participants from two population-based German cohorts, PopGen (n = 294) and KORA FF4 (n = 353), totalling 1794 skin samples. The V1-V2 regions of the 16S ribosomal RNA (rRNA) gene were sequenced. Associations were tested with two bacterial levels, community (beta diversity) and 16S rRNA gene amplicon sequence variants (ASVs). RESULTS We validated known associations of the skin microbiota with skin microenvironment, age, body mass index and sex. These factors were associated with beta diversity and abundance of ASVs in PopGen, which was largely replicated in KORA FF4. Most intriguingly, dietary macronutrients and total dietary energy were associated with several ASVs. ASVs were also associated with smoking, alcohol consumption, skin pH, skin type, transepidermal water loss, education and several environmental exposures, including hours spent outdoors. Associated ASVs included members of the genera Propionibacterium, Corynebacterium and Staphylococcus. CONCLUSIONS We expand the current understanding of factors associated with the skin bacterial community. We show the association of diet with skin bacteria. Finally, we hypothesize that the skin microenvironment and host physiology would shape the skin bacterial community to a greater extent compared with a single skin physiological feature, lifestyle and environmental exposure.
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Affiliation(s)
- L Moitinho-Silva
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany.,Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - N Boraczynski
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - H Emmert
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - H Baurecht
- Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - S Szymczak
- Institute of Medical Informatics and Statistics, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - H Schulz
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - D Haller
- ZIEL Institute for Food and Health, Technische Universität München, Freising, Germany
| | - J Linseisen
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,ZIEL Institute for Food and Health, Technische Universität München, Freising, Germany.,Clinical Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany.,Chair of Epidemiology, Ludwig-Maximilians-Universität München, at UNIKA-T Augsburg, Augsburg, Germany
| | - C Gieger
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - A Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - L Tittmann
- Biobank PopGen and Institute of Epidemiology, Kiel University, Kiel, Germany
| | - W Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
| | - C Bang
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - A Franke
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - E Rodriguez
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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Birckhead A, Combs M, Croser E, Montgomery A, Peters A, Stark D, Malik R. Presumptive neural microsporidiosis in a young adult German Shepherd dog from rural Australia. Aust Vet J 2021; 99:351-355. [PMID: 33904161 DOI: 10.1111/avj.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/21/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
CASE REPORT A 1-year-old, neutered male German Shepherd was presented with a 5-month history of episodic lethargy, intermittent fever, weight loss and a hunched posture. The dog was diagnosed with presumptive microsporidian meningoencephalitis based on cytological findings on cerebrospinal fluid analysis and a positive PCR test. The dog initially responded favourably to a 4-week course of trimethoprim-sulfadiazine, pyrimethamine and fenbendazole, and remained well for 12 weeks following cessation of treatment. Disease then recurred, and despite an initial positive response to treatment, he deteriorated and was euthanased 11 weeks later, 7.5 months after definitive diagnosis and 13 months after clinical signs were first reported. CONCLUSION To the authors knowledge, this is the first case of canine microsporidiosis in Australia.
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Affiliation(s)
- A Birckhead
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - M Combs
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - E Croser
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - A Montgomery
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - A Peters
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - D Stark
- Microbiology Department, St Vincent's Hospital, Sydney, New South Wales, 2010, Australia
| | - R Malik
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia.,Centre for Veterinary Education, University of Sydney, Sydney, New South Wales, 2006, Australia
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GAMA R, Clery A, Griffiths K, Heraghty N, Peters A, Palmer K, Kibble H, Vincent R, Sharpe C, Cairns H, Bramham K. POS-225 ESTIMATED GLOMERULAR FILTRATION RATE EQUATIONS: DO WE NEED TO USE THE ETHNICITY CORRECTION FACTOR IN PEOPLE OF AFRICAN ANCESTRY OUTSIDE OF THE USA? Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Smith DS, Nasir R, Parker W, Peters A, Merrington G, van Egmond R, Lofts S. Developing understanding of the fate and behaviour of silver in fresh waters and waste waters. Sci Total Environ 2021; 757:143648. [PMID: 33316521 DOI: 10.1016/j.scitotenv.2020.143648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
The Windermere Humic Aqueous Model (WHAM) is often used for risk assessment of metals; WHAM can be used to estimate the potential bioavailability of dissolved metals, where metals complexed to dissolved organic matter (DOM) are expected to be less toxic than ionic forms. Silver is a potential metal of concern but WHAM has not been rigorously tested against experimental measurements. This study compares WHAM predictions to measured ionic silver during fixed pH (4, 8 or 10) argentometric titrations of DOM from diverse origins. There were almost two orders of magnitude variation in free silver between sources but, within model uncertainty, WHAM captured this variability. This agreement, between measurements and models, suggests that WHAM is an appropriate tool for silver risk assessment in surface receiving waters when DOM is predominantly in the form of humic/fulvic acids. In sewage samples WHAM dramatically underestimated silver binding by approximately 3 orders of magnitude. Simulations with additional specific strong silver binding sulphide-like binding sites could explain Ag binding at low loadings, but not at higher loadings. This suggests the presence of additional intermediate strength binding sites. These additional ligands would represent components of the raw sewage largely absent in natural waters unimpacted by sewage effluents. A revised empirical model was proposed to account for these sewage-specific binding sites. Further, it is suspected that as sewage organic matter is degraded, either by natural attenuation or by engineered treatment, that sewage organic matter will degrade to a form more readily modelled by WHAM; i.e., humic-like substances. These ageing experiments were performed starting from raw sewage, and the material did in fact become more humic-like, but even after 30 days of aerobic incubation still showed greater Ag+ binding than WHAM predictions. In these incubation experiments it was found that silver (up to 1000 μg/L) had minimal impact on ammonia oxidation kinetics.
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Affiliation(s)
- D Scott Smith
- Department of Chemistry and Biochemistry, Wilfrid Laurier University, Waterloo, ON, Canada.
| | - R Nasir
- Department of Chemistry and Biochemistry, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Wayne Parker
- Department of Civil and Environmental Engineering, University of Waterloo, Waterloo, ON, Canada
| | - A Peters
- WCA Environment Ltd., Brunel House, Faringdon, Oxfordshire, United Kingdom
| | - G Merrington
- WCA Environment Ltd., Brunel House, Faringdon, Oxfordshire, United Kingdom
| | - R van Egmond
- Safety and Environmental Assurance Centre, Unilever, Sharnbrook, Bedfordshire, United Kingdom
| | - S Lofts
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, United Kingdom
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Camen S, Palosaari T, Kuulasmaa K, Soederberg S, Palmieri L, Ferrario M, Blankenberg S, Niiranen T, Tunstall-Pedoe H, Peters A, Zeller T, Linneberg A, Salomaa V, Iacoviello L, Schnabel R. Cardiac troponin I and incident stroke in European cohorts – insights from the BiomarCaRE project. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes (ischemic and hemorrhagic) are scarce.
Methods
High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82,881 individuals (median age 50.7 years, 49.7% men) free of stroke or myocardial infarction at baseline from nine prospective European community cohorts. Multiple imputations were used to handle missing data. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for over-optimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.
Results
Over a median follow-up of 12.7 years, 3,033 individuals were diagnosed with incident non-fatal or fatal stroke (N=1,654 ischemic strokes, N=612 hemorrhagic strokes, N=767 indeterminate strokes). In multivariable regression models hsTnI concentrations were associated with overall stroke (hazard ratio (HR) per one standard deviation increase 1.16, 95% confidence interval (CI) 1.10–1.21), ischemic stroke (HR 1.15, 95% CI 1.09–1.21) and hemorrhagic stroke (HR 1.10, 95% CI 1.01–1.21). Adding hsTnI concentrations to classical cardiovascular risk factors (C-indices 0.808, 0.840 and 0.735 for overall, ischemic and hemorrhagic stroke, respectively) increased the C-index significantly, but modestly. In individuals with an intermediate ten-year risk (5–20%) the net reclassification improvement for overall stroke was 0.039 (p=0.010).
Conclusions
Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort, but might be of some value in individuals at an intermediate risk.
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): The BiomarCaRE Project is funded by the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement no.HEALTH-F2-2011-278913. This project has received further funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No 648131).
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Affiliation(s)
- S Camen
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - T Palosaari
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - K Kuulasmaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - S Soederberg
- Umea University, Department of Public Health and Clinical Medicine, and Heart Centre, Umea, Sweden
| | - L Palmieri
- Istituto Superiore di Sanità-ISS, Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Rome, Italy
| | | | - S Blankenberg
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - T Niiranen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - A Peters
- German Research Center for Environmental Health, Neuherberg, Germany
| | - T Zeller
- University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - A Linneberg
- Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention, Copenhagen, Denmark
| | - V Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - R.B Schnabel
- University Heart and Vascular Center Hamburg, Hamburg, Germany
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Davis G, Schladweiler K, Chung Y, Emmanuel B, Kreindler J, Katial R, Burton T, Blauer-Peterson C, Seare J, Peters A. P504 HEALTH CARE RESOURCE USE AND COST FOR PATIENTS WITH CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mambetsariev N, Patel A, Peters A. M159 LIP SWELLING AS AN EARLY PRESENTATION OF DISSEMINATED VARICELLA ZOSTER INFECTION. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peters A, Schladweiler K, Chung Y, Emmanuel B, Kreindler J, Katial R, Burton T, Blauer-Peterson C, Seare J, Davis G. P510 CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS: DEMOGRAPHICS AND CLINICAL CHARACTERISTICS OF PATIENTS BASED ON SURGERY STATUS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Abstract
Background
Atrial Fibrillation (AF) is common and is caused and predisposed to by a complex pathophysiology. Aging is among the most important risk factors for AF. Yet, some individuals develop AF in early years, whereas elderly individuals may remain free of AF. Aside from measurable concomitant risks, we hypothesized that a pathophysiologically relevant biological age exists, which outweighs a patient's calendar age. Telomere length is a measurable marker of age, which might reflect biological age. AF and telomere length have previously been associated, but results remained controversial. Here, we tested the relation between AF and telomere length in a well-characterized and so far largest cohort.
Methods
Since 2005, we enrolled 2475 patients with AF from the prospective AFLMU cohort, preferentially if they developed AF before age 65 years, and 3077 control individuals free of AF from the community-based KORA Study between 2006–08. All participants received a detailed clinical characterization, an electrocardiogram, and a blood draw for biomarker analyses. In all participants, we determined telomere length using a qPCR-based method. In a 384 well format, we employed a multiplex TaqMan assay to determine both telomere length and the single copy gene 36B4. Telomere length was expressed by the delta-CT method and was reformatted to have lower CT values indicate shorter telomere length. We compared telomere length between cases and controls using multi-variably corrected logistic regression models.
Results
Our cohort's mean age was 58 years in AFLMU and 56 years in KORA F4. Men were enrolled more commonly, with 72.3% in AFLMU and 51.7% in KORA F4. For consistency with available information, we confirmed that telomere length is continuously decreasing with age and that men have shorter telomere length compared to women. As a main result we found that AF patients have significantly shorter telomere length compared to controls (controls: telomere length 13,10 [12.60, 13.63] versus AF: 9.81 [5.98, 13.1], p<0,001). This relation remained significant following multi-variable adjustment for sex, body mass index, hypertension, and diabetes. The odds ratio per unit longer telomer length was 0.77 [95% confidence interval 0.74–0.77], p<0.001. We also calculated a propensity-score matched model of cases with and without AF confirming our main results (controls: telomere length 13.21 [11.65, 13.67] versus AF: 9.03 [5.35, 12.54], p<0.001). The multi-variable adjusted model revealed an odds ratio of 0,75 [95% confidence interval 0.73–0.76], p<0.001.
Conclusion
AF is significantly associated with telomere length in one of the largest cohorts to date. Assessment of telomere length may adjudicate patients with AF due to premature biological aging. The underlying reasons for such premature aging remain to be identified.
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Commission - Horizon 2020
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Affiliation(s)
- M Sinner
- University Hospital of Munich, Department of Medicine I, Munich, Germany
| | - D Kupka
- University Hospital of Munich, Department of Medicine I, Munich, Germany
| | - W Wilfert
- University Hospital of Munich, Institute of Laboratory Medicine, Munich, Germany
| | - M Waldenberger
- Helmholtz Center of Munich, Institute of Epidemiology, Neuherberg, Germany
| | - A Peters
- Helmholtz Center of Munich, Institute of Epidemiology, Neuherberg, Germany
| | - L Holdt
- University Hospital of Munich, Institute of Laboratory Medicine, Munich, Germany
| | - S Kaab
- University Hospital of Munich, Department of Medicine I, Munich, Germany
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Peters A, Han J, Hellings P, Heffler E, Gevaert P, Bachert C, Xu Y, Chuang C, Mannent L, Guyot P, Kamat S. P506 INDIRECT TREATMENT COMPARISON OF BIOLOGICS USED FOR THE TREATMENT OF CHRONIC RHINOSINUSITIS WITH NASAL POLYPS. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system driven by autoreactive lymphocytes. Due to its close contact with the gut-associated lymphoid tissue, the intestinal microbiota and/or their metabolites may be one of the factors that influence the activation of autoreactive lymphocytes. This article summarizes and discusses the current research efforts to characterize the microbiome of MS patients using human material. In addition, we present research studies that utilized classical or humanized animal models to determine the influence of certain microbiota species or compositions of microbiota on the immune system and disease progression and to define possible causal associations.
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Affiliation(s)
- L A Gerdes
- Institut für Klinische Neuroimmunologie und Biomedizinisches Zentrum, LMU Klinikum München, Großhaderner Str. 9, 82152, Planegg-Martinsried, Deutschland
| | - H Yoon
- Institut für Klinische Neuroimmunologie und Biomedizinisches Zentrum, LMU Klinikum München, Großhaderner Str. 9, 82152, Planegg-Martinsried, Deutschland
| | - A Peters
- Institut für Klinische Neuroimmunologie und Biomedizinisches Zentrum, LMU Klinikum München, Großhaderner Str. 9, 82152, Planegg-Martinsried, Deutschland.
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Jiang L, Atasoy S, Johar H, Herder C, Peters A, Kruse J, Ladwig KH. Anxiety boosts progression of prediabetes to type 2 diabetes: findings from the prospective Cooperative Health Research in the Region of Augsburg F4 and FF4 studies. Diabet Med 2020; 37:1737-1741. [PMID: 31943340 DOI: 10.1111/dme.14232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 01/14/2023]
Abstract
AIM To investigate the association between anxiety symptoms and the progression from prediabetes to type 2 diabetes. METHODS A sample of 1708 participants aged 31-82 years from the population-based Cooperative Health Research in the Region of Augsburg F4 and the follow-up Cooperative Health Research in the Region of Augsburg FF4 studies was included. Prediabetes was defined as impaired fasting glucose and/or impaired glucose tolerance, and anxiety status was measured by the generalized anxiety disorder-7 questionnaire. Newly diagnosed type 2 diabetes cases were identified after 6.5 years (11 102 person-years) and confirmed by medical records. Multivariate logistic regression analyses were employed to estimate the effect of prediabetes and anxiety on the incidence of type 2 diabetes with different levels of adjustments for potential confounders. The population attributable risk of type 2 diabetes in participants with prediabetes and anxiety was estimated. RESULTS Prediabetes at baseline was prevalent in 247 participants, of whom 77 developed diabetes after follow-up, accounting for a progression rate of 31%. In participants with prediabetes, high anxiety was associated with a 3-fold increased risk of progression to type 2 diabetes in comparison with low anxiety, even after accounting for socio-demographic, lifestyle and metabolic risk factors (OR = 2.82, 95% CI = 0.95-8.37, P = 0.06). A significant proportion of incident type 2 diabetes was attributed to having anxiety in addition to prediabetes (attributable risk proportion: 0.52; 95% CI = 0.004-1.04, P = 0.05). CONCLUSIONS Anxiety symptoms independently increase the progression risk of prediabetes to type 2 diabetes and should be routinely considered alongside the traditional risk factors in people with prediabetes.
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Affiliation(s)
- L Jiang
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - S Atasoy
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - H Johar
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - C Herder
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - A Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - J Kruse
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen and Marburg, Gießen, Germany
| | - K-H Ladwig
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Ebner L, Klaus J, Loebelenz L, Munz J, Peters A, Schroeder C, Hourscht C, Drakopoulos D, Sieron D, Heverhagen J, Christe A. INFLUENCE OF SOFT VS HARD COMPUTED TOMOGRAPHY RECONSTRUCTION KERNEL ON RADIOLOGICAL PATTERN RECOGNITION. Chest 2020. [DOI: 10.1016/j.chest.2020.05.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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McMurrich W, Peters A, Ellis M, Shalaby H, Baer G, MacDonald D, McKinley JC. MIS Distal Metatarsal Metaphyseal Osteotomy in the treatment of metatarsalgia: MOXFQ patient reported outcomes. Foot (Edinb) 2020; 43:101661. [PMID: 32120285 DOI: 10.1016/j.foot.2019.101661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/05/2019] [Accepted: 11/14/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The aim of this paper is to present validated patient reported outcomes for MIS Distal Metatarsal Metaphyseal Osteotomy (DMMO) in the treatment of metatarsalgia. The study aims to evaluate the DMMO procedure, report patient satisfaction with the operated foot and report any complications of this procedure. PATIENTS AND METHODS Between 2014 and 2016, patients who had failed conservative treatment for metatarsalgia were identified in the orthopaedic outpatient clinic. Twenty four consecutive patients requiring DMMO plus/minus toe straightening were prospectively studied. Patients requiring additional procedures at the time of surgery were excluded. Patients completed the validated Manchester-Oxford Foot Questionnaire (MOXFQ) three weeks pre-operatively and 1 year postoperatively. The MOXFQ results were analysed using Paired t-tests. A supplementary question was asked regarding patient satisfaction with the operated foot. RESULTS There were 20 women and 4 men with a mean age of 64 years (sd 8.6). Statistically significant differences were found between the pre and postoperative MOXFQ. The postoperative MOXFQ score demonstrated a poorer result for two patients, no change for two patients and improvement in 20 patients, with four of these patients recording the lowest possible score. There was a 29.5 point improvement in mean metric MOXFQ Index score. Seventy-nine percent (n = 19) of patients were satisfied or very satisfied with the operated foot. The average recoil of the metatarsal heads following DMMO was M2 4.01 mm, M3 4.55 mm, M4 4.16 mm. There was one delayed union and no non-unions. Further reported complications were a gastric bleed, pulmonary embolism (VTE), and one intra operative broken burr. CONCLUSION Our study demonstrates a clinically important and statistically significant improvement in patient reported outcomes following DMMO, with 79% of patients satisfied or very satisfied with this procedure. The average recoil of the metatarsal heads following DMMO was M2 4.01 mm, M3 4.55 mm, M4 4.16 mm with one delayed union and no non-unions.
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Affiliation(s)
| | | | - M Ellis
- Queen Margaret University, Musselburgh, United Kingdom
| | | | - G Baer
- Queen Margaret University, Musselburgh, United Kingdom
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Affiliation(s)
- A Peters
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - P Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - J Otter
- Imperial College London, London, UK
| | - D Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Thampi N, Longtin Y, Peters A, Pittet D, Overy K. It's in our hands: a rapid, international initiative to translate a hand hygiene song during the COVID-19 pandemic. J Hosp Infect 2020; 105:574-576. [PMID: 32387744 PMCID: PMC7202809 DOI: 10.1016/j.jhin.2020.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 11/27/2022]
Affiliation(s)
- N Thampi
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Y Longtin
- Department of Medicine, Jewish General Hospital, Montreal, Canada
| | - A Peters
- World Health Organization (WHO) Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Pittet
- World Health Organization (WHO) Collaborating Center on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - K Overy
- Reid School of Music, ECA, University of Edinburgh, Edinburgh, UK
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Peters A, Parneix P, Otter J, Pittet D. Putting some context to the aerosolization debate around SARS-CoV-2. J Hosp Infect 2020; 105:381-382. [PMID: 32360356 PMCID: PMC7190524 DOI: 10.1016/j.jhin.2020.04.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
- A Peters
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - P Parneix
- Nouvelle Aquitaine Healthcare-Associated Infection Control Centre, Bordeaux University Hospital, Bordeaux, France
| | - J Otter
- Imperial College London, London, UK
| | - D Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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