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Verrips M, van Haren JS, Oei SG, Moser A, der Hout-van der Jagt MBV. Clinical aspects of umbilical cord cannulation during transfer from the uterus to a liquid-based perinatal life support system for extremely premature infants a qualitative generic study. PLoS One 2023; 18:e0290659. [PMID: 38127930 PMCID: PMC10734990 DOI: 10.1371/journal.pone.0290659] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/13/2023] [Indexed: 12/23/2023] Open
Abstract
A liquid-based perinatal life support system (PLS) for extremely premature infants (born before 28 week of gestational age) envisions a connection between the infant's native umbilical cord and an artificial placenta system through cannulation. This system mimics a natural mothers' womb to achieve better organ maturations. The objective of this study is to gain insight into the clinical focus points of umbilical cord cannulation and how cannulation should be addressed in extremely premature infants during the transfer from the uterus to an in-utero simulating liquid-based PLS system. We performed an explorative qualitative study. Twelve medical specialists with knowledge of vessel cannulation participated. We collected data through twelve interviews and two focus group discussions. Data were analyzed using inductive content and constant comparison analysis via open and axial coding. Results were derived on the following topics: (1) cannulation technique, (2) cannula fixation, (3) local and systemic anticoagulation, and (4) vasospasm. A side-entry technique is preferred as this may decrease wall damage, stabilizes the vessel better and ensures continuous blood flow. Sutures, especially via an automatic microsurgery instrument, are favored above glue, stents, or balloons as these may be firmer and faster. Medication possibilities for both vasospasm and anticoagulation should function locally since there were uncertainties regarding the systemic effects. According to the findings of this research, the needed umbilical cord cannulation method should include minimal wall damage, improved vascular stability, blood flow maintenance, a strong fixation connection, and local anticoagulation effect.
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Affiliation(s)
- M. Verrips
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands
| | - J. S van Haren
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands
- Faculty of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - S. G Oei
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands
| | - A Moser
- Department of Family Practice, Maastricht University, Maastricht, the Netherlands
| | - M. B. Van der Hout-van der Jagt
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands
- Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
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Rupp J, Dreo B, Gütl K, Fessler J, Moser A, Haditsch B, Schilcher G, Matzkies LM, Steinmetz I, Greinix H, Stradner MH. T Cell Phenotyping in Individuals Hospitalized with COVID-19. J Immunol 2021; 206:1478-1482. [PMID: 33558375 DOI: 10.4049/jimmunol.2001034] [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] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/12/2021] [Indexed: 01/03/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic. Cytokine release syndrome occurring in a minority of SARS-CoV-2 infections is associated with severe disease and high mortality. We profiled the composition, activation, and proliferation of T cells in 20 patients with severe or critical COVID-19 and 40 matched healthy controls by flow cytometry. Unsupervised hierarchical cluster analysis based on 18 T cell subsets resulted in separation of healthy controls and COVID-19 patients. Compared to healthy controls, patients suffering from severe and critical COVID-19 had increased frequencies of activated and proliferating CD38+Ki67+ CD4+ and CD8+ T cells, suggesting active antiviral T cell defense. Frequencies of CD38+Ki67+ Th1 and CD4+ cells correlated negatively with plasma IL-6. Thus, our data suggest that patients suffering from COVID-19 have a distinct T cell composition that is potentially modulated by IL-6.
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Affiliation(s)
- Janine Rupp
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Barbara Dreo
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Katharina Gütl
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Johannes Fessler
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Adrian Moser
- Österreichische Gesundheitskasse, Gesundheitszentrum Graz, 8010 Graz, Austria
| | - Bernd Haditsch
- Österreichische Gesundheitskasse, Gesundheitszentrum Graz, 8010 Graz, Austria
| | - Gernot Schilcher
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Lucie-Marie Matzkies
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria; and
| | - Ivo Steinmetz
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8036 Graz, Austria; and
| | - Hildegard Greinix
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Martin H Stradner
- Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
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Koch CE, Begemann K, Kiehn JT, Griewahn L, Mauer J, M E Hess, Moser A, Schmid SM, Brüning JC, Oster H. Circadian regulation of hedonic appetite in mice by clocks in dopaminergic neurons of the VTA. Nat Commun 2020; 11:3071. [PMID: 32555162 PMCID: PMC7299974 DOI: 10.1038/s41467-020-16882-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/22/2020] [Indexed: 12/15/2022] Open
Abstract
Unlimited access to calorie-dense, palatable food is a hallmark of Western societies and substantially contributes to the worldwide rise of metabolic disorders. In addition to promoting overconsumption, palatable diets dampen daily intake patterns, further augmenting metabolic disruption. We developed a paradigm to reveal differential timing in the regulation of food intake behavior in mice. While homeostatic intake peaks in the active phase, conditioned place preference and choice experiments show an increased sensitivity to overeating on palatable food during the rest phase. This hedonic appetite rhythm is driven by endogenous circadian clocks in dopaminergic neurons of the ventral tegmental area (VTA). Mice with disrupted clock function in the VTA lose their hedonic overconsumption rhythms without affecting homeostatic intake. These findings assign a functional role of VTA clocks in modulating palatable feeding behaviors and identify a potential therapeutic route to counteract hyperphagy in an obesogenic environment. In addition to promoting overconsumption, palatable diets dampen daily intake patterns, which further augments metabolic dysfunction. Here, the authors find that in mice, circadian clocks in dopaminergic neurons in the ventral tegmental area drive hedonic appetite rhythms.
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Affiliation(s)
- C E Koch
- Institute of Neurobiology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany
| | - K Begemann
- Institute of Neurobiology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany
| | - J T Kiehn
- Institute of Neurobiology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany
| | - L Griewahn
- Institute of Neurobiology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany
| | - J Mauer
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Gleueler Street 50, 50931, Cologne, Germany
| | - M E Hess
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Gleueler Street 50, 50931, Cologne, Germany
| | - A Moser
- Department of Neurology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany
| | - S M Schmid
- Institute of Endocrinology and Diabetes, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany.,Deutsches Zentrum für Diabetesforschung e. V. (DZD), Neuherberg, Deutschland
| | - J C Brüning
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Gleueler Street 50, 50931, Cologne, Germany
| | - H Oster
- Institute of Neurobiology, University of Lübeck, CBBM, Marie Curie Street, 23562, Lübeck, Germany.
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Herghelegiu AM, Wenzel KM, Moser A, Prada GI, Nuta CR, Stuck AE. Effects of Health Risk Assessment and Counselling on Fruit and Vegetable Intake in Older People: A Pragmatic Randomised Controlled Trial. J Nutr Health Aging 2020; 24:591-597. [PMID: 32510111 DOI: 10.1007/s12603-020-1373-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Interventions to increase fruit and vegetable intake among community-dwelling older people have shown mixed effects. We investigated whether an intervention based on an initial multidimensional health risk assessment and subsequent physician-lead nutrition counselling has favourable effects on dietary intake among community-dwelling older people. DESIGN Randomised controlled trial comparing the intervention versus usual care. SETTING AND PARTICIPANTS Non-disabled persons aged 65 years or older at an ambulatory geriatric clinic in Bucharest, Romania, allocated to intervention (n=100) and control (n=100) groups. INTERVENTION Participants received a computer-generated health profile report based on answers to a health risk assessment questionnaire, followed by monthly individual counselling sessions with a geriatrician on topics related to health promotion and disease prevention, with a special focus on adequate fruit and vegetable consumption. MEASUREMENTS Fruit and vegetable intake at baseline and at 6-month follow-up. RESULTS At baseline, fruit and vegetable intake was below the recommended five portions per day in most study participants (85% in the intervention group, and 86% among controls, respectively). At six months, intake increased in the intervention group from a median of 3.8 to 4.6 portions per day, and decreased in the control group due to a seasonal effect from a median of 3.8 to 3.1 portions per day. At six months, fruit and vegetable consumption was significantly higher among persons in the intervention group as compared to controls (median difference 1.4 portions per day, 95% confidence interval 1.1-1.7, p<0.001). CONCLUSION Personalised food-based dietary guidance, delivered as part of multidimensional preventive health counselling during geriatric clinic visits, results in relevant improvement of fruit and vegetable intake in community-dwelling older adults.
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Affiliation(s)
- A M Herghelegiu
- Andreas Ernst Stuck, Department of Geriatrics, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland,
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Downar J, Moorhouse P, Goldman R, Grossman D, Sinha S, Sussman T, Kaasalainen S, MacDonald S, Moser A, You JJ. Improving End-of-Life Care and Advance Care Planning for Frail Older Adults in Canad. J Frailty Aging 2019; 7:240-246. [PMID: 30298172 DOI: 10.14283/jfa.2018.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We present five Key Concepts that describe priorities for improving end-of-life care for frail older adults in Canada, and recommendations based on each Key Concept. Key Concept #1: Our end-of-life care system is focused on cancer, not frailty. Key Concept #2: We need better strategies to systematically identify frail older adults who would benefit from a palliative approach. Key Concept #3: The majority of palliative and end-of-life care will be, and should be, provided by clinicians who are not palliative care specialists. Key Concept #4: Organizational change and innovative funding models could deliver far better end-of-life care to frail individuals for less than we are currently spending. Key Concept #5: Improving the quality and quantity of advance care planning for frail older adults could reduce unwanted intensive care and costs at the end of life, and improve the experience for individuals and family members alike.
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Affiliation(s)
- J Downar
- James Downar, MDCM, MHSc, Interdepartmental Division of Critical Care Medicine and Palliative Care, Department of Medicine, University of Toronto, 200 Elizabeth St. 9N-926, Toronto, ON, M5G 2C4, canada, T. (416) 340-4800 x2674, F. (416) 340-4823. E.
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Feldman S, Sokoloff L, Feldman S, Moser A, Conn D. ECHO Care of the Elderly – Using Technology to Build Capacity of Primary Care Providers in Long-term Care. J Am Med Dir Assoc 2019. [DOI: 10.1016/j.jamda.2019.01.059] [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: 10/27/2022]
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7
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Lore J, Stangeby P, Guo H, Covele B, Moser A, Frerichs H. Modeling non-axisymmetry in the DIII-D small angle slot divertor using EMC3-EIRENE. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Voortman MM, Greiner P, Moser D, Stradner MH, Graninger W, Moser A, Haditsch B, Enzinger C, Fuchs S, Fazekas F, Fessler J, Khalil M. The effect of disease modifying therapies on CD62L expression in multiple sclerosis. Mult Scler J Exp Transl Clin 2018; 4:2055217318800810. [PMID: 30263146 PMCID: PMC6149021 DOI: 10.1177/2055217318800810] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/09/2018] [Accepted: 08/22/2018] [Indexed: 12/04/2022] Open
Abstract
Background The increasing armamentarium of disease-modifying therapies in
multiple sclerosis is accompanied by potentially severe adverse
effects. The cell-adhesion molecule CD62L, which facilitates
leukocyte extravasation, has been proposed as a predictive
marker for treatment tolerability. However, pre-analytical
procedures might impact test results, thereby limiting its
clinical usability. Whether the immediate analysis of CD62L
expression of peripheral blood mononuclear cells can aid
treatment decision making is yet unclear. Objective To investigate the effect of various disease-modifying therapies in
multiple sclerosis on CD62L expression of
CD3+CD4+ peripheral blood
mononuclear cells in freshly collected blood samples. Methods We collected peripheral blood samples from patients with clinically
isolated syndrome and multiple sclerosis (baseline/follow up
n = 234/n = 98) and
healthy controls (n = 51).
CD62L+CD3+CD4+ expression
was analysed within 1 hour by fluorescence-activated cell
sorting. Results CD62L+CD3+CD4+ expression was
significantly decreased in patients treated with natalizumab
(n = 26) and fingolimod
(n = 20) and increased with
dimethyl-fumarate (n = 15) compared to patients
receiving interferon/glatiramer acetate
(n = 90/30) or no disease-modifying therapies
(n = 53) and controls
(n = 51) (p<0.001). CD62L
expression showed temporal stability during unchanged
disease-modifying therapy usage, but increased after natalizumab
withdrawal and decreased upon fingolimod introduction. Conclusion CD62L+CD3+CD4+ expression is
altered in patients treated with different disease-modifying
therapies when measured in freshly collected samples. The
clinical meaning of CD62L changes under disease-modifying
therapies warrants further investigation.
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Affiliation(s)
| | - Paul Greiner
- Department of Neurology, Medical University of Graz, Austria
| | - Daniel Moser
- Department of Neurology, Medical University of Graz, Austria
| | | | - Winfried Graninger
- Division of Rheumatology and Immunology, Medical University of Graz, Austria
| | - Adrian Moser
- Division of Gastroenterology and Hepatology, Medical University of Graz, Austria
| | | | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Austria
| | - Siegrid Fuchs
- Department of Neurology, Medical University of Graz, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Austria
| | - Johannes Fessler
- Division of Rheumatology and Immunology, Medical University of Graz, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, Austria
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9
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Chamberlain J, Brinkhof M, Hug K, Jordan X, Moser A, Schubert M. Mortality and longevity after traumatic spinal cord injury in Switzerland from 1990 to 2011: a 21-year longitudinal study. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.087] [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: 11/30/2022] Open
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10
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Dziwornu GA, Toorabally NR, Bhowon MG, Jhaumeer-Laulloo S, Sunassee SN, Moser A, Salbert T, Argyropoulos D. Computer Assisted Structure Elucidation of Two Biflavonoids from the Leaves of Ochna Mauritiana. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608237] [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: 10/18/2022]
Affiliation(s)
- GA Dziwornu
- Chemistry Department, University of Cape Town, Cape Town, South Africa
| | - NR Toorabally
- Department of Chemistry, University of Mauritius, Reduit, Mauritius
| | - MG Bhowon
- Department of Chemistry, University of Mauritius, Reduit, Mauritius
| | | | - SN Sunassee
- Chemistry Department, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council, Drug Discovery and Development Research Unit, University of Cape Town, Cape Town, South Africa
| | - A Moser
- Advanced Chemistry Development (ACD/Labs), Inc, Toronto, Canada
| | - T Salbert
- Advanced Chemistry Development (ACD/Labs) Germany GmbH, Frankfurt am Main, Germany
| | - D Argyropoulos
- Advanced Chemistry Development (ACD/Labs) UK Ltd, Bracknell, United Kingdom
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Savelberg W, van der Weijden T, Boersma L, Smidt M, Willekens C, Moser A. Developing a patient decision aid for the treatment of women with early stage breast cancer: the struggle between simplicity and complexity. BMC Med Inform Decis Mak 2017; 17:112. [PMID: 28764688 PMCID: PMC5540178 DOI: 10.1186/s12911-017-0505-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 09/06/2016] [Accepted: 07/10/2017] [Indexed: 11/29/2022] Open
Abstract
Background A patient decision aid (PtDA) can support shared decision making (SDM) in preference-sensitive care, with more than one clinically applicable treatment option. The development of a PtDA is a complex process, involving several steps, such as designing, developing and testing the draft with all the stakeholders, known as alpha testing. This is followed by testing in ‘real life’ situations, known as beta testing, and then finalising the definite version. Our aim was developing and alpha testing a PtDA for primary treatment of early stage breast cancer, ensuring that the tool is considered relevant, valid and feasible by patients and professionals. Methods Our qualitative descriptive study applied various methods including face-to-face think-aloud interviews, a focus group and semi-structured telephone interviews. The study population consisted of breast cancer patients facing the choice between breast-conserving therapy with or without preceding neo-adjuvant chemotherapy and mastectomy, and professionals involved in breast cancer care in dedicated multidisciplinary breast cancer teams. Results A PtDA was developed in four iterative test rounds, taking nearly 2 years, involving 26 patients and 26 professionals. While the research group initially opted for simplicity for the sake of implementation, the clinicians objected that the complexity of the decision could not be ignored. Other topics of concern were the conflicting views of professionals and patients regarding side effects, the amount of information and how to present it. Conclusion The development was an extensive process, because the professionals rejected the simplifications proposed by the research group. This resulted in the development of a completely new draft PtDA, which took double the expected time and resources. The final version of the PtDA appeared to be well-appreciated by professionals and patients, although its acceptability will only be proven in actual practice (beta testing). Trial registration NTR TC 5721. Electronic supplementary material The online version of this article (doi:10.1186/s12911-017-0505-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- W Savelberg
- Oncology Centre, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - T van der Weijden
- School for Public Health and Primary Care (CAPHRI) Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.,Department of Family Medicine, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - L Boersma
- Department of Radiotherapy, Maastricht University Medical Center, (MAASTRO clinic) Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - M Smidt
- Oncology Centre, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - C Willekens
- SBOH (Foundation for vocational training in family medicine), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - A Moser
- Zuyd University of Applied Sciences, Nieuw Eyckholt 300, 6419 DJ, Heerlen, The Netherlands
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12
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Kuehnle E, Oeztuerk T, Siggelkow W, Luebbe K, Moser A, Noeding S, John J, Noesselt T, Busch C, Arfsten M, Lemster S, Hillemans P, Doerk T, Park-Simon TW. Abstract P5-10-09: Prospective cross-sectional-study on participation in mammography screening according to immigration background and education status. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-10-09] [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: 11/16/2022]
Abstract
Abstract
Introduction
Although the health of immigrants is an important issue in national health care policy there is a serious shortage of data in many countries. Most studies lack information on educational status which is a major limitation. In this prospective cross-sectional-study we analyzed the influence of immigration background and educational status on the participation in mammography screening programs in Lower-Saxony, Germany.
Material and methods
Data collection was conducted from 2012-2016 in six certified breast cancer centers using a personal questionnaire and data from the patients' medical records. Stratification into subgroups was carried out according to first and second generation immigrants and country of origin.
Results
1547/2129 primary breast cancer cases were analyzed. The percentage of patients with a history of immigration in our study cohort was 17.7%. The majority of them were citizens of EU27 Member states. First generation immigrants (n= 146), second generation immigrants (n=129), natives (n= 1272). No significant difference was seen in sex, age, tumor stage, histology, grading, Ki-67, Her2/neu-status, and hormone receptor status. A 100% participation rate in the mammography screening program was seen in patients with no school graduation. The lowest participation rate (85.5%) was seen in the group of native Germans with a college graduation and in first generation immigrants with a high school graduation (86.7%). Detailed statistical analysis will be presented on the poster.
Conclusion
No difference was seen between immigrants and native Germans with regard to tumor biology. In first-generation immigrants mammography screening was well accepted despite cultural and linguistic differences. Participation rate decreased with higher education level in all groups. High school graduates with immigrant background participated more frequently in breast cancer screening than native high school graduates. These findings mainly relate to immigrants from EU27 Member states rather than immigrants from non EU countries.
Citation Format: Kuehnle E, Oeztuerk T, Siggelkow W, Luebbe K, Moser A, Noeding S, John J, Noesselt T, Busch C, Arfsten M, Lemster S, Hillemans P, Doerk T, Park-Simon T-W. Prospective cross-sectional-study on participation in mammography screening according to immigration background and education status [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-09.
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Affiliation(s)
- E Kuehnle
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - T Oeztuerk
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - W Siggelkow
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - K Luebbe
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - A Moser
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - S Noeding
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - J John
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - T Noesselt
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - C Busch
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - M Arfsten
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - S Lemster
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - P Hillemans
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - T Doerk
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
| | - T-W Park-Simon
- Hannover Medical School, Hanover, Lower-Saxony, Germany; Diakovere Henriettenstift, Breast Center, Hanover, Lower-Saxony, Germany; Klinikum Hanover Nordstadt, Cooperativ Breast Center KRH, Hannover, Lower-Saxony, Germany; Helios Klinikum Hildesheim, Breast Center, Hildesheim, Lower-Saxony, Germany; Kreiskrankenhaus Stadthagen, Breast Center Schaumburg, Stadthagen, Lower-Saxony, Germany; Sana Klinikum Hameln-Pyrmont, Breast Center, Hameln, Lower-Saxony, Germany
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Radl SV, Schipfer C, Kaiser S, Moser A, Kaynak B, Kern W, Schlögl S. Photo-responsive thiol–ene networks for the design of switchable polymer patterns. Polym Chem 2017. [DOI: 10.1039/c7py00055c] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Photo-patternable thiol–ene networks are prepared by combining versatile o-NBE chemistry with the distinctive advantages of a typical “click” reaction.
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Affiliation(s)
- S. V. Radl
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
| | - C. Schipfer
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
| | - S. Kaiser
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
| | - A. Moser
- Chair of Materials Science and Testing of Plastics
- Montanuniversitaet Leoben
- A-8700 Leoben
- Austria
| | - B. Kaynak
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
| | - W. Kern
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
- Chair of Chemistry of Polymeric Materials
- Montanuniversitaet Leoben
| | - S. Schlögl
- Polymer Competence Center Leoben GmbH
- A-8700 Leoben
- Austria
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Kühnle E, Tordai KE, Siggelkow W, Lübbe K, Moser A, Noeding S, John J, Hillemanns P, Öztürk T, Dörk-Bousset T, Park-Simon TW. Prospektive Querschnittstudie zur Anwendungshäufigkeit und Umsetzung der S3-Leitlinie an vier zertifizierten Brustzentren in Hannover und Hildesheim. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593141] [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: 10/20/2022] Open
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15
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Sprenger M, Robausch M, Moser A. Quantifying low-value services by using routine data from Austrian primary care. Eur J Public Health 2016; 26:912-916. [DOI: 10.1093/eurpub/ckw080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Lechner W, Moser A, Altendorfer A, Georg D. PO-0830: Correlation of MLC positions detected using log-files with MLC positions detected using the EPID. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32080-1] [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]
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17
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Jarius S, Wildemann B, Stöcker W, Moser A, Wandinger K. Psychotic syndrome associated with anti-Ca/ARHGAP26 and voltage-gated potassium channel antibodies. J Neuroimmunol 2015; 286:79-82. [DOI: 10.1016/j.jneuroim.2015.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 07/16/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2022]
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18
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Tronnier VM, Domingo A, Moll CK, Rasche D, Mohr C, Rosales R, Capetian P, Jamora RD, Lee LV, Münchau A, Diesta CC, Tadic V, Klein C, Brüggemann N, Moser A. Biochemical mechanisms of pallidal deep brain stimulation in X-linked dystonia parkinsonism. Parkinsonism Relat Disord 2015; 21:954-9. [PMID: 26093890 DOI: 10.1016/j.parkreldis.2015.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/17/2015] [Accepted: 06/08/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Invasive techniques such as in-vivo microdialysis provide the opportunity to directly assess neurotransmitter levels in subcortical brain areas. METHODS Five male Filipino patients (mean age 42.4, range 34-52 years) with severe X-linked dystonia-parkinsonism underwent bilateral implantation of deep brain leads into the internal part of the globus pallidus (GPi). Intraoperative microdialysis and measurement of gamma aminobutyric acid and glutamate was performed in the GPi in three patients and globus pallidus externus (GPe) in two patients at baseline for 25/30 min and during 25/30 min of high-frequency GPi stimulation. RESULTS While the gamma-aminobutyric acid concentration increased in the GPi during high frequency stimulation (231 ± 102% in comparison to baseline values), a decrease was observed in the GPe (22 ± 10%). Extracellular glutamate levels largely remained unchanged. CONCLUSIONS Pallidal microdialysis is a promising intraoperative monitoring tool to better understand pathophysiological implications in movement disorders and therapeutic mechanisms of high frequency stimulation. The increased inhibitory tone of GPi neurons and the subsequent thalamic inhibition could be one of the key mechanisms of GPi deep brain stimulation in dystonia. Such a mechanism may explain how competing (dystonic) movements can be suppressed in GPi/thalamic circuits in favour of desired motor programs.
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Affiliation(s)
- V M Tronnier
- Department of Neurosurgery, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - A Domingo
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C K Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
| | - D Rasche
- Department of Neurosurgery, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - C Mohr
- Department of Neuroradiology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - R Rosales
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines; Department of Neurology and Psychiatry, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - P Capetian
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany; Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - R D Jamora
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines; Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - L V Lee
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines
| | - A Münchau
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C C Diesta
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines
| | - V Tadic
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C Klein
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - N Brüggemann
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany; Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - A Moser
- Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Bussar C, Stöcker P, Cai Z, Moraes L, Alvarez R, Chen H, Breuer C, Moser A, Leuthold M, Sauer D. Large-scale Integration of Renewable Energies and Impact on Storage Demand in a European Renewable Power System of 2050. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.egypro.2015.07.662] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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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Stevens A, Moser A, Koke A, van der Weijden T, Beurskens A, Marcellis R. The use of a patient-specific instrument in physiotherapy goal setting. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1802] [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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21
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Feldmeyer L, Bogdan I, Moser A, Specker R, Kamarashev J, French L, Läuchli S. Short- and long-term efficacy and mechanism of action of tumescent suction curettage for axillary hyperhidrosis. J Eur Acad Dermatol Venereol 2015; 29:1933-7. [DOI: 10.1111/jdv.13078] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/27/2015] [Indexed: 11/26/2022]
Affiliation(s)
- L. Feldmeyer
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - I. Bogdan
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - A. Moser
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - R. Specker
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - J. Kamarashev
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - L.E. French
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - S. Läuchli
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
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Tucker MR, Moser A, Lambercy O, Sulzer J, Gassert R. Design of a wearable perturbator for human knee impedance estimation during gait. IEEE Int Conf Rehabil Robot 2014; 2013:6650372. [PMID: 24187191 DOI: 10.1109/icorr.2013.6650372] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mechanical impedance modulation is the key to natural, stable and efficient human locomotion. An improved understanding of this mechanism is necessary for the development of the next generation of intelligent prosthetic and orthotic devices. This paper documents the design methodologies that were employed to realize a knee perturbator that can experimentally estimate human knee impedance during gait through the application of angular velocity perturbations. The proposed experiment requires a light, transparent, wearable, and remotely actuated device that closely follows the movement of the biological joint. A genetic algorithm was used to design a polycentric hinge whose instantaneous center of rotation is optimized to be kinematically compatible with the human knee. A wafer disc clutch was designed to switch between a high transparency passive mode and a high impedance actuated mode. A remote actuation and transmission scheme was designed to enable high power output perturbations while minimizing the device's mass. Position and torque sensors were designed for device control and to provide data for post-processing and joint impedance estimation. Pending the fabrication and mechanical testing of the device, we expect this knee perturbator to be a valuable tool for experimental investigation of locomotive joint impedance modulation.
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Panczak R, Held L, Moser A, Jones P, Ruhli FJ, Staub K. Finding ‘big shots’ – spatial analyses of obesity among Swiss male conscripts 2010-2012. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.148] [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: 11/13/2022] Open
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24
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Pieloth D, Moser A, Schaldach G, Walzel P. CFD-Simulation von Wäschern. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450616] [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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Hipp D, Dickerson K, Moser A, Gerhardstein P. Age-related changes in visual contour integration: Implications for physiology from psychophysics. Dev Psychobiol 2014; 56:1390-405. [DOI: 10.1002/dev.21225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 05/05/2014] [Indexed: 11/09/2022]
Affiliation(s)
- D. Hipp
- Department of Psychology; Binghamton University, SUNY; Binghamton NY 13902
| | - K. Dickerson
- Department of Psychology; Binghamton University, SUNY; Binghamton NY 13902
| | - A. Moser
- Department of Psychology; Binghamton University, SUNY; Binghamton NY 13902
| | - Peter Gerhardstein
- Department of Psychology; Binghamton University, SUNY; Binghamton NY 13902
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Piwko C, Yunger S, Moser A, Peter L, Vicente C. Abstract P4-12-16: Safety profile and costs of related adverse events of trastuzumab emtansine compared to other regimens in the Canadian health care system. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-12-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Trastuzumab Emtansine (T-DM1) is an antibody–drug conjugate (ADC) comprised of the microtubule inhibitory cytotoxic agent DM1 and trastuzumab which, in addition to its antitumor properties, targets T-DM1 to HER2–overexpressing cells. The phase III EMILIA study compared the safety and efficacy of T-DM1 (n = 496) versus capecitabine plus lapatinib (CAP+LAP, n = 495) in patients with HER2-positive locally advanced or MBC previously treated with trastuzumab and a taxane. The phase II TDM4450g study compared the safety and efficacy of T-DM1 (n = 67) versus trastuzumab plus docetaxel (TRAZ+DOCE, n = 70) in patients with previously untreated MBC. These trials demonstrated statistically and clinically meaningful differences between T-DM1 and its comparators. In the EMILIA trial, the proportion of patients who developed grade ≥3 treatment-related AEs that were deemed related to treatment by the investigators was lower in the T-DM1 arm (30.6%) compared to the CAP+LAP arm (48.8%) and 5.9% of patients on T-DM1 discontinued treatment due to an AE, compared with 10.7% of patients on CAP+LAP.
In the TDM4450g study, the proportion of patients who developed grade ≥3 AEs that were deemed related to treatment by the investigators was lower in the T-DM1 arm (33.3%) versus the TRAZ+DOCE arm (81.82%) and 7.2% of patients on T-DM1 discontinued treatment due to an AE, compared with 34.8% of patients on TRAZ+DOCE.
The objective of this analysis was to estimate and compare the Canadian costs of managing the treatment-related AEs of T-DM1 as reported in the EMILIA and TDM4450g trials, from the perspective of Canadian public payers.
Methods
An Excel based spreadsheet model was utilized to estimate the costs of managing the treatment-related AEs. Clinical data (number and severity of AEs) were obtained from the two trials. Resource utilization and costing information were obtained from the literature, clinical experts, and Canadian standard costing sources (minimum and maximum costs were used). Costs were reported as 2012 CAD. The AEs that were considered for costing in this analysis were all treatment-related grade ≥3 AEs as well as grade 2 AEs that occurred in ≥5% of patients in both arms of either study.
Results
The management of treatment-related AEs by using T-DM1 resulted in cost savings ranging from $1,684 - $8,036 versus CAP+LAP as reported in the EMILIA trial and from $4,326 - $25,402 versus TRAZ+DOCE as per the TDM4450g trial (see Table 1).
Table 1: Range of Costs of Managing Treatment-Related AEs as Reported in the EMILIA and TDM4450g trials EMILIATDM4450g T-DM1CAP + LAPT-DM1TRAZ+DOCECost per patient$1,376 - $2,463$3,060 - $10,499$798 - $2,215$5,124 - $27,617Cost savings$1,684 - $8,036$4,326 - $25,402
Conclusions
This analysis demonstrated that utilizing T-DM1 for the management of HER2-positive MBC results in significant cost savings of related AEs management due to the improved safety profile compared to CAP+LAP and TRAZ+DOCE.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-12-16.
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Affiliation(s)
- C Piwko
- PIVINA Consulting Inc, Mississauga, ON, Canada; Hoffmann-La Roche Limited, Mississauga, ON, Canada; F. Hoffmann - La Roche AG, Basel, Switzerland
| | - S Yunger
- PIVINA Consulting Inc, Mississauga, ON, Canada; Hoffmann-La Roche Limited, Mississauga, ON, Canada; F. Hoffmann - La Roche AG, Basel, Switzerland
| | - A Moser
- PIVINA Consulting Inc, Mississauga, ON, Canada; Hoffmann-La Roche Limited, Mississauga, ON, Canada; F. Hoffmann - La Roche AG, Basel, Switzerland
| | - L Peter
- PIVINA Consulting Inc, Mississauga, ON, Canada; Hoffmann-La Roche Limited, Mississauga, ON, Canada; F. Hoffmann - La Roche AG, Basel, Switzerland
| | - C Vicente
- PIVINA Consulting Inc, Mississauga, ON, Canada; Hoffmann-La Roche Limited, Mississauga, ON, Canada; F. Hoffmann - La Roche AG, Basel, Switzerland
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Schoenenberger A, Özgüler O, Bieri C, Businger R, Moser A, Haberkern M, Stuck A, Exadaktylos A. Evaluation of an emergency geriatric screening for older patients in the emergency department. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hipp D, Moser A, Zhang X, Yin L, Gerhardstein P. Using Reverse Correlation to let Adults and Children Show us their Emotional Expression Templates. J Vis 2013. [DOI: 10.1167/13.9.590] [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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Moser A, Stephan R, Ziegler D, Johler S. Species distribution and resistance profiles of coagulase-negative staphylococci isolated from bovine mastitis in Switzerland. SCHWEIZ ARCH TIERH 2013; 155:333-8. [DOI: 10.1024/0036-7281/a000468] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Moser A, Stephan R, Corti S, Lehner A. Resistance profiles and genetic diversity of Escherichia coli strains isolated from acute bovine mastitis. SCHWEIZ ARCH TIERH 2013; 155:351-7. [DOI: 10.1024/0036-7281/a000470] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Moser A, Stephan R, Sager J, Corti S, Lehner A. Arcanobacterium pluranimalium leading to a bovine mastitis: Species identification by a newly developed pla gene based PCR. SCHWEIZ ARCH TIERH 2013; 155:373-5. [DOI: 10.1024/0036-7281/a000473] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Moser A, Stephan R, Corti S, Johler S. Comparison of genomic and antimicrobial resistance features of latex agglutination test-positive and latex agglutination test-negative Staphylococcus aureus isolates causing bovine mastitis. J Dairy Sci 2012; 96:329-34. [PMID: 23127911 DOI: 10.3168/jds.2012-5944] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 09/18/2012] [Indexed: 11/19/2022]
Abstract
The dairy industry suffers massive economic losses due to staphylococcal mastitis in cattle. The Staphaureux latex agglutination test (Oxoid, Basel, Switzerland) was reported to lead to negative results in 54% of bovine Staphylococcus aureus strains, and latex-negative strains are thought to be less virulent than Staphaurex latex-positive strains. However, comparative information on virulence and resistance profiles of these 2 groups of Staph. aureus is scarce. Our objective was to associate the latex agglutination phenotype of Staph. aureus strains isolated from bovine mastitis milk with data on clonal complexes, virulence genes, and antibiotic resistance to (1) determine the virulence profiles of the Staphaureux test positive and Staphaurex test negative groups, and (2) provide data needed to improve treatment of bovine mastitis and to identify potential vaccine targets. Seventy-eight Staph. aureus strains isolated from 78 cows on 57 Swiss farms were characterized. Latex agglutination was tested by Staphaureux kit, and resistance profiles were generated by disk diffusion. A DNA microarray was used to assign clonal complexes (CC) and to determine virulence and resistance gene profiles. By the Staphaureux test, 49% of the isolates were latex-positive and 51% were latex-negative. All latex-negative strains were assigned to CC151, whereas latex-positive strains were assigned to various clonal complexes, including CC97 (n=16), CC8 (n=10), CC479 (n=5), CC20 (n=4), CC7 (n=1), CC9 (n=1), and CC45 (n=1). Although the latex-negative isolates were susceptible to all antimicrobial agents tested, 24% of latex-positive isolates were classified as intermediate with regard to cefalexin-kanamycin and 13% were resistant to both ampicillin and penicillin. Microarray profiles of latex-negative isolates were highly similar, but differed largely from those of latex-positive isolates. Although the latex-negative group lacked several enterotoxin genes and sak, it exhibited significantly higher prevalence rates of genes encoding enterotoxin C, toxic shock syndrome toxin, and leukocidins (lukM/lukF-P83, lukD). Our findings suggest that latex-negative isolates represent a group of closely related strains with specific resistance and virulence gene patterns.
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Affiliation(s)
- A Moser
- Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 272, 8057 Zurich, Switzerland
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Abstract
A new scale-up concept based upon mixing models for bioreactors equipped with Rushton turbines using the tanks-in-series concept is presented. The physical mixing model includes four adjustable parameters, i.e., radial and axial circulation time, number of ideally mixed elements in one cascade, and the volume of the ideally mixed turbine region. The values of the model parameters were adjusted with the application of a modified Monte-Carlo optimization method, which fitted the simulated response function to the experimental curve. The number of cascade elements turned out to be constant (N = 4). The model parameter radial circulation time is in good agreement with the one obtained by the pumping capacity. In case of remaining parameters a first or second order formal equation was developed, including four operational parameters (stirring and aeration intensity, scale, viscosity). This concept can be extended to several other types of bioreactors as well, and it seems to be a suitable tool to compare the bioprocess performance of different types of bioreactors. (c) 1994 John Wiley & Sons, Inc.
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Affiliation(s)
- B Mayr
- Institute for Biotechnology, Petersgasse 12, 8010 Graz, Austria
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Schoenenberger AW, Stortecky S, Neumann S, Moser A, Juni P, Carrel T, Huber C, Gandon M, Bischoff S, Schoenenberger CM, Stuck AE, Windecker S, Wenaweser P. Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI). Eur Heart J 2012; 34:684-92. [DOI: 10.1093/eurheartj/ehs304] [Citation(s) in RCA: 236] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Hipp D, Moser A, O'Connor M, Gerhardstein P. The Impact of Closure on Contour Detection Thresholds in Children and Adults. J Vis 2012. [DOI: 10.1167/12.9.1293] [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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Löffler S, Xie Y, Klimach P, Richter A, Detemple P, Stieglitz T, Moser A, Hofmann UG. Long term in vivo stability and frequency response of polyimide based flexible array probes. ACTA ACUST UNITED AC 2012. [DOI: 10.1515/bmt-2012-4434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Löffler S, Xie Y, Detemple P, Moser A, Hofmann UG. An implantation technique for polyimide based flexible array probes facilitating neuronavigation and chronic implantation. ACTA ACUST UNITED AC 2012. [DOI: 10.1515/bmt-2012-4437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Spindelboeck W, Moser A. Spontaneous tension pneumothorax and CO₂ narcosis in a near fatal episode of chronic obstructive pulmonary disease exacerbation. Am J Emerg Med 2011; 30:1664.e3-4. [PMID: 22100481 DOI: 10.1016/j.ajem.2011.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/10/2011] [Indexed: 11/29/2022] Open
Abstract
Exacerbation of chronic obstructive pulmonary disease (COPD) is a disease pattern frequently seen in emergency medical services and intensive care units. Usually, exacerbations of COPD are of infectious origin, and an acute vital threat may take several days to develop. Tension pneumothorax in patients with COPD is a rare and often unexpected cause of acute vital threat. To the best of our knowledge, this is a unique case of CO2 narcosis after spontaneous tension pneumothorax in a patient with COPD. We describe the rapid development of respiratory insufficiency and near fatal pulmonary failure in a 65-year-old female patient with COPD due to spontaneous tension pneumothorax. The patient was in respiratory failure and comatose upon arrival of the emergency service. Before mechanical ventilation, coma could be confirmed to be due to CO2 narcosis caused by exorbitant arterial hypercapnia (PCO2, 193 mm Hg). Pneumothorax was diagnosed in the hospital by chest x-ray and resolved after pleural drainage. The patient could be extubated early and discharged without sequelae. In conclusion, we want to report the occurrence of a tension pneumothorax as an important and potentially overseen condition in patients with COPD with acute respiratory failure.
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Affiliation(s)
- Walter Spindelboeck
- Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
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Resel R, Flesch HG, Moser A, Werzer O, Smits ECP, Mathijssen SGJ, Gholamrezaie F, Wondergem HJ, Ponomarenko SA, Smilgies DM, Hlawacek G, Shen Q, Teichert C, Puschnig P, de Leeuw DM. A quinquethiophene based self-assembled monolayer for organic electronic applications. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311091604] [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: 11/10/2022] Open
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Moser H, Moser A, Frayer K, Chen W, Schulman J, O'Neill B, Kishimoto Y. Adrenoleukodystrophy: Increased plasma content of saturated very long-chain fatty-acids. Neurology 2011. [DOI: 10.1212/01.wnl.0000398012.88123.45] [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: 11/15/2022] Open
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Freitas AVL, Mielke OHH, Moser A, Silva-Brandão KL, Iserhard CA. A new genus and species of Euptychiina (Lepidoptera: Nymphalidae: Satyrinae) from southern Brazil. Neotrop Entomol 2011; 40:231-237. [PMID: 21584405 DOI: 10.1590/s1519-566x2011000200012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 11/22/2010] [Indexed: 05/30/2023]
Abstract
This paper describes a new genus and a new species of Euptychiina from open grassland habitats (campos de cima da serra) in southern Brazil. The systematic position of this new taxon is discussed based on morphological and molecular data, and it is considered sister to Taydebis Freitas. Since the campos vegetation is considered endangered due to anthropogenic activities, this butterfly species deserves attention and should be included in future conservation plans for this biome.
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Affiliation(s)
- A V L Freitas
- Depto de Biologia Animal and Museu de Zoologia, Instituto de Biologia, Univ Estadual de Campinas, Campinas, SP, Brasil.
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Sprenger M, Baumgartner J, Moser A, Salzer HJF, Stigler FL, Wendler M. Students' and general practitioners' perceptions of a recently introduced clerkship in general practice. A survey from Austria. Eur J Gen Pract 2011; 16:148-50. [PMID: 20557273 DOI: 10.3109/13814788.2010.495404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In autumn 2007, the Medical University of Graz (MUG) upgraded the status of general practice in medical training by integrating a compulsory five-week clerkship in general practice surgeries in the sixth and last year of the curriculum. In cooperation with the Styrian Academy of General Practice (STAFAM), more than 200 general practitioners (GPs) had been accredited to introduce medical students to the specific tasks, problems and decision-making process in general practice. Between October 2007 and June 2009, more than 300 students completed the clerkship. OBJECTIVE To explore the perceptions of students and GPs towards this new approach to undergraduate teaching in Austrian general practice. METHODS Between March and June 2009, we conducted a cross-sectional survey by using a self-administered questionnaire with 14 items for students as well as GPs. To limit recall bias, we gave the questionnaire to all students (n = 146) and GPs (n = 146) immediately after the clerkship. The response rates were 146/146 (100%) and 114/146 (78%) for students and GPs, respectively. RESULTS The study results show high satisfaction rates among students as well as GPs. Most of the students and GPs perceive the compulsory clerkship in general practice as an essential part of medical education. The organization of the clerkship had the least positive outcome. CONCLUSION Our survey shows that the clerkship is well accepted among Austrian medical students and GPs.
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Gravet A, Souillard N, Habermacher J, Moser A, Lohmann C, Schmitt F, Delarbre JM. [Culture and susceptibility testing of mycobacteria with VersaTREK]. ACTA ACUST UNITED AC 2010; 59:32-8. [PMID: 20850229 DOI: 10.1016/j.patbio.2010.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 08/02/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Our laboratory of microbiology use the VersaTREK/ESP Culture System II for the isolation of mycobacteria. In this study, we evaluate this system for the analysis carried out between April 2009 and March 2010. METHOD The Myco bottles are supplemented with growth supplements and an antimicrobial agent solution prior to inoculation with the specimen. The technology of the VersaTREK/ESP Culture System II is based on the detection of headspace pressure changes within a sealed bottle. It monitors changes in either gas production or gas consumption due to microbial growth. A special algorithm has been developed for detection of very slow growing mycobacteria. The bottles are incubated during 42 days. Meanwhile a solid medium is inoculated too. All specimen types can be analysed with this system. RESULTS Compared to solid culture, the time needed for detection of positive cultures was significantly shorter for the VersaTREK with a good recovery rate. For isolates recovered in both systems, mean time of detection is respectively 19.1 and 35.6 days for liquid and solid cultures. Mycobacteria identification may be determined using nucleic acid probs directly in Myco VersaTREK or in the solid medium. The susceptibility test of Mycobacteria tuberculosis complex is obtained between six and 13 days for rifampin, isoniazid, ethambutol, streptomycin and pyrasinamide. CONCLUSION This system offers a faster diagnosis and is an alternative to other instruments using liquid culture.
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Affiliation(s)
- A Gravet
- Laboratoire de microbiologie, hôpital Emile-Muller, centre hospitalier de Mulhouse, 20, avenue du Docteur-Laennec, 68070 Mulhouse cedex, France.
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Neumann G, Schlüter B, Hornung D, Gottschalk S, Moser A. Neurological picture. Reversible eclamptic leucoencephalopathy syndrome with severe brainstem involvement without neurological signs. J Neurol Neurosurg Psychiatry 2010; 81:1026-7. [PMID: 20581416 DOI: 10.1136/jnnp.2009.196899] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- G Neumann
- Department of Neurology, University of Lübeck, Ratzeburger, Germany.
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Phadke SR, Gupta N, Girisha KM, Kabra M, Maeda M, Vidal E, Moser A, Steinberg S, Puri RD, Verma IC, Braverman N. Rhizomelic chondrodysplasia punctata type 1: report of mutations in 3 children from India. J Appl Genet 2010; 51:107-10. [PMID: 20145307 DOI: 10.1007/bf03195717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Rhizomelic chondrodysplasia punctata is a rare autosomal recessive disorder characterized by stippled epiphyses and rhizomelic shortening of the long bones. We report 3 subjects of rhizomelic chondrodysplasia punctata from India and the PEX7 mutations identified in them. The common PEX7-L292X allele, whose high frequency is due to a founder effect in the northern European Caucasian population, was not identified in these patients. Instead, 2 novel alleles are described, including 64_65delGC, which was present on a single PEX7 haplotype and could represent a common allele in the Indian population.
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Affiliation(s)
- S R Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow-226014, India.
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Meynard JL, Morand-Joubert L, Chêne G, Landman R, Obadia M, Castrec E, Barbaza MO, Vivier G, Rose S, Moser A, Pinta A, Kraemer S, Girard PM. Validité interne et validité externe d’une cohorte demandée par la commission de la transparence : suivi sur deux ans de 364 patients infectés par le VIH-1 et traités par enfuvirtide (cohorte ZOOM). Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.07.036] [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: 10/20/2022] Open
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Füllgraf H, Moser A. Primäre Neurosarkoidose schwer zu beweisen? Eine Fallvorstellung. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238824] [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: 10/20/2022]
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Schumacher A, Thümen A, Moser A. Nocturnal but not diurnal high frequency stimulation of the caudate nucleus ameliorates reward-coupled learning strategies in rats. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238845] [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: 10/20/2022]
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