1
|
Gottschalk I, Walter A, Menzel T, Weber EC, Wendt S, Sreeram N, Gembruch U, Berg C, Abel JS. D-Transposition of the great arteries with restrictive foramen ovale in the fetus: the dilemma of predicting the need for postnatal urgent balloon atrial septostomy. Arch Gynecol Obstet 2024; 309:1353-1367. [PMID: 36971845 PMCID: PMC10894161 DOI: 10.1007/s00404-023-06997-8] [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: 01/18/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE Restrictive foramen ovale (FO) in dextro-transposition of the great arteries (d-TGA) with intact ventricular septum may lead to severe life-threatening hypoxia within the first hours of life, making urgent balloon atrial septostomy (BAS) inevitable. Reliable prenatal prediction of restrictive FO is crucial in these cases. However, current prenatal echocardiographic markers show low predictive value, and prenatal prediction often fails with fatal consequences for a subset of newborns. In this study, we described our experience and aimed to identify reliable predictive markers for BAS. METHODS We included 45 fetuses with isolated d-TGA that were diagnosed and delivered between 2010 and 2022 in two large German tertiary referral centers. Inclusion criteria were the availability of former prenatal ultrasound reports, of stored echocardiographic videos and still images, which had to be obtained within the last 14 days prior to delivery and that were of sufficient quality for retrospective re-analysis. Cardiac parameters were retrospectively assessed and their predictive value was evaluated. RESULTS Among the 45 included fetuses with d-TGA, 22 neonates had restrictive FO postnatally and required urgent BAS within the first 24 h of life. In contrast, 23 neonates had normal FO anatomy, but 4 of them unexpectedly showed inadequate interatrial mixing despite their normal FO anatomy, rapidly developed hypoxia and also required urgent BAS ('bad mixer'). Overall, 26 (58%) neonates required urgent BAS, whereas 19 (42%) achieved good O2 saturation and did not undergo urgent BAS. In the former prenatal ultrasound reports, restrictive FO with subsequent urgent BAS was correctly predicted in 11 of 22 cases (50% sensitivity), whereas a normal FO anatomy was correctly predicted in 19 of 23 cases (83% specificity). After current re-analysis of the stored videos and images, we identified three highly significant markers for restrictive FO: a FO diameter < 7 mm (p < 0.01), a fixed (p = 0.035) and a hypermobile (p = 0.014) FO flap. The maximum systolic flow velocities in the pulmonary veins were also significantly increased in restrictive FO (p = 0.021), but no cut-off value to reliably predict restrictive FO could be identified. If the above markers are applied, all 22 cases with restrictive FO and all 23 cases with normal FO anatomy could correctly be predicted (100% positive predictive value). Correct prediction of urgent BAS also succeeded in all 22 cases with restrictive FO (100% PPV), but naturally failed in 4 of the 23 cases with correctly predicted normal FO ('bad mixer') (82.6% negative predictive value). CONCLUSION Precise assessment of FO size and FO flap motility allows a reliable prenatal prediction of both restrictive and normal FO anatomy postnatally. Prediction of likelihood of urgent BAS also succeeds reliably in all fetuses with restrictive FO, but identification of the small subset of fetuses that also requires urgent BAS despite their normal FO anatomy fails, because the ability of sufficient postnatal interatrial mixing cannot be predicted prenatally. Therefore, all fetuses with prenatally diagnosed d-TGA should always be delivered in a tertiary center with cardiac catheter stand-by, allowing BAS within the first 24 h after birth, regardless of their predicted FO anatomy.
Collapse
Affiliation(s)
- I Gottschalk
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
| | - A Walter
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - T Menzel
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - E C Weber
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - S Wendt
- Heartcenter, Department of Cardiac Surgery, Cardiothoracic Intensive Care and Thoracic Surgery, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - N Sreeram
- Department of Pediatric Cardiology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - C Berg
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - J S Abel
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| |
Collapse
|
2
|
Gottschalk I, Berg C, Menzel T, Abel JS, Kribs A, Dübbers M, Kohaut J, Weber LT, Taylan C, Habbig S, Liebau MC, Boemers TM, Weber EC. Single-center outcome analysis of 46 fetuses with megacystis after intrauterine vesico-amniotic shunting with the Somatex®intrauterine shunt. Arch Gynecol Obstet 2024; 309:145-158. [PMID: 36604332 PMCID: PMC10770195 DOI: 10.1007/s00404-022-06905-6] [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: 11/23/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To assess the spectrum of underlying pathologies, the intrauterine course and postnatal outcome of 46 fetuses with megacystis that underwent intrauterine vesico-amniotic shunting (VAS) with the Somatex® shunt in a single center. METHODS Retrospective analysis of 46 fetuses with megacystis that underwent VAS either up to 14 + 0 weeks (early VAS), between 14 + 1 and 17 + 0 weeks (intermediate VAS) or after 17 + 0 weeks of gestation (late VAS) in a single tertiary referral center. Intrauterine course, underlying pathology and postnatal outcome were assessed and correlated with the underlying pathology and gestational age at first VAS. RESULTS 46 fetuses underwent VAS, 41 (89%) were male and 5 (11%) were female. 28 (61%) fetuses had isolated and 18 (39%) had complex megacystis with either aneuploidy (n = 1), anorectal malformations (n = 6), cloacal malformations (n = 3), congenital anomalies overlapping with VACTER association (n = 6) or Megacystis-Microcolon Intestinal-Hypoperistalsis Syndrome (MMIHS) (n = 2). The sonographic 'keyhole sign' significantly predicted isolated megacystis (p < 0.001). 7 pregnancies were terminated, 4 babies died in the neonatal period, 1 baby died at the age of 2.5 months and 34 (74%) infants survived until last follow-up. After exclusion of the terminated pregnancies, intention-to-treat survival rate was 87%. Mean follow-up period was 24 months (range 1-72). The underlying pathology was highly variable and included posterior urethral valve (46%), hypoplastic or atretic urethra (35%), MMIHS or prune belly syndrome (10%) and primary vesico-ureteral reflux (2%). In 7% no pathology could be detected postnatally. No sonographic marker was identified to predict the underlying pathology prenatally. 14 fetuses underwent early, 24 intermediate and 8 late VAS. In the early VAS subgroup, amnion infusion prior to VAS was significantly less often necessary (7%), shunt complications were significantly less common (29%) and immediate kidney replacement therapy postnatally became less often necessary (0%). In contrast, preterm delivery ≤ 32 + 0 weeks was more common (30%) and survival rate was lower (70%) after early VAS compared to intermediate or late VAS. Overall, 90% of liveborn babies had sufficient kidney function without need for kidney replacement therapy until last follow-up, and 95% had sufficient pulmonary function without need for mechanical respiratory support. 18% of babies with complex megacystis suffered from additional health restrictions due to their major concomitant malformations. CONCLUSIONS Our data suggest that VAS is feasible from the first trimester onward. Early intervention has the potential to preserve neonatal kidney function in the majority of cases and enables neonatal survival in up to 87% of cases. Despite successful fetal intervention, parents should be aware of the potential of mid- or long-term kidney failure and of additional health impairments due to concomitant extra-renal anomalies that cannot be excluded at time of intervention.
Collapse
Affiliation(s)
- I Gottschalk
- Division of Prenatal Medicine, Fetal Surgery and Gynecological Ultrasound, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
| | - C Berg
- Division of Prenatal Medicine, Fetal Surgery and Gynecological Ultrasound, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - T Menzel
- Division of Prenatal Medicine, Fetal Surgery and Gynecological Ultrasound, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - J S Abel
- Division of Prenatal Medicine, Fetal Surgery and Gynecological Ultrasound, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - A Kribs
- Department of Neonatology, University Hospital of Cologne, Cologne, Germany
| | - M Dübbers
- Division of Pediatric Surgery, University Hospital of Cologne, Cologne, Germany
| | - J Kohaut
- Division of Pediatric Surgery, University Hospital of Cologne, Cologne, Germany
| | - L T Weber
- Department of Pediatrics, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - C Taylan
- Department of Pediatrics, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - S Habbig
- Department of Pediatrics, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - M C Liebau
- Department of Pediatrics, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - T M Boemers
- Department of Pediatric Surgery and Urology, Children´S Academic Hospital Amsterdamer Cologne, Cologne, Germany
| | - E C Weber
- Division of Prenatal Medicine, Fetal Surgery and Gynecological Ultrasound, Department of Obstetrics and Gynecology, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany
| |
Collapse
|
3
|
Kohaut J, Fischer-Mertens J, Cernaianu G, Schulten D, Holtkamp G, Kohl S, Habbig S, Klein R, Kribs A, Gottschalk I, Berg C, Dübbers M. Postnatal surgical treatment and complications following intrauterine vesicoamniotic shunting with the SOMATEX® intrauterine shunt. A single center experience. J Pediatr Urol 2023; 19:567.e1-567.e6. [PMID: 37451915 DOI: 10.1016/j.jpurol.2023.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/22/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Intrauterine vesicoamniotic shunting (VAS) using a Somatex® shunt was shown to significantly affect survival of male fetuses with megacystis in suspected lower urinary tract obstruction (LUTO) [Figure 1]. Data on postnatal surgical management and complications are largely lacking. OBJECTIVE To describe the postnatal management of patients with prenatal VAS for megacystitis in suspected severe LUTO. STUDY DESIGN All male newborns with previous intrauterine VAS using a Somatex® shunt treated in our institution were retrospectively analyzed. We evaluated the spectrum of urethral pathologies and postnatal surgical management, especially focusing on shunt removal. RESULTS Between 2016 and 2022, 17 patients (all male) were treated postnatally in our institution after VAS for suspected severe LUTO. Five fetuses with dislocated shunts underwent re-implantation in utero. Overall, premature birth before the 38th week of gestation was observed in eight patients (8/17). Seven shunts could be removed without further anesthesia as a bedside procedure. Ten patients required surgical shunt removal under general anesthesia due to migration (59%). Laparoscopic shunt extraction was performed in 8/10 cases. Most frequently, dislocated shunts were located incorporated in the detrusor in eight cases and the removal required a bladder suture in 2/8 patients. In one case, the shunt was removed from the abdominal wall and in one case from the intestine wall [Figure 2]. Posterior urethral valves were found in 8/17 patients, 6/17 patients showed a urethral atresia and one patient had urethral duplication. In two patients, we identified a high grade bilateral vesicoureteral reflux without LUTO. CONCLUSION In our observation, more than half of the newborns with megacystis in suspected LUTO require a shunt removal surgery after early VAS using a Somatex® shunt. Urethral atresia may be found more frequently in these patients. These data should be taken into consideration for prenatal counselling of parents and planning of postnatal management.
Collapse
Affiliation(s)
- J Kohaut
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - J Fischer-Mertens
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - G Cernaianu
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - D Schulten
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - G Holtkamp
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - S Kohl
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - S Habbig
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - R Klein
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - A Kribs
- Department of Pediatrics and Adolescent Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - I Gottschalk
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - C Berg
- Division of Prenatal Medicine, Gynecological Ultrasound and Fetal Surgery, Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - M Dübbers
- Division of Pediatric Surgery, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
4
|
Kegler M, Owolabi S, Reilly K, Pouncy J, Kaufmann J, Marra A, Haardörfer R, Berg C. A qualitative study on the influence of COVID-19 on smoking behaviors through changing social and physical contexts. Health Educ Res 2023; 38:445-457. [PMID: 37489701 PMCID: PMC11007391 DOI: 10.1093/her/cyad031] [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] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
Globally, COVID-19 has been a major societal stressor and disrupted social and physical environments for many. Elucidating mechanisms through which societal disruptions influence smoking behavior has implications for future tobacco control efforts. Qualitative interviews were conducted among 38 adults who smoked combustible cigarettes in 2020 and 2021. The majority were women (75.7%), identified as Black (56.8%), were employed (61.3%), had a smoke-free home (66.7%) and lived in a small metro or rural (79.0%) county, primarily in rural southwest Georgia. Participants reported more time at home, increased isolation and less socializing, changed work and financial situations and altered household and family contexts. The vast majority of participants smoked more at some point during the pandemic with about half of these continuing to smoke more at the time of the interview. More time at home, multiple sources of stress and boredom were the main reasons for increased smoking. Decreases in smoking were attributed to financial strain, smoke-free home rules and nonsmoking family members, concerns about COVID-19 and less socializing with friends who smoke. Future tobacco control efforts during societal stressors such as pandemics should take into account specific psychosocial and environmental influences in attempts to minimize negative changes to smoking patterns.
Collapse
Affiliation(s)
- M Kegler
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - S Owolabi
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - K Reilly
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - J Pouncy
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - J Kaufmann
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - A Marra
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - R Haardörfer
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - C Berg
- Department of Prevention & Community Health, Milken Institute School of Public Health, George Washington University, Science and Engineering Hall, 800 22nd Street NW, Washington, DC 20052, USA
| |
Collapse
|
5
|
Meinhardt AL, McPherson M, Berg C, Cai D, Blumenfrucht M, Chang V, Zhong F. PP01.69 NSCLC with Testicular Metastasis: A Case Report. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.095] [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: 01/30/2023]
|
6
|
Jerlström J, Berg C, Karlsson AH, Wallenbeck A, Hansson H. A formal model for assessing the economic impact of animal welfare improvements at bovine and porcine slaughter. Anim Welf 2022. [DOI: 10.7120/09627286.31.4.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The relationship between animal welfare at slaughter and slaughterhouse profitability is complex, with potential trade-offs between animal welfare costs and benefits. Slaughterhouses currently lack data support for decisions on investments that can improve both animal welfare and profitability.
Therefore, this study mapped the economic impacts for slaughterhouse businesses of improved cattle and pig welfare at slaughter. Specific aims were to: (i) highlight the possible economic impact of animal welfare improvements, based on the scientific literature; (ii) develop an economic model
demonstrating the theoretical contribution of animal welfare to slaughterhouse profitability; and (iii) validate the economic model through focus group interviews with slaughterhouse personnel in Sweden. The findings indicated that investing in animal welfare improvements could result in accumulation
of an intangible asset that can be considered together with other production factors in the economic model. Model validation stressed the importance of selling by-products for the economic outcome and of smooth workflow for productivity. The study thus improves understanding of the economic
impacts of animal welfare at slaughter and incentives for slaughterhouse businesses to improve animal welfare. The results are important for public and private policy-makers interested in enhancing animal welfare at slaughter.
Collapse
Affiliation(s)
- J Jerlström
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences (SLU), Box 234, 532 23 Skara, Sweden
| | - C Berg
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences (SLU), Box 234, 532 23 Skara, Sweden
| | - AH Karlsson
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences (SLU), Box 234, 532 23 Skara, Sweden
| | - A Wallenbeck
- Department of Animal Environment and Health, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences (SLU), Box 234, 532 23 Skara, Sweden
| | - H Hansson
- Department of Economics, Faculty of Natural Resources and Agricultural Sciences, Swedish University of Agricultural Sciences (SLU), Box 7013, 750 07 Uppsala, Sweden
| |
Collapse
|
7
|
Breeze J, Whitford A, Gensheimer WG, Berg C. Physiological and radiological parameters predicting outcome from penetrating traumatic brain injury treated in the deployed military setting. BMJ Mil Health 2022:e002118. [PMID: 36028282 DOI: 10.1136/military-2022-002118] [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: 03/16/2022] [Accepted: 08/07/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Penetrating traumatic brain injury (TBI) is the most common cause of death in current military conflicts, and results in significant morbidity in survivors. Identifying those physiological and radiological parameters associated with worse clinical outcomes following penetrating TBI in the austere setting may assist military clinicians to provide optimal care. METHOD All emergency neurosurgical procedures performed at a Role 3 Medical Treatment Facility in Afghanistan for penetrating TBI between 01 January 2016 and 18 December 2020 were analysed. The odds of certain clinical outcomes (death and functional dependence post-discharge) occurring following surgery were matched to existing agreed preoperative variables described in current US and UK military guidelines. Additional physiological and radiological variables including those comprising the Rotterdam criteria of TBI used in civilian settings were additionally analysed to determine their potential utility in a military austere setting. RESULTS 55 casualties with penetrating TBI underwent surgery, all either by decompressive craniectomy (n=42) or craniotomy±elevation of skull fragments (n=13). The odds of dying in hospital attributable to TBI were greater with casualties with increased glucose on arrival (OR=70.014, CI=3.0399 to 1612.528, OR=70.014, p=0.008) or a mean arterial pressure <90 mm Hg (OR=4.721, CI=0.969 to 22.979, p=0.049). Preoperative hyperglycaemia was also associated with increased odds of being functionally dependent on others on discharge (OR=11.165, CI=1.905 to 65.427, p=0.007). Bihemispheric injury had greater odds of being functionally dependent on others at discharge (OR=5.275, CI=1.094 to 25.433, p=0.038). CONCLUSIONS We would recommend that consideration of these three additional preoperative clinical parameters (hyperglycaemia, hypotension and bihemispheric injury on CT) when managing penetrating TBI be considered in future updates of guidelines for deployed neurosurgical care.
Collapse
Affiliation(s)
- John Breeze
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Bioengineering, Imperial College London, London, UK
| | - A Whitford
- Gaza Barracks, Joint Hospital Group, Catterick, UK
| | - W G Gensheimer
- Warfighter Eye Center, Malcolm Grow Medical Clinics and Surgery Center Joint Base Andrews, Prince George's County, Maryland, USA
| | - C Berg
- Department of Neurosurgery, Wright-Patterson Air Force Base, Dayton, Ohio, USA
| |
Collapse
|
8
|
Tammemagi M, Myers R, Ruparel M, Tremblay A, Atkar-Khattra S, Marshall H, Brims F, Mcwilliams A, Fogarty P, Stone E, Manser R, Canfell K, Lim K, Rosell A, Weber M, Yee J, Mayo J, Berg C, Lam D, Janes S, Fong K, Lam S. OA19.01 Prospective Study of Lung Cancer Screening Criteria: USPSTF2013 vs PLCOm2012 – International Lung Screening Trial (ILST) Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.097] [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]
|
9
|
Abel JS, Berg C, Geipel A, Gembruch U, Herberg U, Breuer J, Brockmeier K, Gottschalk I. Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC). Arch Gynecol Obstet 2021:10.1007/s00404-021-06157-w. [PMID: 34453587 DOI: 10.1007/s00404-021-06157-w] [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: 01/30/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) METHODS: All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed and correlated with the outcome. The accuracy of prenatal diagnosis was assessed. RESULTS 39 cases of TAC were diagnosed prenatally. Mean gestational age at first diagnosis was 22 weeks (range, 13-38). Two cases were lost follow-up. Correct prenatal diagnosis of TAC was made in 21 of 24 (87.5%) cases and of TAC subtype in 19 of 21 (90.5%) cases. Prenatal diagnosis of TAC was incorrect in three cases: one newborn had aortic atresia with ventricular septal defect postnatally, one had hypoplastic right ventricle with dextro Transposition of the Great Arteries with coartation of the aorta and a third newborn had Tetralogy of Fallot with abnormal origin of the left pulmonary artery arising from the ascending aorta postnatally. These three cases were excluded from further analysis. In 9 of 34 (26.5%) cases, TAC was an isolated finding. 13 (38.2%) fetuses had additional chromosomal anomalies. Among them, microdeletion 22q11.2 was most common with a prevalence of 17.6% in our cohort. Another 3 fetuses were highly suspicious for non-chromosomal genetic syndromes due to their additional extra-cardiac anomalies, but molecular diagnosis could not be provided. Major cardiac and extra-cardiac anomalies occurred in 3 (8.8%) and in 20 (58.8%) cases, respectively. Predominantly, extra-cardiac anomalies occurred in association with chromosomal anomalies. Additionally, severe IUGR occurred in 6 (17.6%) cases. There were 14 terminations of pregnancy (41.2%), 1 (2.9%) intrauterine fetal death, 5 postnatal deaths (14.7%) and 14 (41.2%) infants were alive at last follow-up. Intention-to-treat survival rate was 70%. Mean follow-up among survivors was 42 months (range, 6-104). Postoperative health status among survivors was excellent in 11 (78.6%) infants, but 5 (46.2%) of them needed repeated re-interventions due to recurrent pulmonary artery or conduit stenosis. The other 3 (21.4%) survivors were significantly impaired due to non-cardiac problems. CONCLUSION TAC is a rare and complex cardiac anomaly that can be diagnosed prenatally with high precision. TAC is frequently associated with chromosomal and extra-cardiac anomalies, leading to a high intrauterine and postnatal loss rate due to terminations and perioperative mortality. Without severe extra-cardiac anomalies, postoperative short- and medium-term health status is excellent, independent of the subtype of TAC, but the prevalence of repeated interventions due to recurrent stenosis is high.
Collapse
Affiliation(s)
- J S Abel
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany
| | - C Berg
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Herberg
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - J Breuer
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - K Brockmeier
- Department of Pediatric Cardiology, University of Cologne, Cologne, Germany
| | - I Gottschalk
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany.
| |
Collapse
|
10
|
Abel JS, Berg C, Geipel A, Gembruch U, Herberg U, Breuer J, Brockmeier K, Gottschalk I. Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC). Arch Gynecol Obstet 2021; 304:1455-1466. [PMID: 34028563 PMCID: PMC8553718 DOI: 10.1007/s00404-021-06067-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/12/2020] [Accepted: 04/09/2021] [Indexed: 11/18/2022]
Abstract
Purpose To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) Methods All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed and correlated with the outcome. The accuracy of prenatal diagnosis was assessed. Results Thirty nine cases of TAC were diagnosed prenatally. Mean gestational age at first diagnosis was 22 weeks (range 13–38). Two cases were lost follow-up. Correct prenatal diagnosis of TAC was made in 87.5% and of TAC subtype in 90.5%. Prenatal diagnosis was incorrect in three cases: one newborn had aortic atresia with ventricular septal defect (VSD) postnatally, one had hypo-plastic right ventricle with dextro transposition of the great arteries (d-TGA) with coarctation of the aorta and a third newborn had tetralogy of fallot (TOF) with abnormal origin of the left pulmonary artery arising from the ascending aorta postnatally. These 3 cases were excluded from further analysis. In 26.5% of cases, TAC was an isolated finding. 38.2% of fetuses had additional chromosomal anomalies. Among them, microdeletion 22q11.2 was most common with a prevalence of 17.6% in our cohort. Another 3 fetuses were highly suspicious for non-chromosomal genetic syndromes due to their additional extra-cardiac anomalies, but molecular diagnosis could not be provided. Major cardiac and extra-cardiac anomalies occurred in between 8.8% and 58.8%, respectively. Predominantly, extra-cardiac anomalies occurred in association with chromosomal anomalies. Additionally, severe IUGR occurred in 17.6%. There were 14 terminations of pregnancy (41.2%), 1 (2.9%) intrauterine fetal death, 5 postnatal deaths (14.7%) and 14 (41.2%) infants were alive at last follow-up. Intention-to-treat survival rate was 70%. Mean follow-up among survivors was 42 months (range 6–104). Postoperative health status among survivors was excellent in 78.6%, but 46.2% needed repeated re-interventions due to recurrent pulmonary artery or conduit stenosis. The other 21.4% of survivors were significantly impaired due to non-cardiac problems. Conclusion Truncus arteriosus communis is a rare and complex cardiac anomaly that can be diagnosed prenatally with high precision. TAC is frequently associated with chromosomal and extra-cardiac anomalies, leading to a high intrauterine and postnatal loss rate due to terminations and perioperative mortality. Without severe extra-cardiac anomalies, postoperative health status is excellent, independent of the subtype of TAC, but the prevalence of repeated interventions due to recurrent stenosis is high.
Collapse
Affiliation(s)
- J S Abel
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpenerstr. 34, 50931, Cologne, Germany
| | - C Berg
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpenerstr. 34, 50931, Cologne, Germany.,Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Herberg
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - J Breuer
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - K Brockmeier
- Department of Pediatric Cardiology, University of Cologne, Cologne, Germany
| | - I Gottschalk
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpenerstr. 34, 50931, Cologne, Germany.
| |
Collapse
|
11
|
Kagan KO, Enders M, Hoopmann M, Geipel A, Simonini C, Berg C, Gottschalk I, Faschingbauer F, Schneider MO, Ganzenmueller T, Hamprecht K. Outcome of pregnancies with recent primary cytomegalovirus infection in first trimester treated with hyperimmunoglobulin: observational study. Ultrasound Obstet Gynecol 2021; 57:560-567. [PMID: 33491819 DOI: 10.1002/uog.23596] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine the efficacy of hyperimmunoglobulin (HIG) treatment in women with a recent primary cytomegalovirus (CMV) infection up to 14 weeks' gestation. METHODS This is an ongoing observational study conducted at the prenatal medicine departments of the University Hospitals of Tübingen, Bonn, Cologne and Erlangen, Germany, as well as at the Laboratory Prof. Gisela Enders and Colleagues in Stuttgart, Germany and the Institute for Medical Virology at the University of Tübingen, Tübingen, Germany. Enrolment criteria were the presence of confirmed recent primary CMV infection in the first trimester and a gestational age at first HIG administration of ≤ 14 weeks. The following inclusion criteria indicated a recent primary infection: low anti-immunoglobulin (Ig)-G levels, low anti-CMV-IgG avidity in the presence of a positive CMV-IgM test and no positive reactivity or just seroconversion anti-gB2-IgG-reactivity. HIG administration was started as soon as possible within a few days after the first visit. HIG was administered intravenously at a dose of 200 IU/kg maternal body weight and repeated every 2 weeks until about 18 weeks' gestation. The primary outcome was maternal-fetal transmission at the time of amniocentesis. Multivariate logistic regression analysis was used to determine significant covariates that could predict maternal-fetal transmission. RESULTS We included 149 pregnancies (153 fetuses) that completed the treatment. Median maternal age and weight were 32.0 years and 65.0 kg, respectively. Median gestational age at the time of first referral to one of the four centers was 9.4 weeks. Median anti-CMV-IgG level, anti-CMV-IgM index and CMV-IgG avidity were 5.7 U/mL, 2.5 and 22.3%, respectively. HIG treatment was started at a median gestational age of 10.6 weeks and ended at a median of 17.9 weeks. Within this time frame, HIG was administered on average four times in each patient. Amniocentesis was carried out at a median gestational age of 20.4 weeks. In 143 (93.5%) of the 153 cases, the fetus was not infected. Maternal-fetal transmission occurred in 10 cases (6.5% (95% CI, 3.2-11.7%)). On uni- and multivariate logistic regression analysis, the level of anti-IgM index was the only factor associated significantly with maternal-fetal transmission at amniocentesis. However, only four (40.0%) of the 10 cases with maternal-fetal transmission had an anti-IgM index above 11.4, which corresponds to the 95th centile of pregnancies without transmission. CONCLUSIONS HIG is a treatment option to prevent maternal-fetal transmission in pregnancy with a primary CMV infection. However, HIG treatment seems to be beneficial primarily in women with a recent primary infection in the first trimester or during the periconceptional period, and when it is administered at a biweekly dose of 200 IU/kg. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- K O Kagan
- Department for Women's Health, University Hospital of Tübingen, Tübingen, Germany
| | - M Enders
- Laboratory Prof. Gisela Enders and Colleagues, Stuttgart, Germany
| | - M Hoopmann
- Department for Women's Health, University Hospital of Tübingen, Tübingen, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University Hospital of Bonn, Bonn, Germany
| | - C Simonini
- Department of Obstetrics and Prenatal Medicine, University Hospital of Bonn, Bonn, Germany
| | - C Berg
- Department of Obstetrics and Gynaecology, University Hospital of Cologne, Cologne, Germany
| | - I Gottschalk
- Department of Obstetrics and Gynaecology, University Hospital of Cologne, Cologne, Germany
| | - F Faschingbauer
- Department of Obstetrics and Gynaecology, University Hospital of Erlangen, Erlangen, Germany
| | - M O Schneider
- Department of Obstetrics and Gynaecology, University Hospital of Erlangen, Erlangen, Germany
| | - T Ganzenmueller
- Institute for Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| | - K Hamprecht
- Institute for Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| |
Collapse
|
12
|
Landy R, Young C, Skarzynski M, Cheung L, Berg C, Rivera M, Robbins H, Chaturvedi A, Katki H. MA05.10 Performance of Draft 2020 USPSTF Lung-Cancer Screening Guidelines and Potential for use of Risk Models to Reduce Racial/Ethnic Disparities. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.172] [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: 11/16/2022]
|
13
|
Jonsson L, Fröberg A, Korp P, Larsson C, Berg C, Lindgren EC. Possibilities and challenges in developing and implementing an empowerment-based school-intervention in a Swedish disadvantaged community. Health Promot Int 2020; 35:232-243. [PMID: 30848788 PMCID: PMC7250500 DOI: 10.1093/heapro/daz021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/24/2018] [Revised: 01/10/2019] [Accepted: 02/19/2019] [Indexed: 11/14/2022] Open
Abstract
In this paper, we describe and critically reflect on the possibilities and challenges of developing and implementing an empowerment-based school intervention regarding healthy food and physical activity (PA), involving participants from a Swedish multicultural area characterized by low socioeconomic status. The 2-year intervention was continually developed and implemented, as a result of cooperation and shared decision making among researchers and the participants. All 54 participants were seventh graders, and the intervention comprised health coaching, health promotion sessions and a Facebook group. We experienced that participants valued collaborating with peers, and that they took responsibility in codeveloping and implementing the intervention. Participants expressed feeling listened to, being treated with respect and taken seriously. However, we also experienced a number of barriers that challenged our initial intentions of aiding participation and ambition to support empowerment. Moreover, it was challenging to use structured group health coaching and to work with goal-setting in groups of participants with shared, and sometimes competing, goals, wishes and needs related to food and PA. Successful experiences from this intervention was the importance of acquiring a broad and deep understanding of the context and participants, being open to negotiating, as well as adjusting the intervention.
Collapse
Affiliation(s)
- L Jonsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - A Fröberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - P Korp
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - C Larsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - C Berg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - E-C Lindgren
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| |
Collapse
|
14
|
Hees K, Gozzi P, Berg C, David M, Hellmeyer L, Schlembach D. Myometriumdefekte im Bereich der Sectionarbe – Häufigkeit und Art von assoziierten Beschwerden bei Frauen drei und sechs Monate nach Sectio. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718075] [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: 10/23/2022] Open
Affiliation(s)
- K. Hees
- Charité – Universitätsmedizin Berlin
| | - P. Gozzi
- Charité Universitätsmedizin Berlin, Gynäkologie und Geburtsmedizin
| | - C. Berg
- Vivantes Klinikum im Friedrichshain, Gynäkologie und Geburtsmedizin
| | - M. David
- Charité Universitätsmedizin Berlin, Gynäkologie und Geburtsmedizin
| | - L. Hellmeyer
- Vivantes Klinikum im Friedrichshain, Gynäkologie und Geburtsmedizin
| | | |
Collapse
|
15
|
Abstract
Abstract
Background
Heated tobacco products (HTP), such as Philip Morris IQOS, have penetrated the global tobacco market. Currently the only HTP on the market in Israel, IQOS was introduced in 2016. The device is sold in specialty stores and online; while the heat sticks (HEETS) are sold at traditional retailers. In 01/2019 a ban on advertisements in all media (excluding print media) and at the point-of-sale (POS) went into effect. In 01/2020, a POS display ban and plain packaging went into effect. Understanding the POS marketing strategies at a time of regulatory transition could aid regulatory efforts in other countries.
Methods
Observations were conducted in 80 retailers carrying HEETS in 4 large Israeli cities in 12/2019, before the POS display ban and plain packaging went into effect. Data were collected using an adapted version of the Standardized Tobacco Assessment for Retail Settings, which assessed store characteristics, product offerings, pricing, promotional strategies, and placement.
Results
All retailers sold cigarettes; 51% carried also electronic cigarettes. Only one retailer carried the IQOS device. HEETS packages were visible to customers in 47% of retailers. Over 60% carried at least 3 HEETS different flavours (out of 5 available). In all but one retailer, HEETS were sold at higher prices than cigarettes, on average 21% more expensive. Posted ads were uncommon. In 14.5% of retailers, a special IQOS product display cast was prominent. Additionally, 25% of retailers placed cigarettes and 14% placed HEETS near youth-oriented merchandise.
Conclusions
This study provides insights into IQOS marketing strategies during a period of regulatory transition. Findings suggest that IQOS-specific promotions were not common, but a proportion of retailers highlighted IQOS via displays and/or proximity to youth-oriented merchandise. Moreover, IQOS may be promoted to higher socio-economic status populations, as indicated by pricing and possibly by availability of products.
Key messages
Understanding IQOS marketing strategies at point-of-sale is critical to inform regulatory measures globally. IQOS marketing strategies in Israel at the point-of-sale suggest that IQOS is promoted to higher socio-economic status populations.
Collapse
Affiliation(s)
- Y Bar Zeev
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - C Berg
- Milken Institute School of Public Health, George Washington University, Washington, USA
| | - L C Abroms
- Milken Institute School of Public Health, George Washington University, Washington, USA
| | - H Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| |
Collapse
|
16
|
Berg C, Ihling N, Büchs J. Combination of multivariate data analysis and 2D fluorescence spectroscopy in high‐throughput cultivation experiments. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055200] [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: 11/10/2022]
Affiliation(s)
- C. Berg
- RWTH AVT/Bioverfahrenstechnik Forckenbeckstr. 51 52074 Aachen Germany
| | - N. Ihling
- RWTH AVT/Bioverfahrenstechnik Forckenbeckstr. 51 52074 Aachen Germany
| | - J. Büchs
- RWTH AVT/Bioverfahrenstechnik Forckenbeckstr. 51 52074 Aachen Germany
| |
Collapse
|
17
|
Bar-Zeev Y, Berg C, Kislev S, Geva H, Godinger E, Abroms L, Levine H. Tobacco industry tactics in response to extensive tobacco control legislation in Israel. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1292] [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: 11/12/2022] Open
Abstract
Abstract
Issue
Tobacco control in Israel has been lagging, and smoking rates have remained stable in the last decade (∼20%). In 2018, landmark legislation was passed to go into effect during 2019- 2020. The tobacco and vaping industry employed several tactics to circumvent and test the ability to enforce the new legislation. Examining industry responses to legislative reform in Israel may inform policy and enforcement internationally.
Description of the Problem
Resulting from strong political will, supportive media, and a strong coalition of tobacco control advocates, the legislation involves: 1) advertising bans in all media, excluding print press; 2) point-of-sales display bans; 3) plain packaging with textual health warning labels; and 4) extending the legislation to include also vaping products. Industry tactics to circumvent/test this legislation were communicated through an active social media group of tobacco control coalition members who shared information regarding such tactics in all geographical areas in Israel and via different media outlets.
Results
Various measures employed by the industry included, for example, print media advertisements with branded elements in the background (prohibited by law); new signs and display boxes for heated tobacco products and e-cigarettes, at the point-of-sale, that say “An alternative to cigarettes”; distributing branded tin cases for cigarettes; Highlighting different brands online and in print media using colors and fonts that are not allowed as part of plain packaging, and including branded elements inside the cigarette package
Lessons
Anything not specifically covered or detailed or verbiage that is open to interpretation provides an opening for the industry to circumvent the legislation intentions. It is crucial that legislation be as specific and detailed as possible, anticipate industry efforts to identify such 'loopholes', and compel industry compliance through efficient enforcement.
Key messages
In response to extensive tobacco control legislation in Israel, the tobacco industry employed various tactics to bypass legislative efforts. Tobacco control legislation and regulation need to use detailed wording to prevent alternative interpretations by the tobacco industry.
Collapse
Affiliation(s)
- Y Bar-Zeev
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - C Berg
- Milken Institute School of Public Health, George Washington University, Washington DC, Israel
| | - S Kislev
- Smoke Free Israel, Ramat Razial, Israel
| | - H Geva
- Public Health Services, Ministry of Health, Jerusalem, Israel
| | - E Godinger
- Public Policy Unit, Israel Medical Association, Ramat Gan, Israel
| | - L Abroms
- Milken Institute School of Public Health, George Washington University, Washington DC, Israel
| | - H Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| |
Collapse
|
18
|
Strizek B, Gottschalk I, Recker F, Weber E, Flöck A, Gembruch U, Geipel A, Berg C. Vesicoamniotic shunting for fetal megacystis in the first trimester with a Somatex ® intrauterine shunt. Arch Gynecol Obstet 2020; 302:133-140. [PMID: 32449061 PMCID: PMC7266802 DOI: 10.1007/s00404-020-05598-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/02/2020] [Accepted: 05/08/2020] [Indexed: 11/30/2022]
Abstract
Purpose The objective was to evaluate the feasibility of vesicoamniotic shunting (VAS) in the first trimester with the Somatex® intrauterine shunt and report on complications and neonatal outcome. Methods Retrospective cohort study of all VAS before 14 weeks at two tertiary fetal medicine centres from 2015 to 2018 using a Somatex® intrauterine shunt. All patients with a first trimester diagnosis of megacystis in male fetuses with a longitudinal bladder diameter of at least 15 mm were offered VAS. All patients that opted for VAS after counselling by prenatal medicine specialists, neonatologists and pediatric nephrologists were included in the study. Charts were reviewed for complications, obstetric and neonatal outcomes. Results Ten VAS were performed during the study period in male fetuses at a median GA of 13.3 (12.6–13.9) weeks. There were two terminations of pregnancy (TOP) due to additional malformations and one IUFD. Overall there were four shunt dislocations (40%); three of those between 25–30 weeks GA. Seven neonates were born alive at a median GA of 35.1 weeks (31.0–38.9). There was one neonatal death due to pulmonary hypoplasia. Neonatal kidney function was normal in the six neonates surviving the neonatal period. After exclusion of TOP, perinatal survival was 75%, and 85.7% if only live-born children were considered. Conclusion VAS in the first trimester is feasible with the Somatex® Intrauterine shunt with low fetal and maternal complication rates. Neonatal survival rates are high due to a reduction in pulmonary hypoplasia and the rate of renal failure at birth is very low. VAS can be safely offered from the late first trimester using the Somatex® intrauterine shunt.
Collapse
Affiliation(s)
- B Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - I Gottschalk
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Cologne, Cologne, Germany
| | - F Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - E Weber
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Flöck
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - C Berg
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University Hospital Cologne, Cologne, Germany
| |
Collapse
|
19
|
Berg C, Sturua L. THE CRITICAL NEED FOR ENHANCING THE RESEARCH CAPACITY REGARDING THE INTERSECTION OF AIR POLLUTION AND NON-COMMUNICABLE DISEASES IN GEORGIA. Georgian Med News 2020:178-182. [PMID: 32535585 PMCID: PMC7894988] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Globally, 7 million deaths are attributable to the joint effects of indoor and ambient air pollution annually, with ~94% occurring in low- and middle-income countries (LMICs). While 51% of cities in high-income countries with ≥100,000 residents meet WHO air quality guidelines, only 3% of such cities in LMICs meet them. In the country of Georgia, adverse environmental exposures cause 21% of disease burden and 25% of deaths,including30% of disease burden and 14% of deaths among children. According to 2016 WHO data, Georgia's mortality index attributed to ambient and indoor air pollution was 204.9, the 3rd highest in the world. Indoor air pollution is largely a result of indoor cooking/heating using solid fuel and second hand smoke (SHS). Worldwide, 40% of children, 35% of female nonsmokers, and 33% of male nonsmokers are exposed to SHS. Annually, SHS exposure causes ~600,000 deaths (1% of mortality), with half of those deaths in women and over a quarter in children. LMICs are disproportionately impacted by SHS and related morbidity and mortality. In Georgia, the smoking prevalence is 58% in men (6th highest in the world) and 6% in women. Moreover, prior research found that 30% of Georgian adults were exposed the SHS in the past week in public places and 54% at home; 42% reported daily exposure. Georgia's 2017-2021 National Environment and Health Action Planhighlights that addressing air pollution is among the most prominent public health priorities. However, there is limited in-country capacity to conduct research regarding the impact of such environmental hazards on health. Thus, efforts must enhance such research capacity in order to reduce air pollution and its effects on health.
Collapse
Affiliation(s)
- C Berg
- 1Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC; 2George Washington Cancer Center, George Washington University, Washington, DC
| | - L Sturua
- 3National Center for Disease Control and Public Health, Tbilisi; 4Petre Shotadze Tbilisi Medical Academy, Georgia
| |
Collapse
|
20
|
Magnusson M, Forslund HB, Berg C, Wretlind K, Hallmyr M, Hedström C, Vaughn LM. Health promoting ideas and actions generated by community engagement in an underserved Swedish area. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
For an intervention to contribute to decreased health gaps, people living in underserved areas must participate in the research-to-action process during the development of the intervention.
Methods for increased engagement and participation have been developed within the community-based participatory research (CBPR) paradigm. Group Level Assessment (GLA) is a qualitative, participatory methodology that is designed for a large group to generate and evaluate relevant needs and priorities within a lens of action for positive social change. Influence of researchers is tuned down in favour of partnership and impact from the community. Ideally, the process results in participant-driven data and relevant action plans. The aim was to apply GLA to generate reflections on the situation in the community, aligning towards action for change.
Methods
We applied GLA together with people living in Gårdsten, an underserved Swedish suburb where obesity, caries and other illnesses are prevalent. Residents were recruited by posters and post cards at a community center and by snowball sampling. In total, 47 residents attended at least one of eight GLA sessions held over a five-month time period. The majority were women. Outcomes were reflections, suggestions and actions for change.
Results
Themes were: resident pride of the area, the importance of communication and of places to meet, a feeling of being abandoned by society, and a desire for more collaboration between schools and parents. Immediate results were a language café and inquiries from the community about information regarding teeth, food and health. When the results were presented for stakeholders in a report and an exhibition, new collaborations were founded and old were refreshed.
Conclusions
GLA helped residents identify what they thought valuable and relevant concerning health issues and supported them in taking actions to achieve change.
Key messages
Participatory processes that directly engage community residents can result in fruitful discussions and actions. Methodologies like GLA that support such processes may contribute to closing the health gap.
Collapse
Affiliation(s)
- M Magnusson
- Public Health Unit, Angered Hospital, SV Hospital Group, Region Västra Götaland, Sweden
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - H B Forslund
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - C Berg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - K Wretlind
- Public Dental Service Västra Götaland, Region Västra Götaland, University of Malmö, Sweden
| | - M Hallmyr
- Public Health Unit, Angered Hospital, SV Hospital Group, Region Västra Götaland, Sweden
| | - C Hedström
- Public Health Unit, Angered Hospital, SV Hospital Group, Region Västra Götaland, Sweden
| | - L M Vaughn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| |
Collapse
|
21
|
Robbins H, Callister M, Sasieni P, Quaife S, Cheung L, Brennan P, Katki H, Berg C, Baldwin D, Johansson M. P2.11-07 Benefits and Harms of Contemporary Lung Cancer Screening: An Infographic to Support Public and Patient Education. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1707] [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: 10/25/2022]
|
22
|
Wagner P, Eberle K, Sonek J, Berg C, Gembruch U, Hoopmann M, Prodan N, Kagan KO. First-trimester ductus venosus velocity ratio as a marker of major cardiac defects. Ultrasound Obstet Gynecol 2019; 53:663-668. [PMID: 30125415 DOI: 10.1002/uog.20099] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/29/2018] [Accepted: 08/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine ductus venosus (DV) flow in fetuses with and those without a cardiac defect and to evaluate different phases of DV flow in addition to the standard assessment of DV pulsatility index for veins (PIV) and the a-wave. METHODS This was a retrospective study of singleton pregnancies that underwent first-trimester ultrasound screening, which included DV flow assessment, at the University of Tübingen (between 2010 and 2017) or the University of Cologne (between 2013 and 2016). The study population comprised normal fetuses and fetuses with major cardiac defects at a ratio of 10:1. For each fetus, the following parameters of the DV waveform were evaluated: qualitative assessment of the a-wave, PIV measurement and ratios of flow velocities during the S-wave (S) or D-wave (D) and the a-wave (a) or v-wave (v). Reproducibility of DV-PIV and DV flow ratios was evaluated in 30 fetuses in which the DV flow was assessed twice. RESULTS Our study population included 480 anatomically normal fetuses and 48 with a cardiac defect. Median fetal nuchal translucency (NT) in the normal and in the affected group was 1.9 mm and 2.6 mm, respectively. In five (1.0%) of the normal and 18 (37.5%) of the affected cases, fetal NT thickness was above the 99th centile. In the normal group, the DV a-wave was reversed in 15 (3.1%) cases and the DV-PIV was above the 95th centile in 25 (5.2%). In the cases with cardiac defects, the a-wave was reversed and the DV-PIV measurement was above the 95th centile in 26 (54.2%). The reproducibility of measurement of the ratios of DV flow velocities was similar to that of the DV-PIV. Most cardiac defects were associated with an abnormal a/S or a/D ratio. If the cut-off for these two ratios was set at the 5th centile of the normal distribution, the detection rate of fetal cardiac anomalies would be 62.5%. This compares favorably with the DV-PIV, which detects 26 (54.2%) of the affected fetuses for the same threshold. CONCLUSION In the first trimester, the a/S ratio has the potential to detect approximately 60% of congenital cardiac defects for a false-positive rate of 5%. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- P Wagner
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - K Eberle
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - J Sonek
- Fetal Medicine Foundation USA, Dayton, OH, USA
- Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA
| | - C Berg
- Department of Obstetrics and Gynaecology, University of Cologne, Cologne, Germany
- Department of Obstetrics and Gynaecology, University of Bonn, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Gynaecology, University of Bonn, Bonn, Germany
| | - M Hoopmann
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - N Prodan
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| | - K O Kagan
- Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany
| |
Collapse
|
23
|
Affiliation(s)
- M J Keane
- Department of Anaesthesia, Casey Hospital, 52 Kangan Drive, Berwick, Melbourne, Victoria 3806, Australia.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C Berg
- Department of Economics, Royal Melbourne Institute of Technology (RMIT), RMIT University, GPO Box 2476, Melbourne, Victoria 3001, Australia
| |
Collapse
|
24
|
Kagan KO, Enders M, Schampera MS, Baeumel E, Hoopmann M, Geipel A, Berg C, Goelz R, De Catte L, Wallwiener D, Brucker S, Adler SP, Jahn G, Hamprecht K. Prevention of maternal-fetal transmission of cytomegalovirus after primary maternal infection in the first trimester by biweekly hyperimmunoglobulin administration. Ultrasound Obstet Gynecol 2019; 53:383-389. [PMID: 29947159 DOI: 10.1002/uog.19164] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/11/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the efficacy of biweekly hyperimmunoglobulin (HIG) administration to prevent maternal-fetal transmission of cytomegalovirus (CMV) in women with primary first-trimester CMV infection. METHODS This was a prospective observational study of women with confirmed primary CMV infection in the first trimester who had the first HIG administration at or before 14 weeks' gestation. All women had biweekly HIG treatment until 20 weeks' gestation at a dose of 200 IU/kg of maternal body weight. Each subject underwent amniocentesis at least 6 weeks after first presentation at about 20 weeks. Primary outcome was maternal-fetal transmission at the time of amniocentesis, and secondary outcome was the frequency of congenital CMV infection at birth. The results were compared with a historic cohort of women with first-trimester CMV infection who did not undergo HIG treatment and who had amniocentesis at about 20 weeks. RESULTS Subjects were 40 pregnant women with a primary CMV infection, with a median gestational age at first presentation of 9.6 (range, 5.1-14.3) weeks. On average, HIG administration started at 11.1 weeks and continued until 16.6 weeks. Within this interval, HIG was administered between two and six times in each patient. While CMV immunoglobulin-G (IgG) monitoring showed periodic fluctuations during biweekly HIG administration cycles, high CMV-IgG avidity indices remained stable over the whole treatment period. Maternal-fetal transmission before amniocentesis occurred in only one of the 40 cases (2.5% (95% CI, 0-13.2%)). At delivery, two additional subjects were found to have had late-gestation transmission. Considering all three cases with maternal-fetal transmission, the transmission rate was 7.5% (95% CI, 1.6-20.4%) in our 40 cases. All infected neonates were asymptomatic at birth. The matched historical control group consisted of 108 pregnancies. Thirty-eight transmissions (35.2% (95% CI, 26.2-45.0%)) occurred in the control group, which was significantly higher (P < 0.0001) than the transmission rate in the HIG treatment group. CONCLUSION After a primary maternal CMV infection in the first trimester, biweekly HIG administration at a dose of 200 IU/kg prevents maternal-fetal transmission up to 20 weeks' gestation. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- K O Kagan
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - M Enders
- Laboratory Prof. Gisela Enders & Colleagues MVZ and Institute of Virology, Infectiology and Epidemiology e.V, Stuttgart, Germany
| | - M S Schampera
- Institute of Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| | - E Baeumel
- Institute of Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| | - M Hoopmann
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - A Geipel
- Department of Obstetrics and Gynaecology, University of Bonn, Bonn, Germany
| | - C Berg
- Department of Obstetrics and Gynaecology, University of Cologne, Cologne, Germany
| | - R Goelz
- Department of Neonatology, University of Tübingen, Tübingen, Germany
| | - L De Catte
- Department of Obstetrics and Gynaecology, University of Leuven, Leuven, Belgium
| | - D Wallwiener
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - S Brucker
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - S P Adler
- CMV Research Foundation, Richmond, VA, USA
| | - G Jahn
- Institute of Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| | - K Hamprecht
- Institute of Medical Virology and Epidemiology of Viral Diseases, University of Tübingen, Tübingen, Germany
| |
Collapse
|
25
|
Wagner P, Prodan N, Berg C, Gembruch U, Hoopmann M, Kagan KO. Ersttrimesterscreening auf kongenitale Herzfehler mittels verschiedener Methoden der Ductus venosus Beurteilung. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671470] [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: 10/28/2022] Open
Affiliation(s)
- P Wagner
- Universitätsklinikum Tübingen, Frauenklinik, Tübingen, Deutschland
| | - N Prodan
- Universitätsklinikum Tübingen, Frauenklinik, Tübingen, Deutschland
| | - C Berg
- Universitätsklinikum Köln, Frauenklinik, Köln, Deutschland
| | - U Gembruch
- Universitätsklinikum Köln, Frauenklinik, Köln, Deutschland
| | - M Hoopmann
- Universitätsklinikum Tübingen, Frauenklinik, Tübingen, Deutschland
| | - KO Kagan
- Universitätsklinikum Tübingen, Frauenklinik, Tübingen, Deutschland
| |
Collapse
|
26
|
Gottschalk I, Abel JS, Menzel T, Herberg U, Breuer J, Gembruch U, Geipel A, Brockmeier K, Berg C. Prenatal diagnosis and postnatal outcome of fetuses with double outlet right ventricle (DORV) in a single center. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671112] [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: 10/28/2022] Open
Affiliation(s)
- I Gottschalk
- Universitätsfrauenklinik Köln, Bereich für Pränatalmedizin und Gynäkologische Sonografie, Köln, Deutschland
| | - JS Abel
- Universitätsfrauenklinik Köln, Bereich für Pränatalmedizin und Gynäkologische Sonografie, Köln, Deutschland
| | - T Menzel
- Universitätsfrauenklinik Köln, Bereich für Pränatalmedizin und Gynäkologische Sonografie, Köln, Deutschland
| | - U Herberg
- Universitätsklinikum Bonn, Abteilung für Kinderkardiologie, Bonn, Deutschland
| | - J Breuer
- Universitätsklinikum Bonn, Abteilung für Kinderkardiologie, Bonn, Deutschland
| | - U Gembruch
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatalmedizin, Bonn, Deutschland
| | - A Geipel
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatalmedizin, Bonn, Deutschland
| | - K Brockmeier
- Universitätsklinik Köln, Klinik und Poliklinik für Kinderkardiologie, Köln, Deutschland
| | - C Berg
- Universitätsfrauenklinik Köln, Bereich für Pränatalmedizin und Gynäkologische Sonografie, Köln, Deutschland
- Universitätsklinikum Bonn, Abteilung für Geburtshilfe und Pränatalmedizin, Bonn, Deutschland
| |
Collapse
|
27
|
Berg C. MTE04.01 Comparisons of Risk Models. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.053] [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: 10/28/2022]
|
28
|
Kagan KO, Enders M, Hoopmann M, Berg C, Geipel A, Hamprecht K. Prevention of maternal-fetal transmission of CMV by hyperimmunoglobulin (HIG) administered after a primary maternal CMV infection in early gestation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671626] [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: 10/28/2022] Open
Affiliation(s)
- KO Kagan
- Universität Tübingen, Gynäkologie und Geburtshilfe, Tübingen, Deutschland
| | - M Enders
- Labor Prof. Gisela Enders & Partner MVZ, Stuttgart, Deutschland
| | - M Hoopmann
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - C Berg
- Universitätsfrauenklinik Bonn, Bonn, Deutschland
| | - A Geipel
- Universitätsfrauenklinik Bonn, Bonn, Deutschland
| | - K Hamprecht
- Medizinische Virologie und Epidemiologie von Viruserkrankungen, Tübingen, Deutschland
| |
Collapse
|
29
|
Terrill A, Einerson J, Reblin M, MacKenzie J, Berg C, Majersik J, Richards L. Pilot testing a positive psychology intervention to promote well-being in couples coping with stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.445] [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: 11/27/2022]
|
30
|
Calite E, Strizek B, Berg C, Gembruch U, Müller A, Geipel A. Stellenwert sonographischer und MRT-basierter Prognosemarker und intrauterine Therapie bei Feten mit angeborener Zwerchfellhernie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660605] [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: 10/28/2022] Open
Affiliation(s)
- E Calite
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn
| | - B Strizek
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn
| | - C Berg
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn
| | - U Gembruch
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn
| | - A Müller
- Abteilung für Neonatologie, Universitätsklinik Bonn
| | - A Geipel
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn
| |
Collapse
|
31
|
Mallmann MR, Reuter H, Mack-Detlefsen B, Gottschalk I, Geipel A, Berg C, Boemers TM, Gembruch U. Pränatale Diagnostik des Hydro(metro)kolpos: Differentialdiagnosen und assoziierte Fehlbildungen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660619] [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: 10/28/2022] Open
Affiliation(s)
- MR Mallmann
- Abteilung für Geburtshilfe und Pränatale Medizin, Universität Bonn
- Klinik für Geburtshilfe und Gynäkologie, Universität Köln
| | - H Reuter
- Abteilung für Neonatologie und Pädiatrische Intensivmedizin, Universität Bonn
- Institut für Humangenetik, Universität Bonn
| | - B Mack-Detlefsen
- Abteilung für Kinderchirurgie und Kinderurologie, Kinderkrankenhaus Amsterdamer Straße, Köln
| | - I Gottschalk
- Klinik für Geburtshilfe und Gynäkologie, Universität Köln
| | - A Geipel
- Abteilung für Geburtshilfe und Pränatale Medizin, Universität Bonn
| | - C Berg
- Abteilung für Geburtshilfe und Pränatale Medizin, Universität Bonn
- Klinik für Geburtshilfe und Gynäkologie, Universität Köln
| | - TM Boemers
- Abteilung für Kinderchirurgie und Kinderurologie, Kinderkrankenhaus Amsterdamer Straße, Köln
| | - U Gembruch
- Abteilung für Geburtshilfe und Pränatale Medizin, Universität Bonn
| |
Collapse
|
32
|
Recker F, Strizek B, Müller A, Dresbach T, Gembruch U, Geipel A, Berg C. Die fetale endoskopische Trachealintubation (FETI): Neue Behandlungsmethode bei intrauterinen kongenitalen Zervikalteratomen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660607] [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: 10/28/2022] Open
Affiliation(s)
- F Recker
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinikum Bonn
| | - B Strizek
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinikum Bonn
| | - A Müller
- Abteilung für Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Bonn
| | - T Dresbach
- Abteilung für Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Bonn
| | - U Gembruch
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinikum Bonn
| | - A Geipel
- Abteilung für Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Bonn
| | - C Berg
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinikum Bonn
- Abteilung für Pränatale Medizin, Universitätsfrauenklinik Köln
| |
Collapse
|
33
|
Gottschalk I, Strizek B, Jehle C, Stressig R, Herberg U, Breuer J, Brockmeier K, Hellmund A, Geipel A, Gembruch U, Berg C. Pränatale Diagnose und postnatales Outcome von Feten mit Pulmonalatresia und Ventrikelseptumdefekt. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660603] [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: 10/28/2022] Open
Affiliation(s)
- I Gottschalk
- Bereich für Pränatale Medizin und Gynäkologische Sonografie, Universitätsfrauenklinik Köln, Deutschland
| | - B Strizek
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn, Deutschland
| | - C Jehle
- Bereich für Pränatale Medizin und Gynäkologische Sonografie, Universitätsfrauenklinik Köln, Deutschland
| | - R Stressig
- praenatal.de, Pränatale Medizin und Genetik, Köln, Deutschland
| | - U Herberg
- Abteilung für Kinderkardiologie, Universitätsklinik Bonn, Deutschland
| | - J Breuer
- Abteilung für Kinderkardiologie, Universitätsklinik Bonn, Deutschland
| | - K Brockmeier
- Klinik und Poliklinik für Kinderkardiologie, Universitätsklinik Köln, Deutschland
| | - A Hellmund
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn, Deutschland
| | - A Geipel
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn, Deutschland
| | - U Gembruch
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn, Deutschland
| | - C Berg
- Bereich für Pränatale Medizin und Gynäkologische Sonografie, Universitätsfrauenklinik Köln, Deutschland
- Abteilung für Geburtshilfe und Pränatale Medizin, Universitätsklinik Bonn, Deutschland
| |
Collapse
|
34
|
Affiliation(s)
- P. Sengl
- Civil Engineering Office Kofler Umweltmanagement, Austria
| | - M. Magnes
- Institute of Plant Sciences, University of Graz, Austria
| | - L. Erdős
- Institute of Ecology and Botany, MTA Centre for Ecological Research, Vácrátót, Hungary
| | - C. Berg
- Institute of Plant Sciences, University of Graz, Austria
| |
Collapse
|
35
|
Roethlisberger M, Strizek B, Gottschalk I, Mallmann MR, Geipel A, Gembruch U, Berg C. First-trimester intervention in twin reversed arterial perfusion sequence: does size matter? Ultrasound Obstet Gynecol 2017; 50:40-44. [PMID: 27390925 DOI: 10.1002/uog.16013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/11/2016] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To evaluate the outcome of first-trimester intervention (12 + 0 to 14 + 0 weeks of gestation) in pregnancies complicated by twin reversed arterial perfusion (TRAP) sequence. METHODS All monochorionic diamniotic twin pregnancies diagnosed with TRAP sequence that underwent intrafetal laser ablation (IFL) of the feeding vessels before 14 + 0 weeks of gestation at the University of Bonn between 2010 and 2015 were analyzed retrospectively for intrauterine course and outcome. RESULTS In the study period, 12 pregnancies with TRAP sequence were treated by IFL. Median gestational age at intervention was 13.2 (interquartile range (IQR), 12.6-13.6) weeks. In all cases, one intervention sufficed to disrupt the perfusion of the TRAP twin. There was no case of miscarriage, preterm prelabor rupture of membranes or hemorrhage. In five (41.7%) pregnancies, intrauterine death of the pump twin occurred at a median of 72.0 (IQR, 54.0-90.0; range, 48-96) h after intervention. The remaining seven pregnancies continued uneventfully resulting in birth of a healthy infant at term. A comparison of survivors and non-survivors identified a significant difference in median discordance between crown-rump length (CRL) of the pump twin and upper pole-rump length (URL) of the TRAP twin ((CRL - URL)/CRL ratio, 0.56 vs 0.31; P < 0.05 and URL/CRL ratio, 0.44 vs 0.68; P < 0.05). Survivors were treated at a significantly later gestational age than were non-survivors (median, 13.4 (IQR, 12.9-14.1) vs 12.6 (IQR, 12.5-13.1); P < 0.05). However, none of these parameters independently predicted survival. CONCLUSIONS Although technically feasible, IFL performed in the first trimester for TRAP sequence is associated with a significant fetal loss rate. Gestational age at intervention, (CRL - URL)/CRL ratio and URL/CRL ratio are potential predictors of pregnancy outcome. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- M Roethlisberger
- Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - B Strizek
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - I Gottschalk
- Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - M R Mallmann
- Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - A Geipel
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Gembruch
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - C Berg
- Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| |
Collapse
|
36
|
Gottschalk I, Jehle C, Herberg U, Breuer J, Brockmeier K, Bennink G, Hellmund A, Strizek B, Gembruch U, Geipel A, Berg C. Prenatal diagnosis of absent pulmonary valve syndrome from first trimester onwards: novel insights into pathophysiology, associated conditions and outcome. Ultrasound Obstet Gynecol 2017; 49:637-642. [PMID: 27240926 DOI: 10.1002/uog.15977] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the spectrum of associated anomalies, intrauterine course and outcome in fetuses with absent pulmonary valve syndrome (APVS). METHODS All cases with a prenatal diagnosis of APVS at two centers over a period of 13 years were analyzed retrospectively. APVS was diagnosed in the presence of rudimentary or dysplastic pulmonary valve leaflets with to-and-fro blood flow in the pulmonary trunk on color and pulsed-wave Doppler ultrasound. Data on demographic characteristics, presence of associated conditions, Doppler studies and pregnancy outcome were reviewed. RESULTS During the study period, 40 cases of APVS were diagnosed prenatally. Thirty-seven (92.5%) cases were associated with tetralogy of Fallot (TOF) and three (7.5%) had an intact ventricular septum. Patency of the ductus arteriosus (DA) was found in 17/37 (45.9%) TOF cases and in all three cases with an intact ventricular septum. Mean gestational age at diagnosis was 19.7 (range, 12-34) weeks with 10 (25.0%) cases (all with TOF) diagnosed in the first trimester. TOF was an isolated finding in 15 (37.5%) cases. Chromosomal anomalies, cardiac defects and extracardiac anomalies were present in 18 (45.0%), four (10.0%) and three (7.5%) cases, respectively. Among the 40 cases, there were 19 (47.5%) terminations of pregnancy, six (15.0%) intrauterine deaths, four (10.0%) neonatal deaths and 11 (27.5%) survivors. Patency of the DA, reversed flow during atrial contraction in the ductus venosus, umbilical artery or fetal middle cerebral artery, and hydrops/increased nuchal translucency thickness were significantly associated with non-survival. All 10 cases diagnosed in the first trimester had a patent DA and abnormal Doppler parameters, eight had hydrops and/or increased nuchal translucency, six were associated with trisomy 13 or 18 and none survived. CONCLUSION APVS diagnosed in the first trimester is significantly associated with TOF, patency of the DA, abnormal Doppler parameters, lethal trisomies and intrauterine mortality. Cases of APVS with isolated TOF and agenesis of the DA have a better outcome than those with additional anomalies, with > 80% survival. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- I Gottschalk
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - C Jehle
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Herberg
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - J Breuer
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
| | - K Brockmeier
- Heart Center, University Hospital of Cologne, Cologne, Germany
| | - G Bennink
- Heart Center, University Hospital of Cologne, Cologne, Germany
| | - A Hellmund
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - B Strizek
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - A Geipel
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - C Berg
- Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
- Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| |
Collapse
|
37
|
Hernandez A, Berg C, Eriksson S, Edstam L, Orihuela A, Leon H, Galina C. The Welfare Quality® assessment protocol: how can it be adapted to family farming dual purpose cattle raised under extensive systems in tropical conditions? Anim Welf 2017. [DOI: 10.7120/09627286.26.2.177] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
38
|
Rüland AM, Berg C, Gembruch U, Geipel A. Prenatal Diagnosis of Anomalies of the Corpus Callosum over a 13-Year Period. Ultraschall Med 2016; 37:598-603. [PMID: 26114344 DOI: 10.1055/s-0034-1399699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Purpose: The clinical use of detailed fetal neurosonography has increased over the past decade. This retrospective study explored the spectrum and frequency of different forms of corpus callosum anomalies (CCAs) in a level III center setting. Materials and Methods: Between 1999 and 2012, 48 907 detailed second and third trimester scans were performed. Among them, 140 (0.29 %) cases of CCA were diagnosed. We differentiated between complete and partial agenesis, hypoplastic corpus callosum (CC) and isolated and non-isolated forms. Results: The 140 cases with CCA included 107 with complete agenesis (76 %), 20 with partial agenesis (14 %) and 13 with a hypoplastic CC (9 %). Of them, 29 % (41/140) were isolated and 71 % (99/140) were non-isolated cases. Analysis of three time periods demonstrated an increase in the diagnosis of all types of CCA (1999 - 2004: n = 26; 2005 - 2008: n = 32; 2009 - 2012: n = 82), whereas the ratio between isolated and non-isolated types remained stable. The median gestational age at diagnosis was 25.0 weeks and did not change over the years. Non-isolated forms were associated with additional non-chromosomal cerebral anomalies in 22.2 % (22/99), extracerebral non-chromosomal malformations in 40.4 % (40/99), aneuploidies in 21.2 % (21/99), and syndromes in 16.2 % (16/99). All aneuploid fetuses except one showed cerebral or extracerebral malformations. Conclusion: The rise in prenatal diagnosis of CCA reflects the increased use of systematic fetal neurosonography over the years. Despite an overall increase in diagnosed cases, the relationship between isolated CCAs and complex forms remained stable. Since the percentage of coexisting anomalies is high, a detailed assessment by a specialist is recommended.
Collapse
|
39
|
Rüland AM, Berg C, Gembruch U, Geipel A. Prenatal Diagnosis of Anomalies of the Corpus Callosum over a 13-Year Period. Ultraschall Med 2016; 37:E1. [PMID: 31847035 DOI: 10.1055/s-0035-1553665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
40
|
Mallmann MR, Reutter H, Müller AM, Geipel A, Berg C, Gembruch U. Der OEIS-Komplex und assoziierte Fehlbildungen in 12 pränatal diagnostizierten Fällen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592923] [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
|
41
|
Roethlisberger M, Gottschalk I, Geipel A, Mallmann P, Gembruch U, Berg C. Erst Trimester Interventionen bei Twin Reversed Arterial Perfusion (TRAP) Sequenz. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592876] [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
|
42
|
Mallmann MR, Graham V, Rösing B, Gottschalk I, Müller A, Gembruch U, Geipel A, Berg C. Thorako-amniote Shuntanlage bei fetalem Hydrothorax – Prädiktoren für den intrauterine Verlauf und das postnatale Outcome. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593253] [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
|
43
|
Gottschalk I, Mallmann M, Müller A, Geipel A, Gembruch U, Strizek B, Berg C. Outcome nach intrauteriner Laserablation broncho-pulmonaler Sequestrationen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592883] [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
|
44
|
Hoellen F, Weichert J, Krapp M, Germer U, Axt-Fliedner R, Kempe A, Geipel A, Berg C, Gembruch U. Fetal cephaloceles – prenatal diagnosis and course of pregnancy in 67 consecutive cases. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592850] [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
|
45
|
Lachat C, Hawwash D, Ocké MC, Berg C, Forsum E, Hörnell A, Larsson CL, Sonestedt E, Wirfält E, Åkesson A, Kolsteren P, Byrnes G, De Keyzer W, Van Camp J, Cade JE, Slimani N, Cevallos M, Egger M, Huybrechts I. Strengthening the Reporting of Observational Studies in Epidemiology - nutritional epidemiology (STROBE-nut): An extension of the STROBE statement. NUTR BULL 2016; 41:240-251. [PMID: 27587981 PMCID: PMC4988500 DOI: 10.1111/nbu.12217] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [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] [Indexed: 01/06/2023]
Abstract
Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology - Nutritional Epidemiology (STROBE-nut). Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, co-ordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.
Collapse
Affiliation(s)
- C Lachat
- Department of Food Safety and Food Quality Ghent University Ghent Belgium; Unit of Nutrition and Child Health Institute of Tropical Medicine Antwerp Belgium
| | - D Hawwash
- Department of Food Safety and Food Quality Ghent University Ghent Belgium
| | - M C Ocké
- National Institute for Public Health and the Environment Bilthoven The Netherlands
| | - C Berg
- Department of Food and Nutrition, and Sport Science University of Gothenburg Gothenburg Sweden
| | - E Forsum
- Department of Clinical and Experimental Medicine Linköping University Linköping Sweden
| | - A Hörnell
- Department of Food and Nutrition Umeå University Umeå Sweden
| | - C L Larsson
- Department of Food and Nutrition, and Sport Science University of Gothenburg Gothenburg Sweden
| | - E Sonestedt
- Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - E Wirfält
- Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - A Åkesson
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - P Kolsteren
- Department of Food Safety and Food Quality Ghent University Ghent Belgium; Unit of Nutrition and Child Health Institute of Tropical Medicine Antwerp Belgium
| | - G Byrnes
- International Agency for Research on Cancer Lyon France
| | - W De Keyzer
- Department of Biosciences and Food Sciences University College Ghent Ghent Belgium
| | - J Van Camp
- Department of Food Safety and Food Quality Ghent University Ghent Belgium
| | - J E Cade
- School of Food Science and Nutrition University of Leeds Leeds UK
| | - N Slimani
- International Agency for Research on Cancer Lyon France
| | - M Cevallos
- Institute of Social and Preventive Medicine University of Bern Bern Switzerland; Department of Clinical Research University of Bern Bern Switzerland
| | - M Egger
- Institute of Social and Preventive Medicine University of Bern Bern Switzerland
| | - I Huybrechts
- International Agency for Research on Cancer Lyon France
| |
Collapse
|
46
|
Zimmermann T, Beckebaum S, Berg C, Berg T, Braun F, Eurich D, Herzer K, Neumann U, Rupp C, Sterneck M, Strassburg C, Welker MW, Zachoval R, Gotthardt DN, Weigand K, Schmidt H, Wedemeyer H, Galle PR, Zeuzem S, Sarrazin C. [Expert recommendations: Hepatitis C and transplantation]. Z Gastroenterol 2016; 54:665-84. [PMID: 27429106 DOI: 10.1055/s-0042-107360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With the approval of new direct acting antiviral agents (DAA), therapeutic options for patients with chronic hepatitis C virus (HCV) infection are now generally available before and after liver transplantation (LT). Interferon-free DAA regimens are highly effective therapies and provide a good safety profile. However, the body of clinical evidence in this patient population is limited and the best treatment strategies for patients on the waiting list with (de)compensated cirrhosis and after LT are not well defined. The following recommendations for antiviral therapy in the context of LT are based on the currently available literature and clinical experience of experts in the field, and have been discussed in an expert meeting. The aim of this article is to guide clinicians in the decision making when treating patients before and after LT with DAAs.
Collapse
Affiliation(s)
- T Zimmermann
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Beckebaum
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - C Berg
- Abteilung Innere Medizin I, Universitätsklinikum Tübingen
| | - T Berg
- Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig
| | - F Braun
- Transplantationszentrum, Universitätsklinikum Schleswig-Holstein, Kiel
| | - D Eurich
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité-Universitätsmedizin Berlin
| | - K Herzer
- Klinik für Gastroenterologie und Hepatologie/Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen
| | - U Neumann
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Fakultät, RWTH Aachen
| | - C Rupp
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - M Sterneck
- Klinik und Poliklinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg-Eppendorf
| | - C Strassburg
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn
| | - M-W Welker
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - R Zachoval
- Transplantationszentrum München der LMU, München
| | - D N Gotthardt
- Abteilung Innere Medizin IV, Universitätsklinikum Heidelberg
| | - K Weigand
- Innere Medizin I, Universitätsklinikum Regensburg
| | - H Schmidt
- Klinik für Transplantationsmedizin, Universitätsklinikum Münster
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
| | - P R Galle
- I. Med. Klinik und Poliklinik, Universitätsmedizin Mainz
| | - S Zeuzem
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - C Sarrazin
- Med. Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main
| |
Collapse
|
47
|
Kloth C, Berg C, Miller S, Nikolaou K, Schraml C. [Not Available]. ROFO-FORTSCHR RONTG 2016; 188:864-6. [PMID: 27409060 DOI: 10.1055/s-0042-104195] [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]
|
48
|
Berg C, Strizek B. Re: Fetal umbilical-portal-systemic venous shunt: in-utero classification and clinical significance. R. Achiron and Z. Kivilevitch. Ultrasound Obstet Gynecol 2016; 47: 739-747. Ultrasound Obstet Gynecol 2016; 47:672-673. [PMID: 27256656 DOI: 10.1002/uog.15946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Berg
- Division of Prenatal Medicine and Gynecologic Sonography, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| | - B Strizek
- Division of Fetal Surgery, Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
| |
Collapse
|
49
|
Abel JS, Flöck A, Berg C, Gembruch U, Geipel A. Drillings- und Vierlingsschwangerschaften mit monochorialer Komponente – Vergleich des Outcomes nach konservativem Vorgehen und Reduktion. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583775] [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
|
50
|
Ayub TH, Geipel A, Gembruch U, Berg C. Erste Erfahrungen mit einem neuen Shuntsystem zur intrauterinen Shunteinlage bei fetaler Megazystis im ersten Trimenon. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583808] [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
|