1
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Reiker T, Liu Z, Winter C, Cappellari MV, Abradelo DG, Strassert CA, Zhang D, Zacharias H. Ultrafast electron dynamics in excited states of conjugated thiophene-fluorene organic polymer (pF8T2) thin films. Phys Chem Chem Phys 2024; 26:4736-4751. [PMID: 38251969 DOI: 10.1039/d3cp00502j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
The electronic states of poly(9,9-dioctylfluorenyl-alt-bithiophene) pF8T2 on H/Si(100) substrates, prototypical for organic photovoltaics, were investigated by ultrafast photoelectron spectroscopy and by time-resolved fluorescence studies. Occupied and unoccupied electronic states were analysed by ultraviolet photoelectron spectroscopy (UPS), static and dynamic femtosecond two-photon photoemission (2PPE), and time-correlated single photon counting (TCSPC). Time-resolved measurements allow assessment of population lifetimes of intermediate states. The combination of time-resolved photoelectron spectroscopy and fluorescence excitation allows following the electronic dynamics in excited states from the femtosecond to the nanosecond time scale. For this prototypical material the electron kinetic energy resolved lifetimes range from about a few tens of femtoseconds up to hundreds of picoseconds. After annealing these types of organic thin films the efficiency of organic solar cells usually increases. We show that annealing does not influence the initial ultrafast charge generation processes, but the long-lived states. However, the nanosecond scale fluorescence lifetimes measured by TCSPC are prolonged after annealing, which therefore is identified as the cause of a greater exciton diffusion range and thus is beneficial for charge carrier extraction.
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Affiliation(s)
- T Reiker
- Center for Soft Nanoscience, University of Münster, 48149 Münster, Germany.
- Physics Institute, University of Münster, 48149 Münster, Germany
| | - Z Liu
- Organic Solids Laboratory, Institute of Chemistry, Chinese Academy of Science, Beijing 100190, P. R. China
| | - C Winter
- Physics Institute, University of Münster, 48149 Münster, Germany
| | - M V Cappellari
- Center for Nanotechnology and Institute for Inorganic and Analytical Chemistry, University of Münster, Heisenbergstraße 11, 48149 Münster, Germany
| | - D Gonzalez Abradelo
- Center for Nanotechnology and Institute for Inorganic and Analytical Chemistry, University of Münster, Heisenbergstraße 11, 48149 Münster, Germany
| | - C A Strassert
- Center for Nanotechnology and Institute for Inorganic and Analytical Chemistry, University of Münster, Heisenbergstraße 11, 48149 Münster, Germany
| | - D Zhang
- Organic Solids Laboratory, Institute of Chemistry, Chinese Academy of Science, Beijing 100190, P. R. China
| | - H Zacharias
- Center for Soft Nanoscience, University of Münster, 48149 Münster, Germany.
- Physics Institute, University of Münster, 48149 Münster, Germany
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2
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Braccini F, Catoni I, Belfkira F, Lagier J, Roze E, Paris J, Huth J, Bronsard V, Cartier H, David M, Galatoire O, Obadia D, Sabatier H, Sarfati E, Kestemont P, Winter C, Redaelli A. SAMCEP Society consensus on the treatment of upper facial lines with botulinum neurotoxin type A: A tailored approach. J Cosmet Dermatol 2023; 22:2692-2704. [PMID: 37408173 DOI: 10.1111/jocd.15768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND The safety and efficacy of botulinum neurotoxin type A (BoNTA) treatments are well established, but injection techniques, target muscles, and toxin doses continue to evolve, with each refinement producing improvements in treatment outcomes. The recommendations in this consensus move away from standard templates and illustrate how to tailor treatments to individual patterns and strengths of muscle activity, and patient preferences. METHODS Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus-based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow's feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes. RESULTS For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images. CONCLUSION This consensus provides up-to-date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity.
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Affiliation(s)
| | - I Catoni
- Private clinic, Neuilly-sur-Seine, France
| | | | - J Lagier
- Neurology hospital center, Paris, France
| | - E Roze
- Private clinic, Marseille, France
| | - J Paris
- Private clinic, Marseille, France
| | - J Huth
- Private clinic, Perigueux, France
| | | | | | - M David
- Private clinic, Metz, France
| | | | - D Obadia
- Neurology hospital center, Paris, France
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3
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Bieroza M, Acharya S, Benisch J, ter Borg RN, Hallberg L, Negri C, Pruitt A, Pucher M, Saavedra F, Staniszewska K, van’t Veen SGM, Vincent A, Winter C, Basu NB, Jarvie HP, Kirchner JW. Advances in Catchment Science, Hydrochemistry, and Aquatic Ecology Enabled by High-Frequency Water Quality Measurements. Environ Sci Technol 2023; 57:4701-4719. [PMID: 36912874 PMCID: PMC10061935 DOI: 10.1021/acs.est.2c07798] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
High-frequency water quality measurements in streams and rivers have expanded in scope and sophistication during the last two decades. Existing technology allows in situ automated measurements of water quality constituents, including both solutes and particulates, at unprecedented frequencies from seconds to subdaily sampling intervals. This detailed chemical information can be combined with measurements of hydrological and biogeochemical processes, bringing new insights into the sources, transport pathways, and transformation processes of solutes and particulates in complex catchments and along the aquatic continuum. Here, we summarize established and emerging high-frequency water quality technologies, outline key high-frequency hydrochemical data sets, and review scientific advances in key focus areas enabled by the rapid development of high-frequency water quality measurements in streams and rivers. Finally, we discuss future directions and challenges for using high-frequency water quality measurements to bridge scientific and management gaps by promoting a holistic understanding of freshwater systems and catchment status, health, and function.
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Affiliation(s)
- Magdalena Bieroza
- Department
of Soil and Environment, SLU, Box 7014, Uppsala 750
07 Sweden
| | - Suman Acharya
- Department
of Environment and Genetics, School of Agriculture, Biomedicine and
Environment, La Trobe University, Albury/Wodonga Campus, Victoria 3690, Australia
| | - Jakob Benisch
- Institute
for Urban Water Management, TU Dresden, Bergstrasse 66, Dresden 01068, Germany
| | | | - Lukas Hallberg
- Department
of Soil and Environment, SLU, Box 7014, Uppsala 750
07 Sweden
| | - Camilla Negri
- Environment
Research Centre, Teagasc, Johnstown Castle, Wexford Y35 Y521, Ireland
- The
James
Hutton Institute, Craigiebuckler, Aberdeen AB15 8QH, United Kingdom
- School
of
Archaeology, Geography and Environmental Science, University of Reading, Whiteknights, Reading RG6 6AB, United Kingdom
| | - Abagael Pruitt
- Department
of Biological Sciences, University of Notre
Dame, Notre
Dame, Indiana 46556, United States
| | - Matthias Pucher
- Institute
of Hydrobiology and Aquatic Ecosystem Management, Vienna University of Natural Resources and Life Sciences, Gregor Mendel Straße 33, Vienna 1180, Austria
| | - Felipe Saavedra
- Department
for Catchment Hydrology, Helmholtz Centre
for Environmental Research - UFZ, Theodor-Lieser-Straße 4, Halle (Saale) 06120, Germany
| | - Kasia Staniszewska
- Department
of Earth and Atmospheric Sciences, University
of Alberta, Edmonton, Alberta T6G 2E3, Canada
| | - Sofie G. M. van’t Veen
- Department
of Ecoscience, Aarhus University, Aarhus 8000, Denmark
- Envidan
A/S, Silkeborg 8600, Denmark
| | - Anna Vincent
- Department
of Biological Sciences, University of Notre
Dame, Notre
Dame, Indiana 46556, United States
| | - Carolin Winter
- Environmental
Hydrological Systems, University of Freiburg, Friedrichstraße 39, Freiburg 79098, Germany
- Department
of Hydrogeology, Helmholtz Centre for Environmental
Research - UFZ, Permoserstr.
15, Leipzig 04318, Germany
| | - Nandita B. Basu
- Department
of Civil and Environmental Engineering and Department of Earth and
Environmental Sciences, and Water Institute, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - Helen P. Jarvie
- Water Institute
and Department of Geography and Environmental Management, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
| | - James W. Kirchner
- Department
of Environmental System Sciences, ETH Zurich, Zurich CH-8092, Switzerland
- Swiss
Federal Research Institute WSL, Birmensdorf CH-8903, Switzerland
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4
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Bierwirth NC, Kim J, Moreira A, Winter L, Winter C, Blanco CL. Early hyperglycemia in extreme prematurity is associated with pulmonary and pancreatic dysfunction. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00600-6] [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: 01/28/2023]
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Thieleke-Matos C, Endjala N, Nepolo E, Winter C, Nowaseb V, Mataranyika M, Ochurus P, Jansen A, Weiss S, Ellerbrok H. Establishment of the Namibian National Public Health Institute: laboratory systems strengthening. Eur J Public Health 2022. [PMCID: PMC9593457 DOI: 10.1093/eurpub/ckac131.033] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In 2020, the Namibian Ministry of Health and Social Services (MoHSS) and the Robert Koch Institute (RKI) started a twinning project with the long-term goal of establishing a Namibia Institute of Public Health (NIPH). A fundamental pillar of an NIPH is a fully operational Public Health laboratory system. Due to the COVID-19 pandemic, the need for strengthening the existing Namibian Laboratory system became eminent. Following the Intra-Action Review (IAR) of the COVID-19 response in Namibia in 2020, three regional diagnostic laboratories, at points of entry, were assessed. The major issues identified were long delays between sampling of both suspected cases and COVID-19 patients and receiving test results due to extended sample transport times to the central laboratory in Windhoek and the overload of the central capacities due to overwhelming numbers of samples during peak times. This led to the establishment of three SARS-CoV-2 PCR diagnostic laboratories through procurement and installation of equipment, provision of consumables/reagents, and on-site training of laboratory technicians with continued virtual technical support. Consequently, an important reduction of the diagnosis turnaround time was achieved. Of great value was the technical support given by the staff at the central laboratory during the trainings allowing for immediate validation of the newly established laboratories and to strengthen the communication between regional laboratories and the central laboratory. The Namibian molecular diagnostic capacities have increased in important regions in Namibia and will provide data to support the health policies of the future NIPH. New diagnostic protocols will be developed to foster the sustainability of the established laboratories and could support the implementation of genomic surveillance capacities. Finally, stronger relationships were built through these joint activities, which will support and the next steps of the establishment of the NIPH. Key messages • Supporting and Strengthening the Namibian Public Health Laboratory system. • Long-term goal of establishing a Namibia Institute of Public Health (NIPH).
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Affiliation(s)
| | - N Endjala
- Namibia Institute of Pathology , Windhoek, Namibia
| | - E Nepolo
- University of Namibia , Windhoek, Namibia
| | - C Winter
- Robert Koch Institute , Berlin, Germany
| | - V Nowaseb
- Namibia Institute of Pathology , Windhoek, Namibia
| | - M Mataranyika
- Ministry of Health and Social Sciences , Windhoek, Namibia
| | - P Ochurus
- Ministry of Health and Social Sciences , Windhoek, Namibia
| | - A Jansen
- Robert Koch Institute , Berlin, Germany
| | - S Weiss
- Robert Koch Institute , Berlin, Germany
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6
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Pace R, Boucas da Silva R, Adam L, Näf G, Winter C, Aspradakis M, Hayoz S, Baumert B. OC-0949 Improved sparing of liver and lung tissue: DIBH for right breast irradiation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02729-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Kelly S, Redmond P, King S, Oliver‐Williams C, Lamé G, Liberati E, Kuhn I, Winter C, Draycott T, Dixon‐Woods M, Burt J. Training in the use of intrapartum electronic fetal monitoring with cardiotocography: systematic review and meta‐analysis. BJOG 2021. [PMCID: PMC8359372 DOI: 10.1111/1471-0528.16619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Sub‐optimal classification, interpretation and response to intrapartum electronic fetal monitoring using cardiotocography are known problems. Training is often recommended as a solution, but there is lack of clarity about the effects of training and which type of training works best. Objectives Systematic review of the effects of training healthcare professionals in intrapartum cardiotocography (PROSPERO protocol: CRD42017064525). Search strategy CENTRAL, Cochrane Library, MEDLINE, EMBASE, PsycINFO, British Nursing Database, CINAHL, ERIC, Scopus, Web of Science, ProQuest, grey literature and ongoing clinical trials were searched. Selection criteria Primary studies that reported impact of training healthcare professionals in intrapartum cardiotocography. Title/abstract, full‐text screening and quality assessment were conducted in duplicate. Data collection and analysis Data were synthesised both narratively and using meta‐analysis. Risk of bias and overall quality were assessed with the Mixed Methods Appraisal Tool and GRADE. Main results Sixty‐four studies were included. Overall, training and reporting were heterogeneous, the outcomes evaluated varied widely and study quality was low. Five randomised controlled trials reported that training improved knowledge of maternity professionals compared with no training, but evidence was of low quality. Evidence for the impact of cardiotocography training on neonatal and maternal outcomes was limited, showed inconsistent effects, and was of low overall quality. Evidence for the optimal content and method of delivery of training was very limited. Conclusions Given the scale of harm and litigation claims associated with electronic fetal monitoring, the evidence‐base for training requires improvement. It should address intervention design, evaluation of clinical outcomes and system‐wide contexts of sub‐optimal practice. Tweetable abstract Training in fetal monitoring: systematic review finds little evidence of impact on neonatal outcomes. Training in fetal monitoring: systematic review finds little evidence of impact on neonatal outcomes.
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Affiliation(s)
- S Kelly
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - P Redmond
- School of Population Health and Environmental Sciences King’s College London London UK
| | - S King
- Independent consultant Cambridge UK
| | - C Oliver‐Williams
- Cardiovascular Epidemiology Unit Department of Public Health and Primary Care University of Cambridge Cambridge UK
- Homerton CollegeUniversity of Cambridge Cambridge UK
| | - G Lamé
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - E Liberati
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - I Kuhn
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - C Winter
- PROMPT Maternity Foundation Southmead Hospital Bristol UK
| | - T Draycott
- Translational Health Sciences University of Bristol Bristol UK
| | - M Dixon‐Woods
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - J Burt
- THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge Cambridge UK
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8
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van der Nelson H, O'Brien S, Burnard S, Mayer M, Alvarez M, Knowlden J, Winter C, Dailami N, Marques E, Burden C, Siassakos D, Draycott T. Intramuscular oxytocin versus Syntometrine ® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life. BJOG 2021; 128:1236-1246. [PMID: 33300296 DOI: 10.1111/1471-0528.16622] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare intramuscular oxytocin, Syntometrine® and carbetocin for prevention of postpartum haemorrhage after vaginal birth. DESIGN Randomised double-blinded clinical trial. SETTING Six hospitals in England. POPULATION A total of 5929 normotensive women having a singleton vaginal birth. METHODS Randomisation when birth was imminent. MAIN OUTCOME MEASURES Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. RESULTS Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. CONCLUSIONS Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. TWEETABLE ABSTRACT IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.
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Affiliation(s)
- H van der Nelson
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S O'Brien
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S Burnard
- Royal United Hospitals NHS Trust, Bath, UK
| | - M Mayer
- North Bristol NHS Trust, Bristol, UK
| | - M Alvarez
- North Bristol NHS Trust, Bristol, UK
| | | | - C Winter
- North Bristol NHS Trust, Bristol, UK
| | - N Dailami
- University of the West of England, Bristol, UK
| | - E Marques
- North Bristol NHS Trust, Bristol, UK
| | - C Burden
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
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9
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Geiges G, Winter C, Katzenberger K, Kübrich M. Quality of life of patients with hormone-dependent advanced prostate cancer receiving palliative treatment with Leuprorelin depot injection (Lutrate®) – interim results from a non-interventional study in Germany. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36201-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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10
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Nini A, Boschheidgen M, Hiester A, Winter C, Antoch G, Schimmöller L, Albers P. Preoperative clinical and radiographic predictors of major vascular reconstructions in patients with testicular cancer undergoing postchemotherapy residual tumor resection (PC-RPLND). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32834-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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11
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Nini A, Fingerhut A, Niegisch G, Hiester A, Winter C, Albers P. Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in patients with testis cancer in the salvage setting. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34110-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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12
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Rodriguez SH, Appoloni C, Campos P, Gonçalves B, Kajiya E, Molari R, Rizzutto M, Winter C. Non-Destructive and portable analyses helping the study and conservation of a Saraceni copper plate painting in the São Paulo museum of art. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Funke K, Rittweger N, Schindler N, Ishorst T, Lippmann B, Barmashenko G, Aliane V, Winter C. P59 Can iTBS via rTMS affect the behavioral phenotype in a rat model of developmental schizophrenia? Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Winter C, Weber W, Drumm NJ. Lymphangioma at the neck of a filly. PFERDEHEILKUNDE 2020. [DOI: 10.21836/pem20200504] [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]
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15
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O'Brien SM, Winter C, Burden CA, Boulvain M, Draycott TJ, Crofts JF. Fetal head position and perineal distension associated with the use of the BD Odon Device™ in operative vaginal birth: a simulation study. BJOG 2019; 124 Suppl 4:10-18. [PMID: 28940873 PMCID: PMC7198112 DOI: 10.1111/1471-0528.14759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2017] [Indexed: 01/21/2023]
Abstract
Objective To investigate (i) the placement of the BD Odon Device on the model fetal head, and
(ii) perineal distention during simulated operative vaginal births conducted with the BD
Odon Device Design Observational simulation study Setting North Bristol NHS Trust, UK Population or Sample 440 simulated operative vaginal births Methods Three bespoke fetal mannequins were developed to represent (i) bi-parietal diameter of
the 50th centile at term (ii) bi-parietal diameter at the 5th
centile at term and (iii) 50th centile head with 2 cm of caput. Siting of the
BD Odon Device on model heads was determined before and after 400 simulated operative
vaginal births. Variables were analysed to determine their effect on device siting and
movement during birth. The fetal mannequins were placed inside a maternal mannequin (PROMPT Flex, Limbs
& Things, Bristol, UK) and the BD Odon Device was placed around the fetal head as
per the instructions for use. The location of the air cuff was determined before and
after the head was delivered. Perineal distension was determined by recording maximum
perineal distention during a simulated operative vaginal birth using the same procedure,
as well as scenarios employing an inappropriately non-deflated air cuff (for the BD Odon
Device), the Kiwi ventouse and non-rotational forceps. Main Outcome Measures Site and displacement during birth of the BD Odon Device on a model head. Maximal
perineal distension during birth. Results The BD Odon Device was reliably sited in a standard over the fetal head position
(approximately 40mm above the fetal chin) for all stations, head sizes and positions
with no significant displacement. In occipito-posterior births, compared to
occipito-anterior or transverse, the BD Odon Device routinely sited further down the
fetal head (toward the chin). The BD Odon Device was not associated with more perineal distension than forceps or
Kiwi ventouse (21mm vs 26mm vs 21mm at posterior fourchette). Conclusions The BD Odon Device reliably sited over a safe area of the fetal head in 400 simulated
births representative of clinical practice. The BD Odon Device generates similar levels
of perineal distension compared to Kiwi ventouse when used correctly.
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Affiliation(s)
- S M O'Brien
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - C Winter
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK
| | - C A Burden
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - M Boulvain
- Department of Obstetrics & Gynaecology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - T J Draycott
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - J F Crofts
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK
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16
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O'Brien SM, Winter C, Burden CA, Boulvain M, Draycott TJ, Crofts JF. Pressure and traction on a model fetal head and neck associated with the use of forceps, Kiwi™ ventouse and the BD Odon Device™ in operative vaginal birth: a simulation study. BJOG 2019; 124 Suppl 4:19-25. [PMID: 28940875 PMCID: PMC7198111 DOI: 10.1111/1471-0528.14760] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 11/30/2022]
Abstract
Objective To determine the pressure and traction forces exerted on a model fetal head by the BD
Odon Device, forceps and Kiwi ventouse during simulated births. Design Simulation study. Setting Simulated operative vaginal birth. Population or Sample 84 simulated operative vaginal births. Methods A bespoke fetal mannequin with pressure sensors around the head and strain gauge across
the neck was used to investigate pressure applied over the head, and traction across the
neck during 84 simulated births using the BD Odon Device, non-rotational forceps and
Kiwi ventouse. Main Outcome Measures Peak pressure on the fetal face and lateral aspects of the head during correct use of
the BD Odon Device and forceps. Peak pressure on orbits and neck during misplacement of
the BD Odon Device and forceps. Peak traction force generated until instrument failure
using the BD Odon Device, forceps and Kiwi ventouse. Results When correctly sited and using 80kPa inflation pressure on the cuff, the BD Odon Device
generated a lower peak pressure on the fetal head than forceps (83kPa vs 146kPa). When
instruments were purposefully misplaced over the orbits the BD Odon Device generated a
lower peak pressure on the orbits than forceps (70kPa vs 123kPa). When purposefully
misplaced over the neck the BD Odon Device, compared to forceps, generated a greater
peak pressure on the anterio-lateral aspect of the neck (56kPa vs 17kPa) and a lower
peak pressure on the posterior aspect of the neck (76kPa vs 93kPa) than forceps. In
cases of true cephalic disproportion the BD Odon Device ‘popped-off’ at a
lower traction force than forceps (208N vs 270N). Conclusions In simulated assisted vaginal birth with correctly placed instruments the peak pressure
exerted on the fetal head by a BD Odon Device is lower than pressure exerted by
non-rotational forceps. In cases in which delivery of the fetal head is not possible due
to cephalo-pelvic disproportion lower traction forces could be applied using the BD Odon
Device than with forceps before the procedure was abandoned due to device failure.
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Affiliation(s)
- S M O'Brien
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - C Winter
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK
| | - C A Burden
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - M Boulvain
- Department of Obstetrics & Gynaecology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - T J Draycott
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.,School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - J F Crofts
- Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK
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O'Brien SM, Mouser A, Odon JE, Winter C, Draycott TJ, Sumitro T, Alisantoso D, Lim WL, Merialdi M, Stankovic AK, Crofts JF. Design and development of the BD Odon Device TM : a human factors evaluation process. BJOG 2019; 124 Suppl 4:35-43. [PMID: 28940874 DOI: 10.1111/1471-0528.14758] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To (1) determine how intended users interact with and use the BD Odon Device in simulation, (2) use these findings to alter progressively the design of the BD Odon Device and (3) validate that these changes have improved the ability of practitioners to use the BD Odon Device. DESIGN Human factors evaluation study. SETTING Simulation suite designed to mimic delivery room. POPULATION OR SAMPLE Three hundred and ninety simulated operative births, performed by 100 practising clinicians. METHODS Simulated operative vaginal births performed using the BD Odon Device and the device Instructions for use were subjected to three formative human factors evaluations and one human factors validation test. Following each evaluation, findings were reviewed and the design of the BD Odon Device and Instructions for use were modified. MAIN OUTCOME MEASURES Successful performance of an operative vaginal birth using the BD Odon Device in accordance with provided training and Instructions for use. RESULTS Using version two of the BD Odon Device, and following exposure to face-to-face training and written instructions, 25% of accouchers were able successfully to perform a simulated operative vaginal birth. In the final evaluation, following device design and training material alterations, all accouchers were able successfully to perform a simulated operative vaginal birth using version four of the BD Odon Device. CONCLUSIONS Human factors evaluations have enabled a multi-professional device and training materials design team to alter the design of the BD Odon Device and the Instructions for use in an evidence-based fashion. This process has resulted in a device which has a predictable and likely safe pattern of use. TWEETABLE ABSTRACT Human Factors evaluations help make the BD Odon Device safe and usable for clinical practice.
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Affiliation(s)
- S M O'Brien
- Department of Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.,School of Clinical Sciences, University of Bristol, Bristol, UK
| | - A Mouser
- Preanalytical Systems, BD, Franklin Lakes, NJ, USA
| | - J E Odon
- Inventor of BD Odon Device, Banfield, Buenos Aires, Argentina
| | - C Winter
- Department of Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - T J Draycott
- Department of Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - T Sumitro
- R&D Department, BD, Singapore, Singapore
| | | | - W L Lim
- R&D Department, BD, Singapore, Singapore
| | - M Merialdi
- Global Health, BD, Franklin Lakes, NJ, USA
| | | | - J F Crofts
- Department of Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
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18
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Belva F, Roelants M, Kluijfhout S, Winter C, De Schrijver F, Desmyttere S, De Rycke M, Tournaye H, Liebaers I, Bonduelle M. Body composition and blood pressure in 6-year-old singletons born after pre-implantation genetic testing for monogenic and structural chromosomal aberrations: a matched cohort study. Hum Reprod Open 2018; 2018:hoy013. [PMID: 30895254 PMCID: PMC6276641 DOI: 10.1093/hropen/hoy013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/19/2018] [Accepted: 08/22/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Does Day 3 embryo biopsy for pre-implantation genetic testing for monogenic (PGT-M) and structural chromosomal aberrations (PGT-SR) affect body composition and blood pressure readings of 6-year-old singletons? SUMMARY ANSWER This study of 87 PGT-M and PGT-SR conceived singletons showed no differences in anthropometric measurements and blood pressure readings in comparison with a matched cohort of peers born after ICSI without embryo biopsy. WHAT IS KNOWN ALREADY While neonatal outcomes after PGT conception have been found comparable to those after ICSI without embryo biopsy, only a few studies have reported outcomes after PGT at older ages. Moreover, embryo biopsy is also applied in couples who opt for PGT-M and PGT-SR and hence are not necessarily infertile. Health parameters and in particular body composition data in this group of children are lacking. STUDY DESIGN SIZE DURATION This single-centre matched-pair cohort study evaluated body composition of 6-year-old children born after fresh blastocyst embryo transfer with or without embryo biopsy performed at Day 3 for the purpose of PGT-M and PGT-SR. For each child born after embryo biopsy, a singleton born after transfer of a fresh ICSI embryo at the blastocyst stage and reaching the age of 6 years between May 2011 and June 2017 was matched as closely as possible for gender, age, maternal educational level and birth order. PARTICIPANTS/MATERIALS SETTING METHODS Anthropometry (weight, height, BMI, skinfold thickness, waist and mid-upper arm circumference) and blood pressure readings in a longitudinally followed cohort of 87 singletons conceived by PGT-M and PGT-SR and a pairwise matched sample of 87 children conceived by ICSI are described. Results are adjusted for current, neonatal and parental characteristics. MAIN RESULTS AND THE ROLE OF CHANCE From the 124 eligible PGT-M and PGT-SR families, 110 could be reached of whom 23 refused and 87 (87/110 = 79%) participated. All anthropometric measurements, including z-scores of BMI, waist and mid-upper arm circumference, were comparable between the PGT-M and PGT-SR (-0.23; 0.27; 0.17, respectively) and ICSI (-0.29; 0.11; 0.11, respectively) groups (all P > 0.05). Furthermore, indices of peripheral (triceps) and central (subscapular) adiposity derived from skinfold thickness were comparable (PGT-M and PGT-SR: 14.7 mm; 11.6 mm and ICSI: 15.5 mm; 11.5 mm) as well as the percentage total body fat mass derived from these (PGT-M and PGT-SR: 13.7% and ICSI: 13.9%) (all P > 0.05). Z-scores for blood pressure were also comparable between the PGT and ICSI groups (all P > 0.05). Results did not change when adjusted for neonatal (birthweight, birth order), current (age) and parental (smoking during pregnancy, parental BMI) characteristics. Hospitalization rate and surgical intervention rate were not different for PGT-M and PGT-SR children compared to matched peers born after ICSI. LIMITATIONS REASONS FOR CAUTION Although our study describes the largest cohort of singletons born after embryo biopsy worldwide, we were only able to detect moderate differences in anthropometrics and blood pressure with our sample size. WIDER IMPLICATIONS OF THE FINDINGS Although Day 3 embryo biopsy followed by blastocyst transfer is not associated with adverse outcomes regarding anthropometry and blood pressure, future studies should focus on outcomes in children born after trophectoderm biopsy and/or transfer of warmed embryos after vitrification. STUDY FUNDING/COMPETING INTERESTS This study was supported by Methusalem grants and by grants from Wetenschappelijk Fonds Willy Gepts; all issued by the Vrije Universiteit Brussel (VUB). All co-authors, except M.B. declared no conflict of interest. M.B. has received consultancy fees from MSD, Serono Symposia and Merck. The Universitair Ziekenhuis Brussel (UZ Brussel) and the Centre for Medical Genetics have received several educational grants from IBSA, Ferring, Organon, Shering-Plough, Merck for establishing the database for follow-up research and organizing the data collection.
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Affiliation(s)
- F Belva
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - M Roelants
- Department of Public Health and Primary Care, Environment and Health/Youth Health Care, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - S Kluijfhout
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - C Winter
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - F De Schrijver
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - S Desmyttere
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - M De Rycke
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - I Liebaers
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
| | - M Bonduelle
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels, Belgium
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Shomali M, Cheng J, Koundinya M, Weinstein M, Malkova N, Sun F, Hebert A, Cindachao M, Hoffman D, McManus J, Levit M, Pollard J, Vincent S, Besret L, Adrian F, Winter C, El-Ahmad Y, Halley F, Hsu K, Lager J, Garcia-Echeverria C, Bouaboula M. Abstract P3-04-05: Identification of SAR439859, an orally bioavailable selective estrogen receptor degrader (SERD) that has strong antitumor activity in wild-type and mutant ER+ breast cancer models. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-04-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Estrogen receptor positive (ER+) breast cancer accounts for 70% of all breast cancers and is primarily treated with endocrine therapy. Approximately 40% of patients on endocrine therapy will become resistant via a number of mechanisms. There is evidence that in many cases ER continues to play a central role, including mutations in ER leading to a constitutively active receptor. Estrogen receptor degraders like fulvestrant are effective in shutting down ER signaling; however, poor pharmaceutical properties limit fulvestrant clinical activity and prevent it from achieving maximum receptor blockade.
We describe the discovery of SAR439859, a novel, orally bioavailable SERD that is a potent antagonist and degrader of ER both in vitro and in vivo. SAR439859 has robust activity in multiple ER+ breast cancer cell lines including cells that are resistant to tamoxifen as well as cell lines harboring ER mutants. Across a large panel of ER+ cells, SAR439859 demonstrated broad and superior ER degradation activity than most SERDs undergoing clinical testing. This leads to a profound inhibition of ER signaling, better inhibition of cell growth and results in improved in vivo efficacy. SAR439859 demonstrated tumor regression in all ER+ BC models including MCF7-ESR1 mutant-Y537S model, as well as patient-derived xenograft model that is resistant to endocrine therapies. Furthermore, SAR439859 displays limited cross-resistance with other class of SERDs.
Taken together, these results suggest that SAR439859 would be of therapeutic benefit in metastatic BC setting for patients harboring wild type or mutant ER. SAR439859 is being advanced toward the clinic.
Citation Format: Shomali M, Cheng J, Koundinya M, Weinstein M, Malkova N, Sun F, Hebert A, Cindachao M, Hoffman D, McManus J, Levit M, Pollard J, Vincent S, Besret L, Adrian F, Winter C, El-Ahmad Y, Halley F, Hsu K, Lager J, Garcia-Echeverria C, Bouaboula M. Identification of SAR439859, an orally bioavailable selective estrogen receptor degrader (SERD) that has strong antitumor activity in wild-type and mutant ER+ breast cancer models [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-04-05.
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Affiliation(s)
- M Shomali
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - J Cheng
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - M Koundinya
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - M Weinstein
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - N Malkova
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - F Sun
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - A Hebert
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - M Cindachao
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - D Hoffman
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - J McManus
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - M Levit
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - J Pollard
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - S Vincent
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - L Besret
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - F Adrian
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - C Winter
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - Y El-Ahmad
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - F Halley
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - K Hsu
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | - J Lager
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
| | | | - M Bouaboula
- Sanofi, Cambridge, MA; Sanofi, Vitry-Sur-Seine, France
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Hadar R, Vengeliene V, Barroeta Hlusicke E, Canals S, Noori HR, Wieske F, Rummel J, Harnack D, Heinz A, Spanagel R, Winter C. Paradoxical augmented relapse in alcohol-dependent rats during deep-brain stimulation in the nucleus accumbens. Transl Psychiatry 2016; 6:e840. [PMID: 27327255 PMCID: PMC4931598 DOI: 10.1038/tp.2016.100] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/14/2016] [Accepted: 04/20/2016] [Indexed: 12/24/2022] Open
Abstract
Case reports indicate that deep-brain stimulation in the nucleus accumbens may be beneficial to alcohol-dependent patients. The lack of clinical trials and our limited knowledge of deep-brain stimulation call for translational experiments to validate these reports. To mimic the human situation, we used a chronic-continuous brain-stimulation paradigm targeting the nucleus accumbens and other brain sites in alcohol-dependent rats. To determine the network effects of deep-brain stimulation in alcohol-dependent rats, we combined electrical stimulation of the nucleus accumbens with functional magnetic resonance imaging (fMRI), and studied neurotransmitter levels in nucleus accumbens-stimulated versus sham-stimulated rats. Surprisingly, we report here that electrical stimulation of the nucleus accumbens led to augmented relapse behavior in alcohol-dependent rats. Our associated fMRI data revealed some activated areas, including the medial prefrontal cortex and caudate putamen. However, when we applied stimulation to these areas, relapse behavior was not affected, confirming that the nucleus accumbens is critical for generating this paradoxical effect. Neurochemical analysis of the major activated brain sites of the network revealed that the effect of stimulation may depend on accumbal dopamine levels. This was supported by the finding that brain-stimulation-treated rats exhibited augmented alcohol-induced dopamine release compared with sham-stimulated animals. Our data suggest that deep-brain stimulation in the nucleus accumbens enhances alcohol-liking probably via augmented dopamine release and can thereby promote relapse.
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Affiliation(s)
- R Hadar
- Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - V Vengeliene
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - E Barroeta Hlusicke
- Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Canals
- Cellular and Systems Neurobiology Unit, Instituto de Neurociencias, Consejo Superior de Investigaciones Científicas and Universidad Miguel Hernández, Sant Joan d'Alacant, Spain
| | - H R Noori
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Wieske
- Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J Rummel
- Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - D Harnack
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - C Winter
- Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany,Department of Psychiatry and Psychotherapy, University Hospital Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany. E-mail:
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Winter C, Nilsson MP, Olsson E, George AM, Chen Y, Kvist A, Törngren T, Vallon-Christersson J, Hegardt C, Häkkinen J, Jönsson G, Grabau D, Malmberg M, Kristoffersson U, Rehn M, Gruvberger-Saal SK, Larsson C, Borg Å, Loman N, Saal LH. Targeted sequencing of BRCA1 and BRCA2 across a large unselected breast cancer cohort suggests that one-third of mutations are somatic. Ann Oncol 2016; 27:1532-8. [PMID: 27194814 PMCID: PMC4959927 DOI: 10.1093/annonc/mdw209] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [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: 02/04/2016] [Accepted: 05/10/2016] [Indexed: 01/20/2023] Open
Abstract
We carried out targeted sequencing of BRCA1/2 in an unselected cohort of patients diagnosed with primary breast cancer within a population without strong founder mutations. Eleven percent of cases harbored a germline or somatic BRCA1/2 mutation, and the ratio of germline versus somatic mutation was 2 : 1. This has implications for treatment, genetic counseling, and interpretation of tumor-only testing. Background A mutation found in the BRCA1 or BRCA2 gene of a breast tumor could be either germline or somatically acquired. The prevalence of somatic BRCA1/2 mutations and the ratio between somatic and germline BRCA1/2 mutations in unselected breast cancer patients are currently unclear. Patients and methods Paired normal and tumor DNA was analyzed for BRCA1/2 mutations by massively parallel sequencing in an unselected cohort of 273 breast cancer patients from south Sweden. Results Deleterious germline mutations in BRCA1 (n = 10) or BRCA2 (n = 10) were detected in 20 patients (7%). Deleterious somatic mutations in BRCA1 (n = 4) or BRCA2 (n = 5) were detected in 9 patients (3%). Accordingly, about 1 in 9 breast carcinomas (11%) in our cohort harbor a BRCA1/2 mutation. For each gene, the tumor phenotypes were very similar regardless of the mutation being germline or somatically acquired, whereas the tumor phenotypes differed significantly between wild-type and mutated cases. For age at diagnosis, the patients with somatic BRCA1/2 mutations resembled the wild-type patients (median age at diagnosis, germline BRCA1: 41.5 years; germline BRCA2: 49.5 years; somatic BRCA1/2: 65 years; wild-type BRCA1/2: 62.5 years). Conclusions In a population without strong germline founder mutations, the likelihood of a BRCA1/2 mutation found in a breast carcinoma being somatic was ∼1/3 and germline 2/3. This may have implications for treatment and genetic counseling.
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Affiliation(s)
- C Winter
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - M P Nilsson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Department of Oncology, Skåne University Hospital, Lund
| | - E Olsson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - A M George
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - Y Chen
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - A Kvist
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - T Törngren
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - J Vallon-Christersson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund CREATE Health Strategic Centre for Translational Cancer Research, Lund University, Lund
| | - C Hegardt
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund CREATE Health Strategic Centre for Translational Cancer Research, Lund University, Lund
| | - J Häkkinen
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - G Jönsson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - D Grabau
- Department of Pathology, Skåne University Hospital, Lund
| | - M Malmberg
- Department of Oncology, Skåne University Hospital, Lund
| | | | - M Rehn
- Department of Surgery, Lund University and Skåne University Hospital, Lund
| | - S K Gruvberger-Saal
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund
| | - C Larsson
- Lund University Cancer Center, Lund Department of Translational Cancer Research, Lund University, Lund, Sweden
| | - Å Borg
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund CREATE Health Strategic Centre for Translational Cancer Research, Lund University, Lund
| | - N Loman
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund Department of Oncology, Skåne University Hospital, Lund
| | - L H Saal
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund Lund University Cancer Center, Lund CREATE Health Strategic Centre for Translational Cancer Research, Lund University, Lund
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Winter C, Van Acker F, Bonduelle M, Van Berkel K, Belva F, Liebaers I, Nekkebroeck J. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis. Hum Reprod 2016; 31:1288-99. [DOI: 10.1093/humrep/dew074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
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Tini A, Pytko I, Lang S, Winter C, Guckenberger M, Linsenmeier C. EP-2113: Clinical implementation of an optical surface monitoring system(OSMS®, Varian) in breast irradiation. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sharpe J, Tini A, Minneken I, Winter C, Meier V, Rohrer Bley C. EP-2103: Margin assessment for feline and canine radiotherapy using a custom cranial immobilisation device. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33354-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Petersen U, Winter C, Petersen W. Endoskopisch gestützte Auffüllung symptomatischer Kalkaneuszysten. Arthroskopie 2015. [DOI: 10.1007/s00142-015-0030-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Edwards SE, Platt S, Lenguerrand E, Winter C, Mears J, Davis S, Lucas G, Hotton E, Fox R, Draycott T, Siassakos D. Effective interprofessional simulation training for medical and midwifery students. BMJ Simul Technol Enhanc Learn 2015; 1:87-93. [PMID: 35515198 DOI: 10.1136/bmjstel-2015-000022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 11/04/2022]
Abstract
Introduction Good interprofessional teamworking is essential for high quality, efficient and safe clinical care. Undergraduate interprofessional training has been advocated for many years to improve interprofessional working. However, few successful initiatives have been reported and even fewer have formally assessed their educational impact. Methods This was a prospective observational study of medical and midwifery students at a tertiary-level maternity unit. An interprofessional training module was developed and delivered by a multiprofessional faculty to medical and midwifery students, including short lectures, team-building exercises and practical simulation-based training for one obstetric (shoulder dystocia) and three generic emergencies (sepsis, haemorrhage, collapse). Outcome measures were interprofessional attitudes, assessed with a validated questionnaire (UWE Interprofessional Questionnaire) and clinical knowledge, measured with validated multiple-choice questions. Results Seventy-two students participated (34 medical, 38 midwifery). Following training median interprofessional attitude scores improved in all domains (p<0.0001), and more students responded in positive categories for communication and teamwork (69-89%, p=0.004), interprofessional interaction (3-16%, p=0.012) and interprofessional relationships (74-89%, p=0.006). Scores for knowledge improved following training for medical students (65.5% (61.8-70%) to 82.3% (79.1-84.5%) (median (IQR)) p<0.0001) and student midwives (70% (64.1-76.4%) to 81.8% (79.1-86.4%) p<0.0001), and in all subject areas (p<0.0001). Conclusions This training was associated with meaningful improvements in students' attitudes to teamwork, and knowledge acquisition. Integrating practical tasks and teamwork training, in authentic clinical settings, with matched numbers of medical and non-medical students can facilitate learning of both why and how to work together. This type of training could be adopted widely in undergraduate healthcare education.
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Affiliation(s)
- S E Edwards
- University of Bristol, School of Clinical Sciences, Department of Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK
| | - S Platt
- Department of Obstetrics and Gynaecology, St Michael's Hospital, Bristol, UK
| | - E Lenguerrand
- University of Bristol School of Clinical Sciences, RISQ Research, Southmead Hospital, Bristol, UK
| | - C Winter
- Department of Obstetrics and Gynaecology, RISQ Research, Southmead Hospital, Bristol, UK
| | - J Mears
- Department of Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK
| | - S Davis
- University of West of England, Health and Life Sciences, Bristol, UK
| | - G Lucas
- University of West of England, Health and Life Sciences, Bristol, UK
| | - E Hotton
- Department of Obstetrics and Gynaecology, Royal United Hospitals, Bath, UK
| | - R Fox
- Department of Obstetrics and Gynaecology, RISQ Research, Southmead Hospital, Bristol, UK
| | - T Draycott
- University of Bristol, School of Clinical Sciences, Department of Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK
| | - D Siassakos
- University of Bristol, School of Clinical Sciences, Department of Obstetrics and Gynaecology, Southmead Hospital, Bristol, UK
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Lang S, Linsenmeier C, Brown M, Tini A, Cavelaars F, Winter C, Krayenbuehl J. EP-1302: Implementation and validation of a new fixation system for stereotactic radiotherapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rexroth U, Diercke M, Peron E, Winter C, an der Heiden M, Gilsdorf A. Ebola response missions: to go or not to go? Cross-sectional study on the motivation of European public health experts, December 2014. ACTA ACUST UNITED AC 2015; 20. [PMID: 25846488 DOI: 10.2807/1560-7917.es2015.20.12.21070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We surveyed European infectious disease epidemiologists and microbiologists about their decisions to apply for Ebola response missions. Of 368 respondents, 49 (15%) had applied. Applicants did not differ from non-applicants in terms of age, sex or profession but had more training in field epidemiology and more international experience. Common concerns included lack of support from families and employers. Clearer terms of reference and support from employers could motivate application and support outbreak response in West Africa.
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Affiliation(s)
- U Rexroth
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Surveillance Unit, Berlin, Germany
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Winter C, Van Acker F, Bonduelle M, Desmyttere S, Nekkebroeck J. Psychosocial development of full term singletons, born after preimplantation genetic diagnosis (PGD) at preschool age and family functioning: a prospective case-controlled study and multi-informant approach. Hum Reprod 2015; 30:1122-36. [DOI: 10.1093/humrep/dev036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/06/2015] [Indexed: 11/13/2022] Open
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Jadavji NM, Wieske F, Dirnagl U, Winter C. Methylenetetrahydrofolate reductase deficiency alters levels of glutamate and γ-aminobutyric acid in brain tissue. Mol Genet Metab Rep 2015; 3:1-4. [PMID: 26937386 PMCID: PMC4750636 DOI: 10.1016/j.ymgmr.2015.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 12/12/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/30/2022] Open
Abstract
Methylenetetrahydrofolate reductase (MTHFR) is an enzyme key regulator in folate metabolism. Deficiencies in MTHFR result in increased levels of homocysteine, which leads to reduced levels of S-adenosylmethionine (SAM). In the brain, SAM donates methyl groups to catechol-O-methyltransferase (COMT), which is involved in neurotransmitter analysis. Using the MTHFR-deficient mouse model the purpose of this study was to investigate levels of monoamine neurotransmitters and amino acid levels in brain tissue. MTHFR deficiency affected levels of both glutamate and γ-aminobutyric acid in within the cerebellum and hippocampus. Mthfr−/− mice had reduced levels of glutamate in the amygdala and γ-aminobutyric acid in the thalamus. The excitatory mechanisms of homocysteine through activation of the N-methyl-d-aspartate receptor in brain tissue might alter levels of glutamate and γ-aminobutyric acid.
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Key Words
- 5-HIAA, 5-hydroxyindoleacetic acid
- 5-HT, serotonin.
- 5-methylTHF, 5-methyltetrahydrofolate
- COMT, catechol-O-methyltransferase
- DOPAC, 3,4-dihydroxyphenylacetic acid
- GABA, γ-aminobutyric acid
- Glutamate
- HPLC, high performance liquid chromatography
- HVA, homovanillic acid
- Homocysteine
- MTHFR, methylenetetrahydrofolate reductase
- Methylenetetrahydrofolate reductase
- Monoamine neurotransmitters
- S-Adenosylmethionine
- SAM, S-adenosylmethionine
- γ-Aminobutyric acid
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Affiliation(s)
- N M Jadavji
- Department of Experimental Neurology, Center for Stroke Research Berlin, Charité University Medicine Berlin, Germany
| | - F Wieske
- Department of Experimental Psychiatry, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - U Dirnagl
- Department of Experimental Neurology, Center for Stroke Research Berlin, Charité University Medicine Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - C Winter
- Department of Experimental Psychiatry, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
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Kösters C, Bockholt S, Müller C, Winter C, Rosenbaum D, Raschke MJ, Ochman S. Comparing the outcomes between Chopart, Lisfranc and multiple metatarsal shaft fractures. Arch Orthop Trauma Surg 2014; 134:1397-404. [PMID: 25064509 DOI: 10.1007/s00402-014-2059-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures. DESIGN Retrospective case series. SETTING Level one trauma center. INTERVENTION Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics. MAIN OUTCOME MEASUREMENTS The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Maryland Foot Score were used to assess pain and functional outcome. 3D gait analysis, pedobarographic analysis and radiologic examinations were performed. The activity level was measured by a step counting accelerometer. All results were compared to an age-matched healthy control group. RESULTS 24 patients with a median age of 44 years (16-72) were included: 12 patients with multiple metatarsal shaft fractures, 6 patients with Chopart and 6 patients with Lisfranc fractures. The median follow-up was 2.6 years. The pedobarographic analysis reports reduced contact time of the total foot (p = 0.08), the forefoot (p = 0.008) and the hallux (p = 0.015) for the injured foot. A median score of 64 for the SF-36, 64 for the AOFAS Midfoot Score and 73 for the Maryland Foot Score indicated a poor restoration of foot function. Multiple metatarsal shaft fractures presented a significantly lower walking speed (p = 0.03) and cadence (p = 0.04). CONCLUSION The worst results were reported for multiple metatarsal shaft fractures on outcome scores, pedobarography, gait analysis and activity. Metatarsal serial fractures should not be underestimated as well as Chopart and Lisfranc fractures. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- C Kösters
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital, University of Muenster, Albert Schweitzer Campus 1, Building W1, 48149, Muenster, Germany,
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Lusch A, Zaum M, Winter C, Albers P. [Management of complications after residual tumor resection for metastatic testicular cancer]. Urologe A 2014; 53:991-5. [PMID: 25023235 DOI: 10.1007/s00120-014-3502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Residual tumor resection (RTR) in patients with metastatic testicular cancer plays a pivotal role in a multimodal treatment. It can be performed unilaterally or as an extended bilateral RTR. Additional surgical procedures might be necessary, such as nephrectomy, splenectomy, partial colectomy, or vascular interventions with possible caval resection, cavotomy, or aortic resection with aortic grafting. Consequently, several complications can be seen in the intra- and postoperative course, most common of which are superficial wound infections, intestinal paralysis, lymphocele, and chylous ascites. We sought to describe complication management and how to prevent complications before they arise.
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Affiliation(s)
- A Lusch
- Urologische Klinik, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland,
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Winter C, Van Acker F, Bonduelle M, Desmyttere S, De Schrijver F, Nekkebroeck J. Cognitive and psychomotor development of 5- to 6-year-old singletons born after PGD: a prospective case-controlled matched study. Hum Reprod 2014; 29:1968-77. [DOI: 10.1093/humrep/deu165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Gale A, Siassakos D, Attilakos G, Winter C, Draycott T. Operative vaginal birth: better training for better outcomes. BJOG 2014; 121:643-4. [DOI: 10.1111/1471-0528.12560] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 11/28/2022]
Affiliation(s)
- A Gale
- Directorate of Women's Health; Lancashire Teaching Hospitals NHS Foundation Trust; Preston UK
| | - D Siassakos
- Directorate of Women's and Children's Health; Southmead Hospital; North Bristol NHS Trust; Bristol UK
| | - G Attilakos
- University College London Hospitals NHS Foundation Trust; London UK
| | - C Winter
- Directorate of Women's and Children's Health; Southmead Hospital; North Bristol NHS Trust; Bristol UK
| | - T Draycott
- Directorate of Women's and Children's Health; Southmead Hospital; North Bristol NHS Trust; Bristol UK
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Müller C, Winter C, Boos J, Gosheger G, Hardes J, Vieth V, Rosenbaum D. Effects of an exercise intervention on bone mass in pediatric bone tumor patients. Int J Sports Med 2014; 35:696-703. [PMID: 24408763 DOI: 10.1055/s-0033-1358475] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim was to evaluate the effects of additional exercises during inpatient stays on bone mass in pediatric bone tumor patients. 21 patients were non-randomly allocated either to the exercise group (n = 10) or the control group (n = 11). DXA of the lumbar spine, the non-affected femur and both calcanei was performed after completion of neoadjuvant chemotherapy (baseline), as well as 6 and 12 months after baseline. Bone mineral content (BMC), bone mineral density (BMD) and height-corrected lumbar spine Z-scores were determined. Group changes after 6 and 12 months were compared by covariance analyses. Additionally, daily physical activities (PA) were assessed by means of accelerometry. After adjusting for initial age, height and weight, mean reductions in lumbar spine and femoral BMC were lower in the exercise group (not significant). Effect sizes during the observational period for lumbar spine and femur BMC were generally small (partial η² = 0.03). The exercise group demonstrated substantially higher PA levels in terms of gait cycles per day, per hour and moderate PA (activities above 40 gait cycles per minute). Additional exercises for bone tumor patients are feasible during hospitalization. Though the intervention did not influence BMC, it appeared beneficial regarding PA promotion with respect to volume and intensity.
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Affiliation(s)
- C Müller
- Institute of Experimental Musculoskeletal Medicine, Movement Analysis Lab, University Hospital of Muenster, Germany
| | - C Winter
- Institute of Experimental Musculoskeletal Medicine, Movement Analysis Lab, University Hospital of Muenster, Germany
| | - J Boos
- Department of Pediatric Oncology and Hematology, University Hospital of Muenster, Germany
| | - G Gosheger
- Department of General Orthopedics and Tumororthopedics, University Hospital of Muenster, Germany
| | - J Hardes
- Department of General Orthopedics and Tumororthopedics, University Hospital of Muenster, Germany
| | - V Vieth
- Department of Clinical Radiology, University Hospital of Muenster, -Germany
| | - D Rosenbaum
- Institute of Experimental Musculoskeletal Medicine, Movement Analysis Lab, University Hospital of Muenster, Germany
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Voorjans Leconte E, Wipf S, Lang S, Stüssi A, Riesterer O, Winter C. PD-0473: Comparing the reproducibility of respiratory pattern during SBRT verses 4DCT. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Leong A, Pavic M, Winter C. Integration of a 3D Virtual Radiation Therapy Environment System for Clinical Patient Education. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martin G, Böttcher M, Canolli M, Plörer D, Winter C, Musselmann R, Walcher S, Pogarell O. Parallel consumption of pregabalin in opioid maintenance treatment detected by multi-target screening in oral fluid. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tubiana R, Mandelbrot L, Le Chenadec J, Delmas S, Rouzioux C, Hirt D, Treluyer JM, Ekoukou D, Bui E, Chaix ML, Blanche S, Warszawski J, Ngondi J, Chernai N, Teglas JP, Laurent C, Huyn P, Le Chenadec J, Delmas S, Warszawski J, Muret P, Baazia Y, Jeantils V, Lachassine E, Rodrigues A, Sackho A, Sagnet-Pham I, Tassi S, Breilh D, Iriard X, Andre G, Douard D, Reigadas S, Roux D, Louis I, Morlat P, Pedebosq S, Barre J, Estrangin E, Fauveau E, Garrait V, Ledudal P, Pichon C, Richier L, Thebault A, Touboul C, Bornarel D, Chambrin V, Clech L, Dubreuil P, Foix L'helias L, Picone O, Schoen H, Stralka M, Crenn-Hebert C, Floch-Tudal C, Hery E, Ichou H, Mandelbrot L, Meier F, Tournier V, Walter S, Chevojon P, Devidas A, Granier M, Khanfar-boudjemai M, Malbrunot C, Nguyen R, Ollivier B, Radideau E, Turpault I, Jault T, Barrail A, Colmant C, Fourcade C, Goujard C, Pallier C, Peretti D, Taburet AM, Bocket L, D'angelo S, Godart F, Hammou Y, Houdret N, Mazingue F, Thielemans B, Brochier C, Cotte L, Januel F, Le Thi T, Gagneux MC, Bozio A, Massardier J, Kebaïli K, Ben AK, Heller-Roussin B, Riehl C, Roos S, Taccot F, Winter C, Arias J, Brunet-François C, Dailly E, Flet L, Gournay V, Mechinaud F, Reliquet V, Winner N, Peytavin G, Bardin C, Boudjoudi N, Compagnucci A, Guerin C, Krivine A, Pannier E, Salmon D, Treluyer JM, Firtion G, Ayral D, Ciraru-Vigneron N, Mazeron MC, Rizzo Badoin N, Trout H, Benachi A, Boissand C, Bonnet D, Boucly S, Blanche S, Chaix ML, Duvivier C, Parat S, Cayol V, Oucherif S, Rouzioux C, Viard JP, Bonmarchand M, De Montgolfier I, Dommergues M, Fievet MH, Iguertsira M, Pauchard M, Quetin F, Soulie C, Tubiana R, Faye A, Magnier S, Bui E, Carbonne B, Daguenel Nguyen A, Harchi N, Meyohas MC, Poirier JM, Rodriguez J, Hervé F, Pialloux G, Dehee A, Dollfus C, Tillous Borde I, Vaudre G, Wallet A, Allemon MC, Bolot P, Boussairi A, Chaplain C, Ekoukou D, Ghibaudo N, Kana JM, Khuong MA, Weil M, Entz-Werle N, Livolsi Lutz P, Beretz L, Cheneau M, Partisani ML, Schmitt MP, Acar P, Armand E, Berrebi A, Guibaud Plo C, Lavit M, Nicot F, Tricoire J, Ajana F, Huleux T. Lopinavir/Ritonavir Monotherapy as a Nucleoside Analogue–Sparing Strategy to Prevent HIV-1 Mother-to-Child Transmission: The ANRS 135 PRIMEVA Phase 2/3 Randomized Trial. Clin Infect Dis 2013; 57:891-902. [DOI: 10.1093/cid/cit390] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Willeke P, Winter C, Schotte H, Becker H, Marx J, Gaubitz M, Rosenbaum D. AB0487 Etanercept increases step activity in patients with active rheumatoid arthritis and short disease duration. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.487] [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: 11/03/2022]
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Fatemi SH, Folsom T, Reutiman T, Mori S, Rooney R, Winter C, Smee D, Kornfield T, Patterson P. Prenatal human influenza viral infection and brain disorder in mouse: Relevance for genesis of schizophrenia. Neurotoxicol Teratol 2013. [DOI: 10.1016/j.ntt.2013.03.012] [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: 10/26/2022]
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Abstract
Abstract
The German regulatory body has issued technical documents on methods and data for probabilistic safety assessment, elaborated for a comprehensive integrated safety review of all nuclear power plants in operation. These documents contain, among others, a graded approach for the probabilistic assessment of external flooding. Main aspects are explained such as the underlying probabilistic considerations and the mathematical procedures for the calculation of exceedance frequencies for nuclear power plants at tidal rivers in Germany. Morever, extreme events such as tsunami waves have been investigated.
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Affiliation(s)
- H.-P. Berg
- Federal Office for Radiation Protection, Salzgitter, Germany. E-mail:
| | - C. Winter
- University Bremen, Center Marine Environmental Sciences (MARUM) Bremen, Germany
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Cavelaars F, Lang S, Linsenmeier C, Winter C. OC-0071: Inter-tester reproducibility of tumour-change in SCLC cancer patients undergoing chemo-radiotherapy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32378-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Winter C, Gerbault O, Kestemont P, Castillo L. [Aesthetic augmentation of the dorsum, mid-term results]. Rev Laryngol Otol Rhinol (Bord) 2013; 134:179-184. [PMID: 25252571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE OF THE STUDY Dorsum aesthetic augmentation can be divided according to their objective, total and partial increase or camouflage. The objective of this original article is to define the valid techniques in each indication through a cohort study, clinical cases, and current data from the literature. PATIENT AND METHOD It is a monocentric mono operator retrospective study from 2005 to 2010 included. On 171 rhinoplasties, 57 were augmentation rhinoplasties of which 40 were of interest to the dorsum. Excluded patients were bone grafts, lost and one patient operated on a active Wegener desease. Thus 26 rhinoplasties were analyzed by an independent observer. RESULTS All grafts confused there were 11.5% of resorption which corresponds to the data from the literature, 17% of resorption in the camouflage indications and 7% in augmentation, as well as a higher resorption for crushed cartilage (33%) rate. There was more mobility in augmentation (28%) than in the camouflage (8%) and greater visibility of the banks of the graft in augmentation (35%) compared to the camouflage (8%). CONCLUSION In the mild to severe saddle nose, the DCF is greater than cartilage monobloc or crushed in terms of stability and visibility, its indications could be expanded to harmonisation. Camouflage crushed cartilage is not sustainable and the temporal aponeurosis could it be preferred. Resorbable fillers can offer an alternative to surgery or improve its results.
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Carpenter EL, Haglund EA, Mace EM, Deng D, Martinez D, Wood AC, Chow AK, Weiser DA, Belcastro LT, Winter C, Bresler SC, Vigny M, Mazot P, Asgharzadeh S, Seeger RC, Zhao H, Guo R, Christensen JG, Orange JS, Pawel BR, Lemmon MA, Mossé YP. Erratum: Antibody targeting of anaplastic lymphoma kinase induces cytotoxicity of human neuroblastoma. Oncogene 2012. [DOI: 10.1038/onc.2012.208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Beyer J, Albers P, Altena R, Aparicio J, Bokemeyer C, Busch J, Cathomas R, Cavallin-Stahl E, Clarke NW, Claßen J, Cohn-Cedermark G, Dahl AA, Daugaard G, De Giorgi U, De Santis M, De Wit M, De Wit R, Dieckmann KP, Fenner M, Fizazi K, Flechon A, Fossa SD, Germá Lluch JR, Gietema JA, Gillessen S, Giwercman A, Hartmann JT, Heidenreich A, Hentrich M, Honecker F, Horwich A, Huddart RA, Kliesch S, Kollmannsberger C, Krege S, Laguna MP, Looijenga LHJ, Lorch A, Lotz JP, Mayer F, Necchi A, Nicolai N, Nuver J, Oechsle K, Oldenburg J, Oosterhuis JW, Powles T, Rajpert-De Meyts E, Rick O, Rosti G, Salvioni R, Schrader M, Schweyer S, Sedlmayer F, Sohaib A, Souchon R, Tandstad T, Winter C, Wittekind C. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Oncol 2012; 24:878-88. [PMID: 23152360 PMCID: PMC3603440 DOI: 10.1093/annonc/mds579] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.
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Affiliation(s)
- J Beyer
- Department of Hematology and Oncology, Vivantes Klinikum Am Urban, Berlin.
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Willi R, Winter C, Wieske F, Kempf A, Yee BK, Schwab ME, Singer P. Loss of EphA4 impairs short-term spatial recognition memory performance and locomotor habituation. Genes Brain Behav 2012; 11:1020-31. [PMID: 22938696 DOI: 10.1111/j.1601-183x.2012.00842.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 07/29/2012] [Accepted: 08/25/2012] [Indexed: 12/20/2022]
Abstract
EphA4 receptor (EphA4) tyrosine kinase is an important regulator of central nervous system development and synaptic plasticity in the mature brain, but its relevance to the control of normal behavior remains largely unexplored. This study is the first attempt to obtain a behavioral profile of constitutive homozygous and heterozygous EphA4 knockout mice. A deficit in locomotor habituation in the open field, impairment in spatial recognition in the Y-maze and reduced probability of spatial spontaneous alternation in the T-maze were identified in homozygous EphA4(-/-) mice, while heterozygo us EphA4(+/-) mice appeared normal on these tests in comparison with wild-type (WT) controls. The multiple phenotypes observed in EphA4(-/-) mice might stem from an underlying deficit in habituation learning, reflecting an elementary form of nonassociative learning that is in contrast to Pavlovian associative learning, which appeared unaffected by EphA4 disruption. A deficit in motor coordination on the accelerating rotarod was also demonstrated only in EphA4(-/-) mice--a finding in keeping with the presence of abnormal gait in EphA4(-/-) mice--although they were able to improve performance over training. There was no evidence for substantial changes in major neurochemical markers in various brain regions rich in EphA4 as shown by post-mortem analysis. This excludes the possibility of major neurochemical compensation in the brain of EphA4(-/-) mice. In summary, we have demonstrated for the first time the behavioral significance of EphA4 disruption, supporting further investigation of EphA4 as a possible target for behavioral interventions where habituation deficits are prominent.
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Affiliation(s)
- R Willi
- Brain Research Institute, University of Zurich.,Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Present address: CNS Discovery, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - C Winter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany
| | - F Wieske
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany
| | - A Kempf
- Brain Research Institute, University of Zurich.,Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - B K Yee
- Laboratory of Behavioral Neurobiology, Department of Biology, ETH Zurich, Schwerzenbach, Switzerland.,Present address: Robert Stone Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, USA
| | - M E Schwab
- Brain Research Institute, University of Zurich.,Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - P Singer
- Laboratory of Behavioral Neurobiology, Department of Biology, ETH Zurich, Schwerzenbach, Switzerland.,Present address: Robert Stone Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, USA
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Barski D, Richter M, Winter C, Arsov C, de Geeter P, Rabenalt R, Albers P. Holmium laser ablation of the prostate (HoLAP): intermediate-term results of 144 patients. World J Urol 2012; 31:1253-9. [PMID: 22782618 DOI: 10.1007/s00345-012-0901-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 06/21/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To retrospectively analyse the intermediate-term outcome of holmium laser ablation of the prostate (HoLAP) of up to 4 years postoperatively in one of the largest series and to define the selection criteria for patients who benefit from potentially lower complications associated with HoLAP. METHODS Between June 2006 and November 2010, 144 patients with benign prostatic obstruction were treated at two centres with standardised HoLAP (2.0 J/50 Hz or 3.2 J/25 Hz with Versapulse(®) 80-100 W laser Lumenis(®)). Median follow-up was 21 months (range, 1-54). International prostate symptom score and quality of life (IPSS-QoL), PSA, prostate volume, maximal flow rate (Qmax), postvoiding residual volume (Vres) were evaluated pre- and postoperatively. All complications were graded according to CTCAE (v4.03). RESULTS Mean patient age was 70.1 ± 7.7 years (range, 46-90). With a preoperative median prostate volume of 40 ml (range, 10-130), the median operation time was 50 min (range, 9-138). We observed a median catheterisation time of 1 day (range, 0-12) and hospitalisation time of 2 days (range, 1-16). IPSS-QoL, Qmax and Vres were significantly improved after 3 months, and all parameters remained unchanged after 12, 24 and 36 months. The rate of re-operation was significantly lower in patients with prostate volume <40 ml, compared to patients with prostates ≥ 40 ml (9.1 vs. 25 %, p = 0.04). CONCLUSIONS HoLAP is a safe and effective procedure for the treatment of prostates <40 ml. Patients benefit from HoLAP because of a low bleeding rate and short hospital stay. Due to high recurrence rates, HoLAP should be avoided in prostates >40 ml.
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Affiliation(s)
- D Barski
- Department of Urology, Duesseldorf University Hospital, Moorenstrasse 5, 40225, Düsseldorf, Germany,
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Lerdsaway K, Thammavongsa K, Ounaphom P, Khamphaphongphane B, Somoulay V, Vongphrachanh P, Komase K, Yamamoto K, Archkhawong S, Ketmayoon P, Phengxay M, Chanthapaseuth T, Feldon K, Denny J, Winter C, Lewis H. Rubella susceptibility study among women of child-bearing age - Vientiane Capital, Lao PDR, 2010. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.217] [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] Open
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Linthavong S, Ouandala V, Dusan F, Vongphrachanh P, Kounnavong B, Corwin A, Chanthavisouk C, Winter C, Denny J. Anthrax knowledge, attitudes and practice survey - Lao PDR, 2010. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.654] [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] Open
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