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Michael FA, Hessz D, Graf C, Zimmer C, Nour S, Jung M, Kloka J, Knabe M, Welsch C, Blumenstein I, Dultz G, Finkelmeier F, Walter D, Mihm U, Lingwal N, Zeuzem S, Bojunga J, Friedrich-Rust M. Thoracic impedance pneumography in propofol-sedated patients undergoing percutaneous endoscopic gastrostomy (PEG) placement in gastrointestinal endoscopy: A prospective, randomized trial. J Clin Anesth 2024; 94:111403. [PMID: 38368798 DOI: 10.1016/j.jclinane.2024.111403] [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: 06/06/2023] [Revised: 11/25/2023] [Accepted: 01/23/2024] [Indexed: 02/20/2024]
Abstract
STUDY OBJECTIVE To assess the efficacy of an ECG-based method called thoracic impedance pneumography to reduce hypoxic events in endoscopy. DESIGN This was a single center, 1:1 randomized controlled trial. SETTING The trial was conducted during the placement of percutaneous endoscopic gastrostomy (PEG). PATIENTS 173 patients who underwent PEG placement were enrolled in the present trial. Indication was oncological in most patients (89%). 58% of patients were ASA class II and 42% of patients ASA class III. INTERVENTIONS Patients were randomized in the standard monitoring group (SM) with pulse oximetry and automatic blood pressure measurement or in the intervention group with additional thoracic impedance pneumography (TIM). Sedation was performed with propofol by gastroenterologists or trained nurses. MEASUREMENTS Hypoxic episodes defined as SpO2 < 90% for >15 s were the primary endpoint. Secondary endpoints were minimal SpO2, apnea >10s/>30s and incurred costs. MAIN RESULTS Additional use of thoracic impedance pneumography reduced hypoxic episodes (TIM: 31% vs SM: 49%; p = 0.016; OR 0.47; NNT 5.6) and elevated minimal SpO2 per procedure (TIM: 90.0% ± 8.9; SM: 84.0% ± 17.6; p = 0.007) significantly. Apnea events >10s and > 30s were significantly more often detected in TIM (43%; 7%) compared to SM (1%; 0%; p < 0.001; p = 0.014) resulting in a time advantage of 17 s before the occurrence of hypoxic events. As a result, adjustments of oxygen flow were significantly more often necessary in SM than in TIM (p = 0.034) and assisted ventilation was less often needed in TIM (2%) compared with SM (9%; p = 0.053). Calculated costs for the additional use of thoracic impedance pneumography were 0.13$ (0.12 €/0.11 £) per procedure. CONCLUSIONS Additional thoracic impedance pneumography reduced the quantity and extent of hypoxic events with less need of assisted ventilation. Supplemental costs per procedure were negligible. KEY WORDS thoracic impedance pneumography, capnography, sedation, monitoring, gastrointestinal endoscopy, percutaneous endoscopic gastrostomy.
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Affiliation(s)
- F A Michael
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany.
| | - D Hessz
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - C Graf
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - C Zimmer
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - S Nour
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - M Jung
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - J Kloka
- Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt am Main, Germany
| | - M Knabe
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - C Welsch
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - I Blumenstein
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - G Dultz
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - F Finkelmeier
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - D Walter
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - U Mihm
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - N Lingwal
- Goethe University Frankfurt, University Hospital, Institute of Biostatistics and Mathematical Modeling, Frankfurt am Main, Germany
| | - S Zeuzem
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - J Bojunga
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
| | - M Friedrich-Rust
- Goethe University Frankfurt, University Hospital, Department of Internal Medicine 1, Frankfurt am Main, Germany
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Graf C, Oteng-Attakora K, Ferguson E, Vassallo R, Merz EM. Blood Donor Incentives across 63 Countries: The BEST Collaborative Study. Transfus Med Rev 2024; 38:150809. [PMID: 38228070 DOI: 10.1016/j.tmrv.2023.150809] [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: 10/11/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/18/2024]
Abstract
Incentives for blood donors are a much-debated strategy intended to ensure a sufficient supply of blood. Yet, there is a fundamental lack of knowledge about which incentives are offered by different blood collectors. We provide a comprehensive description of incentive policies for whole blood donors across 63 countries and 50 states of the United States. We collected data on incentive policies by conducting 2 surveys among representatives of blood collection establishments. Additionally, we integrated incentive data from an existing study and the World Health Organization (WHO). Lastly, we performed a web content analysis of blood collector websites and news releases to extend incentive data for the United States as well as underrepresented regions. We present descriptive analyses illustrating the type and value of incentives and their geographical distribution around the globe. Approximately half of the countries in our sample employ financial incentives, which include cash and tax benefits, but also less conventional incentives, such as healthcare supplements and raffles. Time off work is also commonly offered to blood donors and varies across blood collection establishments in duration and whether it is granted to all donors or only to those whose employer allows it. There is a geographical clustering of incentives, such that neighboring countries are more likely to employ similar incentives. This study provides insights into the strategies used for incentivizing blood donation and highlights the global diversity of incentive policies for whole blood donors. In stark contrast to WHO guidelines, half of the countries surveyed employ some kind of high-value incentive for blood donors. More realistic guidelines that are adapted to the local cultural and institutional context may be needed to maintain an adequate blood supply.
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Affiliation(s)
- Caroline Graf
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands.
| | | | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | | | - Eva-Maria Merz
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Donor Medicine Research, Sanquin Research, Amsterdam, the Netherlands
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Graf C, Suanet B, Wiepking P, Merz EM. How public trust and healthcare quality relate to blood donation behavior: Cross-cultural evidence. J Health Psychol 2024; 29:3-14. [PMID: 37277909 PMCID: PMC10757392 DOI: 10.1177/13591053231175809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Blood donors are indispensable for enabling a myriad of medical procedures and treatments. We examined how public trust in the healthcare system and healthcare quality relate to individuals' likelihood of donating blood, using survey data from representative samples of 28 European countries (N = 27,868). Our preregistered analyses revealed that country-level public trust, but not healthcare quality, predicted individual propensity to donate blood. Notably, public trust decreased over time in many countries, while healthcare quality increased. Our results highlight the role of subjective perceptions of the healthcare system, rather than the objective state of healthcare, for blood donation behavior in Europe.
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Affiliation(s)
- Caroline Graf
- Vrije Universiteit Amsterdam, The Netherlands
- Department of Donor Medicine Research, Sanquin Research, The Netherlands
| | | | - Pamala Wiepking
- Vrije Universiteit Amsterdam, The Netherlands
- Indiana University–Purdue University Indianapolis (IUPUI), USA
| | - Eva-Maria Merz
- Vrije Universiteit Amsterdam, The Netherlands
- Department of Donor Medicine Research, Sanquin Research, The Netherlands
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Antonsson E, Gerke F, Langer B, Goroncy C, Dresch T, Leisner T, Graf C, Rühl E. Inelastic mean-free path and mean escape depth of 10-140 eV electrons in SiO 2 nanoparticles determined by Si 2p photoelectron yields. Phys Chem Chem Phys 2023. [PMID: 37222473 DOI: 10.1039/d3cp01284k] [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: 05/25/2023]
Abstract
We report on photoelectron spectra of SiO2 nanoparticles (d = 157 ± 6 nm) above the Si 2p threshold in the photon energy range 118-248 eV with electron kinetic energy 10-140 eV and analyze the photoelectron yield as a function of photon energy. Comparison of the experimental results with Monte-Carlo simulations on electron transport allows us to quantify the inelastic mean-free path and mean escape depth of photoelectrons in the nanoparticle samples. The influence of the nanoparticle geometry and electron elastic scattering on photoelectron yields is highlighted. The results show that the previously proposed direct proportionality of the photoelectron signal to the inelastic mean-free path or the mean escape depth does not hold for photoelectron kinetic energies below 30 eV due to the strong influence of electron elastic scattering. The present results deviate for photoelectron kinetic energies below 30 eV from the previously proposed direct proportionality of the photoelectron signal to the inelastic mean-free path or the mean escape depth, which is the result of a strong influence of electron elastic scattering. The presented inelastic mean-free paths and mean escape depths appear to be useful for the quantitative interpretation of photoemission experiments on nanoparticles and for modeling of the experimental results.
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Affiliation(s)
- E Antonsson
- Physical Chemistry, Freie Universität Berlin, Arnimallee 22, D-14195 Berlin, Germany.
| | - F Gerke
- Physical Chemistry, Freie Universität Berlin, Arnimallee 22, D-14195 Berlin, Germany.
| | - B Langer
- Physical Chemistry, Freie Universität Berlin, Arnimallee 22, D-14195 Berlin, Germany.
| | - C Goroncy
- Physical Chemistry, Freie Universität Berlin, Arnimallee 22, D-14195 Berlin, Germany.
| | - T Dresch
- Institute of Meteorology and Climate Research, Karlsruhe Institut of Technology, - KIT Hermann-von-Helmholtz-Platz 1, D-76344 Eggenstein-Leopoldhafen, Germany
| | - T Leisner
- Institute of Meteorology and Climate Research, Karlsruhe Institut of Technology, - KIT Hermann-von-Helmholtz-Platz 1, D-76344 Eggenstein-Leopoldhafen, Germany
- Institute of Environmental Physics, University of Heidelberg, Im Neuenheimer Feld 229, D-69120 Heidelberg, Germany
| | - C Graf
- Fachbereich Chemie- und Biotechnologie, Hochschule Darmstadt - University of Applied Sciences, Stephanstr. 7, D-64295 Darmstadt, Germany
| | - E Rühl
- Physical Chemistry, Freie Universität Berlin, Arnimallee 22, D-14195 Berlin, Germany.
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Shaikh H, Pezoldt J, Mokhtari Z, Gamboa Vargas J, Le DD, Peña Mosca J, Arellano Viera E, Kern MA, Graf C, Beyersdorf N, Lutz MB, Riedel A, Büttner-Herold M, Zernecke A, Einsele H, Saliba AE, Ludewig B, Huehn J, Beilhack A. Fibroblastic reticular cells mitigate acute GvHD via MHCII-dependent maintenance of regulatory T cells. JCI Insight 2022; 7:154250. [PMID: 36227687 DOI: 10.1172/jci.insight.154250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/07/2022] [Indexed: 12/15/2022] Open
Abstract
Acute graft versus host disease (aGvHD) is a life-threatening complication of allogeneic hematopoietic cell transplantation (allo-HCT) inflicted by alloreactive T cells primed in secondary lymphoid organs (SLOs) and subsequent damage to aGvHD target tissues. In recent years, Treg transfer and/or expansion has emerged as a promising therapy to modulate aGvHD. However, cellular niches essential for fostering Tregs to prevent aGvHD have not been explored. Here, we tested whether and to what extent MHC class II (MHCII) expressed on Ccl19+ fibroblastic reticular cells (FRCs) shape the donor CD4+ T cell response during aGvHD. Animals lacking MHCII expression on Ccl19-Cre-expressing FRCs (MHCIIΔCcl19) showed aberrant CD4+ T cell activation in the effector phase, resulting in exacerbated aGvHD that was associated with significantly reduced expansion of Foxp3+ Tregs and invariant NK T (iNKT) cells. Skewed Treg maintenance in MHCIIΔCcl19 mice resulted in loss of protection from aGvHD provided by adoptively transferred donor Tregs. In contrast, although FRCs upregulated costimulatory surface receptors, and although they degraded and processed exogenous antigens after myeloablative irradiation, FRCs were dispensable to activate alloreactive CD4+ T cells in 2 mouse models of aGvHD. In summary, these data reveal an immunoprotective, MHCII-mediated function of FRC niches in secondary lymphoid organs (SLOs) after allo-HCT and highlight a framework of cellular and molecular interactions that regulate CD4+ T cell alloimmunity.
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Affiliation(s)
- Haroon Shaikh
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany.,Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Joern Pezoldt
- Laboratory of Systems Biology and Genetics, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Department of Experimental Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Zeinab Mokhtari
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Juan Gamboa Vargas
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany.,Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Duc-Dung Le
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Josefina Peña Mosca
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany.,Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Estibaliz Arellano Viera
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Michael Ag Kern
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany.,Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Caroline Graf
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Niklas Beyersdorf
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany.,Institute for Virology and Immunobiology, Würzburg University, Würzburg, Germany
| | - Manfred B Lutz
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany.,Institute for Virology and Immunobiology, Würzburg University, Würzburg, Germany
| | - Angela Riedel
- Mildred Scheel Early Career Centre, University Hospital of Würzburg, Würzburg, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Alma Zernecke
- Institute of Experimental Biomedicine, University Hospital Würzburg, Würzburg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Antoine-Emmanuel Saliba
- Helmholtz Institute for RNA-based Infection Research (HIRI), Helmholtz-Center for Infection (HZI), Würzburg, Germany
| | - Burkhard Ludewig
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Jochen Huehn
- Department of Experimental Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Andreas Beilhack
- Interdisciplinary Center for Clinical Research (IZKF), Experimental Stem Cell Transplantation Laboratory, and.,Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany.,Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
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Chau O, Islam A, Lock M, Yu E, Dinniwell R, Yaremko B, Brackstone M, Pavlosky W, Butler J, Biernaski H, Graf C, Wisenberg G, Prato F, Gaede S. Assessing Acute Cardiac Inflammation after Left-Sided Breast Cancer Radiotherapy with Hybrid PET/MRI (RICT-BREAST). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.761] [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: 10/31/2022]
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Quintana R, Garcia L, Alba P, Roverano S, Alvarez A, Graf C, Pisoni C, Spindler A, Gomez C, Figueredo HM, Papasidero S, Paniego RH, Delavega M, Civit De Garignani EE, Gonzalez Lucero L, Martire V, Águila Maldonado R, Gordon S, Gobbi C, Nieto R, Rausch G, Góngora V, D’amico MA, Dubinsky D, Orden AO, Zacariaz J, Romero J, Pera MA, Rillo O, Baez R, Arturi V, Gonzalez A, Vivero F, Schmid M, Caputo V, Larroude MS, Gomez G, Rodriguez G, Marin J, Collado MV, Jorfen M, Bedran Z, Sarano J, Zelaya D, Sacnun M, Finucci P, Rojas Tessel R, Sattler ME, Machado Escobar M, Astesana P, Paris UV, Allievi A, Vandale JM, Pons-Estel B, Pons-Estel G, García M. POS0707 POTENTIAL USE OF BELIMUMAB IN LUPUS PATIENTS FROM ARGENTINE COHORT ACCORDING DISEASE ACTIVITY STATE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe goal of targeted treatment in patients with Systemic Lupus Erythematosus (SLE) is to achieve clinical remission or low disease activity, with the best quality of life, low damage rates and better survival 1-4. RELESSAR is a multicenter, cross-sectional study registry of ≥18 years SLE (ACR 97) patients 5.ObjectivesTo describe demographic, clinical characteristics and treatments in SLE patients according to disease activity state. To evaluate the proportion of SLE and refractory SLE patients that are potentially candidates for Belimumab treatment (Active SLE despite standard treatment including increased acDNA autoantibodies and low complement).MethodsWe evaluated demographic and clinical data, treatments, score of damage (SLICC), activity (SLEDAI) and comorbidity (Charlson), hospital admissions and severe infections. The patients were compared according to disease activity: remission (SLEDAI = 0 and without corticosteroids), low disease activity (LDA, SLEDAI> 0 and ≤4 and without corticosteroids) and non-optimal control (SLEDAI> 4 and any dose of corticosteroids). Refractory SLE was defined according to Rituximab (RTX) use, non-response to cyclophosphamide or two or more immunosuppressant or splenectomized patients. Potential use of Belimumab according approved prescription in Argentina was analyzed.ResultsOverall, 1277 patients were analyzed: 299 (23.4%) were in remission, 162 (12.7%) in LDA and 816 (63.9%) with non-optimal control of the disease.Patients in non-optimal control group were younger, less frequently female and they showed less time of disease and lower socioeconomic status (p < 0.001). They were also more prevalent mestizos (p= 0.004), had higher SLEDAI and SLICC indexes (p <0.001) and higher use of immunosuppressant therapy (p <0.001). There was no difference regarding biologic treatment (RTX p= 0.547 and Belimumab p= 0.08). This group had higher proportion of hospital admissions and severe infections (p<0.001, respectively).Two hundred and one SLE patients fulfilled the use of Belimumab prescription criteria but only 45/201 patients (22,3%) received it in the last visit. Malar rash was the only clinical variable associated with the use of Belimumab (72.7% vs 29.8% p= 0.005).Seventy-six patients classified as refractory SLE (15.7%) and 56/76 (75.7%) never received Belimumab. Patients on Belimumab therapy were associated to treatment with lower doses of corticoids (p= 0.018) and lower rate of hospital admission caused by SLE flare (p= 0.027).ConclusionA high percentage of patients had uncontrolled disease upon entry into the registry and were potential candidates for treatment with Belimumab. The patients who received biologic treatment showed the benefit of requiring fewer doses of corticosteroids and having a lower rate of hospitalizations.References[1]Mok CC. Treat-to-target in systemic lupus erythematosus: Are we there yet? Expert Rev Clin Pharmacol. 2016;9(5).[2]Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Vol. 31, Best Practice and Research: Clinical Rheumatology. 2017.[3]Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: Remission and low disease activity state. Rheumatol (United Kingdom). 2020;59.[4]Ruiz-Irastorza G, Bertsias G. Treating systemic lupus erythematosus in the 21st century: new drugs and new perspectives on old drugs. Vol. 59, Rheumatology (United Kingdom). 2021.[5]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1997;40(9):1725. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9324032Disclosure of InterestsRosana Quintana: None declared, Lucila Garcia: None declared, Paula Alba: None declared, Susana Roverano: None declared, Analia Alvarez: None declared, Cesar Graf: None declared, Cecilia Pisoni: None declared, Alberto Spindler: None declared, Catalina Gomez: None declared, Heber Matias Figueredo: None declared, Silvia Papasidero: None declared, Raul Horacio Paniego: None declared, Maria DeLaVega: None declared, Emma Estela Civit De Garignani: None declared, Luciana Gonzalez Lucero: None declared, Victoria Martire: None declared, Rodrigo Águila Maldonado: None declared, Sergio Gordon: None declared, Carla Gobbi: None declared, Romina Nieto: None declared, Gretel Rausch: None declared, Vanina Góngora: None declared, Maria Agustina D´Amico: None declared, Diana Dubinsky: None declared, Alberto Omar Orden: None declared, Johana Zacariaz: None declared, Julia Romero: None declared, Mariana Alejandra Pera: None declared, Oscar Rillo: None declared, Roberto Baez: None declared, Valeria Arturi: None declared, Andrea Gonzalez: None declared, Florencia Vivero: None declared, Marcela Schmid: None declared, Victor Caputo: None declared, Maria Silvia Larroude: None declared, Graciela Gomez: None declared, Graciela Rodriguez: None declared, Josefina Marin: None declared, Maria Victoria Collado: None declared, Marisa Jorfen: None declared, Zaida Bedran: None declared, Judith Sarano: None declared, David Zelaya: None declared, MONICA SACNUN: None declared, Pablo Finucci: None declared, Romina Rojas Tessel: None declared, Maria Emilia Sattler: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Pablo Astesana: None declared, Ursula Vanesa Paris: None declared, Alberto Allievi: None declared, Juan Manuel Vandale: None declared, Bernardo Pons-Estel: None declared, Guillermo Pons-Estel: None declared, Mercedes García Grant/research support from: GSK grant
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Brigante A, Isnardi CA, Gómez G, Quintana R, Haye M, Roberts K, García M, Gomez G, Gobbi C, Casado G, Rebak J, Dapeña JM, Berbotto G, Viola M, Saurit V, Petkovic IE, Bertoli A, Giorgis P, Diaz MP, Catay E, Exeni IE, Pons-Estel B, Paira S, Bovea Castelblanco G, De La Sota ME, Larroude MS, Pereira DA, Granel AB, Medina G, Pisoni C, Alvarez A, Aguero SE, Fernandez L, Sacnun M, Soares de Souza S, Velozo E, Aste N, Castro C, Lazaro A, Kerzberg E, Gallardo MDLÁ, Savio V, Gamba J, Secco A, Citera G, Soriano E, Graf C, Pons-Estel G, Delavega M. POS0655 SURVIVAL AND SAFETY OF BIOLOGICAL AND TARGETED SYNTHETIC THERAPIES AS REGARDS TO AGE GROUPS. BIOBADASAR 3.0 REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAdvances in rheumatology and new therapeutic options have certainly impacted patient survival, changing the age range, from youth to seniors. The differences between the age groups could influence the evolution of the disease and the adverse events (AEs) related to the treatments. There are few real-world data on the safety and efficacy of treatments in different age groups.ObjectivesTo evaluate the frequency of AEs and the survival of treatments according to the age in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS).MethodsRetrospective, observational, multicenter study of real-life data of patients included in the BIOBADASAR 3.0 registry; exposed and not exposed to original biological treatments (b-DMARDs), biosimilars, targeted synthetic drugs (ts-DMARDs). The unexposed group received treatment with conventional disease-modifying drugs (cDMARDs). A Kaplan-Meier and Log Rank Test analysis was performed to study AEs-free survival and treatment in different age groups (young people <25; young adults 25-34; mature adults 34-65; old adults >65). Factors related to treatment survival were evaluated using Cox regression models.Results5,297 patients were included, 80.3% female, mean age 43.7 years (SD 15.6) and median disease progression 14.3 [IQR 11.5]. RA 4658 (87.9%); APs 490 (9.25%) and EA 149 (2.8%). The main reason for treatment discontinuation was ineffectiveness, in 624 patients in the exposed group and in 53 (2.5%) patients in control group, followed by the presence of AEs in 352 (11.2%) and 83 (3.9%), respectively (p=0.001).A mean Charlson Score of 0.268 (SD 0.6) in the exposed group and 0.306 (SD 0.7) in the control group (p=0.095). Median EAs-free survival in the exposed group was 12.5 years [IQR 16.6] while in controls was 28 years [IQR 11], p<0.0001. Median AEs-free survival was 12 years (IQR 11) in young people, 11.5 years [IQR: 4.9] in young adults, 10 years [IQR: 3.25] in mature adults and 7.6 years [IQR: 6] in old adults with a difference statistically significant (p>0.017). The exposed group presented a median treatment survival in years of 11.25 years [IQR: 10] in young people; 12.5 years [IQR: 4.7] in young adults, 7.5 years [IQR: 12.1] in mature adults and 4.5 years [IQR: 1.14] in old adults (p>0.0001). Considering only the first line of treatment, a median survival of 11.5 years [IQR: 10] was evidenced in the age group <25; 12 years [IQR: 2.6] between 25-34 years old, 10 years [IQR: 12] in the group between 34-65 years old and 5.5 years [IQR: 1.14] in the group > 65 years old (p>0.004). (Figure 1). Considering the second line of treatment, the differences between the groups were not statistically significant (p=0.57). In the multivariate regression model for patients with RA, the factors with the greatest impact on treatment survival were female sex (HR 1.3, 95% CI 1.2-1.4), old age (HR 1.01, 95% CI 1.008-1.01), treatment with steroids (HR 1.19, 95% CI1.1-1.2) and longer disease duration (HR 1.01, 95% CI1.01 – 1.02).ConclusionIn the present study we were able to demonstrate a greater occurrence of AEs in old adults and mature adults compared to young people and young adults. Conversely, survival for b-DMARDs and ts-DMARDs were greater in youth and young adults. In patients with RA, female sex, corticosteroid therapy, old aged and longer disease duration were associated with treatment discontinuation.References[1]Souto A, et al. Rate of discontinuation and drug survival of biologic therapies in rheumatoid arthritis: a systematic review and meta-analysis of drug registries and health care databases. Rheumatology (Oxford). 2016;55(3):523–34.[2]Ray D, et al. Immune senescence, epigenetics and autoimmunity. Clin Immunol. 2018 Nov;196:59-63. doi: 10.1016/j.clim.2018.04.002. Epub 2018 Apr 11.[3]Vela P, et al. Influence of age on the occurrence of adverse events in rheumatic patients at the onset of biological treatment: data from the BIOBADASER III register. Arthritis Res Ther. 2020 Jun 15;22(1):143. doi: 10.1186/s13075-020-02231-x.Disclosure of InterestsNone declared
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Spadaro G, Graf C, Jin S, Arai S, Inoue Y, Lieberman E, Rinderu MI, Yuan M, Van Lissa CJ, Balliet D. Cross-cultural variation in cooperation: A meta-analysis. J Pers Soc Psychol 2022; 123:1024-1088. [DOI: 10.1037/pspi0000389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chau O, Islam A, Yu E, Qu M, Butler J, Biernaski H, Sun A, Bissonnette JP, MacDonald A, Graf C, So A, Wisenberg G, Lee T, Prato FS, Gaede S. Multi-Modality Imaging Assessment of the Heart Before and After Stage III Non-Small Cell Lung Cancer Radiotherapy. Adv Radiat Oncol 2022; 7:100927. [PMID: 35434423 PMCID: PMC9006649 DOI: 10.1016/j.adro.2022.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022] Open
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Shaikh H, Vargas JG, Mokhtari Z, Jarick KJ, Ulbrich M, Mosca JP, Viera EA, Graf C, Le DD, Heinze KG, Büttner-Herold M, Rosenwald A, Pezoldt J, Huehn J, Beilhack A. Mesenteric Lymph Node Transplantation in Mice to Study Immune Responses of the Gastrointestinal Tract. Front Immunol 2021; 12:689896. [PMID: 34381447 PMCID: PMC8352558 DOI: 10.3389/fimmu.2021.689896] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/08/2021] [Indexed: 02/02/2023] Open
Abstract
Mesenteric lymph nodes (mLNs) are sentinel sites of enteral immunosurveillance and immune homeostasis. Immune cells from the gastrointestinal tract (GIT) are constantly recruited to the mLNs in steady-state and under inflammatory conditions resulting in the induction of tolerance and immune cells activation, respectively. Surgical dissection and transplantation of lymph nodes (LN) is a technique that has supported seminal work to study LN function and is useful to investigate resident stromal and endothelial cell biology and their cellular interactions in experimental disease models. Here, we provide a detailed protocol of syngeneic mLN transplantation and report assays to analyze effective mLN engraftment in congenic recipients. Transplanted mLNs allow to study T cell activation and proliferation in preclinical mouse models. Donor mLNs proved viable and functional after surgical transplantation and regenerated blood and lymphatic vessels. Immune cells from the host completely colonized the transplanted mLNs within 7-8 weeks after the surgical intervention. After allogeneic hematopoietic cell transplantation (allo-HCT), adoptively transferred allogeneic CD4+ T cells from FVB/N (H-2q) mice homed to the transplanted mLNs in C57BL/6 (H-2b) recipients during the initiation phase of acute graft-versus-host disease (aGvHD). These CD4+ T cells retained full proliferative capacity and upregulated effector and gut homing molecules comparable to those in mLNs from unmanipulated wild-type recipients. Wild type mLNs transplanted into MHCII deficient syngeneic hosts sufficed to activate alloreactive T cells upon allogeneic hematopoietic cell transplantation, even in the absence of MHCII+ CD11c+ myeloid cells. These data support that orthotopically transplanted mLNs maintain physiological functions after transplantation. The technique of LN transplantation can be applied to study migratory and resident cell compartment interactions in mLNs as well as immune reactions from and to the gut under inflammatory and non-inflammatory conditions.
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Affiliation(s)
- Haroon Shaikh
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Juan Gamboa Vargas
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Zeinab Mokhtari
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Katja J. Jarick
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Maria Ulbrich
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Josefina Peña Mosca
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
| | - Estibaliz Arellano Viera
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Caroline Graf
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Duc-Dung Le
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
| | - Katrin G. Heinze
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
- Rudolf Virchow Center, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Maike Büttner-Herold
- Department of Nephropathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Rosenwald
- Institute of Pathology, Julius-Maximilians-University Würzburg, Würzburg, Germany
- Comprehensive Cancer Centre Mainfranken, Würzburg University Hospital, Würzburg, Germany
| | - Joern Pezoldt
- Laboratory of Systems Biology and Genetics, Institute of Bioengineering, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Experimental Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Jochen Huehn
- Department of Experimental Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Andreas Beilhack
- Interdisciplinary Center for Clinical Research (IZKF) Experimental Stem Cell Transplantation Laboratory, Würzburg University Hospital, Würzburg, Germany
- Department of Internal Medicine II, Würzburg University Hospital, Würzburg, Germany
- Graduate School of Life Sciences, Würzburg University, Würzburg, Germany
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Graf C, Nickel B, Kraft B. [Erratum to: Rare histopathological finding in scrotal hernia]. Chirurg 2020; 92:71. [PMID: 33346854 DOI: 10.1007/s00104-020-01327-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Graf
- Klinik für Allgemein- und Viszeralchirurgie, Referenzzentrum Hernienchirurgie, Kompetenzzentrum Minimalinvasive Chirurgie, Diakonie-Klinikum Stuttgart, Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Rosenbergstraße 38, 70176, Stuttgart, Deutschland.
| | - B Nickel
- Klinik für Allgemein- und Viszeralchirurgie, Referenzzentrum Hernienchirurgie, Kompetenzzentrum Minimalinvasive Chirurgie, Diakonie-Klinikum Stuttgart, Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Rosenbergstraße 38, 70176, Stuttgart, Deutschland
| | - B Kraft
- Klinik für Allgemein- und Viszeralchirurgie, Referenzzentrum Hernienchirurgie, Kompetenzzentrum Minimalinvasive Chirurgie, Diakonie-Klinikum Stuttgart, Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Rosenbergstraße 38, 70176, Stuttgart, Deutschland
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Hars M, Mendes A, Serratrice C, Herrmann FR, Gold G, Graf C, Zekry D, Trombetti A. Sex-specific association between vitamin D deficiency and COVID-19 mortality in older patients. Osteoporos Int 2020; 31:2495-2496. [PMID: 33048168 PMCID: PMC7552596 DOI: 10.1007/s00198-020-05677-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 01/28/2023]
Affiliation(s)
- M Hars
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Mendes
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Serratrice
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - F R Herrmann
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - G Gold
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Graf
- Department of Rehabilitation and Geriatrics, Division of Rehabilitation and Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Zekry
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Trombetti
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland.
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Archibald J, MacMillan EL, Graf C, Kozlowski P, Laule C, Kramer JLK. Metabolite activity in the anterior cingulate cortex during a painful stimulus using functional MRS. Sci Rep 2020; 10:19218. [PMID: 33154474 PMCID: PMC7645766 DOI: 10.1038/s41598-020-76263-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023] Open
Abstract
To understand neurochemical brain responses to pain, proton magnetic resonance spectroscopy (1H-MRS) is used in humans in vivo to examine various metabolites. Recent MRS investigations have adopted a functional approach, where acquisitions of MRS are performed over time to track task-related changes. Previous studies suggest glutamate is of primary interest, as it may play a role during cortical processing of noxious stimuli. The objective of this study was to examine the metabolic effect (i.e., glutamate) in the anterior cingulate cortex during noxious stimulation using fMRS. The analysis addressed changes in glutamate and glutamate + glutamine (Glx) associated with the onset of pain, and the degree by which fluctuations in metabolites corresponded with continuous pain outcomes. Results suggest healthy participants undergoing tonic noxious stimulation demonstrated increased concentrations of glutamate and Glx at the onset of pain. Subsequent reports of pain were not accompanied by corresponding changes in glutamate of Glx concentrations. An exploratory analysis on sex revealed large effect size changes in glutamate at pain onset in female participants, compared with medium-sized effects in male participants. We propose a role for glutamate in the ACC related to the detection of a noxious stimulus.
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Affiliation(s)
- J Archibald
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
- Department of Experimental Medicine, University of British Columbia, Vancouver, Canada.
| | - E L MacMillan
- Department of Radiology, University of British Columbia, Vancouver, Canada
- ImageTech Lab, Simon Fraser University, Surrey, Canada
- Philips Healthcare Canada, Markham, Canada
| | - C Graf
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - P Kozlowski
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
| | - C Laule
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Hughill Center, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada
- Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - J L K Kramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Center for Brain Health (DMCH), Vancouver, Canada
- Hughill Center, Vancouver, Canada
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Giesen L, Könnecke H, Redaèlli M, Simic D, Heßbrügge M, Vitinius F, van der Arend I, Graf C, Biallas B, Stock S. Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program.
Methods
This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided.
Results
In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected.
Conclusions
This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions.
Key messages
Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.
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Affiliation(s)
- L Giesen
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - H Könnecke
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - M Redaèlli
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - D Simic
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
| | - M Heßbrügge
- Institute of General Medicine, Essen University Hospital, Essen, Germany
| | - F Vitinius
- Department of Psychosomatics and Psychotherapy, The University Hospital of Cologne, Cologne, Germany
| | | | - C Graf
- Department Healthcare Management and Disease Prevention, BEK, Düsseldorf, Germany
| | - B Biallas
- Institute for Movement-Oriented Prevention & Rehabilitation, German Sports University Cologne, Cologne, Germany
| | - S Stock
- Institute of Health Economics and Clinical Epidemiology, The University Hospital of Cologne, Cologne, Germany
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Lier LM, Breuer C, Ferrari N, Friesen D, Maisonave F, Schmidt N, Graf C. Cost-effectiveness of a family-based multicomponent outpatient intervention program for children with obesity in Germany. Public Health 2020; 186:185-192. [PMID: 32858303 DOI: 10.1016/j.puhe.2020.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Facing an epidemic of childhood obesity and budget constraints, public health administrations are showing an urgent interest in interventions that are both health effective and cost-effective. Thus, this study intends to analyze the return on investment of these existing programs. STUDY DESIGN All analyses are based on a comprehensive data set from 249 children with obesity and overweight children who participated in the Children's Health InterventionaL Trial (CHILT), an 11-month outpatient multidisciplinary family-based program. METHODS Cost-effectiveness was assessed by comparing estimated savings associated with a reduction in weight and improvement of obesity-related health parameters with intervention costs. Projected future savings in health care expenditures were modeled on existing research, using estimates of health care costs associated with juvenile obesity and remission thresholds of obesity-related disease. RESULTS On average, participants achieved a 0.19-unit reduction in the body mass index standard deviation score, showed reduction in their blood pressure values (systolic = -1.76 mmHg, diastolic = -2.82 mmHg), and showed improvement in their high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol values (HDL = +1.31 mg/dL, LDL = -4.82 mg/dL). The intervention costs were 1799€ per participant, and the benefits of avoided future health care costs varied by individual. On an aggregated level, future savings amounted to between 1859€ and 1926€ per person, translating into a return on investment of 3.3-7.0%. CONCLUSIONS This study shows that a multicomponent obesity intervention, such as the CHILT, not only results in weight loss and improves important health parameters but also is cost-effective.
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Affiliation(s)
- L M Lier
- MA. Strategy & International Management, BSc Business Administration & Economics Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany, Eisenstraße 5, 50925, Cologne, Germany.
| | - C Breuer
- Habilitation Sport Science Department of Sports Economics and Sport Management, German Sport University Cologne, Cologne, Germany
| | - N Ferrari
- PhD Sport Science Cologne Center for Prevention and Youth/Heart Center Cologne, University Hospital Cologne, Germany
| | - D Friesen
- MA Sports Science Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - F Maisonave
- Diploma in Sport Science Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - N Schmidt
- BA Sport Science, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - C Graf
- Habilitation Sport Science, PhD Sports Medicine Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Degen J, Hawkins RD, Graf C, Kreiss E, Goodman ND. When redundancy is useful: A Bayesian approach to “overinformative” referring expressions. Psychol Rev 2020; 127:591-621. [DOI: 10.1037/rev0000186] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fernández-Ávila DG, Patino-Hernandez D, Kowalski S, Vargas-Caselles A, Sapag Durán AM, Cachafeiro Vilar A, Meléndez B, Pastelín CS, Graf C, Rossetto C, Palleiro D, Trincado D, Fernández-Ávila D, Arrieta D, Reyes G, Then J, Ugarte-Gil MF, Cardiel M, Colman N, Chávez N, Burgos P, Montufar R, Sandino S, Fuentes-Silva Y, Soriano E. AB1270 RHEUMATOLOGY WORKFORCE IN LATIN AMERICA: TRAINING AND CURRENT STATUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The demand for rheumatology care has been steadily increasing over the last few years. However, supply seems to be insufficient, according to previous research1. This situation may be at least partly explained by less physicians beginning a rheumatology residency program2.Objectives:We aim to identify baseline data, room for change, and to strengthen functional processes associated with the rheumatology workforce in order to improve care offered to patients living with rheumatic diseases.Methods:Descriptive cross-sectional study. We obtained data on each country through local PANLAR rheumatologists. They completed an online survey using the RedCap® platform, used for capture and storage of data. The sample was described according to the type of variable.Results:19 Latin American countries were included in this study, globally 1 rheumatologist was available per 106,838 inhabitants. The highest rates were found in Uruguay (1 per 23.695 inhabitants) and Argentina (1 per 40.384 inhabitants). The lowest rates were found in Nicaragua (1 per 640.648 inhabitants) and Guatemala (1 per 559.902 inhabitants). The ratio between women and men rheumatologists was 0,99 women per each man. The lowest proportions were found in Peru (0,26:1), and the highest in the Dominican Republic (2.5:1). The average age for rheumatologists was 51,6 (SD12,75). Lowest average ages were found in Paraguay (43,1 SD10,77) and the highest age averages were found in Peru (56,23 SD12.93). The average monthly compensation was USD $2.382,6 (SD$1.462,5). Venezuela had the lowest salary ($197), the highest salary was found in Costa Rica ($4.500). The proportion of rheumatologists trained abroad was 26,7%, ranging between 0% in Uruguay and 90% in Bolivia.The countries with more rheumatology training programs were Brazil n = 50 and Mexico n = 20, while Ecuador, Honduras and Nicaragua don’t have any. The countries with the greatest amount of active residents were Brazil (n = 252) and Argentina (n = 100). The educational level required to enter the program was postgraduate studies in internal medicine in 42.11% of the programs. Currently, 108 residency programs in Latin America are active. Duration of residency programs is variable: 2 years (79.63% of cases), 3 years (16.67%), 4 years (1.85%), 5 years (0.96%) or 6 years (0.96%). The median monthly compensation for residents was $ 528 USD (IQR $ 774), the country with the highest payment was Costa Rica ($ 2637). Contrarily, in Cuba, Chile and Colombia there is no payment to residents. Finally, in 8 countries (42.11%) residents must not pay for their postgraduate studies, the average annual tuition expense in the rest of countries is $ 1248 (SD $ 2749).Conclusion:The rate of rheumatologists per inhabitant is low. The demographic characteristics and the current status of the rheumatology workforce, as well as rheumatology training in Latin-America varies widely among countries. For instance, relevant differences can be found regarding payment to rheumatologists and residents, and tuition fees. The collected information will be useful when planning regional-based strategies, as well as for future research projects in each country and within PANLAR.References:[1]Battafarano DF, Ditmyer M, Bolster MB, et al. 2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030. Arthritis Care Res.2018;70(4):617-26[2]Zborovski S, Rohekar G, Rohekar S. Strategies to improve recruitment into rheumatology: results of the Workforce in Rheumatology Issues Study. J Rheumatol. 2010;37:1749-55Disclosure of Interests:Daniel G. Fernández-Ávila: None declared, Daniela Patino-Hernandez: None declared, Sergio Kowalski: None declared, Alfredo Vargas-Caselles: None declared, Ana María Sapag Durán: None declared, Antonio Cachafeiro Vilar: None declared, Belia Meléndez: None declared, Carlos Santiago Pastelín: None declared, Cesar Graf: None declared, Chayanne Rossetto: None declared, Daniel Palleiro: None declared, Daniela Trincado: None declared, Diana Fernández-Ávila: None declared, Dina Arrieta: None declared, Gil Reyes: None declared, Jossiell Then: None declared, Manuel F. Ugarte-Gil Grant/research support from: Jannsen, Pfizer, Mario Cardiel: None declared, Nelly Colman: None declared, Nilmo Chávez: None declared, Paula Burgos: None declared, Ruben Montufar: None declared, Sayonara Sandino: None declared, Yurilis Fuentes-Silva: None declared, Enrique Soriano Grant/research support from: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer Inc, Sandoz, Consultant of: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer Inc, Sandoz, Speakers bureau: AbbVie, Amber, Bristol-Myers Squibb, Eli Lilly, Novartis, Pfizer Inc, Roche
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Mareschal J, Delsoglio M, Karsegard V, Achamrah N, Pichard C, Graf C, Herrmann F, Genton L. SUN-PO240: Body Composition Changes Affect Running Performance in a Prospective Study. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32872-9] [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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Graf C, Schierz O, Steinke H, Körner A, Kiess W, Kratzsch J, Hirsch C. Sex hormones in association with general joint laxity and hypermobility in the temporomandibular joint in adolescents-results of the epidemiologic LIFE child study. J Oral Rehabil 2019; 46:1023-1030. [PMID: 31206205 DOI: 10.1111/joor.12834] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/10/2019] [Accepted: 06/09/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this cross-sectional study was to investigate whether sex hormones (testosterone, oestradiol, sex-hormone-binding globulin = SHBG) are associated with general joint laxity (GJL) and hypermobility or derangements of the temporomandibular joint (TMJ) in adolescents. METHODS Within the LIFE Child study, 970 adolescents (10-18 years) were included. GJL was assessed using the Beighton test. Maximum mouth opening (MMO) and clinical clicking sounds as signs of disc displacement (DD) in the TMJ were assessed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones were assessed using standardised laboratory analyses. RESULTS Hypermobile joints were found in 54.9% (N = 532) of the sample; females were more affected than males (61.4% vs. 51.8%, P < 0.001). Using logistic regression analyses, the odds ratio (OR) for having >1 hypermobile joints increased to 1.15 (95% confidence interval [CI]: 1.04-1.27) in males and 1.09 (95% CI: 1.02-1.17) in females per 10 units of the SHBG serum level, compared to those without hypermobile joints-after controlling for the effect of age, adjusted BMI, pubertal development (Tanner scale), testosterone as well as oestradiol levels. Female subjects with >1 hypermobile joints showed a higher OR (1.89; 95% CI: 1.05-3.43) for having clinical clicking sounds in the TMJ and a 3.28 times higher OR (95% CI: 1.44-7.44) for MMO ≥ 55 mm. CONCLUSIONS We observed age- and gender-independent associations of higher SHBG serum levels with GJL in adolescents. Moreover, hypermobile female adolescents show a more frequent hypermobility of the TMJ and clinical signs of DD.
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Affiliation(s)
- Caroline Graf
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Hanno Steinke
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Antje Körner
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Christian Hirsch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
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Mareschal J, Herrmann F, Graf C, Karsegard V, Achamrah N, Delsoglio M, Schindler M, Pichard C, Genton L. La composition corporelle prédit la vitesse de course chez plus de 3000 coureurs à pied. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.293] [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: 11/29/2022]
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Mareschal J, Herrmann F, Graf C, Karsegard V, Achamrah N, Pichard C, Genton L. Body composition predicts running speed in over 3000 people. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1099] [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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Genton L, Norman K, Spoerri A, Pichard C, Karsegard V, Herrmann F, Graf C. BIOIMPEDANCE-DERIVED PHASE ANGLE AND MORTALITY AMONG OLDER PEOPLE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L. Genton
- Clinical Nutrition, University Hospitals of Geneva, Geneva, Switzerland,
| | - K. Norman
- Charite University Medicine Berline, Berlin, Germany,
| | - A. Spoerri
- Social and Preventive Medicine, University of Bern, Bern, Switzerland,
| | - C. Pichard
- Clinical Nutrition, University Hospitals of Geneva, Geneva, Switzerland,
| | - V. Karsegard
- Clinical Nutrition, University Hospitals of Geneva, Geneva, Switzerland,
| | - F.R. Herrmann
- Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - C. Graf
- Rehabilitation and palliative Care, University Hospitals of Geneva, Bernex, Geneva, Switzerland,
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Flöck A, Weber SK, Ferrari N, Fietz C, Graf C, Fimmers R, Gembruch U, Merz WM. Corrigendum to "Determinants of brain-derived neurotrophic factor (BDNF) in umbilical cord and maternal serum" [Psychoneuroendocrinology 63 (2016) 191-197]. Psychoneuroendocrinology 2017; 78:257. [PMID: 27876170 DOI: 10.1016/j.psyneuen.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Flöck
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - S K Weber
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - N Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - C Fietz
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - C Graf
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - R Fimmers
- Institute for Medical Biometry, Informatics and Epidemiology, University Bonn Medical School, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - W M Merz
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany.
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Flöck A, Ferrari N, Graf C, Fimmers R, Gembruch U, Merz WM. Einflussfaktoren auf Adipozytokin-Spiegel in mütterlichem Blut und Nabelschnurblut bei Geburt. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Koch B, Graf C, Hoffmeister U, Platschek AM, Gruber W, Holl R. [Motor Skills of Extremely Obese Children and Adolescents Based on the Multicentre Longitudinal Obesity Database (APV)]. Klin Padiatr 2016; 228:84-90. [PMID: 27023123 DOI: 10.1055/s-0042-100476] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Obese children and adolescents often exhibit progressively declining motor skills. To support young obese patients adequately, it is necessary to assess their individual physical and motor abilities, taking the degree of obesity into account. PATIENTS A total of 5 924 children and adolescents (mean age: 12.7±2.5 years, range 6.0-18.0 years, 3 195 girls) were examined in a standardised multicentre evaluation survey (APV). Fitness parameters were correlated with age- and gender-specific BMI-SDS (Standard Deviation Score) Methods: Anthropometric data were collected and patients performed the modified Munich fitness test (mMFT: maximal power, coordination, trunk flexibility) and a 6-min walk-test (aerobic endurance capacity). RESULTS 33% of patients were extremely obese (BMI>99.5th percentile). Mean BMI-SDS was + 2.32±0.53 (♀-Δ=+ 0.06; p<0.001). The data indicated significant negative correlations between BMI-SDS and selected components of motor performance, especially maximal power (r=- 0,134), and particularly aerobic endurance capacity (r=- 0,214; all p<0.001). Motor performance was significantly below average (n=27 473, 6-18 years), especially among extremely obese patients. Performance in all motor tasks was lower in girls compared to boys, except for trunk flexibility (p<0.001). CONCLUSION Correlations were found between BMI-SDS and motor performance. Extremely obese patients and obese girls showed the most pronounced motor deficits. These results emphasize the importance of standardized evaluation of individual motor performance in children and adolescents with obesity.
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Affiliation(s)
- B Koch
- Zentrum für Adipositasschulung Bremen-Stadt (ZABS), Bremen
| | - C Graf
- Deutsche Sporthochschule Köln, Institut für Bewegungs- und Neurowissenschaft, Köln
| | - U Hoffmeister
- Zentrum für Innere Medizin, Klinik für Innere Medizin II, Universitätsklinikum Ulm, Ulm
| | - A-M Platschek
- Deutsche Sporthochschule Köln, Institut für Bewegungs- und Neurowissenschaft, Köln
| | - W Gruber
- Sportwissenschaft Sportberatung Sportpädagogik, Stahnsdorf
| | - R Holl
- Zentralinstitut für Biomedizinische Technik, Universität Ulm, Ulm
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Flöck A, Weber SK, Ferrari N, Fietz C, Graf C, Fimmers R, Gembruch U, Merz WM. Determinants of brain-derived neurotrophic factor (BDNF) in umbilical cord and maternal serum. Psychoneuroendocrinology 2016; 63:191-7. [PMID: 26460781 DOI: 10.1016/j.psyneuen.2015.09.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/07/2015] [Accepted: 09/28/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Brain-derived neurotrophic factor (BDNF) plays a fundamental role in brain development; additionally, it is involved in various aspects of cerebral function, including neurodegenerative and psychiatric diseases. Involvement of BDNF in parturition has not been investigated. The aim of our study was to analyze determinants of umbilical cord BDNF (UC-BDNF) concentrations of healthy, term newborns and their respective mothers. METHODS This cross-sectional prospective study was performed at a tertiary referral center. Maternal venous blood samples were taken on admission to labor ward; newborn venous blood samples were drawn from the umbilical cord (UC), before delivery of the placenta. Analysis was performed with a commercially available immunoassay. Univariate analyses and stepwise multivariate regression models were applied. RESULTS 120 patients were recruited. UC-BDNF levels were lower than maternal serum concentrations (median 641 ng/mL, IQR 506 vs. median 780 ng/mL, IQR 602). Correlation between UC- and maternal BDNF was low (R=0.251, p=0.01). In univariate analysis, mode of delivery (MoD), gestational age (GA), body mass index at delivery, and gestational diabetes were determinants of UC-BDNF (MoD and smoking for maternal BDNF, respectively). Stepwise multivariate regression analysis revealed a model with MoD and GA as determinants for UC-BDNF (MoD for maternal BDNF). CONCLUSIONS MoD and GA at delivery are determinants of circulating BDNF in the mother and newborn. We hypothesize that BDNF, like other neuroendocrine factors, is involved in the neuroendocrine cascade of delivery. Timing and mode of delivery may exert BDNF-induced effects on the cerebral function of newborns and their mothers.
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Affiliation(s)
- A Flöck
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - S K Weber
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - N Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - C Fietz
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - C Graf
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - R Fimmers
- Institute for Medical Biometry, Informatics and Epidemiology, University Bonn Medical School, Germany
| | - U Gembruch
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany
| | - W M Merz
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Germany.
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Flöck A, Weber S, Ferrari N, Fietz C, Graf C, Fimmers R, Gembruch U, Merz W. Beeinflussen geburtshilfliche Variablen die Konzentration des Neurotrophins BDNF im Serum Neugeborener und ihrer Mütter? Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566467] [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: 10/22/2022]
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Rehaag R, Ferrari N, Fischer S, Froehlich-Gildhoff K, Graf C, Naul R, Nöcker G, Quast T, Tils G, Uslucan HH, Waskow F, Weyers S. Vernetzte kommunale Gesundheitsförderung für Kinder – wirkungsorientierte Qualitätssicherung und Verbesserung der Zugangschancen vulnerabler Zielgruppen. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563108] [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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Graf C, Karsegard V, Spoerri A, Makhlouf AM, Ho S, Herrmann F, Laurence G. SUN-PP115: Loss of Fat-Free Mass Index has Substantial Impact on Mortality Risk for Subjects > 65 Years. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30266-1] [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: 11/25/2022]
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Blüher S, Kromeyer-Hauschild K, Graf C, Grünewald-Funk D, Widhalm K, Korsten-Reck U, Markert J, Güssfeld C, Müller MJ, Moss A, Wabitsch M, Wiegand S. [Current Guidelines to Prevent Obesity in Childhood and Adolescence]. Klin Padiatr 2015; 228:1-10. [PMID: 26302179 DOI: 10.1055/s-0035-1559639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Current guidelines for the prevention of obesity in childhood and adolescence are presented. METHODS A literature search was performed in Medline via PubMed, and appropriate studies were analysed. RESULTS Programs to prevent childhood obesity were to date mainly school-based. Effects were limited to date. Analyses tailored to different age groups show that prevention programs have the best effects in younger children (< 12 years). Evidence based recommendations for preschool- and early school age imply the need for interventions addressing parents and teachers alike. During adolescence, school-based interventions were most effective when adolescents were directly addressed. To date, obesity prevention programs have mainly focused on behavior oriented prevention. Recommendations for condition oriented prevention have been suggested by the German Alliance of Non-communicable Diseases and include one hour of physical activity at school, promotion of healthy food choices by taxing unhealthy foods, mandatory quality standards for meals at kindergarten and schools as well as a ban on unhealthy food advertisement addressing children. CONCLUSION Behavior oriented prevention programs showed hardly any or only limited effects in the long term. Certain risk groups for the development of obesity are not reached effectively by available programs. Due to the heterogeneity of available studies, universally valid conclusions cannot be drawn. The combination with condition oriented prevention, which has to counteract on an obesogenic environment, is crucial for sustainable success of future obesity prevention programs.
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Affiliation(s)
- S Blüher
- IFB AdipositasErkrankungen, Universität Leipzig
| | | | - C Graf
- Institut für Bewegungs- und Neurowissenschaft, Deutsche Sporthochschule Köln
| | | | - K Widhalm
- Abteiliung für Kinderheilkunde und Jugendmedizin, Universität Wien
| | - U Korsten-Reck
- Abteilung für Rehabilitative und Präventive Sportmedizin, Medizinische Universität Freiburg
| | - J Markert
- IFB AdipositasErkrankungen, Universität Leipzig
| | - C Güssfeld
- IFB AdipositasErkrankungen, Universität Leipzig
| | - M J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts Universität Kiel
| | - A Moss
- Abteilung für Pädiatrische Endokrinologie und Diabetes, Klinik für Pädiatrie, Universität Ulm
| | - M Wabitsch
- Abteilung für Pädiatrsiche Endokrinologie und Diabetes, Interdisziplinäre Adipositas-Abteilung, Klinik für Pädiatrie, Universität Ulm
| | - S Wiegand
- Abteilung für Pädiatrische Endokrinologie und Diabetes, Charité Universitätsmedizin, Berlin
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Süßmann F, Seiffert L, Zherebtsov S, Mondes V, Stierle J, Arbeiter M, Plenge J, Rupp P, Peltz C, Kessel A, Trushin SA, Ahn B, Kim D, Graf C, Rühl E, Kling MF, Fennel T. Field propagation-induced directionality of carrier-envelope phase-controlled photoemission from nanospheres. Nat Commun 2015; 6:7944. [PMID: 26264422 PMCID: PMC4557130 DOI: 10.1038/ncomms8944] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 06/27/2015] [Indexed: 12/12/2022] Open
Abstract
Near-fields of non-resonantly laser-excited nanostructures enable strong localization of ultrashort light fields and have opened novel routes to fundamentally modify and control electronic strong-field processes. Harnessing spatiotemporally tunable near-fields for the steering of sub-cycle electron dynamics may enable ultrafast optoelectronic devices and unprecedented control in the generation of attosecond electron and photon pulses. Here we utilize unsupported sub-wavelength dielectric nanospheres to generate near-fields with adjustable structure and study the resulting strong-field dynamics via photoelectron imaging. We demonstrate field propagation-induced tunability of the emission direction of fast recollision electrons up to a regime, where nonlinear charge interaction effects become dominant in the acceleration process. Our analysis supports that the timing of the recollision process remains controllable with attosecond resolution by the carrier-envelope phase, indicating the possibility to expand near-field-mediated control far into the realm of high-field phenomena. The localized enhancement of laser light in optical near-fields of nanostructures enables the steering of ultrafast electronic motion. Here, the authors employ field propagation in nanospheres to obtain directional tunability and attosecond control of near-field-induced strong-field photoemission.
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Affiliation(s)
- F Süßmann
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany.,Physics Department, Ludwig-Maximilians-Universität München, D-85748 Garching, Germany
| | - L Seiffert
- Institut für Physik, Universität Rostock, D-18051 Rostock, Germany
| | - S Zherebtsov
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany.,Physics Department, Ludwig-Maximilians-Universität München, D-85748 Garching, Germany
| | - V Mondes
- Physical Chemistry, Freie Universität Berlin, Takustr. 3, D-14195 Berlin, Germany
| | - J Stierle
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - M Arbeiter
- Institut für Physik, Universität Rostock, D-18051 Rostock, Germany
| | - J Plenge
- Physical Chemistry, Freie Universität Berlin, Takustr. 3, D-14195 Berlin, Germany
| | - P Rupp
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany.,Physics Department, Ludwig-Maximilians-Universität München, D-85748 Garching, Germany
| | - C Peltz
- Institut für Physik, Universität Rostock, D-18051 Rostock, Germany
| | - A Kessel
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - S A Trushin
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany
| | - B Ahn
- Department of Physics, Center for Attosecond Science and Technology, Pohang University of Science and Technology, Pohang 790-784, South Korea.,Max Planck Center for Attosecond Science, Max Planck POSTECH/KOREA Res. Init., Pohang 790-784, South Korea
| | - D Kim
- Department of Physics, Center for Attosecond Science and Technology, Pohang University of Science and Technology, Pohang 790-784, South Korea.,Max Planck Center for Attosecond Science, Max Planck POSTECH/KOREA Res. Init., Pohang 790-784, South Korea
| | - C Graf
- Physical Chemistry, Freie Universität Berlin, Takustr. 3, D-14195 Berlin, Germany
| | - E Rühl
- Physical Chemistry, Freie Universität Berlin, Takustr. 3, D-14195 Berlin, Germany
| | - M F Kling
- Max-Planck-Institut für Quantenoptik, D-85748 Garching, Germany.,Physics Department, Ludwig-Maximilians-Universität München, D-85748 Garching, Germany.,Department of Physics, Center for Attosecond Science and Technology, Pohang University of Science and Technology, Pohang 790-784, South Korea.,J.R. Macdonald Laboratory, Physics Department, Kansas-State University, Manhattan, Kansas, USA
| | - T Fennel
- Institut für Physik, Universität Rostock, D-18051 Rostock, Germany
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Herbst A, Kapellen T, Schober E, Graf C, Meissner T, Holl RW. Impact of regular physical activity on blood glucose control and cardiovascular risk factors in adolescents with type 2 diabetes mellitus--a multicenter study of 578 patients from 225 centres. Pediatr Diabetes 2015; 16:204-10. [PMID: 24888254 DOI: 10.1111/pedi.12144] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 03/06/2014] [Accepted: 03/06/2014] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Regular physical activity (RPA) is a major therapeutic recommendation in children and adolescents with type 2 diabetes mellitus (T2DM). We evaluated the association between frequency of RPA and metabolic control, cardiovascular risk factors, and treatment regimes. METHODS The Pediatric Quality Initiative (DPV), including data from 225 centers in Germany and Austria, provided anonymous data of 578 patients (10-20 yr; mean 15.7 ± 2.1 yr; 61.9% girls) with T2DM. Patients were grouped by the frequency of their self-reported RPA per week: RPA 0, none; RPA 1, 1-2×/wk; RPA 2, >2×/wk. RESULTS The frequency of RPA ranged from 0 to 9×/wk (mean 1.1×/wk ±1.5). 55.7% of the patients reported no RPA (58.1% of the girls). Hemoglobin A1c (HbA1c) differed significantly among RPA groups (p < 0.002), being approximately 0.8 percentage points lower in RPA 2 compared to RPA 0. Body mass index (BMI-SDS) was higher in the groups with less frequent RPA (p < 0.00001). Multiple regression analysis revealed a negative association between RPA and HbA1c (p < 0.0001) and between RPA and BMI-SDS (p < 0.01). The association between RPA and high density lipoprotein (HDL)-cholesterol was positive (p < 0.05), while there was no association to total cholesterol, low density lipoprotein (LDL)-cholesterol or triglycerides. Approximately 80% of the patients received pharmacological treatment (oral antidiabetic drugs and/or insulin) without differences between RPA groups. CONCLUSION More than half of the adolescents with T2DM did not perform RPA. Increasing physical activity was associated with a lower HbA1c, a lower BMI-SDS, a higher HDL-cholesterol, but not with a difference in treatment regime. These results suggest that regular exercise is a justified therapeutic recommendation for children and adolescents with T2DM.
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Affiliation(s)
- A Herbst
- Department of Pediatrics, Hospital of Leverkusen, Leverkusen 51375, Germany
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Klein D, Manz K, Ferrari N, Strüder H, Graf C. Effects of health promotion projects in preschools on body mass index and motor abilities. J Sports Med Phys Fitness 2015; 55:103-112. [PMID: 24998611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The prevalence of obesity and motor deficits in children is on the rise in western industrialized countries. Due to the negative health related consequences, effective early preventive measures are of urgent need. In the present study the effects of the kindergarten-based low-threshold interventions "Kindergarten Mobile (KiMo)", "Ball and Pear (BP)" and "Nursery Fit (NF)" were determined. METHODS One thousand five hundred ten children (53.4% male) participated in the study (age: 4.7 ± 0.9 years, height: 108.3 ± 7.9cm, weight: 19.1 ± 3.6 kg, BMI: 16.1±1.6kg/m²). The children were divided in the groups KiMo (N.=690), BP (N.=74), NF-P (N.=95), NF-NP (N.=289) and CG (N.=362). Anthropometric data and motor abilities were assessed at T1 (baseline) and T2 (follow-up after 6 months). The interventions included an information session for parents/educators, where key guidelines for a healthy lifestyle were communicated and individual fitness passes were handed over (KiMo, NF-P, NF-NP), respectively an instructed activity lesson once per week (BP, NF-P). RESULTS The results showed a decrease of the BMI in the groups KiMo (-0.1 ± 0.6 kg/m²), NF-P (-0.1 ± 0.7 kg/m²) and NF-NP (-0.2 ± 0.6 kg/m²; each P<0.001 in comparison to the CG) and an increase in the group BP (0.1 ± 0.5 kg/m²; P=0.998 in comparison to the CG). Inconsistent results were shown in all groups regarding motor abilities. CONCLUSION To date, no evidence-based recommendations concerning the optimal procedure for health promotion at pre-school age can be concluded. It seems assured, that the entire social environment of children has to be involved in the prevention of overweight and motor deficits, including parents, educators and pediatricians.
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Affiliation(s)
- D Klein
- Institute of Movement and Neurosciences German Sport University Cologne, Cologne, Germany - dshs-koeln.de
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Ostrowski A, Nordmeyer D, Mundhenk L, Fluhr J, Graf C, Rühl E, Gruber A. Allergic contact dermatitis in mice is not affected or penetrated by ahaps-functionaliZed silica nanoparticles. J Comp Pathol 2015. [DOI: 10.1016/j.jcpa.2014.10.150] [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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Graf C, Deakin L, Docking M, Jones J, Joshua S, McKerahan T, Ottmar M, Stevens A, Wates E, Wyatt D. Best practice guidelines on publishing ethics: a publisher's perspective, 2nd edition. Int J Clin Pract 2014; 68:1410-28. [PMID: 25329600 DOI: 10.1111/ijcp.12557] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 11/29/2022] Open
Abstract
Wiley has updated its publishing ethics guidelines, first published in 2006. The new guidelines provide guidance, resources and practical advice on ethical concerns that arise in academic publishing for editors, authors and researchers, among other audiences. New guidance is also included on whistle blowers, animal research, clinical research and clinical trial registration, addressing cultural differences, human rights and confidentiality. The guidelines are uniquely interdisciplinary, and were reviewed by 24 editors and experts chosen from the wide range of communities that Wiley serves. They are also published in Advanced Materials, Headache, Annals of the New York Academy of Sciences, Social Science Quarterly, and on the website http://exchanges.wiley.com/ethicsguidelines.
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Affiliation(s)
- C Graf
- John Wiley & Sons Ltd, Oxford, UK
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Ostrowski A, Nordmeyer D, Mundhenk L, Fluhr J, Graf C, Rühl E, Gruber A. Effects of Skin Barrier Disruptions on the Penetration of Ahaps-Functionalized Silica Nanoparticles in the Mouse. J Comp Pathol 2014. [DOI: 10.1016/j.jcpa.2013.11.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Koletzko B, Armbruster M, Bauer CP, Bös K, Cierpka M, Cremer M, Dieminger B, Flothkötter M, Graf C, Heindl I, Hellmers C, Kersting M, Krawinkel M, Plöger A, Przyrembel H, Reichert-Garschhammer E, Schäfer T, Wahn U, Vetter K, Wabitsch M, Weißenborn A, Wiegand S. Ernährung und Bewegung im Kleinkindalter. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-013-3031-3] [Citation(s) in RCA: 17] [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: 01/27/2023]
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Walton L, Cousens R, Graf C. What IJCP authors think about open access: 392 IJCP authors explain their preferences. Int J Clin Pract 2013; 67:1211-2. [PMID: 24025035 DOI: 10.1111/ijcp.12282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- L Walton
- International Journal of Clinical Practice, Wiley, Oxford, Oxon, UK.
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Wenning P, Kreutz T, Schmidt A, Opitz D, Graf C, Voss S, Bloch W, Brixius K. Endurance exercise alters cellular immune status and resistin concentrations in men suffering from non-insulin-dependent type 2 diabetes. Exp Clin Endocrinol Diabetes 2013; 121:475-82. [PMID: 24026829 DOI: 10.1055/s-0033-1343395] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It has been demonstrated that alterations of adipocytokines can alter immune status in type 2 diabetes. The present study investigated changes of adipocytokine plasma concentrations and cellular immune status in overweight men, suffering from non-insulin dependent type 2 diabetes (n=14, age 61.0±8.7 years, BMI 31.1±3.5 kg/cm2). Subjects underwent a 3 months endurance exercise intervention (twice per week for up to 45 min) cycling at a heart rate corresponding to a 2 mmol/l lactate threshold. Before and after the intervention testing for adipocytokines (leptin, adiponectin, resistin) and cellular immune status (including T memory-cells and regulative T-cells) was performed by RIA and FACS accordingly.The exercise intervention improved anthropometric and metabolic parameters of all subjects. We observed a significant decline for resistin and for the CD19+ B-cells. The CD4+CD25+CD127low Treg-cells decreased, however not statistically significant. All other parameters remained unchanged.In conclusion, even though only training twice a week, the exercise affected parts of the cellular immune system as well as resistin levels in men suffering from non-insulin dependent type 2 diabetes.
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Affiliation(s)
- P Wenning
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Germany
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Rancan F, Nazemi B, Rautenberg S, Ryll M, Hadam S, Gao Q, Hackbarth S, Haag SF, Graf C, Rühl E, Blume-Peytavi U, Lademann J, Vogt A, Meinke MC. Ultraviolet radiation and nanoparticle induced intracellular free radicals generation measured in human keratinocytes by electron paramagnetic resonance spectroscopy. Skin Res Technol 2013; 20:182-93. [DOI: 10.1111/srt.12104] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2013] [Indexed: 01/18/2023]
Affiliation(s)
- F. Rancan
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. Nazemi
- Department of Dermatology and Allergy; Center of Experimental and Applied Cutaneous Physiology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Rautenberg
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Ryll
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Hadam
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Q. Gao
- Physikalische Chemie; Institut für Chemie und Biochemie; Freie Universität Berlin; Berlin Germany
| | - S. Hackbarth
- Photobiophysik; Institut für Physik; Humboldt Universität Berlin; Berlin Germany
| | - S. F. Haag
- Department of Dermatology and Allergy; Center of Experimental and Applied Cutaneous Physiology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. Graf
- Physikalische Chemie; Institut für Chemie und Biochemie; Freie Universität Berlin; Berlin Germany
| | - E. Rühl
- Physikalische Chemie; Institut für Chemie und Biochemie; Freie Universität Berlin; Berlin Germany
| | - U. Blume-Peytavi
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Lademann
- Department of Dermatology and Allergy; Center of Experimental and Applied Cutaneous Physiology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Vogt
- Department of Dermatology and Allergy; Clinical Research Center for Hair and Skin Science; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. C. Meinke
- Department of Dermatology and Allergy; Center of Experimental and Applied Cutaneous Physiology; Charité - Universitätsmedizin Berlin; Berlin Germany
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Graf C, Beneke R, Bloch W, Bucksch J, Dordel S, Eiser S, Ferrari N, Koch B, Krug S, Lawrenz W, Manz K, Naul R, Oberhoffer R, Quilling E, Schulz H, Stemper T, Stibbe G, Tokarski W, Völker K, Woll A. Vorschläge zur Förderung der körperlichen Aktivität von Kindern und Jugendlichen in Deutschland. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-012-2863-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Weiss L, Graf C, Herrmann F, Salomon R, Perrenoud JJ. Intermediate geriatric care in Geneva: A 10-year experience. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.07.457] [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: 11/28/2022]
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Brinkmann C, Chung N, Schmidt U, Kreutz T, Lenzen E, Schiffer T, Geisler S, Graf C, Montiel-Garcia G, Renner R, Bloch W, Brixius K. Training alters the skeletal muscle antioxidative capacity in non-insulin-dependent type 2 diabetic men. Scand J Med Sci Sports 2012; 22:462-70. [PMID: 21477162 DOI: 10.1111/j.1600-0838.2010.01273.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present study analyzes the oxidative stress situation in the skeletal muscle of overweight/obese men suffering from non-insulin-dependent type 2 diabetes mellitus [T2DM, n=16, years=61±7, body mass index (BMI)=31±4 kg/m(2) ] and BMI-matched non-diabetic male control subjects (CON, n=7, years=53±6, BMI=30±4 kg/m(2) ). Furthermore, it investigates whether physical training can alter the skeletal muscle antioxidative capacity of T2DM patients at rest. Molecule content analyses (immunohistochemical stainings) of 8-iso-prostaglandin-F2α (8-Iso-PGF), superoxide dismutase-2 (SOD2), glutathione peroxidase-1 (GPX1), peroxiredoxin isoforms (PRDX 1-6) and heat-shock-protein-70 (HSP70) were performed in biopsies taken from the vastus lateralis muscle. Under basal conditions, 8-Iso-PGF was significantly decreased in T2DM patients (-35.7%), whereas PRDX2 and PRDX6 were significantly increased relative to CON (+82.6%; +82.3%). Differences were neither observed in SOD2 nor in GPX1 or PRDX1, 3, 4, 5 density. Regular physical activity (moderate endurance or resistance training twice a week for 3 months) did not alter PRDX1, 2, 3, 4, 6 in the skeletal muscle of T2DM patients, but significantly increased SOD2 (+65.9%), GPX1 (+62.4%), PRDX5 (+37.5%), and HSP70 (+48.5%). Overweight/obese men with non-insulin-dependent T2DM exhibit up-regulated cytosolic peroxiredoxin contents relative to BMI-matched controls. Regular training further up-regulates cytosolic and mitochondrial antioxidative enzymes in T2DM patients and improves their cellular protection systems. This may contribute to a retardation of the disease's progression.
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Affiliation(s)
- C Brinkmann
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany.
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Samaras N, Frangos E, Forster A, Graf C, Samaras D. Back pain: A case of ivory vertebrae and ribs. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.01.016] [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]
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Jansch M, Stumpf P, Graf C, Rühl E, Müller R. Adsorption kinetics of plasma proteins on ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles. Int J Pharm 2012; 428:125-33. [DOI: 10.1016/j.ijpharm.2012.01.060] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 01/30/2012] [Accepted: 01/31/2012] [Indexed: 10/14/2022]
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Drabik A, Büscher G, Sawicki PT, Thomas K, Graf C, Müller D, Stock S. Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective. Diabetes Res Clin Pract 2012; 95:194-200. [PMID: 22004943 DOI: 10.1016/j.diabres.2011.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 09/15/2011] [Accepted: 09/19/2011] [Indexed: 11/26/2022]
Abstract
AIM Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect. METHODS We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization. RESULTS Annual costs for survivors were 3,318€ (DMP) and 3,570€ (RC). The mean costs in the last year of life were 16,911€ (DMP) and 15,763€ (RC). Ageing had a cost triggering effect for survivors (30€/36€ per year in DMP-/RC-group; p<0.001) and a cost decreasing effect in the last year of life (546€/483€ per year in DMP-/RC-group; p<0.001). The incremental cost-effectiveness ratio of the DMP vs. RC was -1396€ per life-year gained. Hospitalizations increased with age in case of survival and decreased with age in case of death but were always lower in the DMP-group. CONCLUSION Despite increase in costs due to longer life DMPs are cost-effective.
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Affiliation(s)
- A Drabik
- Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Gleueler Straße 176-178, 50935 Köln, Germany.
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