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Hadi E, Haddad L, Levy M, Gindes L, Hausman-Kedem M, Bassan H, Ben-Sira L, Libzon S, Kassif E, Hoffmann C, Leibovitz Z, Kasprian G, Lerman-Sagie T. Fetal intraventricular hemorrhage and periventricular hemorrhagic venous infarction: time for dedicated classification system. Ultrasound Obstet Gynecol 2024. [PMID: 38363592 DOI: 10.1002/uog.27613] [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] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Affiliation(s)
- E Hadi
- Diagnostic Ultrasound Unit, The Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Haddad
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - M Levy
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Raphael Recanati Genetics Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - L Gindes
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - M Hausman-Kedem
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Bassan
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology and Development Center, Shamir Medical Center (Assaf Harofeh), Be'er Ya'akov, Israel
| | - L Ben-Sira
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Radiology, Division of Pediatric Radiology, Dana Children's Hospital, Tel- Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Libzon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E Kassif
- Diagnostic Ultrasound Unit, The Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Hoffmann
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Neuroradiology Unit, Department of Diagnostic Radiology, Sheba Medical Center, Ramat Gan, Israel
| | - Z Leibovitz
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Obstetrics and Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - G Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology, Medical University of Vienna, Vienna, Austria
| | - T Lerman-Sagie
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
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Guberina M, Guberina N, Hoffmann C, Gogishvili A, Freisleben F, Herz A, Hlouschek J, Gauler T, Lang S, Stähr K, Höing B, Pöttgen C, Indenkämpen F, Santiago A, Khouya A, Mattheis S, Stuschke M. Prospects for online adaptive radiation therapy (ART) for head and neck cancer. Radiat Oncol 2024; 19:4. [PMID: 38191400 PMCID: PMC10775598 DOI: 10.1186/s13014-023-02390-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The aim of the present study is to examine the impact of kV-CBCT-based online adaptive radiation therapy (ART) on dosimetric parameters in comparison to image-guided-radiotherapy (IGRT) in consecutive patients with tumors in the head and neck region from a prospective registry. METHODS The study comprises all consecutive patients with tumors in the head and neck area who were treated with kV-CBCT-based online ART or IGRT-modus at the linear-accelerator ETHOS™. As a measure of effectiveness, the equivalent-uniform-dose was calculated for the CTV (EUDCTV) and organs-at-risk (EUDOAR) and normalized to the prescribed dose. As an important determinant for the need of ART the interfractional shifts of anatomic landmarks related to the tongue were analyzed and compared to the intrafractional shifts. The latter determine the performance of the adapted dose distribution on the verification CBCT2 postadaptation. RESULTS Altogether 59 consecutive patients with tumors in the head-and-neck-area were treated from 01.12.2021 to 31.01.2023. Ten of all 59 patients (10/59; 16.9%) received at least one phase within a treatment course with ART. Of 46 fractions in the adaptive mode, irradiation was conducted in 65.2% of fractions with the adaptive-plan, the scheduled-plan in the remaining. The dispersion of the distributions of EUDCTV-values from the 46 dose fractions differed significantly between the scheduled and adaptive plans (Ansari-Bradley-Test, p = 0.0158). Thus, the 2.5th percentile of the EUDCTV-values by the adaptive plans amounted 97.1% (95% CI 96.6-99.5%) and by the scheduled plans 78.1% (95% CI 61.8-88.7%). While the EUDCTV for the accumulated dose distributions stayed above 95% at PTV-margins of ≥ 3 mm for all 8 analyzed treatment phases the scheduled plans did for margins ≥ 5 mm. The intrafractional anatomic shifts of all 8 measured anatomic landmarks were smaller than the interfractional with overall median values of 8.5 mm and 5.5 mm (p < 0.0001 for five and p < 0.05 for all parameters, pairwise comparisons, signed-rank-test). The EUDOAR-values for the larynx and the parotid gland were significantly lower for the adaptive compared with the scheduled plans (Wilcoxon-test, p < 0.001). CONCLUSIONS The mobile tongue and tongue base showed considerable interfractional variations. While PTV-margins of 5 mm were sufficient for IGRT, ART showed the potential of decreasing PTV-margins and spare dose to the organs-at-risk.
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Affiliation(s)
- Maja Guberina
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Nika Guberina
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
| | - C Hoffmann
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - A Gogishvili
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - F Freisleben
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - A Herz
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - J Hlouschek
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - T Gauler
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - S Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - K Stähr
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - B Höing
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - C Pöttgen
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - F Indenkämpen
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - A Santiago
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - A Khouya
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - S Mattheis
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - M Stuschke
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
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Reck J, Kleinert M, Mihov K, Kresse M, Yilmaz C, Hoffmann C, Hoffmann P, Froese V, Kertzscher U, Mykhailiuk K, Michaelis J, Weigel W, Scholand S, Heupke HJ, Weigel M, De Felipe D, Qian T, Conradi H, Zawadzki C, Keil N, Schell M. Eight-channel SiNx microring-resonator based photonic biosensor for label-free fluid analysis in the optical C-band. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083739 DOI: 10.1109/embc40787.2023.10340677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
A lab-on-a-chip multichannel sensing platform for biomedical analysis based on optical silicon nitride (SiNx) microring-resonators (MRR) was established. The resonators were surface functionalized and finally combined with a microfluidic chamber for validation using an avidin-biotin ligand-binding assay. The results with a limit of detection (LOD) of 2.3∙10-5 and a mean intra-assay coefficient of variation (CV) of ±10.0 %, also under consideration of FDA guidelines, show promising future applicability for a wide variety of targets in the field of outpatient medical diagnostics and life science.Clinical Relevance- Biomarkers play a crucial role in physiological processes of the human body. To enable instantaneous and decentralized analysis of these markers, systems are needed that can be used in a laboratory-independent environment with minimal amounts of biofluid. An example is the utilization of such systems for neonates or infants.
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Guberina M, Santiago A, Pöttgen C, Indenkämpen F, Lübcke W, Qamhiyeh S, Gauler T, Hoffmann C, Guberina N, Stuschke M. Respiration-controlled radiotherapy in lung cancer: Systematic evaluation of the optimal application practice. Clin Transl Radiat Oncol 2023; 40:100628. [PMID: 37138702 PMCID: PMC10149340 DOI: 10.1016/j.ctro.2023.100628] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 05/05/2023] Open
Abstract
Background and purpose Definitive radiochemotherapy (RCT) for non-small cell lung cancer (NSCLC) in UICC/TNM I-IVA (singular, oligometastatic) is one of the treatment methods with a potentially curative concept. However, tumour respiratory motion during RT requires exact pre-planning. There are various techniques of motion management like creating internal target volume (ITV), gating, inspiration breath-hold and tracking. The primary goal is to cover the PTV with the prescribed dose while at the same time maximizing dose reduction of surrounding normal tissues (organs at risk, OAR). In this study, two standardized online breath-controlled application techniques used alternately in our department are compared with respect to lung and heart dose. Materials and methods Twenty-four patients who were indicated for thoracic RT received planning CTs in voluntary deep inspiration breath-hold (DIBH) and in free shallow breathing, prospectively gated in expiration (FB-EH). A respiratory gating system by Varian (Real-time Position Management, RPM) was used for monitoring. OAR, GTV, CTV and PTV were contoured on both planning CTs. The PTV margin to the CTV was 5 mm in the axial and 6-8 mm in the cranio-caudal direction. The consistency of the contours was checked by elastic deformation (Varian Eclipse Version 15.5). RT plans were generated and compared in both breathing positions using the same technique, IMRT over fixed irradiation directions or VMAT. The patients were treated in a prospective registry study with the approval of the local ethics committee. Results The PTV in expiration (FB-EH) was on average significantly smaller than the PTV in inspiration (DIBH): for tumours in the lower lobe (LL) 431.5 vs. 477.6 ml (Wilcoxon test for connected samples; p = 0.004), in the upper lobe (UL) 659.5 vs. 686.8 ml (p = 0.005). The intra-patient comparison of plans in DIBH and FB-EH showed superiority of DIBH for UL-tumours and equality of DIBH and FB-EH for LL-tumours. The dose for OAR in UL-tumours was lower in DIBH than in FB-EH (mean lung dose p = 0.011; lungV20, p = 0.002; mean heart dose p = 0.016). The plans for LL-tumours in FB-EH showed no difference in OAR compared to DIBH (mean lung dose p = 0.683; V20Gy p = 0.33; mean heart dose p = 0.929). The RT setting was controlled online for each fraction and was robustly reproducible in FB-EH. Conclusion RT plans for treating lung tumours implemented depend on the reproducibility of the DIBH and advantages of the respiratory situation with respect to OAR. The primary tumour localization in UL correlates with advantages of RT in DIBH, compared to FB-EH. For LL-tumours there is no difference between RT in FB-EH and RT in DIBH with respect to heart or lung exposure and therefore, reproducibility is the dominant criterion. FB-EH is recommended as a very robust and efficient technique for LL-tumours.
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Affiliation(s)
- M. Guberina
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Consortium for Translational Cancer Research, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site University Hospital Essen, Deutsche Krebsforschungszentrum (DKFZ), Essen, Germany
- Corresponding author at: Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufealndstr. 55, Essen 45147, Germany.
| | - A. Santiago
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- Medical Physics, Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - C. Pöttgen
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - F. Indenkämpen
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- Medical Physics, Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - W. Lübcke
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- Medical Physics, Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - S. Qamhiyeh
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- Medical Physics, Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - T. Gauler
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - C. Hoffmann
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - N. Guberina
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
| | - M. Stuschke
- Department for Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Consortium for Translational Cancer Research, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site University Hospital Essen, Deutsche Krebsforschungszentrum (DKFZ), Essen, Germany
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Hoffmann C, Schneider T, Wannous C, Nyberger K, Haavardsson I, Gilmore B, Quigley P, Winkler AS, Ludwig S. Impact of COVID-19 on the private and professional lives of highly educated women working in global health in Europe-A qualitative study. Front Glob Womens Health 2023; 4:1009473. [PMID: 36860347 PMCID: PMC9969128 DOI: 10.3389/fgwh.2023.1009473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/17/2023] [Indexed: 02/15/2023] Open
Abstract
Background The COVID-19 pandemic has led to a deepening of existing inequalities and a rollback of achievements made in gender equality. Women in Global Health (WGH) is a global movement that aims to achieve gender equality in health and increase female leadership in global health. Here, the aim was to understand how the pandemic affects the private and professional lives of women working in global health in different European countries. Suggestions for future pandemic preparedness including how gender perspectives should be integrated into pandemic preparedness and how a women's network such as WGH helped them to overcome the impact of the pandemic were explored. Methods Qualitative semi-structured interviews were conducted in September 2020 with a sample size of nine highly educated women with a mean age of 42.1 years from the different WGH European chapters. The participants were informed of the study and were formally asked for their consent. The interviews were held in English via an online videoconference platform and lasted 20-25 min each. The interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted according to Mayring Qualitative Content Analysis using MAXQDA. Results The pandemic has both positive and negative effects on the professional and private lives of women. It led to an increased workload and stress as well as pressure to publish on COVID-19-related themes. Increased childcare and household responsibilities represented a double burden. The available space was limited if other family members were also working from home. Positive aspects included more time for family or partners and reduced travel. The participants report on perceived gender differences in the experience of the pandemic. International cooperation is considered to be a key factor for future pandemic preparedness. Being part of a women's network such as WGH was perceived as being very supportive in difficult situations during the pandemic. Conclusion This study provides unique insights into the experiences of women working in global health in different European countries. The COVID-19 pandemic influences their professional and private lives. Perceived gender differences are reported and suggest the need for integrating gender perspectives in pandemic preparedness. Networks for women, such as WGH, can facilitate the exchange of information in crises and provide women with professional and personal support.
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Affiliation(s)
- Christina Hoffmann
- Women in Global Health Germany, Charité Center for Global Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Department of Applied Health Sciences, University of Applied Sciences, Bochum, Germany
| | - Tamara Schneider
- Women in Global Health Germany, Charité Center for Global Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Institute for Human Sciences, Department of Psychology, University of Paderborn, Paderborn, Germany
| | - Chadia Wannous
- Women in Global Health Sweden, Swedish Institute for Global Health Transformation, Stockholm, Sweden,Institutional and Regional Affairs Department, World Organisation for Animal Health (WOAH), Paris, France
| | - Karolina Nyberger
- Women in Global Health Sweden, Swedish Institute for Global Health Transformation, Stockholm, Sweden,Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden,Department of Trauma, Acute Surgery and Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Ingeborg Haavardsson
- Women in Global Health Norway, Centre for Global Health, University of Oslo, Oslo, Norway,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Brynne Gilmore
- Women in Global Health Ireland, Irish Global Health Network, Dublin, Ireland,School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Paula Quigley
- Women in Global Health Ireland, Irish Global Health Network, Dublin, Ireland,Inclusive Social Development Department, DAI Global Health, London, United Kingdom
| | - Andrea S. Winkler
- Women in Global Health Germany, Charité Center for Global Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Women in Global Health Norway, Centre for Global Health, University of Oslo, Oslo, Norway,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway,Center for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany
| | - Sabine Ludwig
- Women in Global Health Germany, Charité Center for Global Health, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Faculty for Healthcare and Nursing, Catholic University of Applied Sciences, Mainz, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Correspondence: Sabine Ludwig
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Witt C, Kienast C, Bölke G, Hoffmann C, Roehle R, Bender O, Nowak D, Tauber R, Gunga HC, Hoffmann P, Coats AJS, Liebers U. Long-term indoor gunshot exposure of special police forces induces bronchitic reactions and elevated blood lead levels-The Berlin shooting range study. J Cachexia Sarcopenia Muscle 2023; 14:452-463. [PMID: 36539958 PMCID: PMC9891938 DOI: 10.1002/jcsm.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/11/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Gunshot emissions contain toxic elements that can harm those frequently exposed, such as police officers. Several years ago, police indoor firing ranges were closed by the Berlin municipality in response to police officer health complaints, and an investigation was launched into the possible respiratory health risks of frequent gunshot emission exposure. We, therefore, conducted an exploratory cross-sectional study to investigate clinical and functional parameters of respiratory health as well as the burden of trace elements in policemen with long-term high exposure to indoor gunshot emissions, compared to low-exposure and control groups. METHODS We conducted lung function tests and collected blood and urine samples from Berlin police officers and government employees who were divided into three subject groups based on exposure to gunshot emissions: high exposure (n = 53), low exposure (n = 94) and no exposure (n = 76). Lung function was examined using body plethysmography. Blood and urine samples were tested via inductively coupled plasma mass spectrometry for the presence of common gunshot powder elements (antimony, lead and manganese). Exposure and symptoms were assessed using records as well as questionnaires. RESULTS Higher exposure was associated with more respiratory symptoms during gun shooting practice (64% vs. 21%, P < 0.001) compared to the low-exposure group. Headache, cough, discoloured mucous and shortness of breath were also more common as were some other symptoms. The cough symptomatology of the high-exposure group also persisted significantly longer (median: 0.67 vs. 0.01 days, range: 0 to 5 days, P = 0.029) compared to the low-exposure group. They also showed a lower forced expiratory volume in 1 s/forced vital capacity quotient (Tiffeneau index), P = 0.018 between the three groups and P = 0.005 for the high-exposure group, a possible marker of early, subclinical bronchial obstruction. We observed increased blood lead concentrations depending on subject's age (+1.2% per year, 95% confidence interval: 0.5-1.9%, P < 0.001) and cumulative gunshot exposure (+0.34% per 100 000 shots, 0.02-0.66%, P = 0.037). CONCLUSIONS These first results suggest that long-term exposure to indoor gunshot emissions induces bronchitic reactions due to repeated irritation of the airways. Higher levels of exposure lead to more negatively impacted lung function and higher blood lead levels with the possible reason that more frequent exposure may mean shorter regeneration phases for the respiratory mucous membrane. We recommend a reduction of exposure to gunshot emissions in order to decrease symptoms and avoid any-even small-deterioration in spirometry.
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Affiliation(s)
- Christian Witt
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Camilla Kienast
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg Bölke
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christina Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Roehle
- Charité Coordinating Center for Clinical Studies (KKS), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Olaf Bender
- Charité Coordinating Center for Clinical Studies (KKS), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich; Comprehensive Pneumology Center (CPC) Munich, member DZL, German Center for Lung Research, Munich, Germany
| | - Rudolf Tauber
- Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Peter Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Uta Liebers
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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7
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Hoffmann M, Gerlach S, Hoffmann C, Richter N, Hersch N, Csiszár A, Merkel R, Hoffmann B. PEGylation and folic-acid functionalization of cationic lipoplexes-Improved nucleic acid transfer into cancer cells. Front Bioeng Biotechnol 2022; 10:1066887. [PMID: 36619382 PMCID: PMC9811411 DOI: 10.3389/fbioe.2022.1066887] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Efficient and reliable transfer of nucleic acids for therapy applications is a major challenge. Stabilization of lipo- and polyplexes has already been successfully achieved by PEGylation. This modification reduces the interaction with serum proteins and thus prevents the lipoplexes from being cleared by the reticuloendothelial system. Problematically, this stabilization of lipoplexes simultaneously leads to reduced transfer efficiencies compared to non-PEGylated complexes. However, this reduction in transfer efficiency can be used to advantage since additional modification of PEGylated lipoplexes with functional groups enables improved selective transfer into target cells. Cancer cells overexpress folate receptors because of a significantly increased need of folate due to high cell proliferation rates. Thus, additional folate functionalization of PEGylated lipoplexes improves uptake into cancer cells. We demonstrate herein that NHS coupling chemistries can be used to modify two commercially available transfection reagents (Fuse-It-DNA and Lipofectamine® 3000) with NHS-PEG-folate for increased uptake of nucleic acids into cancer cells. Lipoplex characterization and functional analysis in cultures of cancer- and healthy cells clearly demonstrate that functionalization of PEGylated lipoplexes offers a promising method to generate efficient, stable and selective nucleic acid transfer systems.
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Affiliation(s)
| | | | | | | | | | | | | | - Bernd Hoffmann
- Institute of Biological Information Processing, Mechanobiology (IBI-2), Research Center Juelich, Juelich, Germany
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Koch S, Hoffmann C, Caseiro A, Ledebur M, Menk M, von Schneidemesser E. Air quality in Germany as a contributing factor to morbidity from COVID-19. Environ Res 2022; 214:113896. [PMID: 35841971 PMCID: PMC9277987 DOI: 10.1016/j.envres.2022.113896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/27/2022] [Accepted: 07/10/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The SARS-CoV-2 virus has been spreading in Germany since January 2020, with regional differences in incidence, morbidity, and mortality. Long-term exposure to air pollutants as nitrogen dioxide (NO2), nitrogen monoxide (NO), ozone (O3), and particulate matter (<10 μm PM10, <2.5 μm PM2.5) has a negative impact on respiratory functions. We analyze the association between long-term air pollution and the outcome of SARS-CoV-2 infections in Germany. METHODS We conducted an observational study in Germany on county-level, investigating the association between long-term (2010-2019) air pollutant exposure (European Environment Agency, AirBase data set) and COVID-19 incidence, morbidity, and mortality rate during the first outbreak of SARS-CoV-2 (open source data Robert Koch Institute). We used negative binominal models, including adjustment for risk factors (age, sex, days since first COVID-19 case, population density, socio-economic and health parameters). RESULTS After adjustment for risk factors in the tri-pollutant model (NO2, O3, PM2.5) an increase of 1 μg/m³ NO2 was associated with an increase of the need for intensive care due to COVID-19 by 4.2% (95% CI 1.011-1.074), and mechanical ventilation by 4.6% (95% CI 1.010-1.084). A tendency towards an association of NO2 with COVID-19 incidence was indicated, as the results were just outside of the defined statistical significance (+1.6% (95% CI 1.000-1.032)). Long-term annual mean NO2 level ranged from 4.6 μg/m³ to 32 μg/m³. CONCLUSIONS Our results indicate that long-term NO2 exposure may have increased susceptibility for COVID-19 morbidity in Germany. The results demonstrate the need to reduce ambient air pollution to improve public health.
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Affiliation(s)
- Susanne Koch
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Christina Hoffmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Diagnostic Laboratory Medicine, Clinical Chemistry, And Pathobiochemistry, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Alexandre Caseiro
- Institute for Advanced Sustainability Studies e.V. (IASS), Berliner Strasse 130, 14467, Potsdam, Germany
| | - Marie Ledebur
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Mario Menk
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Erika von Schneidemesser
- Institute for Advanced Sustainability Studies e.V. (IASS), Berliner Strasse 130, 14467, Potsdam, Germany
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Yom S, Takacsi-Nagy Z, Liem X, Salas S, Debard A, Finzi L, Vivar O, Farber L, Gogishvili M, Kristesashvili G, Makharadze T, Hoffmann C, Tourneau CL. NANORAY-312: A Phase III Pivotal Study of NBTXR3 Activated by Investigator's Choice of Radiotherapy Alone or Radiotherapy in Combination with Cetuximab for Platinum-Based Chemotherapy-Ineligible Elderly Patients with Locally Advanced HNSCC. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1372] [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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Liem X, De Baere T, Seiwert T, Shen C, Papai Z, Moreno V, Takacsi-Nagy Z, Helferich F, Thariat J, Gooi Z, Vivar O, Farber L, Yom S, Bossi P, Ferris R, Hackman T, Tourneau CL, Rodriguez J, Hoffmann C. International Guidelines for Intratumoral and Intranodal Injection of NTBXR3 Nanoparticles in Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Shen C, Ducassou A, Bonvalot S, Chajon E, Farber L, Vivar O, Tyan P, De Baere T, Dicker A, Hoffmann C, Tourneau CL. 3-Dimensional Volumetric Distribution and Dispersion Analysis of the Radioenhancer NBTXR3 in Various Solid Malignancies. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.353] [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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Albuquerque DC, Barros E Silva PG, Lopes RD, Hoffmann C, Nogueira PR, Reis H, Nishijuka FA, De Figueiredo Neto JA, De Souza Neto JD, Rohde LEP, Simoes MV, Rocha RM, Moura LZ, Marcondes-Braga FG, Mesquita ET. Main results of the first Brazilian Registry of Heart Failure (BREATHE). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure represents a common cause of hospitalization associated with poor short-term clinical outcomes. Little is known about the long-term prognosis of these patients in Latin America.
Methods
The rationale and design of the study were previously published (1). Briefly, BREATHE was the first nation-wide prospective observational study that included patients hospitalized due to acute heart failure in Brazil. In-hospital management as well as 12-month clinical outcomes were assessed. Patients were included during two time periods: from February 2011 to December 2012 (BREATHE I) and from June 2016 to July 2018 (BREATHE Extension). Adherence to evidence-based therapies was also evaluated.
Results
A total of 3,013 patients were included in 71 centers in Brazil. The median follow-up was 346 days. The BREATHE population included 39.3% of women, had a mean age of 65.2 (± 15.6) with a mean ejection fraction of 39.7% (± 17.5). Among the comorbidities, systemic arterial hypertension was the most common, present in almost 75% of the sample. At hospital admission, 83.8% of patients had clear signs of pulmonary congestion and the main cause of decompensation was poor adherence to heart failure medications, representing 27.8% of cases. Among patients with reduced ejection fraction, the concomitant use of renin-angiotensin-aldosterone inhibitors, beta-blocker and spironolactone at hospital discharge was 44.5% and decreased to 35.2% after 3 months (p<0.01). Mortality rate at 12 months was 28.9 for every 100 patient years with 26.2% readmission at 90 days and 46.4% at 365 days. The most common etiology of heart failure was ischemic disease (Figure 1) but the worst prognosis was associated with Chagas disease (Figure 2) including an analysis of a composite outcome encompassing death, myocardial infarction, stroke or cardiac arrest after discharge.
Conclusions
In this large national prospective registry of patients hospitalized with acute heart failure, mortality and readmission were higher than what have been reported globally. Poor adherence to evidence-based therapies was a common both at hospital discharge and 1-year of follow-up.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Brazilian Society of Cardiology
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Affiliation(s)
- D C Albuquerque
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | | | - R D Lopes
- Duke Clinical Research Institute , Durham , United States of America
| | - C Hoffmann
- Hospital Regional Hans Dieter Schmidt , Joinville , Brazil
| | - P R Nogueira
- Fundação Faculdade Regional de Medicina de São José do Rio Preto , São José do Rio Preto , Brazil
| | - H Reis
- Hospital de Clinicas Gaspar Viana , Belem , Brazil
| | - F A Nishijuka
- Hospital Naval Marcilio Dias , Rio de Janeiro , Brazil
| | - J A De Figueiredo Neto
- Centro de Pesquisa Clínica do Hospital Universitário da Universidade Federal do Maranhão (CEPEC-HUUF , Sao Luis , Brazil
| | | | - L E P Rohde
- Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - M V Simoes
- Hospital Das Clinicas Fmrp-Usp , Ribeirao Preto , Brazil
| | - R M Rocha
- Pedro Ernesto University Hospital , Rio de Janeiro , Brazil
| | | | - F G Marcondes-Braga
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | - E T Mesquita
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
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de Baere T, Shen C, Ducassou A, Bonvalot S, Chajon E, Farber L, Vivar O, Tyan P, Koay E, Lin S, Liao Z, Dicker A, Hoffmann C, Le Tourneau C. 489P Analysis of 3-dimensional volumetric distribution and dispersion of the radioenhancer NBTXR3 in various solid malignancies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.617] [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] Open
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Deichl J, Weigert J, Hoffmann C, Repke JU, Grunert T. Semi‐Empirical and Data‐Driven Modeling of Two‐Phase Flow in Capillary Tubes. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255285] [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: 11/11/2022]
Affiliation(s)
- J. Deichl
- Technische Universität Berlin Process Dynamics and Operations Group Straße des 17. Juni 135 10623 Berlin Germany
| | - J. Weigert
- Technische Universität Berlin Process Dynamics and Operations Group Straße des 17. Juni 135 10623 Berlin Germany
| | - C. Hoffmann
- Technische Universität Berlin Process Dynamics and Operations Group Straße des 17. Juni 135 10623 Berlin Germany
| | - J.-U. Repke
- Technische Universität Berlin Process Dynamics and Operations Group Straße des 17. Juni 135 10623 Berlin Germany
| | - T. Grunert
- BSH Hausgeräte GmbH Wohlrabedamm 15 13629 Berlin Germany
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Shrot S, Kerpel A, Belenky J, Lurye M, Hoffmann C, Yalon M. MR Imaging Characteristics and ADC Histogram Metrics for Differentiating Molecular Subgroups of Pediatric Low-Grade Gliomas. AJNR Am J Neuroradiol 2022; 43:1356-1362. [PMID: 36007944 PMCID: PMC9451619 DOI: 10.3174/ajnr.a7614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE BRAF and type 1 neurofibromatosis status are distinctive features in pediatric low-grade gliomas with prognostic and therapeutic implications. We hypothesized that DWI metrics obtained through volumetric ADC histogram analyses of pediatric low-grade gliomas at baseline would enable early detection of BRAF and type 1 neurofibromatosis status. MATERIALS AND METHODS We retrospectively evaluated 40 pediatric patients with histologically proved pilocytic astrocytoma (n = 33), ganglioglioma (n = 4), pleomorphic xanthoastrocytoma (n = 2), and diffuse astrocytoma grade 2 (n = 1). Apart from 1 patient with type 1 neurofibromatosis who had a biopsy, 11 patients with type 1 neurofibromatosis underwent conventional MR imaging to diagnose a low-grade tumor without a biopsy. BRAF molecular analysis was performed for patients without type 1 neurofibromatosis. Eleven patients presented with BRAF V600E-mutant, 20 had BRAF-KIAA rearrangement, and 8 had BRAF wild-type tumors. Imaging studies were reviewed for location, margins, hemorrhage or calcifications, cystic components, and contrast enhancement. Histogram analysis of tumoral diffusivity was performed. RESULTS Diffusion histogram metrics (mean, median, and 10th and 90th percentiles) but not kurtosis or skewness were different among pediatric low-grade glioma subgroups (P < .05). Diffusivity was lowest in BRAF V600E-mutant tumors (the 10th percentile reached an area under the curve of 0.9 on receiver operating characteristic analysis). There were significant differences between evaluated pediatric low-grade glioma margins and cystic components (P = .03 and P = .001, respectively). Well-defined margins were characteristic of BRAF-KIAA or wild-type BRAF rather than BRAF V600E-mutant or type 1 neurofibromatosis tumors. None of the type 1 neurofibromatosis tumors showed a cystic component. CONCLUSIONS Imaging features of pediatric low-grade gliomas, including quantitative diffusion metrics, may assist in predicting BRAF and type 1 neurofibromatosis status, suggesting a radiologic-genetic correlation, and might enable early genetic signature characterization.
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Affiliation(s)
- S Shrot
- From the Section of Neuroradiology, Division of Diagnostic Imaging (S.S., A.K., J.B., C.H.)
- Sackler School of Medicine (S.S., C.H., M.Y.), Tel Aviv University, Tel Aviv, Israel
| | - A Kerpel
- From the Section of Neuroradiology, Division of Diagnostic Imaging (S.S., A.K., J.B., C.H.)
| | - J Belenky
- From the Section of Neuroradiology, Division of Diagnostic Imaging (S.S., A.K., J.B., C.H.)
| | - M Lurye
- Department of Pediatric Hemato-Oncology (M.L., M.Y.), Sheba Medical Center, Ramat-Gan, Israel
| | - C Hoffmann
- From the Section of Neuroradiology, Division of Diagnostic Imaging (S.S., A.K., J.B., C.H.)
- Sackler School of Medicine (S.S., C.H., M.Y.), Tel Aviv University, Tel Aviv, Israel
| | - M Yalon
- Department of Pediatric Hemato-Oncology (M.L., M.Y.), Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine (S.S., C.H., M.Y.), Tel Aviv University, Tel Aviv, Israel
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Hoffmann C, Schultz A, Weng J, Wang X. A survey of applied corrections to measured Bragg and diffuse diffraction intensities for meaningful structure factor amplitudes. Acta Crystallogr A Found Adv 2022. [DOI: 10.1107/s2053273322099090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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17
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Schaumann K, Albrecht A, Turowski B, Hoffmann C, Cornelius JF, Schipper J. [Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas]. HNO 2022; 70:445-454. [PMID: 34812915 PMCID: PMC9160153 DOI: 10.1007/s00106-021-01116-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/30/2022]
Abstract
The data of 86 patients with retrosigmoid microsurgical resection of vestibular schwannoma in tumor stage Koos II-IV were evaluated. In more than two thirds of the cases it was shown that the cochlear nerve followed the facial nerve, which is easily identified by electroneurography, in recurrent similar patterns in the region of the internal auditory canal. Starting from the fundus, this facilitated early identification and thus preservation of continuity of the cochlear nerve in the course of the internal auditory canal. This was of particular importance when safe functional preservation could not be guaranteed due to tumor size or formation despite intraoperative derivation of somatosenoric potentials, but when the possibility of subsequent hearing rehabilitation with a cochlear implant should be granted. Preoperative MRI sequences gave an indication of the possible nerve courses in some cases, but intraoperative imaging in the internal auditory canal was superior to MRI.
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Affiliation(s)
- Katharina Schaumann
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40255, Düsseldorf, Deutschland.
| | - A Albrecht
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40255, Düsseldorf, Deutschland
| | - B Turowski
- Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - C Hoffmann
- Universitätsklinik für Neurochirurgie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - J F Cornelius
- Universitätsklinik für Neurochirurgie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - J Schipper
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40255, Düsseldorf, Deutschland
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Lessard P, Hoffmann C, De Moreuil C, Rouviere B, Guellec D, Bruguet M, Jousse Joulin S, Didier R, Beuzit S, Le Moigne E. Étude du pronostic vasculaire de l’artérite à cellules géantes en fonction du résultat du doppler des artères temporales : cohorte VASC’HORTON. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.270] [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: 10/18/2022]
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Segev M, Djurabayev B, Hadi E, Yinon Y, Rabinowicz S, Hoffmann C, Shrot S. Third Trimester Structural and Diffusion Brain Imaging after Single Intrauterine Fetal Death in Monochorionic Twins: MRI-Based Cohort Study. AJNR Am J Neuroradiol 2022; 43:620-626. [PMID: 35332016 PMCID: PMC8993195 DOI: 10.3174/ajnr.a7475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Single intrauterine fetal death increases the risk of antenatal brain lesions in the surviving twin. We evaluated the prevalence of structural brain lesions, biometry, and diffusivity on routine third trimester MR imaging performed following single intrauterine fetal death. MATERIALS AND METHODS In a retrospective MR imaging-based cohort study, we compared 29 monochorionic twins complicated with single intrauterine fetal death (14 following laser ablation treatment for twin-to-twin transfusion syndrome, 8 following selective fetal reduction, and 7 spontaneous) with 2 control cohorts (49 singleton fetuses and 28 uncomplicated twin fetuses). All fetuses in the single intrauterine fetal death group underwent fetal brain MR imaging as a routine third trimester evaluation. Structural brain lesions were analyzed. Cerebral biometry and diffusivity were measured and compared. RESULTS Brain lesions consistent with the evolution of prior ischemic injury were found in 1 of 29 fetuses, not detected by ultrasound. No acute brain infarction, hemorrhage, or cortical abnormalities were found. Supratentorial biometric measurements in the single intrauterine fetal death group were significantly smaller than those in the singleton group, but not significantly different from those in the uncomplicated twin group. There were no significant differences in ADC values of the cerebral hemispheres, basal ganglia, and pons between the single intrauterine fetal death group and either control group. CONCLUSIONS Although smaller brain biometry was found, normal diffusivity in surviving twins suggests normal parenchymal microstructure. The rate of cerebral structural injury was relatively low in our cohort, arguing against the routine use of fetal brain MR imaging in twin pregnancies complicated with single intrauterine fetal death. Larger prospective studies are necessary to guide appropriate surveillance protocol and parental counseling in twin pregnancies complicated by single intrauterine fetal death.
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Affiliation(s)
- M Segev
- From the Section of Neuroradiology (M.S., B.D., C.H., S.S.)
| | - B Djurabayev
- From the Section of Neuroradiology (M.S., B.D., C.H., S.S.)
| | - E Hadi
- Division of Diagnostic Imaging, Diagnostic Ultrasound Unit of the Institute of Obstetrical and Gynecological Imaging (E.H.)
| | - Y Yinon
- Department of Obstetrics and Gynecology, and Fetal Medicine Unit (Y.Y.), Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel.,Sackler School of Medicine (Y.Y., C.H., S.S.), Tel Aviv University, Tel-Aviv, Israel
| | - S Rabinowicz
- Pediatric Neurology Unit (S.R.), The Edmond and Lilly Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - C Hoffmann
- From the Section of Neuroradiology (M.S., B.D., C.H., S.S.).,Sackler School of Medicine (Y.Y., C.H., S.S.), Tel Aviv University, Tel-Aviv, Israel
| | - S Shrot
- From the Section of Neuroradiology (M.S., B.D., C.H., S.S.) .,Sackler School of Medicine (Y.Y., C.H., S.S.), Tel Aviv University, Tel-Aviv, Israel
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Hoffmann C, Maglakelidze M, von Schneidemesser E, Witt C, Hoffmann P, Butler T. Asthma and COPD exacerbation in relation to outdoor air pollution in the metropolitan area of Berlin, Germany. Respir Res 2022; 23:64. [PMID: 35307034 PMCID: PMC8935815 DOI: 10.1186/s12931-022-01983-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/11/2022] [Indexed: 01/05/2023] Open
Abstract
Background Ambient air pollution poses a major risk for the development and aggravation of respiratory diseases. Evidence suggests that even in low-level air pollution environments there is a risk for an increase in adverse respiratory symptoms. We examined whether variations in daily air pollution levels of nitrogen dioxide, ozone, or particulate matter in Berlin, Germany were associated with hospital admissions of chronic obstructive pulmonary disease (COPD) and asthma patients in a time series analysis. Methods We calculated single and multi-pollutant models, investigated possible lags in effect, and analysed the influence of meteorological variables on the results. Data from January 2005 through December 2015 were used to quantify the concentration–response. Results The risk ratio for asthma patients to be hospitalised on the same day of NO2 exposure was 1.101 per 10 µg/m3 NO2 increase (95% CI: 1.013 to 1.195), for COPD patients 1.123 (95% CI: 1.081 to 1.168). Neither the exposure to ozone (95% CI: 0.904 to 1.020), PM10 (95% CI: 0.990 to 1.127), nor PM2.5 (95% CI: 0.981 to 1.148) was associated with an increased risk ratio for asthma patients to be hospitalised. Risk ratios for the hospital admission of COPD patients were also not increased due to ozone (95% CI: 0.981 to 1.033), PM10 (95% CI: 0.988 to 1.032), or PM2.5 (95% CI: 0.966 to 1.019) exposure. The presented risk ratios and confidence intervals relate to the day of exposure. We found no increased hospitalisation risks with a delayed occurrence on subsequent days. Conclusions A quantifiable, statistically significant increase in risk for asthma and COPD exacerbations owing to NO2 exposure at levels well below European regulatory limit values was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01983-1.
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Drube J, Haider RS, Matthees ESF, Reichel M, Zeiner J, Fritzwanker S, Ziegler C, Barz S, Klement L, Filor J, Weitzel V, Kliewer A, Miess-Tanneberg E, Kostenis E, Schulz S, Hoffmann C. GPCR kinase knockout cells reveal the impact of individual GRKs on arrestin binding and GPCR regulation. Nat Commun 2022; 13:540. [PMID: 35087057 PMCID: PMC8795447 DOI: 10.1038/s41467-022-28152-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [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: 06/17/2021] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
G protein-coupled receptors (GPCRs) activate G proteins and undergo a complex regulation by interaction with GPCR kinases (GRKs) and the formation of receptor-arrestin complexes. However, the impact of individual GRKs on arrestin binding is not clear. We report the creation of eleven combinatorial HEK293 knockout cell clones lacking GRK2/3/5/6, including single, double, triple and the quadruple GRK knockout. Analysis of β-arrestin1/2 interactions for twelve GPCRs in our GRK knockout cells enables the differentiation of two main receptor subsets: GRK2/3-regulated and GRK2/3/5/6-regulated receptors. Furthermore, we identify GPCRs that interact with β-arrestins via the overexpression of specific GRKs even in the absence of agonists. Finally, using GRK knockout cells, PKC inhibitors and β-arrestin mutants, we present evidence for differential receptor-β-arrestin1/2 complex configurations mediated by selective engagement of kinases. We anticipate our GRK knockout platform to facilitate the elucidation of previously unappreciated details of GRK-specific GPCR regulation and β-arrestin complex formation.
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Affiliation(s)
- J Drube
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - R S Haider
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - E S F Matthees
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - M Reichel
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - J Zeiner
- Molecular, Cellular and Pharmacobiology Section, Institute for Pharmaceutical Biology, University of Bonn, Nussallee 6, 53115, Bonn, Germany
| | - S Fritzwanker
- Institut für Pharmakologie und Toxikologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Drackendorfer Straße 1, D-07747, Jena, Germany
| | - C Ziegler
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - S Barz
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - L Klement
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - J Filor
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - V Weitzel
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany
| | - A Kliewer
- Institut für Pharmakologie und Toxikologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Drackendorfer Straße 1, D-07747, Jena, Germany
| | - E Miess-Tanneberg
- Institut für Pharmakologie und Toxikologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Drackendorfer Straße 1, D-07747, Jena, Germany
| | - E Kostenis
- Molecular, Cellular and Pharmacobiology Section, Institute for Pharmaceutical Biology, University of Bonn, Nussallee 6, 53115, Bonn, Germany
| | - S Schulz
- Institut für Pharmakologie und Toxikologie, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Drackendorfer Straße 1, D-07747, Jena, Germany
| | - C Hoffmann
- Institut für Molekulare Zellbiologie, CMB - Center for Molecular Biomedicine, Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Hans-Knöll-Straße 2, D-07745, Jena, Germany.
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Schaumann K, Albrecht A, Turowski B, Hoffmann C, Cornelius JF, Schipper J. [Erratum to: Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas]. HNO 2022; 70:455. [PMID: 35041029 PMCID: PMC9160148 DOI: 10.1007/s00106-021-01138-6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Katharina Schaumann
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40255, Düsseldorf, Deutschland.
| | - A Albrecht
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40255, Düsseldorf, Deutschland
| | - B Turowski
- Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - C Hoffmann
- Universitätsklinik für Neurochirurgie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - J F Cornelius
- Universitätsklinik für Neurochirurgie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - J Schipper
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde und Poliklinik, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40255, Düsseldorf, Deutschland
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Le Tourneau C, Calugaru V, Moreno V, Calvo E, Liem X, Salas S, Doger B, Jouffroy T, Mirabel X, Rodriguez J, Chilles A, Bernois K, Fakhry N, Wong Hee Kam S, Hoffmann C. A phase I dose expansion study of NBTXR3, radiation enhancing hafnium oxide nanoparticles, for the treatment of cisplatin-ineligible locally advanced HNSCC patients. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hoffmann C, Liebers U, Humbsch P, Drozdek M, Bölke G, Hoffmann P, Holzgreve A, Donaldson GC, Witt C. An adaptation strategy to urban heat: hospital rooms with radiant cooling accelerate patient recovery. ERJ Open Res 2021; 7:00881-2020. [PMID: 34476248 PMCID: PMC8405870 DOI: 10.1183/23120541.00881-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/24/2020] [Accepted: 05/27/2021] [Indexed: 11/05/2022] Open
Abstract
Background Patients with respiratory diseases are vulnerable to the effects of heat. Therefore, it is important to develop adaptation strategies for heat exposure. One option is to optimise the indoor environment. To this end, we equipped hospital patient rooms with radiant cooling. We performed a prospective randomised clinical trial to investigate potentially beneficial effects of the hospitalisation in rooms with radiant cooling on patients with a respiratory disease exacerbation. Methods Recruitment took place in June, July and August 2014 to 2016 in the Charité – Universitätsmedizin Berlin, Germany. We included patients with COPD, asthma, pulmonary hypertension, interstitial lung disease and pneumonia. 62 patients were allocated to either a standard patient room without air conditioning or a room with radiant cooling set to 23°C (73°F). We analysed the patients’ length of stay with a Poisson regression. Physiological parameters, fluid intake and daily step counts were tested with mixed regression models. Results Patients hospitalised in a room with radiant cooling were discharged earlier than patients in standard rooms (p=0.003). The study participants in chambers with radiant cooling had a lower body temperature (p=0.002), lower daily fluid intake (p<0.001), higher systolic blood pressure (p<0.001) and an increased daily step count (p<0.001). Conclusion The results indicate that a radiant cooling system in hospital patient rooms provides clinical benefits for patients with respiratory disease exacerbations during the warm summer months, which may contribute to an earlier mobilisation. Radiant cooling is commended as a suitable adaptation strategy to reduce the clinical impact of climate warming. A radiant cooling system in hospital patient rooms provides clinical benefits for patients with respiratory disease exacerbations during summertime. Patients hospitalised in rooms with air convection free radiant cooling are discharged earlier.https://bit.ly/3p9Fkqm
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Affiliation(s)
- Christina Hoffmann
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Uta Liebers
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Philipp Humbsch
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marija Drozdek
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg Bölke
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Peter Hoffmann
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Adrien Holzgreve
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Dept of Nuclear Medicine, University Hospital, Munich, Germany
| | - Gavin C Donaldson
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Christian Witt
- Dept of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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25
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Lövenich L, Dreissen G, Hoffmann C, Konrad J, Springer R, Höhfeld J, Merkel R, Hoffmann B. Strain induced mechanoresponse depends on cell contractility and BAG3-mediated autophagy. Mol Biol Cell 2021; 32:ar9. [PMID: 34379447 PMCID: PMC8684750 DOI: 10.1091/mbc.e21-05-0254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Basically all mammalian tissues are constantly exposed to a variety of environmental mechanical signals. Depending on the signal strength, mechanics intervenes in a multitude of cellular processes and is thus capable to induce simple cellular adaptations but also complex differentiation processes and even apoptosis. The underlying recognition typically depends on mechanosensitive proteins, which most often sense the mechanical signal for the induction of a cellular signaling cascade by changing their protein conformation. However, the fate of mechanosensors after mechanical stress application is still poorly understood and it remains unclear whether protein degradation pathways affect the mechanosensitivity of cells. Here, we show that cyclic stretch induces autophagosome formation in a time-dependent manner. Formation depends on the cochaperone BAG3 and thus likely involves BAG3-mediated chaperone-assisted selective autophagy. Furthermore, we demonstrate that strain-induced cell reorientation is clearly delayed upon inhibition of autophagy, suggesting a bidirectional crosstalk between mechanotransduction and autophagic degradation. The strength of the observed delay depends on stable adhesion structures and stress fiber formation in a RhoA-dependent manner.
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Affiliation(s)
- Lukas Lövenich
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Georg Dreissen
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Christina Hoffmann
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Jens Konrad
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Ronald Springer
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Jörg Höhfeld
- Institute for Cell Biology, University of Bonn, 53121 Bonn, Germany
| | - Rudolf Merkel
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
| | - Bernd Hoffmann
- Forschungszentrum Jülich, Institute of Biological Information Processing, IBI-2: Mechanobiology, 52428 Jülich, Germany
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Perry A, Chitnis A, Chin A, Hoffmann C, Chang L, Robinson M, Maltas G, Munk E, Shah M. Real-world implementation of video-observed therapy in an urban TB program in the United States. Int J Tuberc Lung Dis 2021; 25:655-661. [PMID: 34330351 PMCID: PMC8327629 DOI: 10.5588/ijtld.21.0170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND: Video directly observed therapy (vDOT) was introduced to increase flexibility and meet patient-specific needs for TB treatment. This study aimed to assess the reach and effectiveness of vDOT for TB treatment under routine conditions in Alameda County, CA, USA, a busy, urban setting, from 2018 to 2020. METHODS: We prospectively evaluated routinely collected data to estimate 1) reach (proportion of patients initiated on vDOT vs. in-person DOT); and 2) effectiveness (proportion of prescribed doses with verified administration by vDOT vs. in-person DOT). RESULTS: Among 163 TB patients, 94 (58%) utilized vDOT during treatment, of whom 54 (57%) received exclusively vDOT. Individuals receiving vDOT were on average younger than those receiving in-person therapy (46 vs. 61 years; P < 0.001). The median time to vDOT initiation was 2.2 weeks (IQR 1.1–10.0); patients were monitored for a median of 27.0 weeks (IQR 24.6–31.9). vDOT led to higher proportions of verified prescribed doses than in-person DOT (68% vs. 54%; P < 0.001). Unobserved self-administration occurred for all patients on weekends based on clinic instructions, but a larger proportion of doses were self-administered during periods of in-person DOT than of vDOT (45% vs. 24%; P < 0.001). CONCLUSION: A TB program successfully maintained vDOT, reaching the majority of patients and achieving greater medication verification than in-person DOT.
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Affiliation(s)
- A Perry
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - A Chitnis
- Tuberculosis Control Section, Alameda County Public Health Department, San Leandro, CA
| | - A Chin
- Tuberculosis Control Section, Alameda County Public Health Department, San Leandro, CA
| | - C Hoffmann
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L Chang
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - M Robinson
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - G Maltas
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - E Munk
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - M Shah
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Le Tourneau C, Calugaru V, Takacsi-Nagy Z, Liem X, Papai Z, Moreno V, Braña I, Salas S, Poissonnet G, Calvo E, Doger B, Choussy O, Mirabel X, Krhili S, Bernois K, Fakhry N, Wong Hee Kam S, Borcoman E, Hoffmann C. OC-0515 NBTXR3 activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06941-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Wang X, Fancher C, Hoffmann C, Schultz A. Single-crystal diffraction beyond three dimensions: dynamic structural responses of hydrogen-bonded materials using time filtering of event-based neutron TOF Laue diffraction. Acta Crystallogr A Found Adv 2021. [DOI: 10.1107/s0108767321099244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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29
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Moreira A, Poulet A, Masliah-Planchon J, Lecerf C, Vacher S, Larbi Chérif L, Dupain C, Marret G, Girard E, Syx L, Hoffmann C, Jeannot E, Klijanienko J, Guillou I, Mariani O, Dubray-Vautrin A, Badois N, Lesnik M, Choussy O, Calugaru V, Borcoman E, Baulande S, Legoix P, Albaud B, Servant N, Bieche I, Le Tourneau C, Kamal M. Prognostic value of tumor mutational burden in patients with oral cavity squamous cell carcinoma treated with upfront surgery. ESMO Open 2021; 6:100178. [PMID: 34118772 PMCID: PMC8207209 DOI: 10.1016/j.esmoop.2021.100178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background Oral cavity is the most prevalent site of head and neck squamous cell carcinomas (HNSCCs). Most often diagnosed at a locally advanced stage, treatment is multimodal with surgery as the cornerstone. The aim of this study was to explore the molecular landscape of a homogenous cohort of oral cavity squamous cell carcinomas (OCSCCs), and to assess the prognostic value of tumor mutational burden (TMB), along with classical molecular and clinical parameters. Patients and methods One hundred and fifty-one consecutive patients with OCSCC treated with upfront surgery at the Institut Curie were analyzed. Sequencing of tumor DNA from frozen specimens was carried out using an in-house targeted next-generation sequencing panel (571 genes). The impact of molecular alterations and TMB on disease-free survival (DFS) and overall survival (OS) was evaluated in univariate and multivariate analyses. Results Pathological tumor stage, extranodal spread, vascular emboli, and perineural invasion were associated with both DFS and OS. TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%), CDKN2A (25%), FAT1 (17%), PIK3CA (14%), and NOTCH1 (15%) genes. Transforming growth factor-β pathway alterations (4%) were associated with poor OS (P = 0.01) and DFS (P = 0.02) in univariate and multivariate analyses. High TMB was associated with prolonged OS (P = 0.01 and P = 0.02, in the highest 10% and 20% TMB values, respectively), but not with DFS. Correlation of TMB with OS remained significant in multivariate analysis (P = 0.01 and P = 0.005 in the highest 10% and 20% TMB values, respectively). Pathological tumor stage combined with high TMB was associated with good prognosis. Conclusion Our results suggest that a high TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery. High TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery Pathological tumor stage combined with high TMB is associated with good prognosis TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%) TGFβ pathway alterations were associated with poor outcomes, although it was only observed in 4% of the patients
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Affiliation(s)
- A Moreira
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - A Poulet
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - J Masliah-Planchon
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - C Lecerf
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Vacher
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - L Larbi Chérif
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - C Dupain
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - G Marret
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - E Girard
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - L Syx
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - C Hoffmann
- INSERM U932 Research Unit, Institut Curie, PSL Research University, Paris, France; Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - E Jeannot
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - J Klijanienko
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - I Guillou
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - O Mariani
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - A Dubray-Vautrin
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - N Badois
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - M Lesnik
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - O Choussy
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - V Calugaru
- Department of Oncologic Radiotherapy, Institut Curie, PSL Research University, Paris, France
| | - E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Baulande
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - P Legoix
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - B Albaud
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - N Servant
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - I Bieche
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; INSERM U1016, Paris Descartes University, Faculty of Pharmaceutical and Biological Sciences, Paris, France
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France; INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France; Paris-Saclay University, Paris, France
| | - M Kamal
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France.
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Gögele C, Hoffmann C, Konrad J, Merkel R, Schwarz S, Tohidnezhad M, Hoffmann B, Schulze-Tanzil GG. Cyclically stretched ACL fibroblasts emigrating from spheroids adapt their cytoskeleton and ligament-related expression profile. Cell Tissue Res 2021; 384:675-690. [PMID: 33835257 PMCID: PMC8211585 DOI: 10.1007/s00441-021-03416-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/12/2020] [Accepted: 01/13/2021] [Indexed: 01/09/2023]
Abstract
Mechanical stress of ligaments varies; hence, ligament fibroblasts must adapt their expression profile to novel mechanomilieus to ensure tissue resilience. Activation of the mechanoreceptors leads to a specific signal transduction, the so-called mechanotransduction. However, with regard to their natural three-dimensional (3D) microenvironment cell reaction to mechanical stimuli during emigrating from a 3D spheroid culture is still unclear. This study aims to provide a deeper understanding of the reaction profile of anterior cruciate ligament (ACL)-derived fibroblasts exposed to cyclic uniaxial strain in two-dimensional (2D) monolayer culture and during emigration from 3D spheroids with respect to cell survival, cell and cytoskeletal orientation, distribution, and expression profile. Monolayers and spheroids were cultured in crosslinked polydimethyl siloxane (PDMS) elastomeric chambers and uniaxially stretched (14% at 0.3 Hz) for 48 h. Cell vitality, their distribution, nuclear shape, stress fiber orientation, focal adhesions, proliferation, expression of ECM components such as sulfated glycosaminoglycans, collagen type I, decorin, tenascin C and cell-cell communication-related gap junctional connexin (CXN) 43, tendon-related markers Mohawk and tenomodulin (myodulin) were analyzed. In contrast to unstretched cells, stretched fibroblasts showed elongation of stress fibers, cell and cytoskeletal alignment perpendicular to strain direction, less rounded cell nuclei, increased numbers of focal adhesions, proliferation, amplified CXN43, and main ECM component expression in both cultures. The applied cyclic stretch protocol evoked an anabolic response and enhanced tendon-related marker expression in ACL-derived fibroblasts emigrating from 3D spheroids and seems also promising to support in future tissue formation in ACL scaffolds seeded in vitro with spheroids.
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Affiliation(s)
- Clemens Gögele
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Prof.-Ernst-Nathan Str. 1, 90419 Nuremberg and Salzburg, Nuremberg, Germany
- Department of Biosciences, Paris Lodron University Salzburg, Hellbrunnerstr. 34, 5020 Salzburg, Austria
| | - Christina Hoffmann
- Institute of Biological Information Processing: IBI-2, Forschungszentrum Jülich, 52425 Jülich, Germany
| | - Jens Konrad
- Institute of Biological Information Processing: IBI-2, Forschungszentrum Jülich, 52425 Jülich, Germany
| | - Rudolf Merkel
- Institute of Biological Information Processing: IBI-2, Forschungszentrum Jülich, 52425 Jülich, Germany
| | - Silke Schwarz
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Prof.-Ernst-Nathan Str. 1, 90419 Nuremberg and Salzburg, Nuremberg, Germany
| | - Mersedeh Tohidnezhad
- Department of Anatomy and Cell Biology, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Bernd Hoffmann
- Institute of Biological Information Processing: IBI-2, Forschungszentrum Jülich, 52425 Jülich, Germany
| | - Gundula Gesine Schulze-Tanzil
- Institute of Anatomy and Cell Biology, Paracelsus Medical University, Prof.-Ernst-Nathan Str. 1, 90419 Nuremberg and Salzburg, Nuremberg, Germany
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Caruhel JB, Sigaux N, Crambert A, Donat N, Boddaert G, Haen P, Hoffmann C. Military gas mask to protect surgeons when performing tracheotomies on patients with COVID-19. BMJ Mil Health 2021; 167:214. [PMID: 32753542 PMCID: PMC7409952 DOI: 10.1136/bmjmilitary-2020-001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Jean-Baptiste Caruhel
- Maxillo-facial, Head and Neck Surgery Department, Hopital d'Instruction des Armees Percy, Clamart, France
| | - N Sigaux
- Maxillo-Facial Surgery Department, Centre Hospitalier Lyon-Sud, Pierre-Benite, France
| | - A Crambert
- Maxillo-facial, Head and Neck Surgery Department, Hopital d'Instruction des Armees Percy, Clamart, France
| | - N Donat
- Intensive Care Unit and Burn Center, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
| | - G Boddaert
- Department of Thoracic and Vascular Surgery, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
| | - P Haen
- Maxillo-Facial Surgery Department, Hopital d'Instruction des Armees Laveran, Marseille, Provence-Alpes-Côte d'Azur, France
| | - C Hoffmann
- Intensive Care Unit and Burn Center, Hopital d'Instruction des Armees Percy, Clamart, Île-de-France, France
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Rivera G, Butka E, Jindal K, Kong W, Waye S, Hoffmann C, Kamimoto K, Morris S. 631 Lineage tracing at single-cell resolution unveils complex differentiation trajectories of adipocyte precursors in the skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Oro S, Le Floch R, Alvès A, Colin A, Ouedraogo R, Welfringer A, Dereure O, Besnard N, Bodemer C, Bernier C, Hoffmann C, Tetart F, Carpentier D, Cordel N, Elie E, Tauber M, Soubiron L, Milpied B, de Prost N. Modalités de réalisation des soins locaux de la nécrolyse épidermique : enquête de pratiques. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.183] [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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Hoffmann C, Macefield RC, Wilson N, Blazeby JM, Avery KNL, Potter S, McNair AGK. A systematic review and in-depth analysis of outcome reporting in early phase studies of colorectal cancer surgical innovation. Colorectal Dis 2020; 22:1862-1873. [PMID: 32882087 DOI: 10.1111/codi.15347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/23/2022]
Abstract
AIM Early phase studies are essential to evaluate new technologies prior to randomized evaluation. Evaluation is limited, however, by inconsistent measurement and reporting of outcomes. This study examines outcome reporting in studies of innovative colorectal cancer surgery. METHODS Systematic searches identified studies of invasive procedures treating primary colorectal adenocarcinoma. Included were a random sample of studies which authors reported as 'new' or 'modified'. Outcomes were extracted verbatim and categorized using an existing framework of 32 domains relevant to early phase studies. Outcomes were classified as 'measured' (where there was an explicit statement to that effect or evidence that data collection had occurred) or 'mentioned but not measured' (where outcomes were discussed but data collection was not evident). Patterns of identified outcomes are described. RESULTS Of 8373 records, 816 were potentially eligible. Full-text review of a random sample of 218 studies identified 51 for inclusion of which 34 (66%) were 'new' and 17 (33%) were 'modified'. Some 2073 outcomes were identified, and all mapped to domains. 'Anticipated disadvantages' were most frequently identified [660 (32%) outcomes identified across 50 (98%) studies]. No domain was represented in all studies. Under half (944, 46%) of outcomes were 'measured'. 'Surgeon's/operator's experience of the innovation' was more frequently 'mentioned but not measured' [207 (18%) outcomes across 46 (90%) studies] than 'measured' [17 (2%) outcomes, 11 (22%) studies]. CONCLUSION There is outcome reporting heterogeneity in studies of early phase colorectal cancer surgery. The adoption of core outcome sets may help to resolve these inconsistencies and enable efficient evaluation of surgical innovations.
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Affiliation(s)
- C Hoffmann
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - R C Macefield
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - N Wilson
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - J M Blazeby
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - K N L Avery
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - S Potter
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Breast Care Centre, North Bristol NHS Trust, Bristol, UK
| | - A G K McNair
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Gastrointestinal Surgery, North Bristol NHS Trust, Bristol, UK
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Blaschke SJ, Demir S, König A, Abraham JA, Vay SU, Rabenstein M, Olschewski DN, Hoffmann C, Hoffmann M, Hersch N, Merkel R, Hoffmann B, Schroeter M, Fink GR, Rueger MA. Substrate Elasticity Exerts Functional Effects on Primary Microglia. Front Cell Neurosci 2020; 14:590500. [PMID: 33250714 PMCID: PMC7674555 DOI: 10.3389/fncel.2020.590500] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022] Open
Abstract
Microglia-the brain's primary immune cells-exert a tightly regulated cascade of pro- and anti-inflammatory effects upon brain pathology, either promoting regeneration or neurodegeneration. Therefore, harnessing microglia emerges as a potential therapeutic concept in neurological research. Recent studies suggest that-besides being affected by chemokines and cytokines-various cell entities in the brain relevantly respond to the mechanical properties of their microenvironment. For example, we lately reported considerable effects of elasticity on neural stem cells, regarding quiescence and differentiation potential. However, the effects of elasticity on microglia remain to be explored.Under the hypothesis that the elasticity of the microenvironment affects key characteristics and functions of microglia, we established an in vitro model of primary rat microglia grown in a polydimethylsiloxane (PDMS) elastomer-based cell culture system. This way, we simulated the brain's physiological elasticity range and compared it to supraphysiological stiffer PDMS controls. We assessed functional parameters of microglia under "resting" conditions, as well as when polarized towards a pro-inflammatory phenotype (M1) by lipopolysaccharide (LPS), or an anti-inflammatory phenotype (M2) by interleukin-4 (IL-4). Microglia viability was unimpaired on soft substrates, but we found various significant effects with a more than two-fold increase in microglia proliferation on soft substrate elasticities mimicking the brain (relative to PDMS controls). Furthermore, soft substrates promoted the expression of the activation marker vimentin in microglia. Moreover, the M2-marker CD206 was upregulated in parallel to an increase in the secretion of Insulin-Like Growth Factor-1 (IGF-1). The upregulation of CD206 was abolished by blockage of stretch-dependent chloride channels. Our data suggest that the cultivation of microglia on substrates of brain-like elasticity promotes a basic anti-inflammatory activation state via stretch-dependent chloride channels. The results highlight the significance of the omnipresent but mostly overlooked mechanobiological effects exerted on microglia and contribute to a better understanding of the complex spatial and temporal interactions between microglia, neural stem cells, and glia, in health and disease.
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Affiliation(s)
- Stefan J Blaschke
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany.,Department of Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Seda Demir
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Anna König
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Jella-Andrea Abraham
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany.,Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Sabine U Vay
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Monika Rabenstein
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Daniel N Olschewski
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Christina Hoffmann
- Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Marco Hoffmann
- Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Nils Hersch
- Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Rudolf Merkel
- Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Bernd Hoffmann
- Department of Mechanobiology, Institute of Biological Information Processing (IBI-2), Research Centre Jülich, Jülich, Germany
| | - Michael Schroeter
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany.,Department of Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Maria A Rueger
- Department of Neurology, Faculty of Medicine and University Hospital, The University of Cologne, Cologne, Germany.,Department of Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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Feliachi S, Le Moigne E, Le Ven F, Hoffmann C, Bressolette L, Didier R, Jobic Y, Gilard M, Mansourati J, Leroyer C, Couturaud F. Comparison between transthoracic echocardiography and transcranial Doppler for detection of PFO in patients in the acute phase of a pulmonary embolism. A Post-hoc analysis of EPIC-FOP. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Patent foramen ovale is a fairly common defect found in a quarter of the population. PFO has always been associated with an increased risk of stroke, the mechanism of which has been attributed to the paradoxical embolism of venous thrombi passing through the PFO directly into the left atrium, however this mechanism remains debated to date.
For the detection of PFO, several modalities exist including transcranial doppler (TCD), transthoracic echocardiography (TTE) and transoesophageal echocardiography. This raises the question of the examination with the best diagnostic performance for its detection.
Purpose
The majority of studies comparing the different modalities of patient PFO diagnosis have been conducted in the context of stroke assessment. Very few studies have focused on the acute PE patient population. The interest of our study is therefore to evaluate the diagnostic performance of two modalities (TTE versus TCD) for the detection of shunts, especially since this population is at risk of stroke by paradoxical embolism due to the phenomenon of hyperpressure in the right heart chambers increasing the chances of having a paradoxical embolism.
Methods
We performed a post HOC analysis of the EPIC-FOP study which is a multicenter, prospective, French cohort study. Patients were recruited within 3 days of diagnosis of PE. Patients included were given a transthoracic echocardiography (TTE) with PFO screening by injection of saline contrast and magnetic resonance imaging (MRI) within 7 days of inclusion to look for signs of recent stroke. A proportion of the patients included in this study also received a transcranial doppler in search of PFO, the results of which were used in our study.
Results
The mean age of the patients was 62±14.66 years with a slight male predominance (55.6%). TCD was able to detect 97 right-left shunts while the TTE detected only 25 shunts. Concordance analysis by Cohen's Kappa Coefficient: 0.1767 [0.0427; 0.3107–p<0.001] is considered poor.
Using TTE as the reference examination, transcranial Doppler has a very good sensitivity 96.00% (79.65% to 99.90%) and a poor specificity 42.06% (33.33% to 51.18%). A good negative likelihood ratio 0.10 (0.01 to 0.66).
Using TCD, incidence of stroke in the acute phase of PE was significantly higher in the PFO population. In the ten strokes detected 9 had occurred in patients with PFO, RR=1.43 IC95% (1.1169 to 1.8228) p=0. 0044. The difference in proportion is calculated to be 26.92%.
Conclusion
It is the first study that compared TCD vs TEE in the setting of acute phase of PE for detection of PFO. TCD showed a good sensitivity and negative likelihood ratio that can be used as a first means to rule out PFO or associated with TTE. Also, our analysis confirms the increased risk of stroke following a PE episode when a PFO is present.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Feliachi
- University Hospital of Brest, Brest, France
| | | | - F Le Ven
- University Hospital of Brest, Brest, France
| | - C Hoffmann
- University Hospital of Brest, Brest, France
| | | | - R Didier
- University Hospital of Brest, Brest, France
| | - Y Jobic
- University Hospital of Brest, Brest, France
| | - M Gilard
- University Hospital of Brest, Brest, France
| | | | - C Leroyer
- University Hospital of Brest, Brest, France
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Ingen‐Housz‐Oro S, Le Floch R, Alves A, Colin A, Ouedraogo R, Welfringer A, Dereure O, Besnard N, Bodemer C, Bernier C, Hoffmann C, Tétart F, Carpentier D, Cordel N, Elie E, Tauber M, Soubiron L, Milpied B, Prost N. Carrying out local care for epidermal necrolysis: survey of practices. J Eur Acad Dermatol Venereol 2020; 35:e155-e157. [DOI: 10.1111/jdv.16884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/11/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022]
Affiliation(s)
- S. Ingen‐Housz‐Oro
- Service de dermatologie AP‐HP, hôpital Henri Mondor Créteil France
- EA7379 EpidermE UPEC Créteil France
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
| | - R. Le Floch
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Réanimation chirurgicale et des brûlésPTMC, CHU Nantes Nantes France
| | - A. Alves
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Réanimation médicale AP‐HP, hôpital Henri Mondor Créteil France
| | - A. Colin
- Service de dermatologie AP‐HP, hôpital Henri Mondor Créteil France
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
| | - R. Ouedraogo
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Réanimation médicale AP‐HP, hôpital Henri Mondor Créteil France
| | - A. Welfringer
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie AP‐HP, hôpital Necker Paris France
| | - O. Dereure
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie Université de Montpellier Montpellier France
| | - N. Besnard
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Département de Médecine Intensive et Réanimation Hôpital Lapeyronie Montpellier France
| | - C. Bodemer
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie AP‐HP, hôpital Necker Paris France
| | - C. Bernier
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie CHU Nantes Nantes France
| | - C. Hoffmann
- Centre de Traitement des Brûlés Hôpital d'Instruction des Armées PERCY Clamart France
| | - F. Tétart
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie CHU Charles Nicolle Rouen France
| | - D. Carpentier
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Réanimation médicale CHU Charles Nicolle Rouen France
| | - N. Cordel
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Unité de dermatologie et immunologie clinique CHU Guadeloupe Pointe‐à‐Pitre France
| | - E. Elie
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Centre de traitement des brûlés CHU de Guadeloupe Pointe‐à‐Pitre France
| | - M. Tauber
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie CHU de Toulouse Toulouse France
| | - L. Soubiron
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- CFXM‐Brûlés Service d'anesthésie Réanimation GH Pellegrin Bordeaux France
| | - B. Milpied
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Service de dermatologie hôpital Saint‐André Bordeaux France
| | - N. Prost
- Centre de référence dermatoses bulleuses toxiques et toxidermies graves TOXIBUL Créteil France
- Réanimation médicale AP‐HP, hôpital Henri Mondor Créteil France
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Macefield RC, Wilson N, Hoffmann C, Blazeby JM, McNair AGK, Avery KNL, Potter S. Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL-D studies to inform development of a core outcome set. BJS Open 2020; 4:1072-1083. [PMID: 33016009 PMCID: PMC8444278 DOI: 10.1002/bjs5.50358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/20/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Outcome selection, measurement and reporting for the evaluation of new surgical procedures and devices is inconsistent and lacks standardization. A core outcome set may promote the safe and transparent evaluation of surgical innovations. This systematic review examined outcome selection, measurement and reporting in studies conducted within the IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) framework to examine current practice and inform the development of a core outcome set for early-phase studies of surgical procedures/devices. METHODS Web of Science and Scopus citation searches were performed to identify author-reported IDEAL/IDEAL-D studies for any surgical procedure/device. Outcomes were extracted verbatim, including contextual information regarding outcome selection and measurement. Outcomes were categorized to inform a conceptual framework of outcome domains relevant to evaluating innovation. RESULTS Some 48 studies were identified. Outcome selection, measurement and reporting varied widely across studies in different IDEAL stages. From 1737 outcomes extracted, 22 domains specific to evaluating innovation were conceptualized under seven broad categories: procedure completion success/failure; modifications; unanticipated events; surgeons' experiences; patients' experiences; resource use specific to the innovative procedure/device; and other innovation-specific outcomes. Most innovation-specific outcomes were measured and reported in only a small number of studies. CONCLUSION This review highlighted the need for guidance and standardization in outcome selection and reporting in the evaluation of new surgical procedures/devices. Novel outcome domains specific to innovation have been identified to establish a core outcome set for future evaluations of surgical innovations.
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Affiliation(s)
- R. C. Macefield
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
| | - N. Wilson
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
| | - C. Hoffmann
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
| | - J. M. Blazeby
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
| | - A. G. K. McNair
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
- Department of Gastrointestinal SurgeryBristolUK
| | - K. N. L. Avery
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
| | - S. Potter
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical SchoolUniversity of BristolBristolUK
- Bristol Breast Care CentreNorth Bristol NHS TrustBristolUK
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Basso AMM, De Castro RJA, de Castro TB, Guimarães HI, Polez VLP, Carbonero ER, Pomin VH, Hoffmann C, Grossi-de-Sa MF, Tavares AH, Bocca AL. Immunomodulatory activity of β-glucan-containing exopolysaccharides from Auricularia auricular in phagocytes and mice infected with Cryptococcus neoformans. Med Mycol 2020; 58:227-239. [PMID: 31095342 DOI: 10.1093/mmy/myz042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 12/19/2022] Open
Abstract
Current antifungal drugs present poor effectiveness and there is no available vaccine for fungal infections. Thus, novel strategies to treat or prevent invasive mycosis, such as cryptococcosis, are highly desirable. One strategy is the use of immunomodulators of polysaccharide nature isolated from mushrooms. The purpose of the present work was to evaluate the immunostimulatory activity of β-(1,3)-glucan-containing exopolysaccharides (EPS) from the edible mushrooms Auricularia auricula in phagocytes and mice infected with Cryptococcus neoformans. EPS triggered macrophages and dendritic cell activation upon binding to Dectin-1, a pattern recognition receptor of the C-type lectin receptor family. Engagement of Dectin-1 culminated in pro-inflammatory cytokine production and cell maturation via its canonical Syk-dependent pathway signaling. Furthermore, upon EPS treatment, M2-like phenotype macrophages, known to support intracellular survival and replication of C. neoformans, repolarize to M1 macrophage pattern associated with enhanced production of the microbicidal molecule nitric oxide that results in efficient killing of C. neoformans. Treatment with EPS also upregulated transcript levels of genes encoding products associated with host protection against C. neoformans and Dectin-1 mediated signaling in macrophages. Finally, orally administrated β-glucan-containing EPS from A. auricular enhanced the survival of mice infected with C. neoformans. In conclusion, the results demonstrate that EPS from A. auricula exert immunostimulatory activity in phagocytes and induce host protection against C. neoformans, suggesting that polysaccharides from this mushroom may be promising as an adjuvant for vaccines or antifungal therapy.
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Affiliation(s)
- A M M Basso
- Department of Cell Biology, Institute of Biological Sciences, University of Brasília, UnB, Brasilia, DF, Brazil
| | - R J A De Castro
- Department of Cell Biology, Institute of Biological Sciences, University of Brasília, UnB, Brasilia, DF, Brazil
| | - T B de Castro
- Department of Cell Biology, Institute of Biological Sciences, University of Brasília, UnB, Brasilia, DF, Brazil
| | - H I Guimarães
- Embrapa Genetic Resources and Biotechnology, Brasília, Brazil
| | - V L P Polez
- Embrapa Genetic Resources and Biotechnology, Brasília, Brazil
| | - E R Carbonero
- Department of Chemistry, Federal University of Goiás, Campus Catalão, GO, Brazil
| | - V H Pomin
- Program of Glicobiology, Institute of Medical Biochemistry Leopoldo de Meis, Federal University Federal of Rio de Janeiro, RJ, Brazil.,Department of BioMolecular Sciences, Division of Pharmacognosy and Research Institute of Pharmaceutical Sciences, School of Pharmacy, the University of Mississippi, Oxford, MS 38677-1848, USA
| | - C Hoffmann
- Department of Food Sciences and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - M F Grossi-de-Sa
- Embrapa Genetic Resources and Biotechnology, Brasília, Brazil.,Graduated Program in Genomic Science and Biotechnology, Catholic University of Brasília, Brasília, DF, Brazil
| | - A H Tavares
- Department of Cell Biology, Institute of Biological Sciences, University of Brasília, UnB, Brasilia, DF, Brazil
| | - A L Bocca
- Department of Cell Biology, Institute of Biological Sciences, University of Brasília, UnB, Brasilia, DF, Brazil
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Lenzer B, Rupprecht M, Hoffmann C, Hoffmann P, Liebers U. Health effects of heating, ventilation and air conditioning on hospital patients: a scoping review. BMC Public Health 2020; 20:1287. [PMID: 32843012 PMCID: PMC7448359 DOI: 10.1186/s12889-020-09358-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the face of climate change, the protection of vulnerable patients from extreme climatic conditions is of growing interest to the healthcare sector and governments. Inpatients are especially susceptible to heat due to acute illness and/or chronic diseases. Their condition can be aggravated by adverse environmental factors. Installing air conditioning can be seen as an element of public health adaptation because it was shown to improve mortality rates of hospital patients experiencing hot temperatures. Still, the mediating factors and resulting health effects are largely unknown. Method The PRISMA-ScR guideline was followed for this scoping review. Available evidence on the health effects of Heating, Ventilation, Air Conditioning (HVAC) and fans was searched in Medline, Embase and the Cochrane Library. The focus of the search strategy was on inpatients of the hospital. Grey literature was screened on 14 relevant websites. English and German publications were eligible without restrictions on publication date. Results were charted according to the categories population, intervention, control and outcome together with a qualitative description. Results The review process yielded eleven publications of which seven were issued after 2003. Seven were clinical trials, three cross-sectional studies and one was a case report. The publications described the installation of HVAC on general wards and in intensive care units. Main topics were heat stress protection and support of thermoregulation, but also the rewarming of hypothermic patients. HVAC use resulted in a recovery effect shown by improved vital signs, reduced cardiac stress, accelerated recuperation and greater physical activity. This protective effect was demonstrated by a shorter hospital stay for patients with respiratory disease and a reduction of mortality for heat illness patients. Conclusion This scoping review summarises the fragmented evidence on health effects of HVAC and fan utilisation for inpatients. Installing HVAC has the potential to improve patients’ outcomes and to make hospital treatment more efficient during heat waves. The application of HVAC could be a promising adaptation measure to mitigate the adverse effects of climate change on health and healthcare systems.
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Affiliation(s)
- Benedikt Lenzer
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Manuel Rupprecht
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christina Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Peter Hoffmann
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute of Laboratory Medicine, Clinical Chemistry, and Pathobiochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Uta Liebers
- Department of Outpatient Pneumology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Hoffmann C, Leven C, Le Mao R, De Moreuil C, Lacut K. [Direct oral anticoagulants: In which indications? Which one to prescribe? For or against their use in frail patients and in atypical cases? Which monitoring and management haemorrhage complications?]. Rev Med Interne 2020; 41:598-606. [PMID: 32674901 DOI: 10.1016/j.revmed.2020.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 05/09/2020] [Accepted: 05/21/2020] [Indexed: 02/08/2023]
Abstract
Since their approval, the direct oral anticoagulants have been widely used in the management of venous thromboembolism, for stroke and systemic embolism prevention in non valvular atrial fibrillation, and in venous thromboembolism prophylaxis after surgical hip or knee replacement. Because they are easy to use, with oral fixed doses and no biological monitoring need, they are more and more prescribed. New indications are rising in cancer associated thrombosis in France beyond the 6 first months of treatment, and to prevent cardiovascular events after an acute coronary syndrome, or in stable coronary or peripheral arterial disease in Europe. The efficacity and safety of direct oral anticoagulants in frail patients or in unusual pathological contexts are not entirely known, but further data are coming and will probably bring new answers.
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Affiliation(s)
- C Hoffmann
- GETBO EA 3878, CHRU Cavale Blanche, Brest, France; Département de Médecine Interne, Vasculaire et Pneumologie, CHRU Cavale Blanche, Brest, France.
| | - C Leven
- GETBO EA 3878, CHRU Cavale Blanche, Brest, France; Département de Biochimie Pharmaco-Toxicologie, CHRU Cavale Blanche, Brest, France
| | - R Le Mao
- GETBO EA 3878, CHRU Cavale Blanche, Brest, France; Département de Médecine Interne, Vasculaire et Pneumologie, CHRU Cavale Blanche, Brest, France
| | - C De Moreuil
- GETBO EA 3878, CHRU Cavale Blanche, Brest, France; Département de Médecine Interne, Vasculaire et Pneumologie, CHRU Cavale Blanche, Brest, France
| | - K Lacut
- GETBO EA 3878, CHRU Cavale Blanche, Brest, France; Département de Médecine Interne, Vasculaire et Pneumologie, CHRU Cavale Blanche, Brest, France
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Scholz M, Onal B, Schleicher P, Pingel A, Hoffmann C, Kandziora F. Two-level ACDF with a zero-profile stand-alone spacer compared to conventional plating: a prospective randomized single-center study. Eur Spine J 2020; 29:2814-2822. [PMID: 32430769 DOI: 10.1007/s00586-020-06454-z] [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] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Stand-alone zero-profile devices have already proven safety, and a reduced dysphagia rate was assumed. So far, no level-one evidence is available to prove the proposed advantages of zero-profile implants in multilevel procedures. The aim of this RCT was to compare the clinical and radiological outcome of a zero-profile spacer versus cage + plate in two-level ACDF. METHODS Consecutive patients with contiguous two-level cDD were randomly assigned either to the interventional group (zero-profile device) or to the control group (cage + plate). Primary endpoint of the study was the prevalence of dysphagia at 24 months. Disability, progress of adjacent segment degeneration, fusion status and loss of correction were analyzed as secondary outcome measure. Primary outcome parameter was statistically analyzed by Chi-square test. RESULTS Forty-one patients met inclusion criteria and were randomly assigned to the interventional and the control group. Dysphagia was frequent in either group at 3 months FU favoring interventional group (p = 0.078). At final FU, less patients of the interventional group complained about dysphagia, but the difference was not significant. No relevant differences at final FU were recorded for NPDI, loss of correction and adjacent-level degeneration. Fusion rate was slightly lower in the interventional group. DISCUSSION Two-level ACDF either by a stand-alone zero-profile spacer or cage + plate is safe. Using a zero-profile cage dysphagia was infrequent at 24 months, but the value did not reach statistical significance in comparison with the cage + plate. Hence, this randomized trial was not able to prove the proposed clinical superiority for dysphagia rates for zero-profile anchored spacer in two-level cDD.
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Affiliation(s)
- M Scholz
- Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany.
| | - B Onal
- Neurosurgical Department, Acıbadem University Vocational School of Health Services, Istanbul, Turkey
| | - P Schleicher
- Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany
| | - A Pingel
- Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany
| | - C Hoffmann
- Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany
| | - F Kandziora
- Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany
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Purevjav N, Okuchi T, Hoffmann C. Strong hydrogen bonding in a dense hydrous magnesium silicate discovered by neutron Laue diffraction. IUCrJ 2020; 7:370-374. [PMID: 32431820 PMCID: PMC7201286 DOI: 10.1107/s2052252520003036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
A large amount of hydrogen circulates inside the Earth, which affects the long-term evolution of the planet. The majority of this hydrogen is stored in deep Earth within the crystal structures of dense minerals that are thermodynamically stable at high pressures and temperatures. To understand the reason for their stability under such extreme conditions, the chemical bonding geometry and cation exchange mechanism for including hydrogen were analyzed in a representative structure of such minerals (i.e. phase E of dense hydrous magnesium silicate) by using time-of-flight single-crystal neutron Laue diffraction. Phase E has a layered structure belonging to the space group R 3 m and a very large hydrogen capacity (up to 18% H2O weight fraction). It is stable at pressures of 13-18 GPa and temperatures of up to at least 1573 K. Deuterated high-quality crystals with the chemical formula Mg2.28Si1.32D2.15O6 were synthesized under the relevant high-pressure and high-temperature conditions. The nuclear density distribution obtained by neutron diffraction indicated that the O-D dipoles were directed towards neighboring O2- ions to form strong interlayer hydrogen bonds. This bonding plays a crucial role in stabilizing hydrogen within the mineral structure under such high-pressure and high-temperature conditions. It is considered that cation exchange occurs among Mg2+, D+ and Si4+ within this structure, making the hydrogen capacity flexible.
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Affiliation(s)
- Narangoo Purevjav
- Institute for Planetary Materials, Okayama University, 827 Yamada, Misasa, Tottori 682-0193, Japan
| | - Takuo Okuchi
- Institute for Planetary Materials, Okayama University, 827 Yamada, Misasa, Tottori 682-0193, Japan
| | - Christina Hoffmann
- Neutron Scattering Division, Neutron Sciences Directorate, Oak Ridge National Laboratory, Tennesee, TN 37831, USA
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Kerpel A, Yalon M, Soudack M, Chiang J, Gajjar A, Nichols KE, Patay Z, Shrot S, Hoffmann C. Neuroimaging Findings in Children with Constitutional Mismatch Repair Deficiency Syndrome. AJNR Am J Neuroradiol 2020; 41:904-910. [PMID: 32354708 DOI: 10.3174/ajnr.a6512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/26/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND PURPOSE Constitutional mismatch repair deficiency is a hereditary childhood cancer predisposition syndrome characterized by brain tumors and colorectal and hematologic malignancies. Our objective was to describe the neuroimaging findings in patients with constitutional mismatch repair deficiency. MATERIALS AND METHODS This retrospective study included 14 children with genetically confirmed constitutional mismatch repair deficiency who were referred to 2 tertiary pediatric oncology centers. RESULTS Fourteen patients from 11 different families had diagnosed constitutional mismatch repair deficiency. The mean age at presentation was 9.3 years (range, 5-14 years). The most common clinical presentation was brain malignancy, diagnosed in 13 of the 14 patients. The most common brain tumors were glioblastoma (n = 7 patients), anaplastic astrocytoma (n = 3 patients), and diffuse astrocytoma (n = 3 patients). Nonspecific subcortical white matter T2 hyperintensities were noted in 10 patients (71%). Subcortical hyperintensities transformed into overt brain tumors on follow-up imaging in 3 patients. Additional non-neoplastic brain MR imaging findings included developmental venous anomalies in 12 patients (85%) and nontherapy-induced cavernous hemangiomas in 3 patients (21%). CONCLUSIONS On brain MR imaging, these patients have both highly characteristic intra-axial tumors (typically multifocal high-grade gliomas) and nonspecific findings, some of which might represent early stages of neoplastic transformation. The incidence of developmental venous anomalies is high in these patients for unclear reasons. Awareness of these imaging findings, especially in combination, is important to raise the suspicion of constitutional mismatch repair deficiency in routine diagnostic imaging evaluation or surveillance imaging studies of asymptomatic carriers because early identification of the phenotypic "gestalt" might improve outcomes.
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Affiliation(s)
- A Kerpel
- From the Department of Radiology (A.K., M.S., S.S., C.H.), Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel .,Sackler School of Medicine (A.K., M.Y., M.S., S.S., C.H.), Tel Aviv University, Tel Aviv, Israel
| | - M Yalon
- Pediatric Hemato-Oncology (M.Y.), Edmond and Lilly Safra Children's Hospital and Cancer Research Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler School of Medicine (A.K., M.Y., M.S., S.S., C.H.), Tel Aviv University, Tel Aviv, Israel
| | - M Soudack
- From the Department of Radiology (A.K., M.S., S.S., C.H.), Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler School of Medicine (A.K., M.Y., M.S., S.S., C.H.), Tel Aviv University, Tel Aviv, Israel
| | | | - A Gajjar
- Divisions of Neuro-Oncology (A.G.)
| | | | - Z Patay
- Department of Oncology and Section of Neuroimaging, Department of Diagnostic Imaging (Z.P.), St. Jude Children's Research Hospital, Memphis, Tennessee
| | - S Shrot
- From the Department of Radiology (A.K., M.S., S.S., C.H.), Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler School of Medicine (A.K., M.Y., M.S., S.S., C.H.), Tel Aviv University, Tel Aviv, Israel
| | - C Hoffmann
- From the Department of Radiology (A.K., M.S., S.S., C.H.), Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler School of Medicine (A.K., M.Y., M.S., S.S., C.H.), Tel Aviv University, Tel Aviv, Israel
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Le Tourneau C, Calugaru V, Borcoman E, Moreno V, Calvo E, Liem X, Salas S, Doger B, Jouffroy T, Mirabel X, Rodriguez J, Chilles A, Bernois K, De Rink M, Baskin-Bey E, Fakhry N, Hee Kam SW, Hoffmann C. Hafnium oxide nanoparticles (NBTXR3) activated by radiotherapy for the treatment of frail and/or elderly patients with locally advanced HNSCC: a phase I/II study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kullmann S, Wagner L, Berti K, Schneeweiss P, Veit R, Hoffmann C, Niess A, Preissl H, Häring H, Fritsche A, Weigert C, Böhm A, Heni M. P6 Exercise improves intranasal insulin mediated functional connectivity in sedentary overweight and obese adults. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Weng J, Dill ED, Martin JD, Whitfield R, Hoffmann C, Ye F. K-space algorithmic reconstruction (KAREN): a robust statistical methodology to separate Bragg and diffuse scattering. J Appl Crystallogr 2020. [DOI: 10.1107/s1600576719017060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Diffuse scattering occurring in the Bragg diffraction pattern of a long-range-ordered structure represents local deviation from the governing regular lattice. However, interpreting the real-space structure from the diffraction pattern presents a significant challenge because of the dramatic difference in intensity between the Bragg and diffuse components of the total scattering function. In contrast to the sharp Bragg diffraction, the diffuse signal has generally been considered to be a weak expansive or continuous background signal. Herein, using 1D and 2D models, it is demonstrated that diffuse scattering in fact consists of a complex array of high-frequency features that must not be averaged into a low-frequency background signal. To evaluate the actual diffuse scattering effectively, an algorithm has been developed that uses robust statistics and traditional signal processing techniques to identify Bragg peaks as signal outliers which can be removed from the overall scattering data and then replaced by statistically valid fill values. This method, described as a `K-space algorithmic reconstruction' (KAREN), can identify Bragg reflections independent of prior knowledge of a system's unit cell. KAREN does not alter any data other than that in the immediate vicinity of the Bragg reflections, and reconstructs the diffuse component surrounding the Bragg peaks without introducing discontinuities which induce Fourier ripples or artifacts from underfilling `punched' voids. The KAREN algorithm for reconstructing diffuse scattering provides demonstrably better resolution than can be obtained from previously described punch-and-fill methods. The superior structural resolution obtained using the KAREN method is demonstrated by evaluating the complex ordered diffuse scattering observed from the neutron diffraction of a single plastic crystal of CBr4 using pair distribution function analysis.
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Le Tourneau C, Garcia V, Doger B, Urban A, Bernois K, Liem X, Salas S, Wong S, Fakhry N, Dimitriu M, Calugaru V, Hoffmann C. PHASE I STUDY OF HAFNIUM OXIDE NANOPARTICLES ACTIVATED BY INTENSITY MODULATED RADIATION THERAPY (IMRT) AS A NEW THERAPEUTIC OPTION FOR ELDERLY OR FRAIL HNSCC PATIENTS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Brückl W, Reck M, Laack E, Hermes B, Rawluk J, Huber R, Hoffmann C, Schueler A. Sequential treatment with afatinib followed by 3rd generation EGFR-TKI – subgroup analysis of the GIDEON trial: A prospective non-interventional study (NIS) in EGFR mutated NSCLC patients in Germany. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.049] [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: 11/12/2022] Open
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