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Sanak F, Iselin K, Job O, Kaufmann C, Hedinger YYM, Thiel M. Five-Year Risk and Safety Profile of Autologous Serum Eye Drop Therapy. Klin Monbl Augenheilkd 2024; 241:388-391. [PMID: 38653292 DOI: 10.1055/a-2244-6285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE To evaluate the risk and safety profile of autologous serum eye drop therapy in clinical routine over a period of 5 years. METHODS This retrospective study involved all patients treated with autologous serum between July 2014 and December 2019 at a tertiary ophthalmic referral center. The electronic patient record system was searched for all patients with autologous serum eye drop therapy at any time point. These records were subsequently searched for keywords such as infectious keratitis, corneal ulcer, conjunctivitis, or endophthalmitis at any recorded contact. The probability of an association between the therapy with autologous serum eye drops and infectious complications was investigated independently by three corneal specialists and rated as likely, potential, or unlikely. RESULTS In total, 752 patients were treated with autologous serum eye drops between July 2014 and December 2019. There were 5 384 batches with a total of 107 680 bottles of serum eye drops that had been produced and dispensed for these patients during this period. The records of 291 patient showed a combination of autologous serum therapy and at least one keyword for infectious diseases. In 288 patients, individual case analyses revealed an unlikely association between the therapy and infection, as their infectious episodes occurred either before the start of the therapy, more than 1 month after the therapy ceased, or in the contralateral untreated eye in the case of unilateral therapy. Three cases of infectious keratitis were classified as potentially associated with autologous serum therapy. However, all three patients suffered from chronic anterior eye diseases with a high risk of spontaneous infectious complications independent of therapy with autologous eye drops. None of the infectious events was rated as being likely due to the serum eye drops. CONCLUSIONS Serum eye drops are often used in patients with severe or chronic anterior eye diseases with an intrinsic risk of infectious diseases. Despite these preexisting risk factors, autologous serum eye drops can be considered safe, even in patients with a compromised ocular surface.
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Affiliation(s)
- Frantisek Sanak
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Zurich, Switzerland
| | - Katja Iselin
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Lucerne, Switzerland
| | - Oliver Job
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Lucerne, Switzerland
| | - Claude Kaufmann
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Zurich, Switzerland
| | - Ying-Yu Melody Hedinger
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Lucerne, Switzerland
| | - Michael Thiel
- Department of Ophthalmology, Lucerne Cantonal Hospital, Switzerland
- Faculty of Medicine, University of Zurich, Switzerland
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Blaser F, Immer F, Kruegel N, Franscini N, Tappeiner C, Rennesson C, Massa H, Reinshagen H, Früh B, Kaufmann C, Meneau I, Said S. National Consensus on Contraindications for Corneal Donation for Transplantation in Switzerland. Klin Monbl Augenheilkd 2024; 241:412-416. [PMID: 38653295 DOI: 10.1055/a-2211-9614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE To establish a national consensus on contraindications for corneal donation for transplantation in Switzerland. METHODS Swisstransplant (SWT), the Swiss national foundation coordinating tissue and organ donations, convened a working group consisting of six national corneal surgeons and eye bankers and donation experts to create a contraindication list for corneal donation. The group reviewed available national and international guidelines and recommendations, while adhering to Swiss law and transplant regulations. In cases of opposing opinions, the group held follow-up meetings until a consensus was reached. A consensus was defined as agreement among all parties present. RESULTS From March 2021 to November 2021, the study group held six meetings and created a standardized minimal contraindication list for corneal donation in Switzerland. Thanks to this list, SWT has created a mandatory working and documentation file for donor coordinators to use when evaluating multiorgan donors for corneal harvesting. The authors agreed that while the national consensus list provides standardized minimal contraindication criteria, local eye banks may choose to introduce additional, more rigorous criteria. CONCLUSION Given that corneal transplantation is the most commonly performed transplantation, establishing a consensus on contraindications is crucial for recipient safety. The creation of a consensus on contraindications for corneal donation in Switzerland is an essential contribution to fulfil the legal requirements concerning quality assurance and provides sufficient high-quality donor tissue within the country. Therefore, periodic review and revision of the consensus is considered critical.
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Affiliation(s)
- Frank Blaser
- Department of Ophthalmology, University Hospital Zürich, Zürich, Switzerland
| | - Franz Immer
- Swisstransplant, Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Nathalie Kruegel
- Swisstransplant, Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Nicola Franscini
- Swisstransplant, Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | | | - Christophe Rennesson
- Swisstransplant, Swiss National Foundation for Organ Donation and Transplantation, Geneva, Switzerland
| | - Horace Massa
- Ophthalmology, University Hospital Genève, Switzerland
| | | | - Beatrice Früh
- Eye Clinic, Inselspital University Hospital Bern, Switzerland
| | | | - Isabelle Meneau
- Department of Ophthalmology, University Hospital Zürich, Zürich, Switzerland
| | - Sadiq Said
- Department of Ophthalmology, University Hospital Zürich, Zürich, Switzerland
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Banerjee S, Kaufmann C, Tinner C, Iselin K, Amstutz CA, Hedinger YYM, Schmid MK, Thiel M. Patient-Reported Outcome Measures (PROMs) with Refractive and Diffractive Extended Depth of Focus (EDOF) Intraocular Lenses. Klin Monbl Augenheilkd 2024; 241:369-373. [PMID: 38653290 DOI: 10.1055/a-2211-8796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Extended depth of focus intraocular lenses (EDOF-IOLs) provide unaided far- and mid-range vision. Refractive IOLs, in contrast to diffractive designs, are associated with a lower depth of focus and absence of dysphotopsia. The aim of this study was to assess spectacle independence for far-range, mid-range, and near-vision activities in patients after implantation of refractive or diffractive EDOF-IOLs using patient-reported outcome measures (PROMs) in a real-world setting. PATIENTS AND METHODS In 2021 and 2022, all patients in a single center referred for bilateral cataract surgery were assigned to 7 experienced cataract surgeons who either bilaterally implanted only a diffractive EDOF-IOL (Carl Zeiss Meditec AG, AT LARA Jena, Germany, three surgeons) or refractive EDOF-IOL (Johnson & Johnson Vision Inc., Tecnis Eyhance Irvine, California, USA, four surgeons) at the surgeon's discretion, with the aim of bilateral emmetropia. Six months after both cataract surgeries, all patients were contacted by telephone and asked to report their outcomes using a structured questionnaire investigating their spectacle usage for various daily activities and their experience with night glare or halos. Inclusion criteria were a normal postoperative visual potential based on the preoperative examination and completion of the questionnaire regarding postoperative visual experience. RESULTS Of the patients, 514 underwent bilateral cataract surgery aiming for bilateral emmetropia with the implantation of EDOF-IOLs (422 with Tecnis Eyhance and 92 with AT LARA). A complete questionnaire was obtained from 472 (92%) patients, who were included in the study (393 vs. 79). Comparing Tecnis Eyhance with AT LARA IOL, 54 vs. 57% patients were able to perform most of their daily activities without spectacles, 9 vs. 19% reported not being dependent on spectacles at all, 25 vs. 29% reported using their smartphones without spectacles, 15 vs. 49% patients reported experiencing glares or halos at night, and 1 vs.15% with driving disturbance. Overall, 95 vs. 93% patients described themselves as "satisfied" or "highly satisfied" with their IOL. CONCLUSIONS With both types of EDOF-IOLs, the majority of patients could perform most of their daily activities without spectacles, except reading, and were highly satisfied with their IOLs. Patients with diffractive Zeiss AT LARA EDOF-IOLs were more likely to accomplish unaided near-range visual tasks; however, they were also at a higher risk of experiencing glares or halos at night.
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Affiliation(s)
- Shalini Banerjee
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Claude Kaufmann
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Medicin, University of Zurich, Zurich, Switzerland
| | - Chiara Tinner
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katja Iselin
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Christoph Andreas Amstutz
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Ying-Yu Melody Hedinger
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Martin K Schmid
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Medicin, University of Zurich, Zurich, Switzerland
| | - Michael Thiel
- Department of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland
- Faculty of Medicin, University of Zurich, Zurich, Switzerland
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Bodmer NS, Christensen DG, Bachmann LM, Faes L, Sanak F, Iselin K, Kaufmann C, Thiel MA, Baenninger PB. Deep Learning Models Used in the Diagnostic Workup of Keratoconus: A Systematic Review and Exploratory Meta-Analysis. Cornea 2024:00003226-990000000-00474. [PMID: 38300179 DOI: 10.1097/ico.0000000000003467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/26/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The prevalence of keratoconus in the general population is reported to be up to 1 of 84. Over the past 2 decades, diagnosis and management evolved rapidly, but keratoconus screening in clinical practice is still challenging and asks for improving the accuracy of keratoconus detection. Deep learning (DL) offers considerable promise for improving the accuracy and speed of medical imaging interpretation. We establish an inventory of studies conducted with DL algorithms that have attempted to diagnose keratoconus. METHODS This systematic review was conducted according to the recommendations of the PRISMA statement. We searched (Pre-)MEDLINE, Embase, Science Citation Index, Conference Proceedings Citation Index, arXiv document server, and Google Scholar from inception to February 18, 2022. We included studies that evaluated the performance of DL algorithms in the diagnosis of keratoconus. The main outcome was diagnostic performance measured as sensitivity and specificity, and the methodological quality of the included studies was assessed using QUADAS-2. RESULTS Searches retrieved 4100 nonduplicate records, and we included 19 studies in the qualitative synthesis and 10 studies in the exploratory meta-analysis. The overall study quality was limited because of poor reporting of patient selection and the use of inadequate reference standards. We found a pooled sensitivity of 97.5% (95% confidence interval, 93.6%-99.0%) and a pooled specificity of 97.2% (95% confidence interval, 85.7%-99.5%) for topography images as input. CONCLUSIONS Our systematic review found that the overall diagnostic performance of DL models to detect keratoconus was good, but the methodological quality of included studies was modest.
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Affiliation(s)
- Nicolas S Bodmer
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Medignition Inc. Research Consultants Zurich, Zurich, Switzerland
- University of Toronto, Institute of Health Policy, Management and Evaluation (IHPME), Toronto, ON, Canada
| | | | - Lucas M Bachmann
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Medignition Inc. Research Consultants Zurich, Zurich, Switzerland
| | - Livia Faes
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Medignition Inc. Research Consultants Zurich, Zurich, Switzerland
- NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Frantisek Sanak
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; and
| | - Katja Iselin
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; and
| | - Claude Kaufmann
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; and
| | - Michael A Thiel
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; and
| | - Philipp B Baenninger
- Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; and
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Iselin KC, Bachmann LM, Thiel MA, Sanak F, Baenninger PB, Kaufmann C. A fluorophotometric comparison of anterior chamber riboflavin delivery via corneal application and fornix instillation. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:627-632. [PMID: 37748681 DOI: 10.1016/j.oftale.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/09/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION AND OBJECTIVES We investigated whether riboflavin self-administration by patients could be a feasible option for corneal cross-linking, given the considerable resources required to impregnate the cornea with riboflavin. We analysed whether administering riboflavin in the inferior fornix (the site of self-administration) results in non-inferior riboflavin concentrations as when applied directly on the cornea (the site of administration by medical personnel). PATIENTS AND METHODS We conducted a prospective study to evaluate riboflavin concentrations at six time-points (baseline, 5, 15, 30, 45 and 60min) in 18 healthy volunteers for each of two application sites: cornea and fornix. Anterior chamber riboflavin (Peschke® TE 0.25%) concentrations were measured by fluorophotometry (Fluorotron™ Master FM-2). RESULTS For the two application sites cornea and fornix, participants did not differ in terms of age and sex. At baseline, the autofluorescence in the anterior chamber was 16.7ng/mL (SD 5.5) and 14.6ng/mL (SD 4.6) (P=.221). After 30min, anterior chamber fluorescein concentrations had risen to 55.1ng/mL (SD 25.5) and 46.1ng/mL (SD 25.1) (P=.293) without a further relevant increase by 60min. CONCLUSIONS This study found that applying riboflavin drops in the inferior fornix was non-inferior to applying it directly to the cornea, based on fluorophotometric measurements of anterior chamber riboflavin concentrations. This suggests that self-application of riboflavin is feasible in terms of corneal riboflavin impregnation.
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Affiliation(s)
- K C Iselin
- Departamento de Oftalmología, Hospital Cantonal de Lucerna, Lucerna, Switzerland
| | | | - M A Thiel
- Departamento de Oftalmología, Hospital Cantonal de Lucerna, Lucerna, Switzerland
| | - F Sanak
- Departamento de Oftalmología, Hospital Cantonal de Lucerna, Lucerna, Switzerland
| | - P B Baenninger
- Departamento de Oftalmología, Hospital Cantonal de Lucerna, Lucerna, Switzerland
| | - C Kaufmann
- Departamento de Oftalmología, Hospital Cantonal de Lucerna, Lucerna, Switzerland.
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Baenninger PB, Romano V, Figueiredo FC, Pradhan SP, Vohra V, Jeng BH, Iselin KC, Murphy CC, Kaufmann C, Thiel MA, Bachmann LM. Differences in minimal disease knowledge of keratoconus patients: results from an international survey. BMJ Open Ophthalmol 2023; 8:bmjophth-2022-001164. [PMID: 37278427 DOI: 10.1136/bmjophth-2022-001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/06/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND/AIMS The objective of this multicentre, multinational, prospective study was to assess the level of basic understanding that individuals with keratoconus possessed about their condition. METHODS We recruited 200 active keratoconus patients who were under regular review, and cornea specialists established a standard of 'minimal keratoconus knowledge' (MKK) that included an understanding of the definition, risk factors, symptoms and treatment options for the condition. We collected data from each participant regarding their clinical characteristics, highest level of education, (para)medical background and experiences with keratoconus within their social circle, and calculated the percentage of MKK attained by each patient. RESULTS Our findings revealed that none of the participants met the MKK standard, with the average MKK score being 34.6% and ranging from 0.0% to 94.4%. Furthermore, our study showed that patients with a university degree, previous surgical intervention for keratoconus or affected parents had a higher MKK. However, age, gender, disease severity, paramedical knowledge, disease duration and best-corrected visual acuity did not significantly affect the MKK score. CONCLUSIONS Our study demonstrates a concerning lack of basic disease knowledge among keratoconus patients in three different countries. The level of knowledge exhibited by our sample was only one-third of what cornea specialists would typically anticipate from patients. This highlights the need for greater education and awareness campaigns surrounding keratoconus. Further research is needed to determine the most efficient approaches for enhancing MKK and subsequently improving the management and treatment of keratoconus.
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Affiliation(s)
- Philipp B Baenninger
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Vito Romano
- Department of Corneal and External Eye Diseases, Royal Liverpool University Hospital, Liverpool, UK
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- Department of Ophthalmology, Newcastle University, Newcastle upon Tyne, UK
| | - Sayali P Pradhan
- Department of Ophthalmology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Vishal Vohra
- Department of Ophthalmology, Newcastle University, Newcastle upon Tyne, UK
- Department of Ophthalmology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Bennie H Jeng
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Katja C Iselin
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conor C Murphy
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Claude Kaufmann
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
| | - Michael A Thiel
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
| | - Lucas M Bachmann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Medignition AG, Zurich, Switzerland
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Schwefel MK, Kaufmann C, Gutmann G, Henze R, Fydrich T, Rapp MA, Ströhle A, Heissel A, Heinzel S. Physical fitness is associated with neural activity during working memory performance in major depressive disorder. Neuroimage Clin 2023; 38:103401. [PMID: 37060626 PMCID: PMC10133876 DOI: 10.1016/j.nicl.2023.103401] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/17/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Deficits in cognition like working memory (WM) are highly prevalent symptoms related to major depressive disorder (MDD). Neuroimaging studies have described frontoparietal abnormalities in patients with MDD as a basis for these deficits. Based on research in healthy adults, it is hypothesized that increased physical fitness might be a protective factor for these deficits in MDD. However, the relationship between physical fitness and WM-related neural activity and performance has not been tested in MDD, to date. Understanding these associations could inform the development of physical exercise interventions in MDD. METHODS Within a larger project, 111 (53female) MDD outpatients and 56 (34female) healthy controls performed an n-back task (0-, 1-, 2-, 3-back) during functional Magnetic Resonance Imaging. Physical fitness from a graded exercise test on a cycle ergometer was performed by 106 MDD patients. RESULTS Patients showed reduced performance particularly at high loads of the n-back WM task and prolonged reaction times at all n-back loads. A whole-brain interaction analysis of group by WM load revealed reduced neural activity in six frontoparietal clusters at medium and high WM loads in MDD patients compared to healthy controls. Analysis of covariance within the MDD sample showed that physical fitness was associated with neural activity in right and left superior parietal lobules. Externally defined Regions of Interest confirmed this analysis. CONCLUSIONS Results indicate frontoparietal hypoactivity in MDD at high demands, arguing for decreased WM capacity. We demonstrate a parietal fitness correlate which could be used to guide future research on effects of exercise on cognitive functioning in MDD.
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Affiliation(s)
- M K Schwefel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - C Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - G Gutmann
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - R Henze
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - T Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - M A Rapp
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - A Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - A Heissel
- Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - S Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Iselin K, Bachmann L, Baenninger P, Sanak F, Kaufmann C. A Clinical Decision Tree to Support Keratoconus Patients Considering Corneal Cross-Linking Combined with Refractive Treatment. Klin Monbl Augenheilkd 2023; 240:379-384. [PMID: 37164397 DOI: 10.1055/a-2017-5203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND To develop a fast and frugal decision tree to identify keratoconus patients most likely to benefit visually from the combination of corneal cross-linking (CXL) with topography-guided photorefractive keratectomy ("CXL plus"). PATIENTS AND METHODS The outcome of interest was an improvement in uncorrected distance visual acuity (UDVA) by at least two lines at the 12-month follow-up. Preoperative and 12-month follow-up data from patients who received CXL plus (n = 96) and CXL only (n = 96) were used in a recursive partitioning approach to construct a frugal tree with three variables (corneal thickness [>/< 430 um], patient interest in CXL plus [yes/no], and tomographic cylinder [</> 3 D]). In addition, we estimated the probability of the outcome from a multivariate logistic regression model for each combination of variables used in the decision tree. RESULTS In the complete sample, 101/192 (52.6%) patients improved by at least two lines at the 12-month follow-up. Patients affirmative in all three answers had a 75.6% (34/45) probability of gaining at least two lines of improvement in UDVA by CXL plus. The statistical model estimated a 66.0% probability for a successful outcome. CONCLUSION A fast and frugal tree consisting of three variables can be used to select a patient group with a high likelihood to benefit from CXL plus. The tree is useful in the preoperative counseling of keratoconus patients contemplating the CXL plus option, an intervention that is not fully covered by many health insurances.
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Affiliation(s)
- Katja Iselin
- Dept. of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | | | - Frantisek Sanak
- Dept. of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Claude Kaufmann
- Dept. of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
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9
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Cirilo E, Junior NR, Andrade T, Souza C, Kaufmann C, Kohler T, Datsch L, Vieira B, Junior J, Carvalho P, Eyng C, Nunes R. Effects of probiotics on blood metabolites, enterocytes, growth, and carcass characteristics of broilers challenged with Salmonella Serovar Heidelberg. Livest Sci 2023. [DOI: 10.1016/j.livsci.2023.105188] [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: 02/22/2023]
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10
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Stadler C, Stöbich M, Ruhs B, Kaufmann C, Pisecky L, Stevoska S, Gotterbarm T, Klotz MC. Intermediate to long-term clinical outcomes and survival analysis of the Salto Mobile Bearing total ankle prothesis. Arch Orthop Trauma Surg 2022; 142:3697-3704. [PMID: 34086075 PMCID: PMC9596531 DOI: 10.1007/s00402-021-03946-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Osteoarthritis of the ankle is a major burden to affected patients. While tibio-talar arthrodesis has been the gold-standard regarding the treatment of osteoarthritis of the ankle joint for many years, at present total ankle arthroplasty (TAA) provides appealing clinical outcomes and is continually gaining popularity. The aim of this study was to evaluate the intermediate- to long-term clinical outcome including the survival rate of Salto Mobile Bearing TAA (Tonier SA, Saint Ismier, France). MATERIAL AND METHODS In this retrospective study intermediate- to long-term outcomes measures [Ankle Range of Motion (ROM), American Orthopaedic Foot and Ankle Score (AOFAS score) and survival rate] of 171 consecutive TAA were analysed and compared before and after surgery. Revision was defined as secondary surgery with prothesis component removal, while reoperation was defined as a non-revisional secondary surgery involving the ankle. RESULTS At a mean follow-up (FU) period of 7.2 ± 2.7 years (range 2.0 to 14.1 years) there was a significant improvement in ankle ROM (total ROM improved from 25.0° ± 15.0° to 28.7° ± 11.3°, p = 0.015; plantarflexion improved from 18.4° ± 11.7° to 20.6° ± 8.2°, p = 0.044; dorsiflexion improved from 6.6° ± 5.7° to 8.1° ± 4.9°, p = 0.011). AOFAS score increased significantly by 41 ± 15 points after surgery (43.3 ± 11.1 before and 84.3 ± 12.0 after surgery, p < 0.001). Overall survival rate within the FU was 81.3% (95% CI 75.3% to 87.3%) with any secondary surgery, 89.9% (95% CI 84.1% to 93.6%) with revision and 93.6% (95% CI 89.8% to 97.3%) with reoperation as endpoint. CONCLUSION This study endorses the previously reported appealing intermediate- to long-term outcomes of the Salto Mobile Bearing TAA. There was a significant increase in ROM and AOFAS score as well as decent implant survival at final FU.
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Affiliation(s)
- C Stadler
- Department for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital GmbH, Johannes Kepler University Linz, Altenberger Strasse 96, 4040 Linz and Krankenhausstraße 9, 4020, Linz, Austria.
| | - M Stöbich
- Orthopaedics and Traumatology, Klinik Diakonissen, Weißenwolffstrasse 13, 4020, Linz, Austria
| | - B Ruhs
- Orthopaedics, Klinik Diakonissen, Weißenwolffstrasse 13, 4020, Linz, Austria
| | - C Kaufmann
- Ordensklinikum Linz Barmherzige Schwestern, Seilerstätte 4, 4010, Linz, Austria
| | - L Pisecky
- Department for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital GmbH, Johannes Kepler University Linz, Altenberger Strasse 96, 4040 Linz and Krankenhausstraße 9, 4020, Linz, Austria
| | - S Stevoska
- Department for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital GmbH, Johannes Kepler University Linz, Altenberger Strasse 96, 4040 Linz and Krankenhausstraße 9, 4020, Linz, Austria
| | - T Gotterbarm
- Department for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital GmbH, Johannes Kepler University Linz, Altenberger Strasse 96, 4040 Linz and Krankenhausstraße 9, 4020, Linz, Austria
| | - M C Klotz
- Department for Orthopaedics and Traumatology, Med Campus III, Kepler University Hospital GmbH, Johannes Kepler University Linz, Altenberger Strasse 96, 4040 Linz and Krankenhausstraße 9, 4020, Linz, Austria
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Magrey M, Jain M, Ranza R, Stigler J, Mcdearmon-Blondell E, Yue C, Padilla B, Kaufmann C, Mcgonagle D. POS1057 IMPACT OF RISANKIZUMAB ON ENTHESITIS AND ASSOCIATED PAIN: POOLED RESULTS FROM THE PHASE 3, RANDOMIZED, DOUBLE-BLIND KEEPsAKE 1 AND 2 TRIALS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundControlling or improving musculoskeletal disease activity of psoriatic arthritis (PsA) (eg, enthesitis and associated pain) is a treatment priority for patients, rheumatologists, and dermatologists.1 Enthesitis is the cardinal lesion in PsA and is immunogenetically and experimentally linked to the interleukin-23 (IL-23) pathway.2 Risankizumab (RZB), a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits IL-23 by binding to its p19 subunit, was studied in a phase 3 adult PsA program (KEEPsAKE clinical trials).3,4 Pooled analyses from the program demonstrated the efficacy of RZB to treat enthesitis and pain associated with PsA, and increase the proportion of patients whose enthesitis resolved compared with placebo (PBO) in those patients who had an inadequate response or intolerance to ≥1 conventional synthetic disease-modifying antirheumatic drugs (KEEPsAKE 1 and 2) and/or ≤ 2 biological therapies (KEEPsAKE 2).ObjectivesTo investigate whether patients without enthesitis at baseline (BL) (Leeds Enthesitis Index [LEI] = 0 at BL) remained enthesitis-free through week (W) 52, patients with enthesitis at BL (LEI > 0 at BL) had resolution of enthesitis through W52, and if greater pain relief was achieved with RZB 150 mg in patients with enthesitis at BL vs PBO up to W24.MethodsThe study design and primary results of KEEPsAKE 1 (NCT03675308) and KEEPsAKE 2 (NCT03671148) have been previously reported.3,4 Briefly, patients were randomized to receive RZB 150 mg or PBO subcutaneously at weeks 0, 4, and 16 during a 24-week, double-blind treatment period; at W28 all patients received open label RZB 150 mg. For this post hoc analysis, the RZB 150 mg and PBO groups were pooled across the 2 studies. Pain reductions (as measured by change from BL in visual analogue scale [VAS] scores) were assessed at each time point through W24 among patients with enthesitis at BL (LEI > 0 at BL) using mixed-effect model repeated measurement analysis. Additional enthesitis analyses were calculated on the data as observed.ResultsAcross the pooled population, over 60% of patients in each treatment group had enthesitis at BL (RZB=444/707 [63%]; PBO=448/700 [64%]). Conversely, 37% (263/707) and 36% (252/700) had no enthesitis (LEI=0) at BL among those randomized to RZB and PBO, respectively. Among enthesitis-free patients at BL (LEI=0 at BL), 84.7% on PBO and 90% on RZB remained free of enthesitis through W24; by W52, approximately 93% of patients in both groups (RZB and PBO to RZB) remained enthesitis free. A numerically higher proportion of patients with enthesitis at BL (LEI > 0 at BL) treated with RZB (52.1%) achieved an enthesitis-free state at W24 vs PBO (41.8%); similar proportions achieved an enthesitis-free state at W36 and W52 during open label treatment (Figure 1). Among patients with enthesitis at BL, a significantly greater improvement in VAS pain scores was observed in patients treated with RZB 150 mg vs PBO, as early as W4 (P < .01) and increased through W24 (Figure 1; P < .001).Figure 1.ConclusionLong-term maintenance of an enthesitis-free state (LEI = 0) was similar between the RZB 150 mg and PBO groups, with approximately 93% of patients remaining free of enthesitis at W52. For LEI > 0 patients, the RZB 150-mg group had numerically more patients whose enthesitis resolved at W24, and similar proportions were observed at W52 after the open label switch. Patients with enthesitis at BL treated with RZB 150 mg had statistically greater improvements in pain compared with patients taking PBO starting at W4 through to W24.References[1]Orbai A-M, et al. Ann Rheum Dis. 2017;76:673–680.[2]Stavre Z, et al. Arthritis Res Ther. 2022;24(1):24.[3]Kristensen LE, et al. Ann Rheum Dis. 2021;0:1–7.[4]Östör A, et al. Ann Rheum Dis. 2021;0:1–8.AcknowledgementsAbbVie Inc. participated in the study design; study research; collection, analysis, and interpretation of data; and writing, reviewing, and approving this abstract for submission. All authors had access to the data; participated in the development, review, and approval of the abstract; and agreed to submit this abstract to EULAR 2022 for consideration as a poster or oral presentation. No honoraria or payments were made for authorship. AbbVie and the authors thank all study investigators for their contributions and the patients who participated in this study. AbbVie funded the research for this study and provided writing support for this abstract. Medical writing assistance, funded by AbbVie, was provided by Kersten Reich, MPH, and Nancy Niguidula, DPH, of JB Ashtin.Disclosure of InterestsMarina Magrey Consultant of: MM has received consulting fees from UCB, Novartis, Eli Lilly, Pfizer, and Janssen., Grant/research support from: MM received research grants from Amgen, AbbVie, and UCB Pharma, Manish Jain Consultant of: MJ received consulting fees from Amgen, Abbvie, Eli Lilly, Pfizer, and Novartis., Grant/research support from: MJ received research support from Amgen, Abbvie, Eli Lilly, Pfizer, and Novartis., R Ranza Speakers bureau: RR is a member of speaker bureaus for AbbVie, Janssen, Novartis, and Pfizer, Consultant of: RR is a consultant for AbbVie, Janssen, Novartis, and Pfizer, Jayne Stigler Shareholder of: JS may hold AbbVie stock or stock options., Employee of: JS is a full-time employee of AbbVie., Erin McDearmon-Blondell Shareholder of: EMB may hold AbbVie stock or stock options., Employee of: EMB is a full-time employee of AbbVie., Cuiyong Yue Shareholder of: CY may hold AbbVie stock or stock options., Employee of: CY is a full-time employee of AbbVie., Byron Padilla Shareholder of: BP may hold AbbVie stock or stock options., Employee of: BP is a full-time employee of AbbVie., Christian Kaufmann Shareholder of: CK may hold AbbVie stock or stock options., Employee of: CK is a full-time employee of AbbVie., Dennis McGonagle Speakers bureau: DM is a member of speaker bureaus for AbbVie, Janssen, Novartis, and Pfizer., Grant/research support from: DM received research grants from AbbVie, Janssen, Novartis, and Pfizer, UCB, BMS, Celgene.
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Papp K, Soliman AM, Kaufmann C, Barcomb L, Wang Z, White D, Ostor A, Kristensen LE. AB0897 Impact of risankizumab on improving symptoms and health-related quality of life and reducing fatigue and pain among psoriatic arthritis patients with moderate-to-severe skin involvement: Evidence from two Phase III trials. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) greatly affects patient-reported health-related quality of life (HRQoL).ObjectivesTo assess the impact of risankizumab (RZB) on patient-reported outcomes (PROs) in patients with high skin burden using integrated efficacy data from two Phase III clinical trials (KEEPsAKE-1 and KEEPsAKE-2).MethodsAdult patients with PsA with inadequate response or intolerance to disease-modifying antirheumatic drugs were randomized 1:1 to receive RZB (150 mg) or placebo (PBO). Improvement from baseline in PROs (Patient’s Global Assessment of Disease Activity [PtGA] by visual analog scale [VAS], Short-Form 36 Health Questionnaire physical and mental component summary scores [SF-36 PCS and MCS], Health Assessment Questionnaire – Disability Index [HAQ-DI], EQ-5D 5-Level questionnaire [EQ-5D-5L] index and by VAS, Functional Assessment of Chronic Illness Therapy – Fatigue [FACIT-Fatigue], and pain by VAS) were assessed at Week 24 in patients with high skin burden (body surface area involvement ≥3% and Psoriasis Area Severity Index >10). Least squares mean (LSM) difference (95% confidence interval [CI]) between RZB and PBO groups based on mixed-model repeated measures regression is reported.ResultsRZB- vs PBO-treated patients demonstrated greater improvements in PROs with notable LSM differences (95% CI) between groups (P<0.01) in PtGA (-18.7 [-25.1, -12.2]), SF-36 PCS (6.3 [4.2, 8.4]) and MCS (4.4 [2.3, 6.6]), HAQ-DI (-0.4 [-0.5, -0.3]), EQ-5D-5L index (0.1 [0.1, 0.2]) and VAS (8.2 [2.5,13.9]), FACIT-Fatigue (4.9 [2.7, 7.2]), and pain (-18.9 [-25.1, -12.7]).ConclusionIn patients with PsA with high skin burden, 24 weeks of RZB treatment, as compared with PBO, improved patients’ HRQoL, including fatigue and pain.AcknowledgementsAbbVie funded the study and participated in interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing services were provided by Samantha Francis Stuart (Fishawack Facilitate Ltd) and funded by AbbVie.Disclosure of InterestsKim Papp Speakers bureau: AbbVie, Akros, Amgen, Anacor Pharmaceuticals, Arcutis Biotherapeutics, Astellas, Avillion, Bausch Health, Baxalta, Boehringer Ingelheim, Bristol Myers Squibb, Can-Fite Biopharma, Celgene, Coherus BioSciences, Dermavant, Dermira, Dice Pharmaceuticals, Dow Pharma, Eli Lilly, Evelo Biosciences, Galapagos NV, Galderma, Gilead, GlaxoSmithKline, Incyte, Janssen, Kyowa-Hakko Kirin, LEO Pharma, MedImmune, Meiji Seika Pharma, Merck-Serono, Merck Sharp & Dohme, Mitsubishi Pharma, Novartis, Pfizer, PRCL Research, Regeneron, Roche, Sanofi-Genzyme, Sun Pharma, Takeda, UCB, and Xencor., Consultant of: AbbVie, Akros, Amgen, Anacor Pharmaceuticals, Arcutis Biotherapeutics, Astellas, Avillion, Bausch Health, Baxalta, Boehringer Ingelheim, Bristol Myers Squibb, Can-Fite Biopharma, Celgene, Coherus BioSciences, Dermavant, Dermira, Dice Pharmaceuticals, Dow Pharma, Eli Lilly, Evelo Biosciences, Galapagos NV, Galderma, Gilead, GlaxoSmithKline, Incyte, Janssen, Kyowa-Hakko Kirin, LEO Pharma, MedImmune, Meiji Seika Pharma, Merck-Serono, Merck Sharp & Dohme, Mitsubishi Pharma, Novartis, Pfizer, PRCL Research, Regeneron, Roche, Sanofi-Genzyme, Sun Pharma, Takeda, UCB, and Xencor., Grant/research support from: AbbVie, Akros, Amgen, Anacor Pharmaceuticals, Arcutis Biotherapeutics, Astellas, Avillion, Bausch Health, Baxalta, Boehringer Ingelheim, Bristol Myers Squibb, Can-Fite Biopharma, Celgene, Coherus BioSciences, Dermavant, Dermira, Dice Pharmaceuticals, Dow Pharma, Eli Lilly, Evelo Biosciences, Galapagos NV, Galderma, Gilead, GlaxoSmithKline, Incyte, Janssen, Kyowa-Hakko Kirin, LEO Pharma, MedImmune, Meiji Seika Pharma, Merck-Serono, Merck Sharp & Dohme, Mitsubishi Pharma, Novartis, Pfizer, PRCL Research, Regeneron, Roche, Sanofi-Genzyme, Sun Pharma, Takeda, UCB, and Xencor., Ahmed M. Soliman Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Christian Kaufmann Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Lisa Barcomb Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Zailong Wang Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Douglas White Speakers bureau: AbbVie and Novartis., Consultant of: AbbVie and Novartis., Andrew Ostor Speakers bureau: BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Eli Lilly, and Novartis., Consultant of: BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Eli Lilly, and Novartis., Grant/research support from: BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Eli Lilly, and Novartis., Lars Erik Kristensen Speakers bureau: Pfizer, AbbVie, Amgen, Forward Pharma, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen, Consultant of: Pfizer, AbbVie, Amgen, Forward Pharma, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen, Grant/research support from: UCB, Novartis, Pfizer, Eli Lilly, Biogen, AbbVie, and Janssen Pharmaceuticals and UCB.
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Sanak F, Baenninger P, Iselin K, Kaufmann C, Bachmann L, Buhl D, Thiel M. VEGF-A in Serum and Plasma Rich in Growth Factors (PRGF) Eye Drops. Klin Monbl Augenheilkd 2022; 239:378-381. [PMID: 35472775 DOI: 10.1055/a-1766-6790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF)-A, the most abundant subtype of the VEGF family in the eye, plays an important role in corneal homeostasis due to its ability to mediate corneal nerve repair. Repeated intravitreal anti-VEGF injections were shown to significantly reduce corneal nerve density, which might negatively affect corneal homeostasis and lead to a neuropathic dry eye disease. Currently, there are two effective modalities to treat dry eye while supplying VEGF to the ocular surface: serum eye drops (SED) and eye drops manufactured from plasma rich in growth factors (PRGF). The purpose of this study was to measure the VEGF-A concentration in SED and PRGF eye drops. MATERIAL AND METHODS Ten healthy volunteers donated blood on two separate occasions, 2 - 8 days apart. Thus, a total of 20 blood samples were processed to obtain both SED and PRGF. Concentrations of VEGF-A were quantified by a Simple Plex platform run in triplicate. RESULTS The VEGF-A concentration in SED and PRGF was very similar between the two blood samples drawn from one individual donor but showed substantial interindividual variability. However, in all 20 samples, VEGF concentrations were substantially higher in SED samples (mean 238.7 ± 146.6 pg/mL) compared to PRGF samples (mean 67.4 ± 46.3 pg/mL). Based upon the analysis of variance (ANOVA) model for the measured concentrations with fixed effects for specimen (SED vs. PRGF) and subject, the mean difference between the SED and PRGF concentration was 168.1 pg/mL (95% confidence interval: [142.4, 193.9], p < 0.001). CONCLUSION Our study showed that the VEGF concentration was higher in SED than in PRGF. This is an important finding, particularly for potential treatment of dry eye disease in patients with neuropathic eye disease, especially in patients that received repeated anti-VEGF intravitreal injections, or in patients with Sjögren's disease, where the level of VEGF in tears might be pathologically decreased. Hypothetically, VEGF might be needed to restore ocular surface homeostasis. Although growing evidence has shown that VEGF-A plays an important role in corneal homeostasis, only a randomized prospective clinical trial will show whether supplying VEGF-A to the ocular surface might successfully restore the corneal homeostasis and overcome the problem of corneal neuropathy in these patients. For such a trial, based on our results, an undiluted SED should be preferred over a PRGF due to the higher content of VEGF-A.
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Affiliation(s)
- Frantisek Sanak
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
| | | | - Katja Iselin
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | - Claude Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
| | - Lucas Bachmann
- Medizinische Fakultät, Universität Zürich, Zürich, Switzerland.,Medignition Inc., Research Consultants, Zürich, Switzerland
| | - Daniela Buhl
- Labormedizin, Luzerner Kantonsspital, Luzern, Switzerland
| | - Michael Thiel
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
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Sanak F, Faes L, Eppenberger L, Baenninger P, Kaufmann C, Golla K, Bachmann L, Buhl D, Schmid MK, Thiel M. Effect of Protective Measures on the Risk of SARS-CoV-2 Infection among Eye Clinic Staff Members. Klin Monbl Augenheilkd 2022; 239:605-609. [PMID: 35472816 DOI: 10.1055/a-1785-5226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Switzerland was strongly affected by the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that resulted in a nationwide lockdown in March 2020. Ophthalmologists were at most risk of contracting a SARS-CoV-2 infection due to their close working distance from patients. The aim of the study is to evaluate the overall effectiveness of protective measures on the risk of SARS-CoV-2 infection among employees in a large public eye hospital. MATERIAL AND METHODS After lifting the lockdown in April 2020, standard precaution measures were taken, such as no handshaking and the use of operating face masks and a protective plastic shield on slit lamps and diagnostic devices. Only patients with no signs of SARS-CoV-2 disease were seen during the study period. Specific anti-SARS-CoV-2 IgG antibody titers were measured in eye clinic employees at the end of April 2020 (1st test phase) and in January 2021 (2nd test phase). The prevalence of SARS-CoV-2 IgG antibody titers among employees with daily patient contact was compared to staff members with no patient contact. RESULTS The SARS-CoV-2 prevalence in employees with daily patient contact, with 0% in the 1st phase and 7.4% in the 2nd phase, was not significantly higher than the prevalence in the control group with no patient contact (0.9% in the 1st phase, p = 0.4; and 8.6% in the 2nd phase, p = 0.8). Furthermore, physicians were not at a significantly higher risk of SARS-CoV-2 infection compared to technicians, nurses, or office staff. CONCLUSIONS This study shows that the abovementioned precaution measurements are effective in preventing transmission of SARS-CoV-2 infection in eye hospitals and enable us to resume practicing ophthalmology in a safe manner.
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Affiliation(s)
- Frantisek Sanak
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Livia Faes
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Retina and Uveitis, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | | | | | - Claude Kaufmann
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Kathrin Golla
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Lucas Bachmann
- Medical Faculty, University of Zürich, Zürich, Switzerland.,Research Consultancy, Medignition INC, Zürich, Switzerland
| | - Daniela Buhl
- Laboratory Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Martin K Schmid
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Michael Thiel
- Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland.,Medical Faculty, University of Zürich, Zürich, Switzerland
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Iselin KC, Kaufmann C, Malata D, Bachmann LM, Power WJ, Quill B, Murphy CC. Telemedicine Service for Keratoconus Monitoring: Patient Satisfaction and Prospects for Further Expansion. Telemed J E Health 2022; 28:1690-1697. [PMID: 35426741 DOI: 10.1089/tmj.2021.0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: During the COVID-19 pandemic, keratoconus patient care moved from in-person clinics to virtual care. We surveyed patient satisfaction with the new virtual clinic model. Methods: We assessed the views of keratoconus patients enrolled in the novel virtual service between June 1 and July 31, 2020, in individual structured telephone interviews using Likert questions. Results: Of the 88 patients enrolled, the opinions of 69 patients could be evaluated (78.4%). Compared with previous in-person visits, mean waiting times for diagnostic examinations dropped from 43 (±32) min to 4 (±3) min (p < 0.001). The majority of patients (68; 99%) were satisfied or very satisfied with the overall service irrespective of the communication channel (telephone or video). A majority also indicated a desire to continue attending the virtual keratoconus clinic after the pandemic and supported the idea of decentralized sites for future diagnostic measurements. Discussion: A novel virtual service to monitor keratoconus progression was well received and was associated with shorter waiting times. There was a strong interest on the part of patients to further develop the virtual keratoconus clinic. Conclusions: This study demonstrates that keratoconus patients managed very well the conversion from in-person to virtual care. A solid majority of keratoconus patients also supported further expansion of the virtual consultations to a completely decentralized telemedicine model.
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Affiliation(s)
- Katja C Iselin
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Department of Ophthalmology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Claude Kaufmann
- Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Diana Malata
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | - William J Power
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Barry Quill
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conor C Murphy
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
- Department of Ophthalmology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Branger GA, Le MT, Inauen LO, Reichmuth V, Kaufmann C, Baenninger P. Ten-Year Outcome of Topography-Guided Transepithelial Surface Ablation for Refractive Myopia Treatment. Klin Monbl Augenheilkd 2022; 239:382-385. [PMID: 35320865 DOI: 10.1055/a-1739-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND To evaluate 10-year long-term refractive visual stability and participants' satisfaction in the refractive treatment of myopic eyes undergoing topography-guided transepithelial surface ablation using a 1KHz excimer laser. PATIENTS AND METHODS This single-center prospective survey assessed participants' satisfaction 10 years after the treatment using a non-validated questionnaire with regards to visual outcome, dry eye, and visual disturbance symptoms. Pre- and postoperative visual and refractive data were evaluated. RESULTS Of 106 participants (54% females) with a mean patient age of 36 (± 8.6) years, 166 eyes were included. Mean preoperative spherical equivalent (SE) was - 4.23 (± 2.48) diopters (D). Uncorrected distant visual acuity (UCVA) after 10 years was ≥ 1.0 (Snellen) in 92% of the eyes. Manifest SE was within ± 1.0 D of the desired refraction in 86% of the eyes after 10 years. Mean quality of life (QOL) improvement was high (9.15 out of 10 points). Dry eye symptoms were reported by 35 out of 104 (34%) patients. Visual symptoms like halos or starbursts were reported by 24 out of 101 (24%) and 12 out of 100 (12%) patients, respectively. CONCLUSIONS Topography-guided transepithelial surface ablation for myopia provided stable long-term results in terms of UCVA and SE. Participant satisfaction was high, with only low rates of dry eye or visual symptoms.
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Affiliation(s)
| | - Minh Tu Le
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | | | | | - Claude Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Faculty of Medicine, University of Zurich Faculty of Medicine, Zurich, Switzerland
| | - Philipp Baenninger
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Faculty of Medicine, University of Zurich Faculty of Medicine, Zurich, Switzerland
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Jost M, Pfaeffli O, Kaufmann C, Reichmuth V, Thiel M, Baenninger P. Efficacy of Diclofenac in Pain Reduction after Topography-Guided Transepithelial Surface Ablation. Klin Monbl Augenheilkd 2022; 239:386-389. [PMID: 35320868 DOI: 10.1055/a-1739-0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report the efficacy of postoperative diclofenac eye drops for pain reduction in patients undergoing topography-guided transepithelial surface ablation. METHODS Retrospective consecutive case series of patients undergoing topography-guided transepithelial surface ablation for refractive myopia treatment using a 1 KHz excimer laser. Patients were divided into three groups. Group 1 did not receive any diclofenac drops, group 2 received one diclofenac drop postoperatively (day 1), and group 3 received one drop of diclofenac postoperatively (day 1) and on the day after treatment (day 2). Postoperative pain was self-assessed by patients per eye daily for the first 4 consecutive days (days 1 to 4) after the treatment using the visual analogue scale (VAS). We compared VAS with respect to the use of additional oral or topical treatment as well as VAS with regards to the total amount of ablated tissue (< 50 µm, 50 - 100 µm, ≥ 100 µm) among the groups. RESULTS We enrolled 163 eyes of 163 patients (55.0% female), with a mean age of 31.3 years (SD ± 6.6; range 21 - 68). We excluded 16 patients who applied other additional analgesics. Group 1 comprised 35 eyes (21%), group 2 had 21 eyes (13%), and group 3 consisted of 107 eyes (66%). Median pain score (VAS) was 5 (range 0, 10) in group 1, which was higher than in groups 2 (median 1, range 0 to 7) and 3 (median 1.5, range 0 to 7) on the day of surgery (p < 0.0001). Percentage of patients using an additional oral NSAID on days 1 and 2 was significantly higher in group 1 (69/83%) when compared to groups 2 (24/43%) or 3 (31/49%) (p < 0.001 day 1, p = 0.001 day 2). No correlation was found between pain sensation and maximum ablation depth (Spearman correlation p > 0.05). CONCLUSION The instillation of one drop of diclofenac after topography-guided transepithelial surface ablation reduced subjective pain sensation according to VAS and decreased the need for additional topical anesthetic drops or oral NSAID.
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Affiliation(s)
- Moritz Jost
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Ophthalmology, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | | | - Claude Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Ophthalmology, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | | | - Michael Thiel
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Ophthalmology, Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Baenninger PB, Bachmann LM, Iselin KC, Pfaeffli OA, Kaufmann C, Thiel MA, Gigerenzer G. Mismatch of corneal specialists' expectations and keratoconus knowledge in general ophthalmologists - a prospective observational study in Switzerland. BMC Med Educ 2021; 21:297. [PMID: 34030668 PMCID: PMC8146633 DOI: 10.1186/s12909-021-02738-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/04/2021] [Accepted: 05/05/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND To assess whether Swiss general ophthalmologists have the minimal keratoconus knowledge that corneal specialists would expect them to have. METHODS Corneal specialists defined "minimal keratoconus knowledge" (MKK) with respect to definition, risk factors, symptoms and possible treatment options of keratoconus. A telephone interview survey was conducted among one hundred ophthalmologists (mean age 51.9 years (SD 9.5), 60 % male) from the German-speaking part of Switzerland. For each participant, years of work experience, number of keratoconus patients seen per year and access to a topography device were obtained. We calculated the proportion of MKK and examined in multivariate analyses whether ophthalmologists with access to topography and with greater work experience performed better than other groups. RESULTS No single ophthalmologist had MKK. The mean MKK was 52.0 %, and the range was 28.6-81.0 %. Per 10 years of working in private practice, the MKK decreased by 8.1 % points (95 % CI: -14.2, -2.00; p = 0.01). Only 24 % of participants correctly recalled the definition of keratoconus, 9 % all risk factors, 5 % all symptoms and 20 % all treatment modalities. The MKK values were not associated with the number of keratoconus patients seen per year and the availability of topography to diagnose keratoconus. CONCLUSIONS There is a substantial mismatch between corneal specialist' expectations and general ophthalmologists' knowledge about keratoconus. The low recall of symptoms and risk factors may explain why ophthalmologists diagnose relatively few cases of keratoconus, resulting in inefficient care delivery and delayed intervention.
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Affiliation(s)
- Philipp B Baenninger
- Faculty of Medicine, University of Zurich, 8091, Zurich, Switzerland.
- Department of Ophthalmology, Cantonal Hospital of Lucerne, 6000, Lucerne-16, Switzerland.
| | - Lucas M Bachmann
- Faculty of Medicine, University of Zurich, 8091, Zurich, Switzerland
- Medignition Inc. Research Consultants Zurich, Verena Conzett-Strasse 9, PO 9628, 8036, Zurich, Switzerland
| | - Katja C Iselin
- Department of Ophthalmology, Cantonal Hospital of Lucerne, 6000, Lucerne-16, Switzerland
| | - Oliver A Pfaeffli
- Department of Ophthalmology, Cantonal Hospital of Lucerne, 6000, Lucerne-16, Switzerland
| | - Claude Kaufmann
- Faculty of Medicine, University of Zurich, 8091, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, 6000, Lucerne-16, Switzerland
| | - Michael A Thiel
- Faculty of Medicine, University of Zurich, 8091, Zurich, Switzerland
- Department of Ophthalmology, Cantonal Hospital of Lucerne, 6000, Lucerne-16, Switzerland
| | - Gerd Gigerenzer
- Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany
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Sanak F, Baenninger P, Kaufmann C, Iselin K, Bachmann L, Buhl D, Thiel M. The Lucerne Protocol for the Production of Autologous Serum Eyedrops. Klin Monbl Augenheilkd 2021; 238:346-348. [PMID: 33930907 DOI: 10.1055/a-1354-6565] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are a variety of protocols for manufacturing autologous serum (AS) eye drops. The Lucerne protocol for the production of AS eye drops uses a slightly reduced gravitational (g)-force and time for the centrifugation process (2500 × g for 10 minutes), compared to previously published optimised protocols, to obtain high levels of epitheliotropic growth factors (3000 × g for 15 minutes). The goal of this study was to compare the concentrations of growth factors, albumin and lysozyme in autologous serum eye drops manufactured with these protocols. MATERIAL AND METHODS Blood from 5 healthy volunteers was placed in plastic tubes without an anticoagulant. Tubes from each donor were left in a vertical position for 2 hours at room temperature to facilitate coagulation, followed by centrifugation at either 2500 × g for 10 minutes or at 3000 × g for 15 minutes at room temperature. The serum levels of beta nerve growth factor (β-NGF), transforming growth factor β1 (TGF-β1), epidermal growth factor (EGF), hepatocyte growth factor (HGF), platelet-derived growth factor BB (PDGF-BB) and vascular endothelial growth factor A (VEGF-A) were measured in triplicate with a multi-analyte Simple Plex platform. The Simple Plex cartridge allows each sample to be run in triplicate for each analyte and prevents any interaction between the antibody components for each biomarker. The serum level of albumin was measured by turbidimetric immunoassay Tina-quant and of lysozyme by single radial immunodiffusion assay. RESULTS For all analytes, the reduced g-force and centrifugation time did not result in a significant difference in serum levels. CONCLUSIONS The Lucerne protocol for the production of autologous serum eye drops with reduced g-force and a shorter centrifugation time does not affect the concentrations of the main epitheliotropic growth factors, albumin and lysozyme, in AS eye drops.
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Affiliation(s)
- Frantisek Sanak
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
| | | | - Claude Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
| | - Katja Iselin
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | - Lucas Bachmann
- Medizinische Fakultät, Universität Zürich, Zürich, Switzerland.,Research Consultancy, Medignition INC, Research Consultancy, Medignition INC, Zürich, Switzerland
| | - Daniela Buhl
- Labormedizin, Luzerner Kantonsspital, Luzern, Switzerland
| | - Michael Thiel
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Medizinische Fakultät, Universität Zürich, Zürich, Switzerland
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20
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Kaufmann C, Arnold M, Schipf A, Bruderer VL, Iselin KC. Tintelnotia destructans Keratitis: A Clinicopathological Report and Review of the Literature. Cornea 2021; 40:380-382. [PMID: 33252388 DOI: 10.1097/ico.0000000000002550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/15/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To present the first clinicopathological report of Tintelnotia destructans keratitis, a filamentous fungus and as of yet uncommon virulent ocular pathogen. METHODS A 70-year-old man presented with an infectious keratitis featuring a stromal infiltrate with feathery borders and a viscous hypopyon. Despite initial improvement under a combined therapy with natamycin and voriconazole, a perforation in the further course required a penetrating keratoplasty. Cultures and the corneal lenticule were available for microscopic examination and antifungal susceptibility testing. The limited literature on the subject was reviewed. RESULTS Microscopic examination of cultures revealed hyphae and conidia being produced in globose fruiting bodies, a common characteristic of Tintelnotia sp. Histopathology showed short-branched hyphae that grew across the cornea regardless of the orientation of the collagen lamellae. Molecular methods identified the species T. destructans. The pattern of antifungal susceptibility included amphotericin B, ciclopirox, natamycin, posaconazole, voriconazole, and terbinafine. The postoperative clinical course was without complications. CONCLUSIONS Although the clinical signs corresponded to the classic features of fungal keratitis, microscopic analysis revealed morphological characteristics of a fungal class that has shown little ophthalmological appearance so far. Data on T. destructans keratitis are highly limited in the literature, but all identified species shared sensitivity to terbinafine.
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Affiliation(s)
- Claude Kaufmann
- Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Mihaela Arnold
- Institute of Medical Microbiology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Alexander Schipf
- Institute of Pathology, Lucerne Cantonal Hospital, Lucerne, Switzerland ; and
| | - Vera L Bruderer
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Katja C Iselin
- Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
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21
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Kaufmann C, Baenninger PB, Pfaeffli OA, Iselin KC, Job O. Don't be afraid of the dark - OCT angiography through a black intraocular lens. Am J Ophthalmol Case Rep 2020; 20:100935. [PMID: 33024889 PMCID: PMC7527705 DOI: 10.1016/j.ajoc.2020.100935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/23/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To report a case in which optical coherence tomography (OCT) and OCT angiography (OCT-A) allowed imaging of the posterior pole in a patient fitted with a black occlusive intraocular lens (IOL). Observations Following retinal central artery occlusion, a 52-year-old patient suffered from disturbing residual light perception. Occlusive contact lenses blocked the light insufficiently, so that the patient had to rely on an eye patch for relief of symptoms. After no neovascularization had formed during an observation period of 12 months, a black IOL (Morcher 85F) was implanted, blocking wavelengths in the visible spectrum but allowing transmission in the near-infrared spectrum. Slit lamp photography, OCT and OCT-A were performed pre- and postoperatively. Postoperatively, slit lamp photography could no longer provide images of the posterior pole, proving the effective blockade of wavelengths in the visible light spectrum. In contrast, transmission in the near-infrared spectrum allowed for OCT and OCT-A imaging of the fundus. The complete suppression of the disturbing perception of light succeeded only temporarily. Conclusions and Importance The implantation of a black IOL does not prevent the imaging of the retinal microvasculature by OCT-A. Black IOLs can therefore be considered even if continued monitoring of the vascular situation of the posterior pole is required.
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Thiel MA, Kaufmann C. Eyeshot: Ocular Injuries caused by TASER pistols. Eur Heart J 2020; 41:3984-3985. [DOI: 10.1093/eurheartj/ehaa684] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Bey K, Weinhold L, Grützmann R, Heinzel S, Kaufmann C, Klawohn J, Riesel A, Lennertz L, Schmid M, Ramirez A, Kathmann N, Wagner M. The polygenic risk for obsessive-compulsive disorder is associated with the personality trait harm avoidance. Acta Psychiatr Scand 2020; 142:326-336. [PMID: 32786038 DOI: 10.1111/acps.13226] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is a complex psychiatric disorder with a substantial genetic contribution. While the specific variants underlying OCD's heritability are still unknown, findings from genome-wide association studies (GWAS) corroborate the importance of common SNPs explaining the phenotypic variance in OCD. Investigating associations between the genetic liability for OCD, as reflected by a polygenic risk score (PRS), and potential endophenotypes of the disorder, such as the personality trait harm avoidance, may aid the understanding of functional pathways from genes to diagnostic phenotypes. METHODS We derived PRS for OCD at several P-value thresholds based on the latest Psychiatric Genomics Consortium OCD GWAS (2688 cases, 7037 controls) in an independent sample of OCD patients (n = 180), their unaffected first-degree relatives (n = 108) and healthy controls (n = 200). Using linear regression, we tested whether these PRS are associated with the personality trait harm avoidance. RESULTS Results showed that OCD PRS significantly predicted OCD status, with patients having the highest scores and relatives having intermediate scores. Furthermore, the genetic risk for OCD was associated with harm avoidance across the entire sample, and among OCD patients. As indicated by mediation analyses, harm avoidance mediated the association between the OCD PRS and OCD caseness. These results were observed at multiple P-value thresholds and persisted after the exclusion of patients with a current comorbid major depressive or anxiety disorder. CONCLUSION Our findings support the polygenic nature of OCD and further validate harm avoidance as a candidate endophenotype and diathesis of OCD.
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Affiliation(s)
- K Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - L Weinhold
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - R Grützmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - S Heinzel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - C Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - J Klawohn
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - A Riesel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychology, University of Hamburg, Hamburg, Germany
| | - L Lennertz
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - M Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - A Ramirez
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Institute of Human Genetics, University Hospital Bonn, Bonn, Germany.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - N Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - M Wagner
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
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Iselin KC, Baenninger PB, Bachmann LM, Bochmann F, Thiel MA, Kaufmann C. Changes in higher order aberrations after central corneal regularization - a comparative two-year analysis of a semi-automated topography-guided photorefractive keratectomy combined with corneal cross-linking. Eye Vis (Lond) 2020; 7:10. [PMID: 32161770 PMCID: PMC7053096 DOI: 10.1186/s40662-020-00179-2] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/11/2020] [Indexed: 12/19/2022]
Abstract
Background The optical quality in progressive keratoconus deteriorates due to ectasia and distortion of the corneal shape and optics. While corneal cross-linking (CXL) aims at stopping disease progression, “CXL-Plus” combines CXL with excimer laser ablation to improve visual function. Central Corneal Regularization (CCR) represents a therapeutic excimer laser modality specifically designed to smoothen the ectatic corneal shape and to reduce higher order aberrations (HOA). We set out to compare CXL-Plus, consisting of CXL combined with CCR, with CXL by itself for patients with progressive keratoconus. Methods Retrospective 2-year matched group analysis of patients who either underwent CXL-Plus (n = 28) or CXL as a sole procedure (n = 28) for progressive keratoconus. Main outcome parameters were HOA, visual function and tomographic results 12 and 24 months postoperatively. Results After 12 months, the total HOA root mean square wavefront error was reduced from 0.79 ± 0.30 to 0.40 ± 0.19 μm (CXL-Plus; p < 0.0001) and changed from 0.71 ± 0.28 to 0.73 ± 0.36 μm (CXL; p = 0.814). Uncorrected distance visual acuity improved from 0.70 ± 0.35 to 0.36 ± 0.29 logMAR (CXL-Plus; p = 0.0002) and from 0.65 ± 0.39 to 0.46 ± 0.37 logMAR (CXL; p = 0.067), translating to gains of three or more lines in 50% (CXL-Plus) and 36% (CXL) of patients. The steepest keratometry value (Kmax) regressed by 5.84 D (CXL-Plus; p < 0.0001) and 0.66 D (CXL; p = 0.752). For none of the investigated parameters a statistically significant change could be shown between 12 and 24 months. Conclusions CXL-Plus in the form of a CCR reduces HOA and Kmax more effectively than CXL as a sole procedure.
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Affiliation(s)
- Katja C Iselin
- 1Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | | | - Frank Bochmann
- 1Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Michael A Thiel
- 1Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Claude Kaufmann
- 1Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
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25
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Baenninger PB, Bodmer NS, Bachmann LM, Iselin K, Kaufmann C, Belin MW, Thiel MA. Keratoconus Characteristics Used in Randomized Trials of Surgical Interventions—A Systematic Review. Cornea 2019; 39:615-620. [DOI: 10.1097/ico.0000000000002202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Iselin KC, Thiel MA, Bachmann LM, Baenninger PB, Kaufmann C. Fluorophotometric Determination of Riboflavin Concentrations in a Human Artificial Anterior Chamber Model. Transl Vis Sci Technol 2019; 8:7. [PMID: 31737431 PMCID: PMC6855370 DOI: 10.1167/tvst.8.6.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/06/2019] [Accepted: 09/01/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Corneal cross-linking (CXL) requires an adequate corneal riboflavin impregnation, which is clinically assessed by verification of a riboflavin "flare" in the anterior chamber. We set out to replace this subjective assessment with an objective measurement method and evaluated fluorophotometry as an apparatus-based technique for riboflavin detection in the anterior chamber. METHODS In an artificial anterior chamber model using human corneas and a modified Fluorotron fluorophotometer, we determined the detection limits of riboflavin concentrations across native corneas by comparison measurements of the same concentrations in glass cuvettes. Subsequently, standard CXL procedures with corneal application of riboflavin were simulated and the proportions of riboflavin entering the anterior chamber were measured fluorophotometrically. RESULTS The measurement results of the riboflavin dilution series in the artificial anterior chamber showed a very high concordance with the results obtained in a glass cuvette (Pitman test P = 0.329). In the CXL simulation, the mean riboflavin concentration measured in the anterior chamber increased within 15 minutes from 5 (±1) to 903 (±204) ng/mL and stood at 1089 (±56) ng/mL after 30 minutes. CONCLUSIONS Fluorophotometry is able to measure riboflavin in an artificial anterior chamber across human corneas over a wide range of concentrations and it reliably detects the increasing riboflavin signal in simulated CXL procedures. TRANSLATIONAL RELEVANCE The replacement of the subjective riboflavin detection by a technically straightforward, objective detection method might increase patient safety and treatment efficiency in CXL.
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Affiliation(s)
- Katja C Iselin
- Dept of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Michael A Thiel
- Dept of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | | | | | - Claude Kaufmann
- Dept of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
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Campbell L, Kohli M, Heaton A, Higgins M, Lee E, Kaufmann C, Heaton R, Moore D, Moore R. B-24 Objective and Subjective Sleep Measures are Associated with Neurocognition in Middle-Aged and Older Adults With and Without HIV. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
Poorer sleep quality is related to worse cognitive functioning in the general population and people living with HIV; however, many studies use self-report sleep questionnaires that rely on retrospective recall. This study aimed to examine the relationship between objective (wrist actigraphy) and subjective sleep quality with neurocognitive functioning.
Method
Eighty-five adults aged 50-74 years with and without HIV (HIV+ n = 53, HIV- n = 32) were recruited from the community and ongoing studies at UC San Diego. Participants completed comprehensive neuropsychological testing assessing global and domain-specific cognition. Participants wore actigraphy watches for 14 nights after neuropsychological testing to objectively assess sleep quality (i.e., total sleep time (TST), efficiency, wake after sleep onset, and sleep fragmentation). The Pittsburgh Sleep Quality Index assessed subjective sleep quality.
Results
After adjusting for demographic variables and use of sleep medications, there were no differences in any sleep quality measures by HIV status (p’s>0.05). In separate adjusted linear regression models, lower sleep efficiency (p = 0.02; 95% CI: -9.5, -1.1) and greater sleep fragmentation (p = 0.02; 95% CI: -0.82, -0.09) were associated with worse learning. Less TST was associated with worse working memory (p = 0.02; 95% CI: -9.2, -0.8). In contrast, worse subjective sleep quality was associated with worse executive function (p < 0.01; 95% CI: -1.18, -0.23) and working memory (p = 0.03; 95% CI: -1.22, -0.07).
Conclusion
Both objective and subjective sleep quality were associated with cognition in both persons with and without HIV; however, subjective and objective sleep quality were associated with different cognitive domains. Therefore, both objective and subjective sleep quality are important health behaviors to assess.
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Kaufmann C, Yourman L, Moore A. MARIJUANA USE AND SLEEP ACROSS THE LIFE COURSE: RESULTS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - A Moore
- University of California-San Diego
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Kaufmann C, Barone J, Cross M, Dekhne N, Devisetty K, Dilworth J, Edmonson D, Eladoumikdachi F, Gass J, Hong R, Kuske R, Lebovic G, Patton B, Phillips R, Tafra L, Smith A, Smith L. Use of a 3-D bioabsorbable marker for planning and targeting radiation to the lumpectomy cavity: 3 year results from a registry study. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30454-4] [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: 10/17/2022]
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30
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Kaufmann C, Zacharias K, Rogers A, O’donnell J, Hill L, Ness K, Schnell N. 3-D specimen tomosynthesis provides more information than 2-D specimen mammography. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30455-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Kaufmann C, Mortimer LA, Brereton HM, Irani YD, Parker DGA, Anson DS, Bachmann LM, Williams KA. Interleukin-10 Gene Transfer in Rat Limbal Transplantation. Curr Eye Res 2017; 42:1426-1434. [DOI: 10.1080/02713683.2017.1344714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Claude Kaufmann
- Department of Ophthalmology, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Lauren A Mortimer
- Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
| | - Helen M Brereton
- Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
| | - Yazad D Irani
- Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
| | - Douglas GA Parker
- Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
| | - Donald S Anson
- Department of Genetic Medicine, Women’s and Children’s Hospital, Adelaide, Australia
| | - Lucas M Bachmann
- Horten Centre for Patient Oriented Research, University of Zurich, Zurich, Switzerland
| | - Keryn A Williams
- Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
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Owusu J, Ramsey C, Tzuang M, Kaufmann C, Parisi J, Kasper J, Spira A. NAPPING FREQUENCY, PLANNED VS. UNINTENTIONAL NAPS, AND DAYTIME FUNCTIONING IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J.T. Owusu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,
| | - C. Ramsey
- Veteran Affairs Connecticut Healthcare System, West Haven, Connecticut,
- Yale School of Medicine, New Haven, Connecticut,
| | - M. Tzuang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,
| | - C. Kaufmann
- University of California San Diego School of Medicine, San Diego, California
| | - J.M. Parisi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,
| | - J.D. Kasper
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,
| | - A.P. Spira
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,
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Iselin K, Baenninger P, Schmittinger-Zirm A, Thiel M, Kaufmann C. Fungal Keratitis: A Six-Year Review at a Tertiary Referral Centre. Klin Monbl Augenheilkd 2017; 234:419-425. [DOI: 10.1055/s-0042-123233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Iselin
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland (Chair: Michael A. Thiel)
| | - P. Baenninger
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland (Chair: Michael A. Thiel)
| | - A. Schmittinger-Zirm
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland (Chair: Michael A. Thiel)
| | - M. Thiel
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland (Chair: Michael A. Thiel)
| | - C. Kaufmann
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland (Chair: Michael A. Thiel)
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Bey K, Lennertz L, Riesel A, Klawohn J, Kaufmann C, Heinzel S, Grützmann R, Kathmann N, Wagner M. Harm avoidance and childhood adversities in patients with obsessive-compulsive disorder and their unaffected first-degree relatives. Acta Psychiatr Scand 2017; 135:328-338. [PMID: 28160276 DOI: 10.1111/acps.12707] [Citation(s) in RCA: 23] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The etiology of obsessive-compulsive disorder (OCD) is assumed to involve interactions between genetically determined vulnerability factors and significant environmental features. Here, we aim to investigate how the personality trait harm avoidance and the experience of childhood adversities contribute to OCD. METHOD A total of 169 patients with OCD, 157 healthy comparison subjects, and 57 unaffected first-degree relatives of patients with OCD participated in the study. Harm avoidance was assessed using the Temperament and Character Inventory, and the severity of childhood adversities was measured with the Childhood Trauma Questionnaire. RESULTS Both patients with OCD and relatives showed elevated levels of harm avoidance compared to controls. Furthermore, patients exhibited significantly higher scores than relatives. This linear pattern was observed throughout all subscales of harm avoidance, and remained stable after controlling for the severity of depressive and obsessive-compulsive symptoms. With regard to childhood adversities, patients with OCD reported higher levels than relatives and controls. CONCLUSION Our results provide further evidence for a diathesis-stress model of OCD. While patients and unaffected relatives share elevated levels of harm avoidance, supporting the role of harm avoidance as an endophenotype of OCD, a heightened severity of childhood adversity was only observed in patients. The assumed biological underpinnings of these findings are discussed.
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Affiliation(s)
- K Bey
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - L Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - A Riesel
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - J Klawohn
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - C Kaufmann
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - S Heinzel
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany.,Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - R Grützmann
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - N Kathmann
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - M Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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Raddatz R, Reinhard J, Langer R, Fessler S, Kaufmann C, Nteli VA, Yuan J, Schiermeier S, Herrmann E, Eichbaum M, Louwen F. Mechanical versus pharmacological term induction: a cohort group analysis of maternal and neonatal outcome – hygroscopic cervical dilator versus intravaginal versus intracervical prostaglandin E2. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Stacey D, Redlich R, Büschel A, Opel N, Grotegerd D, Zaremba D, Dohm K, Bürger C, Meinert SL, Förster K, Repple J, Kaufmann C, Kugel H, Heindel W, Arolt V, Dannlowski U, Baune BT. TNF receptors 1 and 2 exert distinct region-specific effects on striatal and hippocampal grey matter volumes (VBM) in healthy adults. Genes Brain Behav 2016; 16:352-360. [PMID: 27528091 DOI: 10.1111/gbb.12318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/20/2016] [Accepted: 08/10/2016] [Indexed: 12/23/2022]
Abstract
Tumour necrosis factor alpha (TNFα) has been implicated in the pathophysiology of neurodegenerative and neuropsychiatric disease, with research highlighting a role for TNFα in hippocampal and striatal regulation. TNFα signals are primarily transduced by TNF receptors 1 and 2 (TNFR1 and TNFR2), encoded by TNFRSF1A and TNFRSF1B, which exert opposing effects on cell survival (TNFR1, neurodegenerative; TNFR2, neuroprotective). We therefore sought to explore the respective roles of TNFR1 and TNFR2 in the regulation of hippocampal and striatal morphology in an imaging genetics study. Voxel-based morphometry was used to analyse the associations between TNFRSF1A (rs4149576 and rs4149577) and TNFRSF1B (rs1061624) genotypes and grey matter structure. The final samples comprised a total of 505 subjects (mean age = 33.29, SD = 11.55 years; 285 females and 220 males) for morphometric analyses of rs1061624 and rs4149576, and 493 subjects for rs4149577 (mean age = 33.20, SD = 11.56 years; 281 females and 212 males). Analyses of TNFRSF1A single nucleotide polymorphisms (SNPs) rs4149576 and rs4149577 showed highly significant genotypic associations with striatal volume but not the hippocampus. Specifically, for rs4149576, G homozygotes were associated with reduced caudate nucleus volumes relative to A homozygotes and heterozygotes, whereas for rs4149577, reduced caudate volumes were observed in C homozygotes relative to T homozygotes and heterozygotes. Analysis of the TNFRSF1B SNP rs1061624 yielded a significant association with hippocampal but not with striatal volume, whereby G homozygotes were associated with increased volumes relative to A homozygotes and heterozygotes. Our findings indicate a role for TNFR1 in regulating striatal but not hippocampal morphology, as well as a complementary role for TNFR2 in hippocampal but not in striatal morphology.
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Affiliation(s)
- D Stacey
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster
| | - A Büschel
- Department of Psychiatry, University of Münster, Münster
| | - N Opel
- Department of Psychiatry, University of Münster, Münster
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster
| | - D Zaremba
- Department of Psychiatry, University of Münster, Münster
| | - K Dohm
- Department of Psychiatry, University of Münster, Münster
| | - C Bürger
- Department of Psychiatry, University of Münster, Münster
| | - S L Meinert
- Department of Psychiatry, University of Münster, Münster
| | - K Förster
- Department of Psychiatry, University of Münster, Münster
| | - J Repple
- Department of Psychiatry, University of Münster, Münster
| | - C Kaufmann
- Department of Psychiatry, University of Münster, Münster
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster
| | - W Heindel
- Department of Clinical Radiology, University of Münster, Münster
| | - V Arolt
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster.,Department of Psychiatry, University of Marburg, Marburg, Germany
| | - B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
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Abstract
The proliferation of the endometrium in the first half of the normal cycle is caused by the follicular hormone. The transformation into the secretion phase in the second half is caused by the hormone developed by the yellow substance of the corpus luteum. The term “menstrual” bleeding must be preserved for the discharged endometrium which has been proliferated first by the follicular hormone, and then transformed into the secretion phase (pregravid phase) by the corpus luteum hormone. The growth of the uterus in childhood and its pubescence depends on the follicular hormone (vegetative activity of the ovary), just as does the preservation of turgor in the genitals of the puberal woman. Many years ago, cyclic genital activity in the castrated animal was first produced by the injection of hormone, and this effect is now employed as a test for ovarian hormones. I succeeded eighteen months ago in producing complete menstruation in the castrated woman. The size of the doses of ovarian hormones administered is the important factor. In numerous experiments I have shown that—according to our present conceptions—very large doses of follicular hormones are required to produce the proliferation phase of the endometrium. The required dose is about 200,000 mouse units (= 1 million international units). For transformation of the proliferated endometrium into the secretion phase, 35 rabbit units of corpus luteum hormone are needed. The doses of follicular hormones up to now employed in therapeutics do not exert any traceable influence on the endometrium of the castrated woman. Neither have I noticed, that with doses of 600 or 1,000 mouse units, a shrivelling of the uterus which is due to long lasting functional troubles may be done away with. I have therefore proceeded to treat serious hormonal affections of the ovaries with very large doses of ovarian hormones. This paper reports on: ( a) The effect of the follicular hormone on the hypoplastic uterus, in primary and secondary amenorrhœa; ( b) spontaneous regulation of the cycle in secondary amenorrhœa also after treatment; ( c) the treatment of symptoms produced by castration and at the climacteric; ( d) the treatment of genital bleeding with corpus luteum hormone.
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Thiel MA, Bochmann F, Schmittinger-Zirm A, Bänninger PB, Schmid MK, Kaufmann C. [Complications of Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)]. Ophthalmologe 2015; 112:969-73. [PMID: 26573926 DOI: 10.1007/s00347-015-0166-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lamellar keratoplasties, e.g. Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) are considered the procedures of choice for corneal endothelial diseases. In comparison to penetrating keratoplasty (PK) they are associated with faster visual rehabilitation, a lower risk of complications and a decreased necessity for follow-up visits, which reduces the burden on quality of life in elderly patients. In order to advise patients regarding the indications for surgery and to facilitate the follow-up management, it is important to know the most important complications associated with these keratoplasty techniques. RESULTS AND DISCUSSION The most important preoperative complication is a delayed indication for the operation. In contrast to PK, DSAEK and DMEK surgery should be provided at an earlier stage of disease as chronic edema alters the stroma and reduces the speed of visual recovery. The most important complications during or early after surgery are detached lamellae, pupillary blocks with increased pressure or air bubbles in the vitreous cavity in patients with previous vitrectomy. The main long-term complications include chronic increased intraocular pressure and immune-mediated graft rejections in DSAEK patients after reducing or stopping topical corticosteroid therapy. This article describes the potential complications of endothelial keratoplasty and provides a detailed explanation of strategies to avoid these complications.
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Affiliation(s)
- M A Thiel
- Augenklinik, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz.
| | - F Bochmann
- Augenklinik, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz
| | | | - P B Bänninger
- Augenklinik, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz
| | - M K Schmid
- Augenklinik, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz
| | - C Kaufmann
- Augenklinik, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz
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Koller KR, Wolfe AW, Metzger JS, Austin MA, Hopkins SE, Kaufmann C, Jolly SE, Ebbesson SO, Umans JG, Howard BV, Boyer BB. Utilizing Harmonization and Common Surveillance Methods to Consolidate Four Cohorts: The Western Alaska Tribal Collaborative for Health (WATCH) Study. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.247] [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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Hirsch-Hoffmann S, Kaufmann C, Bänninger P, Thiel M. Treatment Options for Demodex Blepharitis: Patient Choice and Efficacy. Klin Monbl Augenheilkd 2015; 232:384-7. [DOI: 10.1055/s-0035-1545780] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - C. Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | - P. Bänninger
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | - M. Thiel
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
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Kaufmann C, Mathis A, Vorburger C. Sugar-feeding behaviour and longevity of European Culicoides biting midges. Med Vet Entomol 2015; 29:17-25. [PMID: 25155520 DOI: 10.1111/mve.12086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 06/23/2014] [Accepted: 07/03/2014] [Indexed: 06/03/2023]
Abstract
Most haematophagous insect vectors can also use sugar as an energy source; thus their sugar-feeding behaviour influences their longevity and blood-feeding rate and hence their vectorial capacity. Scant information is available on the sugar-feeding behaviour of Culicoides Latreille biting midges (Diptera: Ceratopogonidae), which are vectors of bluetongue and Schmallenberg viruses. The longevity of laboratory-reared Culicoides nubeculosus (Meigen) under fluctuating temperatures (16 and 28 °C) and with access to water or water and blood was on average 6.4 days and 8.9 days, respectively, which was around one third of the lifespan of siblings with access to sugar or sugar and blood (22.2 days and 27.1 days, respectively). Access to honeydew significantly increased the midge's longevity, whereas the provision of extrafloral nectaries had no impact. Females with access to sugar produced a significantly higher number of eggs (65.5 ± 5.2) than their starved sisters (45.4 ± 8.4). More than 80% of field-caught female Culicoides from the two most abundant European groups, Obsoletus (n = 2243) and Pulicaris (n = 805), were fructose-positive. Fructose-positivity was high in all physiological stages and no seasonal variability was noted. The high rate of natural sugar feeding of Culicoides offers opportunities for the development of novel control strategies using toxic sugar baits and for the monitoring of vector-borne diseases using sugar-treated FTA (nucleic acid preservation) cards in the field.
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Affiliation(s)
- C Kaufmann
- National Centre for Vector Entomology, Institute of Parasitology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
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Hopkins SE, Austin MA, Metzger JS, Koller KR, Umans JG, Kaufmann C, Wolfe AW, Howard BV, Boyer BB. Sex differences in obesity prevalence and cardiometabolic factors among Western Alaska Native people. Nutr Metab Cardiovasc Dis 2015; 25:312-8. [PMID: 25467216 PMCID: PMC4355237 DOI: 10.1016/j.numecd.2014.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND AIMS Obesity is associated with increased risks of cardiovascular disease, type 2 diabetes, and other chronic diseases. Prevalence estimates for metabolic disorders are well documented in many populations, but Alaska Native groups are understudied. The Western Alaska Tribal Collaborative for Health Study combines data from three Alaska Native study cohorts to assess differences in obesity prevalence and associations with cardiometabolic risk factors by sex. METHODS AND RESULTS Analyses were based upon a sample of 3985 adult Yup'ik and Inupiat participants with a mean age of 40 years. Prevalence of obesity and metabolic risk factors was assessed according to nationally recognized guidelines. Regression analysis was used to evaluate the association between obesity and cardiometabolic risk factors, including lipids, blood pressure and glucose. The prevalence of obesity (BMI ≥ 30) was significantly higher in women (40%) than men (20%). Only 18.6% of men had a waist circumference (WC) > 102 cm, while 58% of women had a WC > 88 cm (p < 0.001). Women had higher mean HDL-C and triglyceride levels compared to men, while systolic and diastolic blood pressure, LDL-C, and glucose means were higher in men than in women. In multivariate analyses, BMI and WC were significantly associated with all of the cardiometabolic risk factors, although these associations were more pronounced in men than women. CONCLUSION The high prevalence of obesity and central adiposity among AN women is an important public health concern. Differences in associations between obesity and cardiometabolic risk factors by sex warrants further investigation to develop effective intervention programs.
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Affiliation(s)
- S E Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA.
| | - M A Austin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - J S Metzger
- Center for Behavioral Health Research and Services, University of Alaska Anchorage, Anchorage, AK, USA
| | - K R Koller
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - J G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA; Center for Clinical and Translational Science, Georgetown-Howard Universities, Washington, DC, USA
| | - C Kaufmann
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - A W Wolfe
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - B V Howard
- MedStar Health Research Institute, Hyattsville, MD, USA; Center for Clinical and Translational Science, Georgetown-Howard Universities, Washington, DC, USA
| | - B B Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA
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Bochmann F, Kipfer A, Tarantino J, Kaufmann C, Bachmann L, Thiel M. Intraoperative testing of opening and closing pressure predicts risk of low intraocular pressure after Ahmed glaucoma valve implantation. Eye (Lond) 2014; 28:1184-9. [PMID: 25060848 DOI: 10.1038/eye.2014.168] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 06/19/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study was to assess whether intraoperative testing of silicone Ahmed glaucoma valves (AGVs) would identify valves with an increased risk of low postoperative intraocular pressure (IOP). METHODS In 30 consecutive cases of glaucoma surgery with AGV implantation, after priming the AGV, we intraoperatively measured the opening pressure A, closing pressure B, and re-opening pressure C using the active infusion pump of a phako-machine. IOP was checked postoperatively on the same day. Low IOP was defined as <5 mm Hg. Intraoperatively measured pressure characteristics of the valve function were analysed for their ability to predict postoperative IOP outcomes. RESULTS Opening A, closing B, and re-opening C pressures (mean, (SD)) were 18.4 (5.1), 8.3 (4.7), and 11.7 (4.8)mm Hg, respectively. Ten patients (33.3%) had low IOP. An opening pressure of ≤18 mm Hg predicted low postoperative IOP with a sensitivity (10/10) of 100% (95% CI, 69.2-100) and a specificity (13/20) of 65.0% (95% CI, 40.8-84.6). CONCLUSIONS AGVs have a high variability of opening, closing, and re-opening pressures. An opening pressure of ≤18 mm Hg, a closing pressure of ≤10 mm Hg, or a re-opening pressure of ≤11 mm Hg identified all patients with low postoperative IOP.
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Affiliation(s)
- F Bochmann
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
| | - A Kipfer
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
| | - J Tarantino
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
| | - C Kaufmann
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
| | - L Bachmann
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
| | - M Thiel
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne 16, Switzerland
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Baenninger P, Kaufmann C, Weisskopf F. Diffuse Lamellar Keratitis Induced by a Corneal Foreign Body Six Months after Femto-LASIK. Klin Monbl Augenheilkd 2014; 231:307-8. [DOI: 10.1055/s-0034-1368275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P. Baenninger
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Switzerland (Chairman: Prof. Dr. Dr. M. A. Thiel)
| | - C. Kaufmann
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Switzerland (Chairman: Prof. Dr. Dr. M. A. Thiel)
| | - F. Weisskopf
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Switzerland (Chairman: Prof. Dr. Dr. M. A. Thiel)
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Baenninger PB, Bachmann LM, Wienecke L, Kaufmann C, Thiel MA. Effects and adverse events after CXL for keratoconus are independent of age: a 1-year follow-up study. Eye (Lond) 2014; 28:691-5. [PMID: 24625376 DOI: 10.1038/eye.2014.56] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 02/03/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To compare the effect, failure rate and the risks of corneal cross-linking (CXL) in keratoconus patients aged ≥35 years to patients <35 years. METHODS In 141 eyes of 116 keratoconus patients we compared the changes in best phoropter-corrected visual acuity (BCVA) and maximum keratometry values (Kmax) before and 12 months after CLX in patients aged ≥35 years (n=34, 38 eyes) to the cohort of patients below 35 years of age. RESULTS Overall, CXL significantly improved BCVA from 0.487 logMAR (95% confidence interval (CI) 0.426-0.548) by -0.197 logMAR (95% CI -0.243 to -0.150; P<0.001) and reduced Kmax from 48.96 diopter (Dpt) by -1.33 Dpt (95% CI -1.85 to -0.81: P<0.001). Age ≥35 years had no effect on the changes of BCVA (-0.02 (95% CI -0.13 to 0.09); P=0.757) or Kmax (0.58 (95%CI -0.51 to 1.68); P=0.294) as compared with younger patients. In 54 patients (55 eyes, 38.5%) aged <35 years and in 18 patients (18 eyes, 47.4%) aged ≥35 years, BCVA increased by ≥2 Snellen lines. Failure (increase in Kmax ≥1 Dpt) was observed in 17 eyes (16.5%) of patients aged <35 years and in 3 eyes (7.9%) of patients aged ≥35 years during the 12-month follow-up period. Adverse outcomes (loss of ≥2 Snellen lines) occurred in 4 (3.9%) eyes of patients aged <35 years and 1 (2.6%) eye of a patient aged ≥35 years. CONCLUSION Effects and adverse events of CXL treatment do not seem to differ between subjects younger or older than 35 years.
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Affiliation(s)
- P B Baenninger
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland
| | - L M Bachmann
- 1] Medignition Inc. Healthcare Innovations, Zug, Switzerland [2] Horten Center, University of Zurich, Zurich, Switzerland
| | - L Wienecke
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland
| | - C Kaufmann
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland
| | - M A Thiel
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland
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Bochmann F, Kaufmann C, Thiel MA. Dynamic contour tonometry versus Goldmann applanation tonometry: challenging the gold standard. Expert Review of Ophthalmology 2014. [DOI: 10.1586/eop.10.68] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Peeters LM, Janssens S, Goddeeris BM, De Keyser K, Wilson AD, Kaufmann C, Schaffartzik A, Marti E, Buys N. Evaluation of an IgE ELISA with Culicoides spp. extracts and recombinant salivary antigens for diagnosis of insect bite hypersensitivity in Warmblood horses. Vet J 2013; 198:141-7. [PMID: 23891138 DOI: 10.1016/j.tvjl.2013.06.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 06/10/2013] [Accepted: 06/13/2013] [Indexed: 11/27/2022]
Abstract
Insect bite hypersensitivity (IBH) in horses represents an immunoglobulin E (IgE)-mediated hypersensitivity to salivary antigens from biting midges (Culicoides spp.). The aim of this study was to evaluate and compare the performances of IgE ELISAs using recombinant Culicoides spp. Obsoletus group salivary gland antigens or crude whole body extracts ('ObsWBE'), C. nubeculosus recombinant proteins (Culn1, 3, 4, 5, 7, 8 and 10) and Obsoletus group recombinant proteins (Culo1 and 2). IgE levels were measured in plasma of 343 Warmblood horses classified as IBH-affected (n=167) and IBH-unaffected (n=176) according to the owners' descriptions. IBH-affected horses were subdivided based on the severity of their clinical signs at sampling and whether or not their IBH history was considered to be classical. The accuracies of the tests increased when clinical signs at sampling were more pronounced or when the IBH history could be considered as classical. A combination of IgE levels against the three best performing Culicoides spp. recombinant proteins (Culn4, Culo1 and Culo2) and ObsWBE resulted in the best performing test. When IBH-affected horses showing a classical history of the disease and severe clinical signs were compared with IBH-unaffected horses, the Youden's index at the optimal cut-off for the three tests in combination was 0.67. This optimal cut-off had a sensitivity of 70%, a specificity of 97% and a total accuracy of 92%. The performance of the IgE ELISA was affected by the severity of IBH clinical signs at sampling and was improved when IgE levels against several recombinant proteins were combined.
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Affiliation(s)
- L M Peeters
- Department of Biosystems, Katholieke Universiteit Leuven, BE-3001 Heverlee, Belgium.
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Schaefert R, Kaufmann C, Wild B, Schellberg D, Boelter R, Faber R, Szecsenyi J, Sauer N, Guthrie E, Herzog W. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial. Psychother Psychosom 2013; 82:106-19. [PMID: 23295775 DOI: 10.1159/000343652] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 09/20/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. METHODS We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). RESULTS At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. CONCLUSIONS Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care.
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Affiliation(s)
- R Schaefert
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany.
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Aigner F, Augustin F, Kaufmann C, Schlager A, Ulmer H, Pratschke J, Schmid T. Prospective, randomized-controlled trial comparing postoperative pain after plug and patch open repair with totally extraperitoneal inguinal hernia repair. Hernia 2013; 18:237-42. [PMID: 23775532 DOI: 10.1007/s10029-013-1123-6] [Citation(s) in RCA: 6] [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: 08/28/2012] [Accepted: 06/08/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to compare postoperative pain between the open tension-free plug and patch (PP) technique and the totally extraperitoneal patch (TEP) hernioplasty. METHODS One hundred and fifty-four male patients with unilateral inguinal hernia were randomized to undergo PP and TEP from 2005 to 2009. Pain assessment was conducted using the numerical rating scale (NRS) and the McGill Pain Questionnaire preoperatively, 6, 12 and 24 months postoperatively. All patients received the same analgesic regimen and documented pain in a NRS-based 4-week diary. RESULTS Of the 154 patients 77 underwent TEP and 77 PP. Median follow-up was 3.8 years. One recurrent hernia was observed in the TEP and two in the PP group (p = 0.56). Median preoperative NRS scores were 2 and 2, 0.3 and 0.4 at 6 months, 0.1 and 0.3 at 12 months, 0.2 and 0.1 at 24 months postoperatively in the PP and TEP groups, respectively (p > 0.05). Data from the 4-week pain diaries revealed significant differences in pain intensity between the two different techniques from the second postoperative week (p < 0.05). Patients in the PP group required more additional analgesics on day four and five postoperatively (p = 0.037 and 0.015, respectively). CONCLUSIONS Our data favor the TEP technique concerning postoperative pain as primary endpoint between tension-free PP and TEP hernia repair.
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Affiliation(s)
- F Aigner
- Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria,
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Kaufmann C, Bochmann F, Baenninger P, Thiel MA. Central corneal regularization--optimization of uncorrected visual acuity in keratoconus patients. Klin Monbl Augenheilkd 2013; 230:333-6. [PMID: 23629772 DOI: 10.1055/s-0032-1328382] [Citation(s) in RCA: 5] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND Combined excimer laser correction and corneal cross-linking is a promising concept in treating keratoconus patients. Central corneal regularization represents advanced topography-guided custom ablation for ectatic corneas, aiming at correcting irregular astigmatism and at increasing the optical regularity of the corneal surface. PATIENTS AND METHODS In a prospective single centre study, 10 keratoconus patients underwent combined treatment with corneal cross-linking and central corneal regularization by an iRES-Laser. Uncorrected visual acuity at 1 and 3 months postoperatively represented the primary endpoint. RESULTS Mean preoperative uncorrected decimal visual acuity was 0.15 (± 0.28 standard deviation). Mean postoperative visual acuity was 0.28 (± 0.47) at one month and 0.24 (± 0.25) at three months, respectively. CONCLUSIONS Combined corneal cross-linking and central corneal regularization treatment has the potential to achieve a clinically significant improvement of uncorrected visual acuity.
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Affiliation(s)
- C Kaufmann
- Dept. of Ophthalmology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
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